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EMERGENCY SANITARY/ STORM SEWER JETTING SERVICES
EM25-ESSJ01
City of El Mirage
10000 N El Mirage Rd
El Mirage, AZ 85335
Request For Proposal #EM25-ESSJ01
Title: Emergency Sanitary/ Storm Sewer Jetting Services
2
City of El Mirage
REQUEST FOR PROPOSAL
Emergency Sanitary/ Storm Sewer Jetting Services
I.
PROFESSIONAL SERVICES CONTRACT....................................................
II.
AGREEMENT .........................................................................................
III.
EXHIBIT A ..............................................................................................
Attachments:
A - RIS_-_El_Mirage_Emergency_Sanitary_jetting_services (1)
Request For Proposal #EM25-ESSJ01
Title: Emergency Sanitary/ Storm Sewer Jetting Services
3
1.
PROFESSIONAL SERVICES CONTRACT
CITY OF EL MIRAGE
THIS PROFESSIONAL SERVICES CONTRACT, is made and entered into this
day of
, 20
, by and between the City of El Mirage, an Arizona municipal corporation
(“City”), and Riley Industrial Services INC a(n) Arizona Corporation (“Contractor”).
RECITALS
A. The City of El Mirage is authorized and empowered by provisions of the City Code to
execute contracts for professional services by and through its City Manager;
B. The City desires to contract for Contractor to provide Emergency Sanitary/ Storm Sewer Jetting
Services (“Services”) as described in the attached scope of work (Exhibit “A”) in accordance with the
terms of this Contract;
C. Contractor is duly qualified to perform the requested Services.
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2.
AGREEMENT
NOW, THEREFORE, in consideration of the mutual promises and obligations set for herein, the parties
hereto agree as follows:
2.1. DESCRIPTION, ACCEPTANCE, DOCUMENTATION
Contractor shall act under the authority and approval of the Contract Administrator for the City to
provide the Services required by this Contract. The Contract Administrator for the City shall be Scott
Ketchmark, (Title) Utilities Superintendent, or designee. The Contract Administrator shall oversee the
execution of this Contract, assist the Contractor in accessing the organization, audit billings, and approve
payments. The Contractor shall channel reports and special requests through the Contract
Administrator. City reserves the right to change the Contract Administrator for the City without prior
approval of the Contractor.
2.2. SERVICE DESCRIPTION
Contractor shall provide the Services described in Exhibit “A.” All work will be reviewed, evaluated,
approved, and monitored by the Contract Administrator to determine acceptable completion. Review
and approval by the Contract Administrator shall not relieve Contractor of any liability for improper,
negligent or inadequate services rendered pursuant to this Contract. Contractor shall provide all work
necessary to assure the Services are completed in a timely and efficient manner consistent with service
requirements, including, but not limited to, working in close interaction with, and interfacing with, City
and its designated employees, and working closely with others, including other consultants or
contractors retained by City.
2.3. DOCUMENTATION AND DATA
All documents, including but not limited to, data compilations, studies, and reports which are prepared
in the performance of this Contract are to be, and remain the property of, the City and are to be
delivered to the Contract Administrator before final payment is made to the Contractor.
2.4. FEE SCHEDULE, RECORDS, AUDIT RIGHTS
The fee Contractor shall be paid for all Services provided pursuant to the terms of this Contract,
inclusive of all expenses under this Contract, shall not exceed TBD.
The Contract Administrator reserves the exclusive right to determine the amount of work performed
and payment due the Contractor on a monthly basis. Contractor shall maintain all books, paper
documents, accounting records and other evidence pertaining to such monthly billings and shall make
such materials available at all reasonable times to the Contract Administrator. Monthly billings shall be
accompanied by such documentation as the Contract Administrator may require to make a
determination of work performed and payment due.
Contractor’s records (hard copy, as well as computer readable data) and any other supporting evidence
deemed necessary by the City to substantiate charges and claims related to this Contract shall be open
to inspection and subject to audit and/or reproduction by City’s authorized representative to the extent
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necessary to adequately permit evaluation and verification of cost of the work, and any invoices, change
orders, payments or claims submitted by the Contractor or any of its payees pursuant to the execution
of the Contract. The City’s authorized representative shall be afforded access, at reasonable times and
places, to all of the Contractor’s records and personnel pursuant to the provisions of this article
throughout the term of this contract and for a period of three years after last or final payment.
Contractor shall require all subcontractors, insurance agents, and material suppliers (payees) to comply
with the provisions of this article by insertion of the requirements hereof in a written contract
agreement between Contractor and payee. Such requirements will also apply to any and all
subcontractors.
If any audit in accordance with this article discloses overcharges of any nature by the Contractor to the
City in excess of one percent (1%) of the total contract billings, the actual cost of the City’s audit shall be
reimbursed to the City by the Contractor. Any adjustments and/or payments which must be made as a
result of any such audit or inspection of the Contractor’s invoices and/or records shall be made within a
reasonable amount of time (not to exceed 90 days) from presentation of City’s findings to Contractor.
2.5. ADDITIONAL SERVICES; PRICE ADJUSTMENT
The total Scope of Work to be performed by Contractor in accordance with this Contract is set forth
herein and in Exhibit “A.” Services not included in this Contract, including Exhibit “A,” will be considered
Additional Services. Contractor shall not perform any Additional Services without written authorization
from the City. It shall be presumed that all Services performed/provided by Contractor were included in
the Contract and contemplated by Contractor as being part of the original Scope of Work and the fees
set forth herein, unless such Services have been separately approved by the City, in writing, as
Additional Services. Contractor shall not be paid for any Additional Services that are not authorized by
the City in writing.
2.6. OWNERSHIP
Upon receipt of payment for Services, Contractor grants to City, and shall cause its subcontractors to
grant to City, the exclusive ownership of any and all copyrights, if any, to evaluations, reports, drawings,
specifications, project manuals, surveys, estimates, reviews, minutes, and other intellectual work
product as may be applicable ("Work Product"). This grant is effective whether the Work Product is on
paper (e.g., a "hard copy"), in electronic format, or in some other form. Contractor warrants, and agrees
to indemnify, hold harmless and defend City for, from and against any claim that any Work Product
infringes on third-party proprietary interests. City may reuse the Work Product at its sole discretion. In
the event the Work Product is used for another project without further consultations with Contractor,
the City agrees to indemnify and hold Contractor harmless from any claim arising out of the Work
Product. In such case, City will also remove any title block from the Work Product.
2.7. TERM AND EXTENSION
This Contract shall be in full force and effect only when approved and signed by City’s City Manager as
attested by the City Clerk. This Contract begins on the Effective Date and continues for (3) years to
03/02/2029, with an option to extend for an additional two-one year extensions.
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2.8. TERMINATION
1. Termination for Cause
The City has the right to terminate this Contract for cause in the event Contractor materially breaches
any provision of this Contract or portion of the Services and fails to remedy the breach within five (5)
business days of notification of the breach, if the breach is remedial. If Contractor fails to remedy the
breach or if the breach is not remedial, City may terminate this Contract for cause immediately upon
written notice to Contractor. In the event the City terminates this Contract or any part of the Services as
herein provided pursuant to this Section 1, the City shall notify the Contractor in writing, and
immediately upon receipt of such notice, the Contractor shall discontinue all work under this Contract.
