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HomeMy WebLinkAboutAGMT - Broadband Powering Services Inc. (SB Traffic Signal) '. l:• PLEASE'COMPLETE THIS INFORMATION RECORDING REQUESTED BY: Recorded in Official Records, County of Orange Darlene Bloom, Interim Clerk-Recorder 1111001111011111111111111111111111111111111111111111 NO FEE AND WHEN RECORDED MAIL TO: 20020916900 08:55am 10122102 110 69 R28 4 t _ 9 ✓1,t & 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 CL o"JC(LY ��1�� ai f. 8c.12 c.12 CG 90740 THIS SPACE FOR RECORDER'S USE ONLY TITLE OF DOCUMENT: G- it 5055 Li SEAL BEACH BOULEVARD TRAFFIC SIGNAL OP FIBRE OPTIC INTERCONNECT SYSTEM — PROJECT 50011 • d° THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION I ',l (Additional recording fee applies) `x.059-TITLE PAGE(R7/95) • WHEN RECORDED RETURN TO: RECORDING REQUESTED PURSUANT TO CITY CLERK GOVERNMENT CODE SECTION 6103 CITY OF SEAL BEACH 211 8TH STREET SEAL BEACH, CALIFORNIA 90740 ,(!� RESOLUTION NUMBER .�C>ce A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEAL BEACH DECLARING WORK TO BE COMPLETED AS TO PLANS AND SPECIFICATIONS FOR SEAL BEACH BOULEVARD TRAFFIC SIGNAL FIBER OPTIC INTERCONNECT SYSTEM PROJECT #50011, CONTRACT ENTERED INTO BETWEEN BROADBAND POWERING SERVICES, INC. AND THE CITY OF SEAL BEACH THE CITY COUNCIL OF THE CITY OF SEAL BEACH DOES HEREBY RESOLVE: WHEREAS, on April 8, 2002, the City of Seal Beach entered into a contract with Broadband Powering Services, Inc. WHEREAS, the City Engineer has submitted the approval of the final quantities and cost figures. NOW, THEREFORE BE IT RESOLVED by the City Council of the City of Seal Beach as follows: Section 1. That the work required to be performed by said Contractor has been completed. Section 2. That the total cost of said work is in the amount of $259,184.30, and the Final Contract Report is attached hereto as Exhibit "A "I Section 3. That the work is hereby accepted and approved. ✓ Section 4. It is further ordered that a "Notice of Acceptance", Exhibit "A", be filed on behalf of the City is in the Office of the County of Orange within 10 days of the date of this resolution. PASSED, APPROVED AND ADOPTED' by the City o cil of the.City of Seal Beach at a meeting thereof held on the ( - day , 2002, by the following vote: A AYES: Councilmembe s,i,,_i.. i,/ __ fs_. _ ell _ _e 41 NOES: Councilmember ABSENT: Councilmember 4111; Set) P. 1.049 -- Mayor ATTE.T: Ci • Clerk I II • • STATE OF CALIFORNIA) COUNTY OF ORANGE )SS CITY OF SEAL BEACH ) I, Joanne M. Yeo, City Clerk of Seal Beach, California, do hereby certify that the foregoing resolution is the original copy of Resolution Number) f,I'on file in the office of the City Clerk, passed, approved, and adopted by tl}g City Counc i t le City of Seal Beach, at a regular meeting thereof held on the //1 day of , 200 . >Liao ty Clerk II .: . . c • • • RECORDING REQUESTED I3Y AND WHEN RECORDED MAIL TO CITY OF SEAL BEACH Attn: City Clerk 211 8th Street Seal Beach, CA 90740 Space of above this line for Recorder's use. *** No Recording Fee Pursuant to Government Code Section 6103,27383 **** NOTICE OF COMPLETION Notice pursuant to Civil Code Section 3093, must be filed within 10 days after completion. Notice is hereby given that: I. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property hereniafter described: 2. The full name of the owner is: City of Seal Beach 3. The address of the owner is: City of Seal I3each. 211 8111 Street. Seal Beach. CA 90740 4. The nature of the interest or estate of the owner is; In fee.The City of Seal Beach. 5. A work of improvement on the property hereinafter described as completed on 8/1/02.The work was: Seal Beach Boulevard Traffic Signal Fiber Optic Interconnect System . Project No. 50011. 6. The name of the contractor, if any, for such of improvement was: Broadband Powering Services, Inc. 7. The date of the Contract was: April 8.2002. 8. The property on which said work of improvement was completed in the City of Seal Beach, County of Orange, State of California, and is described as follows: Seal Beach Boulevard Traffic Signal Fiber Optic Interconnect System Date: / 9 o 2 • Signa are of owner r corporate officer of owner named in paragraph 2 or his agent. DEPUTY CITY ENGINEER VERIFICATION I,the undersigned, say: the Director of Public Works declarant of the foregoing notice of completion; have read.said notice of completion and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury the foregoing is true and correct. 7. Executed on 9 " . 