Upon termination for cause, Contractor shall immediately deliver to the City all drawings, research,
data, studies, reports, estimates and any and all other documents or work product generated by the
Contractor under the Contract, together with all unused material supplied by the City. Contractor shall
be responsible only for such portion of the work which has been completed and accepted by the City.
Use of incomplete data by the City shall be the City’s sole responsibility.
In the event of termination for cause, Contractor shall only be compensated a portion of the agreed
upon fee for such portion of the work that City agrees, in its sole discretion to accept. City shall have no
obligation to accept any portion of Contractor’s work if the contract is terminated for cause and shall
have no obligation to pay Contractor for any portion of the work, if any, not accepted by City.
If the Contractor materially fails to fulfill in a timely and proper manner its obligations under this
Contract, of if the Contractor violates any of the covenants, agreements, or stipulations of this Contract,
the City may withhold from payment due to the Contractor such amounts as are necessary to protect
the City’s position for the purpose of set-off until such time as the exact amount of damages can be
determined.
2. Termination for Convenience
The City has the right to terminate this Contract for convenience or to abandon any portion of the work
for which Services have not been performed by the Contractor. In the event the City terminates this
Contract or any part of the Services as herein provided pursuant to this Section 3.2.2, the City shall
notify the Contractor in writing, and immediately upon receipt of such notice, the Contractor shall
discontinue all work under this Contract.
Upon such termination for convenience or abandonment, the Contractor shall immediately deliver to
the City all drawings, research, data, studies, reports, estimates and any and all other documents or
work product generated by the Contractor under the Contract, together with all unused material
supplied by the City. Contractor shall be responsible only for such portion of the work which has been
completed and accepted by the City. Use of incomplete data by the City shall be the City’s sole
responsibility.
The Contractor shall receive as compensation in full for Services performed to the date of such
Request For Proposal #EM25-ESSJ01
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termination or abandonment, a fee for the percentage of Services actually completed and accepted by
the City. This fee shall be in an amount to be mutually agreed upon by the Contractor and the City,
based upon the scope of work set forth in Exhibit “A’ and the payment schedule set forth in Article 2,
hereof. If mutual agreement cannot be reached after reasonable negotiation, the Contract
Administrator shall determine the percentage of satisfactory completion of each task set forth in the
scope of work contained in Exhibit “A” and the amount of compensation Contractor is entitled to for
such work and the Contract Administrator’s determination in this regard shall be final. The City shall
make such final payment within sixty (60) days after the Contractor has delivered the last of the partially
completed items.
2.9. ENTIRE AGREEMENT
This Contract constitutes the entire understanding of the parties and supersedes all previous
representations, written or oral, with respect to the Services specified herein. This Contract may not be
modified or amended except by a written document, signed by authorized representatives of each
party.
2.10. ARIZONA LAW
This Contract shall be governed and interpreted according to the laws of the State of Arizona. Any action
brought to interpret or enforce any provision of this Contract that cannot be administratively resolved,
or otherwise related to or arising from this Contract, shall be commenced and maintained in the state or
federal courts of the State of Arizona, Maricopa County, and each of the parties, to the extent permitted
by law, consents to jurisdiction and venue in such courts for such purposes.
2.11. COMPLIANCE WITH LAWS
Contractor shall comply with all existing and subsequently enacted federal, state and local laws,
ordinances, codes, and regulations that are, or become applicable to this Contract. If a subsequently
enacted law imposes substantial additional costs on Contractor, a request for an amendment may be
submitted pursuant to this Contract.
2.12. MODIFICATIONS
Any amendment, modification or variation from the terms of this Contract shall be in writing and shall
be effective only after approval of all parties signing the original Contract.
2.13. ASSIGNMENT
Services covered under this Contract shall not be assigned or sublet in whole or in part without the prior
written consent of the Finance Director and Contract Administrator.
2.14. SUCCESSORS AND ASSIGNS
This Contract shall extend to and be binding upon Contractor, its successors and assigns, including any
individual, company, partnership or other entity with or into which Contractor shall merge, consolidate
or be liquidated, or any person, corporation, partnership or other entity to which Contractor shall sell its
assets.
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2.15. ATTORNEY’S FEES
In the event either party brings any action for any relief, declaratory or otherwise, arising out of this
Contract, or on account of any breach or default hereof, the prevailing party may be entitled to receive
from the other party reasonable attorneys’ fees and reasonable costs and expenses determined by the
court sitting without a jury or arbitration board, which shall be deemed to have accrued on the
commencement of such action and shall be enforceable whether or not such action is prosecuted to
judgment or by arbitration award.
2.16. INDEPENDENT CONTRACTOR
The Services Contractor provides under the terms of this Contract to the City are that of an Independent
Contractor, not an employee or agent of the City. The City will report the value paid for these Services
each year to the Internal Revenue Service (I.R.S.) using Form 1099.
City shall not withhold income tax as a deduction from contractual payments. As a result of this,
Contractor may be subject to I.R.S. provisions for payment of estimated income tax. Contractor is
responsible for consulting the local I.R.S. office for current information on estimated tax requirements.
Contractor will not be entitled to any benefits provided by City to its employees, including, but not
limited to, health benefits, workers’ compensation, unemployment coverage, deferred compensation,
and all other typical employee benefits.
2.17. CONFLICT OF INTEREST
The City may cancel any contract or agreement, without penalty or obligation, if any person significantly
involved in initiating, negotiating, securing, drafting or creating the contract on behalf of the City’s
departments or agencies is, at any time while the contract or any extension of the contract is in effect,
an employee of any other party to the contract in any capacity or a consultant to any other party to the
Contract with respect to the subject matter of the Contract. The cancellation will be effective when
written notice from the City is received by all other parties to the Contract, unless the notice specifies a
later time (A.R.S. §38-511).
2.18. NOTICES
All notices or demands required to be given pursuant to the terms of this Contract shall be given to the
other party in writing, delivered by hand or registered or certified mail, at the addresses set forth below,
or to such other address as the parties may substitute by written notice given in the manner prescribed
in this paragraph.
In the case of Contractor:
Riley Industrial Services Inc.
Attn: Nathaniel Engels
2615 San Juan Blvd.
Farmington, NM 87401
In the case of City
City of El Mirage
Request For Proposal #EM25-ESSJ01
Title: Emergency Sanitary/ Storm Sewer Jetting Services
9
Attn: City Manager
10000 North El Mirage Road
El Mirage, Arizona 85335
With a copy to:
City of El Mirage
Attn: City Attorney
10000 North El Mirage Road
El Mirage, Arizona 85335
Notices shall be deemed received on date delivered, if delivered by hand, and on the delivery date
indicated on receipt if delivered by certified or registered mail.
2.19. FORCE MAJEURE
Neither party shall be responsible for delays or failures in performance resulting from acts beyond their
control. Such acts shall include, but not be limited to, acts of God, riots, acts of war, epidemics,
governmental regulations imposed after the fact, fire, communication line failures, power failures, or
earthquakes.
2.20. TAXES
Contractor shall be solely responsible for any and all tax obligations which may result out of the
Contractor’s performance of this Contract. The City shall have no obligation to pay any amounts for
taxes of any type incurred by the Contractor.
2.21. ADVERTISING AND PROMOTION
Contractor shall not publish, release, disclose or announce to any member of the public, press, official
body, or any other third party: (1) any information concerning this Contract, the Services, or any part
thereof; or (2) any documentation or the contents thereof, without the prior written consent of the City,
except as required by law or judicial or regulatory process. The name of any site on which Services are
performed shall not be used in any advertising or other promotional context by Contractor without the
prior written consent of the City.