200 a, at S I Beach,Califoi (Date of Signature) ! Director of 3 ors . EXHIBIT "A" • CONTRACTOR TO PRINT COMPANY NAME: r --C'e-°L( DOCUMENTS TO SUBMIT UPON AWARD: PUBLIC WORKS CONTRACT PERFORMANCE BOND PAYMENT BOND INDEMNIFICATION AND HOLD HARMLESS LABOR LAW REQUIREMENTS FOR: CONTRACT DOCUMENTS ACKNOWLEDGEMENT OF LICENSE LAW WORKMEN'S COMPENSATION CERTIFICATE INSURANCE REQUIREMENTS -Insert other requirements if applicable- Seal Beach Traffic Signal Fiber Optic Interconnect CITY PROJECT NUMBER: 51011 These Contract Documents are the exclusive property of the Agency and shall not be used in any manner without prior consent of the Agency. Any reuse of these plans and specifications by Others shall be at Other's sole risk and without liability to the Agency. CITY OF SEAL BEACH - 211 EIGHTH STREET -SEAL BEACH, CA 90740 -6379. 1 BOOK- II:OF III 0 • y 1 CONTRACT DOCUMENTS 1- DOCUMENTS TO SUBMIT UPON AWARD: 1 PUBLIC WORKS CONTRACT 3 PERFORMANCE BOND 5 INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTION 9 AGREEMENT TO COMPLY WITHCALIFORNIA LABOR LAW REQUIREMENTS 10 STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS 11 INSURANCE REQUIREMENTS 13 WORKER'S COMPENSATION CERTIFICATE OF INSURANCE 15 ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY 16 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY 18 ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY 20 2 • • PUBLIC WORKS CONTRACT Seal Beach Traffic Signal Fiber Optic Interconnect, Project No. 50011 For the following project named len9 a nr1-, Tru 1, r. ,in the City of Seal Beach. TIES AGREEMENT, made and entered into this 23 day of ( ft-AS 2002- by and between the City of Seal Beach, California, hereinafter referred to as the "C¢TY," Party of the First Part, and 0 (1,11pL, 10 ,1Lc imionc.onner} rood anck Pow eius ,c (Ses,. i co o cd'n hereinafter designated as the " CONTRACTOR," Party of the Second Part. WITNESSETH: That the Parties do hereto mutually agree as follows: ARTICLE I. For and in consideration of the payments and agreements hereinafter mentioned to be made and performed by said CITY, the CONTRACTOR agrees with said CITY to perform and complete in a good and workmanlike manner all the work pertaining thereto shown -on the drawings and described in the Specifications and Contract Documents, therefore, to furnish at his own proper cost and expense all tools, equipment, labor and materials necessary therefore (except those materials expressly noted as to be furnished by the CITY), and to do everything required by this Agreement and the said Specifications, Drawings, and Contract Documents. ARTICLE H. For furnishing all said materials and labor, furnishing and removing all plant, temporary works or structures, tools and equipment and doing all the work contemplated and embraced in this Agreement, also for all loss and damage arising out of the nature of the work aforesaid, or from the action of the elements, or from any unforeseen difficulties which may arise or be encountered in the prosecution of the work until its acceptance by said CITY, and for all risks of every description connected with the work; also for all expenses incurred by or in consequence of the suspension or discontinuance of work; except such' 'as in the said Specifications are expressly stipulated to be bome by the said CITY and faithfully completing the work and the whole thereof, in the manner shown and described in the said Drawings, Specifications, and Contract Documents and in accordance with the requirements of the Engineer, said CITY will pay and the CONTRACTOR shall receive in full compensation, therefore, the unit prices and the lump sum prices named in the Schedule of Work Items of the Proposal. ARTICLE 111. The CITY hereby promises and agrees with said CONTRACTOR to employ and does hereby employ said CONTRACTOR to provide the materials and to do the work according to the terms and conditions herein contained and referred to for the price aforesaid, and hereby contracts to pay the same, at the time, in the manner and upon the conditions set forth in the Specifications and Contract Documents, and the said parties for themselves, their heirs, executors, administrators, successors and assigns, do hereby agree to the full performance of the covenants herein contained. ARTICLE IV. The advertisement for Bids, the Proposal, the Specifications, and the Drawings mentioned therein, and all addenda issued by the CITY with respect to the foregoing prior to the opening of bids, are hereby incorporated in and made a part of this Agreement. ARTICLE V. The statement of prevailing wages appearing in the General Prevailing Wage Rates is hereby specifically referred to and by this reference is made a part of this contract. It is further expressly agreed by and between the parties hereto that should there be any conflict between the terms of this instrument and the bid of proposal of said CONTRACTOR, then this instrument shall control and nothing herein shall be considered as an acceptance of the said terms of said proposal conflicting herewith. ARTICLE VI. By my signature hereunder, as CONTRACTOR, I certify that I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workmen's compensation or to undertake self - insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. 