2.22. COUNTERPARTS
This Contract may be executed in one or more counterparts, and each originally executed duplicate
counterpart of this Contract shall be deemed to possess the full force and effect of the original.
2.23. CAPTIONS
The captions used in this Contract are solely for the convenience of the parties, do not constitute a part
of this Contract and are not to be used to construe or interpret this Contract.
2.24. SUBCONTRACTORS
During the performance of the Contract, the Contractor may engage such additional subcontractors as
may be required for the timely completion of this Contract. The addition of any subcontractors shall be
Request For Proposal #EM25-ESSJ01
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subject to the prior approval of the City.
In the event of subcontracting, the sole responsibility for fulfillment of all terms and conditions of this
Contract rests with the Contractor.
2.25. INDEMNIFICATION
The Contractor agrees, to the fullest extent permitted by law, to indemnify and hold harmless the City,
its officers, directors and employees (collectively, City) against all damages, liabilities or costs, including
reasonable attorneys’ fees and defense costs, to the extent caused by the Contractor’s negligent
performance of professional services under this Contract and that of its subcontractors or anyone for
whom the Contractor is legally liable.
The City agrees, to the fullest extent permitted by law, to indemnify and hold harmless the Contractor,
its officers, directors, employees and subcontractors (collectively, Consultant) against all damages,
liabilities or costs, including reasonable attorney’s fees and defense costs, to the extent caused by the
City’s negligent acts in connection with the Services and the acts of its contractors, subcontractors or
consultants or anyone for whom the City is legally liable.
Neither the City nor the Contractor shall be obligated to indemnify the other party in any manner
whatsoever for the other party’s own negligence or for the negligence of others.
2.26. INSURANCE
The Contractor shall secure and maintain at all times that this Contract is in effect, insurance coverage
which shall include statutory workers’ compensation, comprehensive general and automobile liability,
owner’s and Contractor’s protective liability insurance and errors and omissions professional liability.
The comprehensive general and automobile liability limits shall be no less than one million dollars
($1,000,000) combined single limit. The owner’s and Contractor’s protective liability limits shall be no
less than one million dollars ($1,000,000) for each occurrence and one million dollars ($1,000,000) policy
aggregate naming the City as an additional insured. The minimum amounts of coverage for Contractor’s
professional liability shall be one million dollars ($1,000,000). In other than errors and omissions
professional liability, City’s and Contractor’s protective liability and worker’s compensation, the City of El
Mirage shall be named as an additional insured.
All insurance coverage shall be written through a carrier licensed in Arizona, or an approved non-
admitted list of carriers published by the Arizona Department of Insurance, and possessing an A.M. Best
rating of at least A- or above with policies and forms satisfactory to the City.
The Contractor shall submit to the City a certificate of insurance evidencing the coverage and limits
stated in the foregoing paragraph within ten (10) days of award of this Contract. City shall not issue a
“Notice to Proceed” until after Contractor has submitted the certificate of insurance to City. Insurance
evidenced by the certificate shall not expire or be canceled or materially changed without thirty (30)
days prior written notice to the City, and a statement to that effect must appear on the face of the
certificate and the certificate shall be signed by a person authorized to bind the insurer.
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The insurance policies, except Workers’ Compensation required by this Contract, shall name the City, its
agents, representatives, officers, directors, officials and employees as Additional Insureds.
2.27. COOPERATIVE PURCHASING
While this Contract is for the City of El Mirage, other public agencies and political subdivisions may
express interest in utilizing the Contract. In addition to the City of El Mirage, and with approval of the
Contractor, this Contract may be extended for use by other eligible public agencies (i.e. municipalities,
school districts, nonprofit educational institutions, public health institutions, community facilities
districts, and government agencies of the State). Eligible public agencies may elect to utilize the contract
through cooperative purchasing (or piggybacking) on the contract and do so at their discretion. No
volume is implied or guaranteed, and the Contractor must be in agreement with the cooperative
transaction. The Strategic Alliance for Volume Expenditures (SAVE), a group of school districts and other
public agencies, have signed an intergovernmental cooperative purchase agreement to obtain
economies of scale. As a member of SAVE, the City of El Mirage will act as the lead agency. Any such
usage by other participating public agencies must be in accordance with the ordinance, charter and/or
procurement rules and regulations of the respective public agency. Potential participating public
agencies (i.e. municipalities, school districts, nonprofit educational institutions, public health
institutions, community facilities districts, and government agencies of the State) recognize potential
equipment, logistical and capacity limitations by the Contractor may limit the Contractor's ability to
extend use of this Contract. Any orders placed to the Contractor will be placed by the specific public
agency participating in this purchase, and payment for purchases made under this Contract will be the
sole responsibility of each participating public agency. The City of El Mirage shall not be responsible for
any disputes arising out of transactions made by others.
2.28. FEDERAL AND STATE EMPLOYMENT IMMIGRATION LAWS
To the extent applicable under A.R.S. § 41-4401, Contractor warrants its and its subcontractors’
compliance with all federal immigration laws and regulations that relate to their compliance with the E-
verify requirements under A.R.S. § 23-214(A). Contractor’s or its subcontractors’ breach of the above-
mentioned warranty shall be deemed a material breach of the Contract and may result in the
termination of the Contract by the City. The City retains the legal right to randomly inspect the papers
and records of Contractor and its subcontractors to ensure that the Contractor and its subcontractors
are complying with the above-mentioned warranty.
The Contractor warrants to keep the papers and records open for random inspection during normal
business hours by the City. The Contractor shall cooperate with the City’s random inspections including
granting the City entry rights to Contractor’s property to perform the random inspections and waiving
its right to keep such papers and records confidential. The failure of Contractor to comply with this
warranty regarding the keeping of papers and records and cooperating with City’s random inspections
shall constitute a material breach of the Contract and the City will have the right to immediately
terminate the Contract.
Request For Proposal #EM25-ESSJ01
Title: Emergency Sanitary/ Storm Sewer Jetting Services
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2.29. SEVERABILITY
If any term or provision of this Contract shall be found to be illegal or unenforceable, then
notwithstanding such illegality or unenforceability, this Contract shall remain in full force and effect and
such term or provision shall be deemed to be deleted.
Request For Proposal #EM25-ESSJ01
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3.
EXHIBIT A
SCOPE OF SERVICES
The selected Contractor shall furnish all labor, equipment, tools, materials, transportation, and
incidentals necessary to perform emergency sewer and storm sewer jetting services. Tasks may include,
but are not limited to, the following:
Minimum Service Requirements
• Two-hour on-site response time from the time of City notification.
• Inspection of upstream and downstream manholes to determine blockage location.
• Jetting of sewer trunk lines, collector mains, and interceptor mains to remove obstructions.
• Clearing debris and spraying down affected manholes.
• Providing traffic control, if necessary, in accordance with local regulations.
• Proper collection, hauling, and disposal of septage and jetting byproducts in accordance with
applicable laws.
Additional Requirements
• Work must be performed in compliance with all applicable federal, state, and local regulations,
including OSHA standards.
• The Contractor will be asked to provide job-specific estimates based on their pre-established
fee schedule.
• Materials not listed in the fee schedule may be used with City pre-approval.
• Contractor personnel must maintain professional conduct and wear identifiable company
uniforms.
• Contractor shall coordinate with the City’s representative at all times
SEVERABILITY
If any term or provision of this Contract shall be found to be illegal or unenforceable, then
notwithstanding such illegality or unenforceability, this Contract shall remain in full force and effect and
such term or provision shall be deemed to be deleted.