3 • • IN WITNESS WHEREOF: The Parties hereto have caused this contract to be executed the day and year first above written. CITY OF SEAL , : EACH, ALIFORNIA • Party of the Fir ,�' art BY --1 City Mana ATTES /Cit /y Clerk v BY /(61 CONTRACTOR - Party of the Second Part C 1%CMS Title Address 4 Broadband f owertng Cerwce 26051 Merit Circle, Suite 105 Laguna Hills, CA 92653 EXECUTED IN TRIPLICATE g • 1 • Final premium amount is based upon actual final - contract price Bond No. 6$.599777 Bond Premium $5,504.00 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded Broadband Powering Services, Inc. 26051 Merit Circle, Ste. 105, Laguna Hills, CA 92653 (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: Seal Bea Traffic Signal Fihpr ()pt-i TnFermnnPrt, (9i—y Project NtnmhPr 51)011 WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW, THEREFORE, we, the undersigned Principal, and Western Surety Company 21650 Oxnard Street, Ste. 600 -4, Woodland Hills, CA 91367 (Name and address of Surety) ( "Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of Three Hundred Thousand Two Hundred Seventy —Four and 00/100 Dollars ($ 300, 274.00 ), this amount being not less than the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and 5 • • 1 Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: April 18, 2002 "Principal" "Surety" Broadband Powering Services, Inc. Western Surety Company By: By: / i2/bie-- i./IA, 17414-6-e12/ 14 Its Its By: C.o.o Its By. Patricia Ruth Minder, Attorney —in —Fact Its (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached. 6 . Y. Bond No. 58599777 • • Bond Premium Included in Performance Bond PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded to Broadband Powering Services, Inc. 26051 Merit Circle, Ste. 105, Laguna Hills, CA 92653 (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: Seal Beach Traffic Signal Fiber Optic Interconnect, City Project Number 50011 WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law., NOW, THEREFORE, we, the undersigned Principal, and Western Surety Company 21650 Oxnard Street, Ste. 600 -4, Woodland Hills, CA 91367 (Name and address of Surety) ( "Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of Three Hundred Thousand Two Hundred Seventy —Four and 00/100 Dollars ($300, 274.00 this amount being not less than fifty percent (50 %) of the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code, or any amounts due under the Unemployment Insurance Code with respect to work or Iabor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment"Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to work or labor performed under the Contract, the Surety will pay for the same in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and void. This bond shall insure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the 7 • 1 Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: April 18, 2002 "Principal" Broadband Powering Services, Inc. By: Its 0- .C% 0. Its "Surety" Western Surety Company By: Its By. Patricia Ruth Minder, Attorney —in —Fact Its (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached.. 8 • CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT lCFltt ll,— �1.�1J✓J./�1�1 -/'- f- .- �-��1'I�fl — -I '.'o�f./�"lJ�1�/l/ 1. I -/lllllJ1-/ll-!l./l../l!1 l \l State of California kCounty of Orange On 4/18/02 h, personally appeared Patricia Ruth Minder NAME(S) OF SIGNER(S) \t1 © personally known to me OR - El proved to me on the basis of satisfactory evidence to be the person() whose name() isWtt 6 subscribed to the within instrument and ac- knowledged to me that he /Elk:01111W executed the same in his/1)001T x authorized capacity, and that by his//00:11W4x signature() on the instrument the personi9, or the entity upon behalf of which the operson(x) acted, a .e. uted the instrument. 