SIGNATURE
SIGNATURE
J. Crystal Dyches
FULL NAME
FULL NAME
DATE SIGNED
City Manager
TITLE
DATE SIGNED
Contractor
TITLE
SIGNATURE
SIGNATURE
FULL NAME
Jill A. Boltz
FULL NAME
DATE SIGNED
City Attorney
TITLE
DATE SIGNED
City Clerk
TITLE
Exhibits List
A - RIS_-_El_Mirage_Emergency_Sanitary_jetting_services (1)
Exhibit A
RIS_-
_El_Mirage_Emergency_Sanitary_jetting_services
(1)
January 15, 2026
City of El Mirage, AZ
Re: EM25 – ESSJ01 – Emergency Sanitary/ Storm Sewer Jetting Services
Riley Industrial Services Company Information:
Riley Industrial Services, Inc. has been under the same continuous ownership and management
for over 55 years. Riley Industrial Services Inc. was established in 1970 by founder and
president G.W. “Sonny” Riley. We are a third-generation family-owned and operated
corporation. This three-generation family-owned and operated corporation includes sons
George W. Riley III, Glen Riley and Gary Riley as officers, Alicia McCuller, Amy Riley, Chris Riley,
Brandon Riley, and G.W. Riley IV. From the outset, the company has enjoyed consistent growth.
Riley Industrial continues to differentiate themselves from others through quality service and
workmanship, modern and well-maintained equipment, trained and experienced personnel,
and the unique ability to respond to their customers’ needs in emergency situations or just in
the normal course of daily business. Riley Industrial’s long-standing and loyal customer base is a
testimony to their success.
We are licensed in Arizona, Colorado, Idaho, Montana, Nebraska, Nevada, New Mexico,
Texas, Utah and Wyoming.
Riley currently employees 450 personnel.
Location of Offices:
• Farmington, NM (Primary office)
• Carlsbad, NM
• Lubbock, TX
• Odessa, TX
• El Mirage, AZ
• Show Low, AZ
• Safford, AZ
PLANT LOCATION
MAILING ADDRESS
2615 SAN JUAN BLVD
FARMINGTON, NM 87401
P.O. BOX 2014 FARMINGTON, NM 87499
PHONE (505) 327-4947
FAX (505) 326-0305
Mission Statement:
To provide the best service possible at the most competitive price, always with integrity and
never sacrificing safety.
At Riley Industrial Services, safety is the key and main mindset to all of our projects and
endeavors. With the combined experience of our management, safety and leadership personnel,
we ensure that our customer always received safe and efficient services. Written Job Hazard
Assessments are performed at all work sites, daily, without exception. All hazards and
operational parameters are taken into account and evaluated, before any work will start.
Communication will be established with the site client, before work ever starts and all parties will
be in complete communication, starting from the first call out notification until the completion of
the scope of work and assigned tasks. If issues are discovered, they are immediately brought to
the attention of the site client and also documented in accordance with The City of Tempe’s
policies and guidelines.
Riley Industrial Services utilizes a computerized system to compose and track the Daily Time
Reports for each day on each job. This system enables Riley to provide our customer, in this case
the City of Tempe, with accurate and timely time reports and invoicing.
We firmly believe that all customers, whether it is a small 2-man crew or a large 60-man crew,
carry the same importance and deserve the same respect and honesty. This belief is carried
thru the company and is held by all employees, management to the newest helper. It is this
belief that enables us to place our customer’s needs, expectations and priorities in a very high
priority. The only thing that will ride above this priority is the safety of our employees and the
wellbeing of their families.
Qualifications and Experience:
Riley Industrial has been in the municipal sewer/storm system jetting business for 46 years. The
El Mirage office located at 12555 West Butler Dr. will be the Riely office that will service this
contract. Riley has 16 jetting employees located at our El Mirage Office and 56 jetting
employees’ company wide. Riley can have available four 2-man crews for emergency call out.
Riley Industrial will dedicate the necessary equipment, and trained personnel, to ensure that the
needs and directions of the customer and the documented scope of work is performed in a safe
and efficient manner, resulting in a high-quality job. All calls for service will be placed in priority,
with emergency services given the highest priority. Crews will be dispatched in a timely manner,
while communications are established with the site facility and its representatives, to ensure that all
needs are met and that the scope of work is completed as quickly as possible
Riley Industrial currently has contracts with the following municipals:
• City of Farmington, NM
• Arizona Department of Transportation
• City of Lubbock, TX
• Maricopa Department of Transportation.
• San Juan County, NM
• City of Tempe, AZ
Riley estimates the following response times:
• Working Hours = 1 to 2 hours
• Overnight Hours = 2 to 3 hours
• Weekend Hours = 2 to 3 hours
• Holiday Hours = 2 to 3 hours
References:
City of Tempe – Water Utilities Division
Derek Wall – Environmental Programs Specialist
C: 480.250.5328 O: 480.350.8239
Email: Derek_Wall@tempe.gov
City of El Mirage
Scott Ketchmark - Utilities Superintendent
C: 623.518.0412 O: 623.876.4261
Email: Sketchmark@Elmirage.gov
Maricopa County
Mark Sanchez - Civil Engineering Specialist
C:602.679.1490 O:602.506.9369 Ext: 69369
Email: Mark.sanchez@maricopa.gov
Arizona Department of Transportation
Justin Brooks - Urban Pumphouse Supervisor
C: 602.615.0397 O: 602.712.3826
Email: jbrook@azdot.gov
Timothy Mitchell - Highway Ops Supervisor
C: 928.285.8616 O: 928.927.6311
Email: tmitchell@azdot.gov
Service Rates:
Hourly Labor Rates:
Standard Time
Overtime
Holiday
Project Manager
$75.00
$112.50
$150.00
Foreman
$65.00
$97.50
$130.00
Operator
$55.00
$82.50
$110.00
Helper
$40.00
$60.00
$80.00
Note: Overtime is defined as any time worked (or travel) over 10 hours per day
Monday – Thursday and any time worked on Friday, Saturday, or Sunday. Any
holiday work is charged at two times the standard rate.
Equipment:
Support Truck
$15.00/hour
CCTV Van
$100.00/hour
GapVac Combo Truck
$175.00/hour
Jetter Trailer
$95.00/hour
Pressure wash unit
$15.00/hour
5,000-gallon tanker
$85.00/hour
Note: Any other equipment requested will be invoiced per our 2026 Price List.
Because of the unstable fuel prices that exist, an applicable fuel surcharge (FSC)
will need to be added to invoices based on the current cost of fuel.
Material:
Misc. Sundries & PPE
$30.00/man/day
Water
$0.05/gallon
Disposal Fees:
Working
$ 0.42/gallon
Overnight
$ 0.52/gallon*
Weekend
$ 0.52/gallon*
Holiday
$ 0.52/gallon*
*Waste from overnight, weekends, and holidays will be store inside of Riley’s trucks and
disposed of during the next working day.