1§ cr COMM. #1337890 > Notary Public California N 11 a .' ORANGE COUNTY i =nT� My Comm. Expires 1/30/06 1 1 k CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL q❑ CORPORATE OFFICER El PARTNER(S) 1 ® ATTORNEY -IN -FACT El TRUSTEE(S) ❑ GUARDIAN /CONSERVATOR ❑ OTHER: ``` SIGNER IS REPRESENTING: `, NAME OF PERSON(S) OR ENTITY(IES) 1 Western Surety ComDanv SIGNER(S) OTHER THAN NAMED ABOVE No. 5907 before me, N. Swartz, Notary Public NAME, TITLE OF OFFICER . E.G., `JANE DOE, NOTARY PUBLIC" WITNESS/ 11 1 8 ti .std -offi I seal. Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fil fraudulent reattachment of this form. `� fi 11111 lj NUMBER OF PAGES k 4/18/02 t1�1 SIGNATURE Nommil OPTIONAL migaranigior TITLE(S) ❑ LIMITED ❑ GENERAL A DESCRIPTION OF ATTACHED DOCUMENT Performance /Payment Bond TITLE OR TYPE OF DOCUMENT DATE OF DOCUMENT -••• — -. -- ` ©1993 NATIONAL NOTARY ASSOCIATION • 8236 Remmel Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184 r✓estern Surety Coripany POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Patricia Ruth Minder, Steven Alan Swartz, Individually of San Clemente, CA, its true and lawful Attorney(s) -in -Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as Indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Executive Vice President and Its corporate seal to be hereto affixed on this 4th day of June, 2001. State of South Dakota County of Minnehaha } ss WESTERN SURETY COMPANY 7 Stephen T. Pate, Executive Vice President On this 4th day of June, 2001, before me personally came Stephen T. Pate, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Executive Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires October 22, 2005 i J. MOHR i NOTARY PUBLIC � r SOUTH DAKOTA Sir f My Commission Expires 10.22.2006 i CERTIFICATE J. Mohr, Notary Public 1, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 1 8th day of April 2002 Form F4280 -04 -01 WESTERN SURETY COMPANY L. Nelson, Assistant Secretary • • Authorizing By -Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attomey, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. c • UPWIND/4 ALL-PURPOSE CKNOWLCE®ORAIENT • .�'aS `� s�S�S�S,,. :�S . S,nS, -c�S�A �.,�5;�1.5!s�i s�S �S�S�25...�.5. -ai n.S�S�c�S,� s���S�S � .•!v.S,.c�.'.S�S!7.S�c�S;�S�``' State of California rnrn County of c nano e) ss. On ' "�' J 2_3 90o2 before me, Ja n P [T t i l e r Date Name and Title of Officer (e g., 'Jane Doe, Notary Public ") personally appeared R4 eft- c k Con ci Scoff} man i t mmmaa S Name(s) of Signer(s) 324ersonally known to me ❑ proved to me on the basis of satisfactory evidence JANET MILLER Commission # 1351328 Notary Public - California Orange County My Comm. Expires Apr 14, 2006 to be the person(s) whose name(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. WITNESS my hand and official seal. L \ ann.1'. 1/4-'0 OOJtil Signature d( Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: mem )',L�r�crm rnfo Y. ,(� k lct Document Date: UU Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer NIA Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: RIG HTTHJMBPRINT OF SIGNER Top of thumb here Signer Is Representing: i 2 `4'1, 7z:? y,?,�dr, ,,,- ., G‹✓::-g::e6 4 <4: : ‹t 4 er: < L (g4Q-?4 t%< ✓4`4 6 L'<✓:��c ✓4<w: ?4:✓;. °a 0 1999 National Notary Associates • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313.2402 • www nationatnotary erg Prod. No 5907 Reorder: Call Toll -Free 1-800-876-6827 • • z INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTION TITLE OF PROJECT OR WORK: -&1 Q S nrii "tn n L,, r. Acc�„r, 0' , (Len Indemnitor(s) (list all names): r rlten.ronne Broadband Powering Services 26051 Merit Circle, Suite 105 Laguna Hills, CA 92653 e To the fullest extent permitted by law, Indemnitor hereby agrees, at its sole cost and expense, to defend, protect, indemnify, and hold harmless the City of Seal Beach and its elected officials, officers, attorneys, agents, employees, volunteers, successors, and assigns (collectively "Indemnitees ") from and against any and all damages, costs, expenses, liabilities, claims, demands, causes of action, proceedings, expenses, judgments, penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys, or other professionals and all costs associated therewith (collectively "Liabilities "), arising or claimed to arise, directly or indirectly, out-of, in connection with, resulting from, or related to any act, failure to act, error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors, materialmen, suppliers or their officers, agents, servants or employees, arising or claimed to arise, directly or indirectly, out of, m connection with, resulting from, or related to the above - referenced contract, agreement, license, or permit (the "Agreement ") or the performance or failure to perform any term, provision, covenant, or condition of the Agreement, including this indemnity provision. This indemnity provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. This indemnity provision shall- survive the termination of the Agreement and is in addition to any other rights or remedies which Indemnitees may have under the law. Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. Indemnitor shall pay Indemnitees for any attorneys fees and costs incurred in enforcing this indemnification provision. Notwithstanding the foregoing, nothing in this instrument shall be construed to encompass (a) Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying Agreement is subject to Civil Code § 2782(a) or (b) the contracting public agency's active negligence to the limited extent that the underlying Agreement is. subject to Civil Code § 2782(b). This indemnity is effective without reference to the existence or applicability of any insurance coverage which may have been required under the Agreement or any additional insured endorsements which may extend to Indemnitees. Indemnitor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation and contribution against the Indemnitees, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor regardless of any prior, concurrent, or subsequent active or passive negligence by the Indemnitees. In the event there is more than one person or entity named in the Agreement as an Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint and several. "Indemnitor" Name BY: I re. c,tcden t Its 9 Name: By: C Its • • AGREEMENT TO COMPLY WITHCALIFORNIA LABOR LAW REQUIREMENTS [Labor Code §§ 1720, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861, 3700] The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the Following provisions of California law: 1. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency ( "Agency ") and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5. •Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 conceming penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency, forfeit twenty-five dollars ($25) for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2, Part 7, Chapter 1, Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer. to be insured against liability for worker's compensation or to undertake self - insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract." Date Signature 1 4 10 • • STATEMENT ACKNOWLEDGING PENAL AND CIVIL. PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business & Professions Code § 7028.15] [Public Contract Code § 20103.5] I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the entity on whose behalf this certification is given, hold a currently valid California contractor's license as set forth below (required at time of award) : Business & Professions Code § 7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefor, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or imprisonment in the county jail for not less than 10 days nor more than six months, or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be performed. ' (c) This section shall not apply to a joint venture license, as required by Section 7029.1. However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to this section with respect to his or her individual licensure. (d) This section shall not affect the right or ability of a licensed architect, land surveyor, or registered professional engineer to form joint ventures with licensed contractors to render services within the scope of their respective practices. (e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non - responsive and shall be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any purchase order issued to, a contractor who is not licensed pursuant to this chapter is void. (f) Any compliance or noncompliance with subdivision (e) of this section, as added by Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect. (g) A public employee or officer shall not be subject to a citation pursuant to this section if the public employee, officer, or employing agency made an inquiry to the board for the purposes of verifying the license status of any person or contractor and the board failed to respond to the inquiry within 11 • 1 three business days. For purposes of this section, a telephone response by the board shall be deemed sufficient. Public Contract Code § 20103.5: In all contracts subject to this part where federal