Traffic Control – Excluded (city to manage traffic control)
RILEIND-01
AFORAKER1
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
X
X
EACH OCCURRENCE
$
1,000,000
CLAIMS-MADE X OCCUR
OP53511030
5/1/2025
5/1/2026
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$
300,000
X XCU Included
MED EXP (Any one person)
$
10,000
PERSONAL & ADV INJURY
$
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
2,000,000
POLICY X PRO-
LOC
PRODUCTS - COMP/OP AGG
$
2,000,000
JECT
Ltd Pollution
$
1,000,000
OTHER:
A
AUTOMOBILE LIABILITY
X
X OP53511030
5/1/2025
5/1/2026
COMBINED SINGLE LIMIT
(Ea accident)
$
1,000,000
X
ANY AUTO
BODILY INJURY (Per person)
$
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON-OWNED
AUTOS ONLY
BODILY INJURY (Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
$
A
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS-MADE
X
X OU43761030
5/1/2025
5/1/2026
EACH OCCURRENCE
$
5,000,000
X
AGGREGATE
$
5,000,000
DED
RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A X RIWC637005
5/1/2025
5/1/2026
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
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
.
SEE ATTACHED ACORD 101
CERTIFICATE HOLDER
CANCELLATION
City of El Mirage
10000 N. El Mirage Rd.
City Hall
El Mirage, AZ 85335
AUTHORIZED REPRESENTATIVE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
DATE (MM/DD/YYYY)
12/23/2025
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 # 0757776
HUB International Insurance Services (SOW)
6565 Americas Parkway Suite 720
Albuquerque, NM 87110
CONTACT
NAME:
PHONE
(505) 828-4000
(A/C, No, Ext):
FAX
(866) 487-3972
(A/C, No):
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : National American Insurance Company (OK) 23663
INSURED
Riley Industrial Services, Inc.
PO Box 2014
Farmington, NM 87499
INSURER B : Berkshire Hathaway Homestate Insurance Company
20044
INSURER C :
INSURER D :
INSURER E :
INSURER F :
AGENCY CUSTOMER ID: RILEIND-01
AFORAKER1
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
LOC #: 1
ADDITIONAL REMARKS SCHEDULE
Page 1 of 1
AGENCY
License # 0757776
HUB International Insurance Services (SOW)
NAMED INSURED
Riley Industrial Services, Inc.
PO Box 2014
Farmington, NM 87499
POLICY NUMBER
SEE PAGE 1
CARRIER
SEE PAGE 1
NAIC CODE
SEE P 1
EFFECTIVE DATE: SEE PAGE 1
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance
Description of Operations/Locations/Vehicles:
City of El Mirage is included as Additional Insured with regard to the General Liability (Ongoing & Completed Operations) and Auto
Liability policies on a Primary and Non-Contributory basis as required by written contract with Named Insured. Waiver of
Subrogation in favor of Additional Insured with regard to the General Liability, Auto Liability and Workers Compensation policies as
required by written contract with Named Insured. Excess Liability on a follow form basis that extends coverage over General
Liability, Pollution Liability, Automobile Liability, and Employer's Liability.
NA CG 16 12 23
Includes Copyrighte d Material of Insurance Services Office , Inc.,
with its pe rmission.
Page 1 of
POLICY NUMBER: OP53511030
COMMERCIAL GENERAL LIABILITY
NA CG 16 12 23
NATIONAL AMERICAN INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - WITH PRODUCTS-COMPLETED
OPERATIONS COVERAGE - AUTOMATIC STATUS WHEN
REQUIRED IN A WRITTEN CONTRACT
It is understood and agreed that this endorsement amends theCOMMERCIAL GENERAL LIABILITY COVER AGE
PART as follows:
A. Section II - Who Is An Insured is amended to
include as an additional insured any person or
organization whom you are required by "written
contract" to add as an additional insured on this
Coverage Part.
by' are replaced by the words 'arising out of '.
2. The insurance provided to the additional
insured is subject to all of the terms,
provisions, conditions and exclusions of this
policy and applies only to the extent
B. The insurance provided to the additional insured
permitted by applicable law. We will not
is limited as follows:
provide the additional insured any higher limit
of insurance than:
1. The person or organization is an additional
insured only with respect to liability for "bodily
injury," "property damage," or "personal and
advertising injury" caused in whole or in part
a. That required by the "written contract";or
b. That afforded to you under this policy,
by:
a.
Your acts or omissions, or the acts or
whichever is less.
3. Notwithstanding anything to the contrary in
omissions of those acting on your behalf,
Condition 4. Other Insurance (Section IV),
in the performance of your ongoing
this insurance is excess of all other insurance
operations
specified
in
the
"written
available to any additional insured whether
contract"; or
b. "Your work" specified in the "written
contract" but only for "bodily injury,"
on a primary, excess, contingent or any other
basis.
But if required by the "written
contract" to be primary and non-contributory,
"property damage," or "personal and
this insurance will be primary and non-
advertising
injury"
included
in
the
contributory,
but
only
with
respect
to
"products-completed operations hazard;"
but only if the "written contract" requires
you to provide the additional insured
such coverage and this Coverage Part
otherwise provides such coverage.
However, if the "written contract" specifically
insurance on which the additional insured is
a Named Insured.
4. The insurance provided to the additional
insured does not apply to "bodily injury,"
"property
damage,"
or
"personal
and
advertising injury" aris ing out of:
requires you to obtain additional insured
a. The rendering of, or the failure to render,
coverage for another party, person or entity
any
professional,
architectural,
described
or
identified
in
the
"written
contract"
for
"bodily
injury"
"property
damage", or "personal and advertising injury"
engineering,
or
surveying
services,
including but not limited to:
arising out of your ongoing operations
described in 1.a. or "your work" described in
1.b., or arising out of both your ongoing
operations described in 1.a. and "your work"
(1) The preparing, approving, or failing
to prepare or approve maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or
described in 1.b., then in paragraph B.1.
drawings and specifications; or
above, the words 'caused in whole or in part
NA CG 16 12 23
Includes Copyrighte d Material of Insurance Services Office , Inc.,
with its pe rmission.
Page 2 of
(2) Supervision,
inspection,
quality
We have no duty to defend or indemnify an
control, architectural or engineering
additional insured under this endorsement
activities ; or
until we receive from the additional insured
written notice of a claim or "suit," and the
b. Any location or work for which the
additional insured has satisfied all of the
additional insured is specifically listed as
above conditions.
an additional insured, by name, on
another endorsement attached to this
Coverage Part.
D. Only for the purpose of the ins urance provided by
this endorsement, SECTION V - DEFINITIONS is
amended to add the follow ing definition:
C. SECTION
IV
-
COMMERCIAL
GENERAL
LIABILITY CONDITIONS is amended as follows:
"Written contract" means a written contract or
written agreement that requires you to make a
1. The Duties In The Event of Occurrence,
person or organization an additional insured on
Offense,
Claim
or
Suit
condition
is
this Coverage Part, provided the contract or
amended to add the following additional
conditions
applicable
to
the
additional
agreement:
insured:
1. Is currently in effect or becomes effective
An additional ins ured under this endorsement
during the term of this policy; and
will as soon as practicable:
2. Was executed prior to:
(1)
(2)
Give us written notice of an "occurrence"
or an offense which may result in a claim
or "suit" under this insurance, and of any
claim or "suit" that does result;
Provide notice of s uch an "occurrence" or
a. The "bodily injury" or "property damage";
or
b. The offenses that caused the "personal
and advertising injury,"
offense to any other insurance carrier the
additional insured has for a loss we may
for which the additional
insured seeks
coverage under this Coverage Part.
cover under this Coverage Part
provide us with proof of such notice;
and
All other terms and conditions of the Policy remain
the same.
(3) Send us copies of all legal papers
received, and otherwise cooperate with
us in the investigation, defense, or
settlement of the claim or "suit"; and
(4) Tender the defense and indemnity of any
claim or "suit" to any other insurer or self
insurer whose policy or program applies
to a loss we may cover under this
Coverage Part.
But if the "written
contract" requires this insurance to be
primary
and
non-contributory,
this
provision (4) does not apply to insurance
on which the additional insured is a
Named Insured.
GL2017 01 17
Page 1 of 1
POLICY NUMBER: OP53511030
COMMERCIAL GENERAL LIABILITY
GL2017 01 17
NATIONAL AMERICAN INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US - AUTOMATIC STATUS WHEN
REQUIRED IN A WRITTEN CONTRACT
This endorsement modifies insurance provided under the follow ing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is agreed that this policy is hereby amended as
indicated. All other terms and conditions of this
policy remain unchanged.
It is agreed that notwithstanding anything to the
contrary in Paragraph 8 of COMMERCIAL GENER AL
LIABILITY CONDITIONS (Section IV), TRANSFER
OF RIGHTS OF RECOVERY AGAINST OTHERS
TO US, in the event of any payment under this policy,
we waive our right to recovery against anyperson or
organization for whom the insured is operating under
a written contract when such contract requires a
waiver of subrogation.
CG 20 01 12 19
© Insurance Servic es Office, Inc., 2018
Page 1 of 1
POLICY NUMBER: OP53511030
COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the follow ing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
(2) You have agreed in writing in a contract or
Condition
contrary:
and supersedes any provision to the
agreement that this insurance would be
primary and would not seek contribution
Primary And Noncontributory Insurance
from any other insurance available to the
This insurance is primary to and will not seek
additional insured.
contribution from any other insurance available to
an additional insured under your policy provided
that:
(1) The additional insured is a Named Insured
under such other insurance; and
CG 25 03 05 09
© Insurance Services Office, Inc., 2008
Page 1 of 2
0
POLICY NUMBER: OP53511030
COMMERCIAL GENERAL LIABILITY
CG 25 03 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED CONSTRUCTION PROJECT(S)
GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Project(s): ALL PROJECTS
Information required to complete this Schedule, if not show n above, will be shown in the Declarations.
A. For all sums which the insured becomes legally
3. Any payments made under Coverage A for
obligated to pay as damages caused by "occur-
damages or under Coverage C for medical
rences" under Section I - Coverage A, and for all
expenses shall reduce the Designated Con-
medical expenses caused by accidents under
struction Project General Aggregate Limit for
Section I - Coverage C, which can be attributed
that designated construction project. Such
only to ongoing operations at a single designated
construction project shown in the Schedule
above:
payments shall not reduce the General Ag-
gregate Limit shown in the Declarations nor
shall they reduce any other Designated Con-
1. A separate Designated Construction Project
General Aggregate Limit applies to each des-
ignated construction project, and that limit is
equal to the amount of the General Aggregate
Limit shown in the Declarations.
2. The Designated Construction Project General
Aggregate Limit is the most we will pay for the
sum of all damages under Coverage A, ex-
struction Project General Aggregate Limit for
any other designated construction project
shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented To
You and Medical Expense continue to apply.
However, instead of being subject to the
General Aggregate Limit shown in the Decla-
cept damages because of "bodily injury" or
rations, such limits will be subject to the appl i-
"property damage" included in the "products-
completed operations hazard", and for medi-
cal expenses under Coverage C regardless of
the number of:
cable Designated Construction Project Gen-
eral Aggregate Limit.
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
Named Insured: RILEY INDUSTRIAL
Endorsement Effective:
5/01/2025
Page 2 of 2
© Insurance Services Office, Inc., 2008
CG 25 03 05 09
0
B. For all sums which the insured becomes legally
C. When coverage for liability arising out of the
obligated to pay as damages caused by "occur-
"products-completed operations hazard" is pro-
rences" under Section I - Coverage A, and for all
vided, any payments for damages because of
medical expenses caused by accidents under
"bodily injury" or "property damage" included in
Section I - Coverage C, which cannot be attrib-
the "products-completed operations hazard" will
uted only to ongoing operations at a single des-
ignated construction project shown in the Sched-
ule above:
reduce the Products-completed Operations Ag-
gregate Limit, and not reduce the General Ag-
gregate Limit nor the Designated Construction
1. Any payments made under Coverage A for
Project General Aggregate Limit.
damages or under Coverage C for medical
D. If the applicable designated construction project
expenses shall reduce the amount available
under the General Aggregate Limit or the
Products-completed Operations Aggregate
Limit, whichever is applicable; and
2. Such payments shall not reduce any Desig-
nated Construction Project General Aggre-
has been abandoned, delayed, or abandoned
and then restarted, or if the authorized contract-
ing parties deviate from plans, blueprints, de-
signs, specifications or timetables, the project will
still be deemed to be the same construction pro-
ject.
gate Limit.
E. The provisions of Section III - Limits Of Insur-
ance not otherwise modified by this endorsement
shall continue to apply as stipulated.
NAICO-25 (Ed. 5/2007)
Page 1 of 1
NATIONAL AMERICAN INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTO COVERAGE PART
TRUCKERS COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below:
NAMED INSURED:
RILEY INDUSTRIAL
ENDORSEMENT NO.:
POLICY NUMBER:
OP53511030
ISSUE DATE: 05/01/2025
SCHEDULE
Name of Person or Organization:
AUTOMATIC STATUS WHEN REQUIRED BY WRITTEN CONTRACT
To the extent that the person(s) or organization(s) shown in the schedule is liable for the conduct of an
"insured" arising out of the ownership, maintenance or use of a covered auto under the above policy,
they are also "insureds" but only to the extent of that liability."
All other terms and conditions of this policy remain unchanged.
POLICY NUMBER: OP53511030
COMMERCIAL AUTO
CA 04 43 12 23
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CA 04 43 12 23
© Insurance Services Offic e, Inc., 2022
Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION) -
AUTOMATIC WHEN REQUIRED BY WRITTEN
CONTRACT OR AGREEMENT
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage pr ovided by this endorsement, the provisions of the Coverage Form apply unless modified
by the endorsement.
The Transfer Of Right s Of Recovery Against Others
To Us Condition does not apply to any person(s) or
organization(s) for whom you are required to waive
subrogation with respect to the coverage provided
under this Coverage Form, but only to the extent that
subrogation is waived:
A. Under a written contract or agreement with such
person(s) or organization(s); and
B. Prior to the "accident" or the "loss".
POLICY NUMBER: OP53511030
COMMERCIAL AUTO
CA 04 49 11 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CA 04 49 11 16
© Insurance Servic es Office, Inc., 2016
Page 1 of 1
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the follow ing:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
A. The following is added to the Other Insurance
B. The following is added to the Other Insurance
Condition in the Business Auto Coverage Form
Condition in the Auto Dealers Coverage Form and
and the Other Insurance - Primary And Excess
supersedes any provision to the contrary:
Insurance Provisions in the Motor Carrier
This Coverage Form's Covered Autos Liability
Coverage Form and supersedes any provision to
Coverage and General Liability Coverages are
the contrary:
This Coverage Form's Covered Autos Liability
primary to and will not seek contribution from any
other insurance available to an "insured" under
Coverage is primary to and will
not seek
your policy provided that:
contribution from any other insurance available to
an "insured" under your policy provided that:
1. Such "insured" is a Named Insured under such
other insurance; and
1. Such "insured" is a Named Insured under such
2. You have agreed in writing in a contract or
other insurance; and
agreement that this
insurance
would be
2. You have agreed in writing in a contract or
primary and would not seek contribution from
agreement that this
insurance
would be
any
other
insurance
available
to
such
primary and would not seek contribution from
"insured".
any
other
insurance
available
to such
"insured".
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 00 03 13
(Ed. 4-84)
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 No.:
Premium $
Endorsement Effective: 05/01/2025
Insured:
Policy No.: RIWC637005
Insurance Company: Berkshire Hathaway Homestate Ins Co
WC 00 03 13
(Ed. 4-84)
© 1983 National Council on Compensation Insurance
Countersigned by
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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
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 anyone not named in the Schedule.
Schedule
Blanket Waiver
Person/Organization:
Blanket Waiver - Any person or organization for whom the Named
Insured has agreed by written contract to furnish this waiver.
Job Description
Waiver Premium
All AZ Operations
2,524.00
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 00 03 13
(Ed. 4-84)
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 No.:
Premium $
Endorsement Effective: 05/01/2025
Insured:
Policy No.: RIWC637005
Insurance Company: Berkshire Hathaway Homestate Ins Co
WC 00 03 13
(Ed. 4-84)
© 1983 National Council on Compensation Insurance
Countersigned by
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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
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 anyone not named in the Schedule.
Schedule
Blanket Waiver
Person/Organization:
Blanket Waiver - Any person or organization for whom the Named
Insured has agreed by written contract to furnish this waiver.
Job Description
Waiver Premium
All CO Operations
0.00
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 00 03 13
(Ed. 4-84)
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 No.:
Premium $
Endorsement Effective: 05/01/2025
Insured:
Policy No.: RIWC637005
Insurance Company: Berkshire Hathaway Homestate Ins Co
WC 00 03 13
(Ed. 4-84)
© 1983 National Council on Compensation Insurance
Countersigned by
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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
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 anyone not named in the Schedule.
Schedule
Blanket Waiver
Person/Organization:
Blanket Waiver - Any person or organization for whom the Named
Insured has agreed by written contract to furnish this waiver.
Job Description
Waiver Premium
All NE Operations
0.00
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 00 03 13
(Ed. 4-84)
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 No.:
Premium $
Endorsement Effective: 05/01/2025
Insured:
Policy No.: RIWC637005
Insurance Company: Berkshire Hathaway Homestate Ins Co
WC 00 03 13
(Ed. 4-84)
© 1983 National Council on Compensation Insurance
Countersigned by
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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
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 anyone not named in the Schedule.
Schedule
Blanket Waiver
Person/Organization:
Blanket Waiver - Any person or organization for whom the Named
Insured has agreed by written contract to furnish this waiver.
Job Description
Waiver Premium
All NM Operations
6,591.00
GL1004-A-SPC (Ed. 5/2015)
Includes copyrighted material of Ins urance Servic es Office, Inc., with its permission.
Page 1 of
POLICY NUMBER: OP53511030
COMMERCIAL GENERAL LIABILITY
NATIONAL AMERICAN INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTAMINATION OR POLLUTION COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
The following provisions are added to Section I,
Coverage A in our reliance of the accuracy of your
statements that all oil and oil-related operations have
the
necessary
dikes
and
all
environmental
safeguards as required by governmental
laws,
statutes and regulations pertaining to the operations.
(b)
such "pollution incident" can be identified
with
certainty,
and
such
"pollution
incident" commences at a specific time
and date during the policy period;
Such "pollution incident" is an accident
and unintentional release, discharge,
(1) LIMITED POLLUTION COVER AGE:
emission or escape of "pollutants," is
Exclusion f. under Paragraph 2., Exclusions of
sudden and accidental and is neither
Section I - Coverage A - Bodily Injury And
expected nor intended by any insured;
Property Damage Liability is replaced by the
following:
This insurance does not apply to:
(c) Such "pollution incident" is not a repeat
or resumption of a previous discharge,
dispersal, release or escape of the same
"pollutants" from essentially the same
f.
Pollution
source within twelve (12) months of a
(1) "Bodily injury" or "property damage"
previous discharge, dispersal, release or
(2)
which would not have occurred in whole
or part but for the actual, alleged or
threatened
discharge,
dispersal,
seepage, migration, release or escape of
"pollutants" at any time.
Any loss, cost or expense arising out of
any:
(d)
(e)
escape;
Such "bodily injur y" or "property damage"
is not caused or contributed to in any
degree by any "pollution incident" that
commenced prior to the beginning of the
Policy Period shown in the Declarations;
Such "pollution incident" is discovered or
(a)
(b)
Request, demand, order or statutory
or regulatory requirement that any
insured or others test for, monitor,
clean up, remove, contain, treat,
detoxify or neutralize, or in any way
respond to, or assess the effects of
"pollutants"; or
Claim or suit by or on behalf of a
governmental authority for damages
(f)
otherwise becomes known to you within
thirty (30) days of its commencement and
is reported to us in writing within thirty
(30) days after you first obtain knowledge
of the "pollution incident"; and
Such "pollution incident" does not result
from or is not contributed to by your
failure to comply with any government
statute, rule, regulation, or order.
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing,
or in any way responding to, or
assessing the effects of, "pollutants."
This exclusion does not apply to that portion
of any "bodily injury" or "property damage"
which is caused by a "pollution incident", and
(2) LIMITS FOR POLLUTION C OVERAGE:
The most we will pay for liability because of
covered
"bodily
injury"
and
"property
damage" caused by one or more "pollution
incidents" shall not be greater than the
following limits of insurance:
Combined "Bodily Injur y"
which is less than the limits of insurance set
and "Property Damage"
forth below in this endorsement, but only if
the following conditions are met:
$ 1,000,000
Limit per "Pollution Incident"
(a) The commencement time and date of
GL1004A-SPC (Ed. 5/2015)
Includes copyrighted material of Ins urance Servic es Office, Inc., with its permission.
Page 2 of
"Pollution Incident"
Aggregate Limit per Annual
$ 1,000,000 Policy Period
Amount of deductible per
$ 1,000
"Pollution Incident"
and "Property Damage" Limit Per "Pollution
Incident" is the most we will pay for the s um of all
liability because of "bodily injury" and "property
damages" caused by any one "pollution incident."
Each payment we make for liability due to "bodily
injury" and "property damage" and/or due to
defense expense related thereto reduces the
For the purpose of mitigating further "bodily
"Pollution
Incident" Aggregate Limit
by the
injury" or "property damage" caused by a
covered "pollution incident," $ 1,000,000
may be applied to costs or expenses incurred
by any insured for cleaning up, removing or
containing a covered "pollution incident" on
that particular part of real property upon which
the operations of the insured are conducted.
This amount shall not be in addition to the
amount of such payment. This reduced limit will
then be the Amount of Insurance. When this limit
is used up, we shall have no further obligation to
defend claims or "suits" seeking such damages
or pay such damages or defense expense.
The coverage provided by this endorsement does
not apply to:
(3)
limits set forth in this endorsement, but such
amounts shall reduce such applicable limits.
DEDUCTIBLE:
A. Damages claimed by any "Co-Owner of the
Working Inter est"; or
B. Coverage B. Personal Injury and Advertising
Expense.
(a) Our obligation to pay damages on your
behalf applies only to the amount of
damages
in
excess
of
any
deductible
amounts stated above as applicable to such
coverages, and the limits of insurance
DEFINITIONS
All provis ions of the POLICY DEFINITIONS
portion of this insurance remain unchanged
except as modified by the follow ing:
applicable to each "occurrence" for such
coverages will not be reduced by the amount
(6) For purposes only of the coverages addressed in
of such deductible. Aggregate limits for such
this endorsement, the definition of "property
coverages shall also not be reduced by the
application of such deductible amount.
damage" is replaced with the follow ing:
"Property Damage" means:
(b)
(c)
The deductible amount stated applies
respectively to all damages because of
"bodily injury" and "property damage" as the
result
of
any
one
"pollution
incident,"
regardless of the number of persons or
organizations who sustain damage because
of that "pollution incident."
We may pay any part or all of the deductible
amount to effect settlement of any claims or
"suit" and, upon notific ation of the action
taken, you will promptly reimburse us for
such part of the deductible amount as has
been paid by us.
(a)
(b)
(c)
Physical
Injury
to,
destruction
of,
or
contamination of tangible property, including
all resulting loss of use of that pr operty; or
Loss of use of tangible property that is not
physically injured, destroyed or contaminated
but has been evacuated, withdrawn from use
or rendered inaccessible because of a
"pollution incident."
Any loss, cost, or expense which you
become legally obligated to pay, provided
that you receive
notice asserting such
obligation during the policy period or within
30 days thereafter, and provided further that
(4) NON-EXTENSION OF C OVERAGE:
such loss, cost or expense arises out of:
(5)
The only coverage under this policy for liability in
any way relating to, or caused by, any "pollution
incident" is that which is set forth in this
endorsement.
"POLLUTION INCIDENT" AGGREGATE LIM IT:
1. A request, demand or order that any
insured or others test for, monitor, clean-
up, remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of"pollutants;" or
The "Pollution Incident" Aggregate Limit is the
2. A claim or legal proceeding by or on
most we will pay for the sum of all liability
because of "bodily injury" and "property damage"
caused by all "pollution incidents" subject to such
aggregate limit. The Combined "Bodily Injury"
behalf of a governmental authority for
GL1004A-SPC (Ed. 5/2015)
Includes copyrighted material of Ins urance Servic es Office, Inc., with its permission.
Page 3 of
payments
because
of
testing
for,
cleaning
up,
removing,
containing,
treating, detoxifiying or neutralizing, or in
any way responding to or assessing the
effects of "pollutants."
reclaimed.
"Co-Owner of the Working Interest" means any
person or organization who is, with you, a co-
owner, joint venturer or mining partner in mineral
properties who:
"Pollution
Incident"
means
an
"occurrence"
consisting of any actual emission, discharge,
release, or escape of pollutant into or upon land,
the atmosphere, or any watercourse or body of
water, provided that such emission, discharge,
(a)
(b)
Participates in the operating expense of such
properties; or
Has the right to participate in the control,
development or oper ation of s uch properties.
release or escape results in "environmental
"Envir onmental Damage" means any injurious
damage."
The entirety of any such actual
presence
actually
in
or
upon
land,
the
emission, discharge, release or escape shall be
deemed to be one "pollution incident."
"Pollutant" means any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals,
waste and saline substances. Waste includes
materials
to be
recycled,
reconditioned
or
atmosphere, or any watercourse or body of water
of solid, liquid, gaseous or thermal contaminants,
irritants or "pollutants."
ALL OTHER TERM S AND CONDITIONS
REMAIN THE SAME.
NA CX 25 01 14
Page 1 of 2
X
POLICY NUMBER: OU43761030
COMMERCIAL EXCESS LIABILITY
NA CX 25 01 14
THIS ENDORSEMENT DESCRIBES COVERAGE FOR CERTAIN SPECIFIED PERILS,
CAUSES OR CIRCUMSTANCES UNDER THE POLICY. PLEASE READ IT CAREFULLY.
OIL AND GAS OPERATIONS COVERAGE ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL EXCESS LIABILITY COVERAGE PART
Schedule
Blowout and Cratering Hazard
Underground Resources and Equipment
X
Saline Substance Contamination Hazard
Pollution Incident
I.
It is hereby understood and agreed that this policy provides insurance limited to $ 5,000,000 in excess of
$1,000,000 (the "limits") per occurrence and in the aggregate for loss, injury, or damage caused by, arising
from, or related to the coverages listed in the above schedule, subject to the following conditions:
A. The specific coverage listed in the above schedule is marked with an (x); and
B. The "controlling underlying insurance" listed in Schedule of Controlling Underlying Insurance provides
insurance for the specific coverage listed in the above schedule.
II. For purposes of this insurance, the coverages listed in the above schedule have the following meanings:
A. "Blowout and Cratering Hazard"
1. "Blowout and cratering hazard" includes damage to property located on or above the surface of the
earth contributed to or resulting from the "blowout" or "cratering" of any well.
2. "Blowout" means a sudden and uncontrolled expulsion from the well above the earth's surface of oil,
gas, water or drilling fluid resulting in loss of control of the well.
3. "Cratering" shall be defined as the action caused by the erosive and eruptive action of air, gas, oil or
water flowing upward through the earth's surface under and around a rig and resulting in the forming of
a basin-like opening in the earth's surface known as a "crater."
B. "Underground Resources and Equipment."
Underground resources include any loss or damage to any of the following:
1. Oil, gas, water, or other mineral substances which have not been reduced to physical possession
above the surface on the earth or above the surface of any body of water;
2. Any well, hole formation, strata, or area in or through which exploration for or production of any
substance is carried on; or
3. Any casing, pipe, bit, tool, pump, or other drilling or well servicing machinery or equipment located
beneath the surface of the earth in any such well or hole or beneath the surface of any body of water.
C. "Saline Substance Contamination Hazard."
"Saline Substances Contamination Hazard" includes damage to any of the following wherever
located:
1. Oil, gas, water or other mineral substance, if the damage is caused directly or indirectly by a saline
substance; or
X
X
NA CX 25 01 14
Page 2 of 2
2. Any other property.
D. "Bodily injury" or "property damage", as defined in the scheduled underlying policy, which is caused by a
"pollution incident."
A "pollution incident" means an "occurrence" consisting of any actual emission, discharge, release, or
escape of "pollutant" into or upon land, the atmosphere, or any water course or body of water, provided that
such emission, discharge, release or escape results in "environmental damage." The entirety of any such
actual emission, discharge, release or escape shall be deemed to be one "pollution incident."
"Pollutant" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor,
soot, fumes, acids, alkalis, chemicals, waste and saline substances. Waste includes materials to be
recycled, reconditioned or reclaimed.
"Environmental Damage" means any injurious presence actually in or upon land, the atmosphere, or any
watercourse or body of water of solid, liquid, gaseous or thermal contaminants, irritants or "pollutants."
Except to the extent of the "limits" specified above, this policy excludes coverage for and provides no insurance for
loss, damage, or injury caused by, arising from, or related to the above described perils, causes, or circumstances.
We and you agree that there is no coverage under this policy for the above described losses related to the
above specified perils, causes, or circumstances unless they are also covered by the scheduled underlying
policies.
We and you further agree that we would not ordinarily provide excess insurance for the above described
losses, damage, or injury caused by, arising from, or related to the specified perils, causes, or
circumstances, but We have agreed that You have purchased coverage therefore subject to the "limits"
specified above in excess of $1,000,000 per occurrence and in the aggregate.