funds are involved, no bid submitted shall be invalidated-by the failure of the bidder to be licensed in accordance with the laws of this state. However, at the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of this state. The first payment for work or material under any contract shall not be made unless and until the Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or contractor not so licensed shall be subject to all legal penalties imposed by law, including, but not limited to, any appropriate disciplinary action by the Contractors' State License Board. The agency shall include a statement to that effect in the standard form of pre - qualification questionnaire and financial statement. Failure of the bidder to obtain proper and adequate licensing for an award of a contract shall constitute a failure to execute the contract and shall result in the forfeiture of the security of the bidder. License no.: rig L{ Date Class: C -I G Signature Expiration date: 13(51 o Z- 12 • INSURANCE REQUIREMENTS FOR CITY OF SEAL BEACH PUBLIC WORKS CONTRACT LIABILITY INSURANCE The Contractor shall at all times during the terms of the Contract carry, maintain, and keep in full force and effect a policy or policies of comprehensive general liability insurance in which the City, along with its City Council and each member thereof, and every officer, official, agent, attorney, employee or volunteer of the City, is the named insured or is named as an additional insured with the Contractor in accordance with the General Provisions. The insurance company issuing such policy(ies) must be acceptable to, and approved by, the City Engineer and City Attorney. Contractor shall maintain limits of no less than One Million Dollars ($1,000,000) combined single limit coverage per occurrence for personal injury or death or property loss or damage which may arise from or relate directly or indirectly to the acts, operations or omissions of the performance of the Contractor and/or its subcontractors and/or the employees, agents, officers, officials or volunteers of either, in the performance of this Public Works Contract. Such insurance shall include coverage for all automobiles utilized by Contractor's or any subcontractor's employees or agents in the performance of the Contract. Contractor shall also provide an endorsement in the forms included in Book II. 13 1 • ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY Name and address of named insured ( "Named Insured "): Name and address of Insurance Company ( "Company "): OFFICIAL TITLE OF PROJECT: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy ") or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non - renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereof. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: Director of Public Works City of Seal Beach 211 8th Street Seal Beach CA 90740 16 • • WORKER'S COMPENSATION CERTIFICATE OF INSURANCE . WHEREAS, the CITY OF SEAL BEACH has required certain insurance to be provided by NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insureds and that the same are in force at this time. 1. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL BEACH, CA 90740 -6379. 2. The insureds under such policy or policies are: 3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of California covering all operations of the named insureds, as follows: POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability, unless and until thirty days' advance written notice thereof has been served upon the City Clerk of the CITY OF SEAL BEACH. By: Its Authorized Representative 15 • 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD THIS ENDORSEMENT ATTACHES FROM/TO LIMITS OF • LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Contractual Liability Explosion Hazard Owners/Landlords/Tenants Collapse Hazard Manufacturers /Contractors Underground Property Damage Products /Completed Operations Pollution Liability Broad Form Property Damage Liquor Liability Extended Bodily Injury Broad Form Comprehensive General Liability Endorsement 12. A deductible or self-insured retention (check one) of $ applies to all coverage(s) except: (if none, so state). The deductible is applicable per claim or per occurrence (check one). 13. This is an occurrence or claims made policy (check one). 14. This endorsement is effective on at 12:01 A.M. and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed , 19 Signature of Authorized Representative (Original signature only; no facsim -ile signature or initialed signature accepted) Phone No.: ( ) 17 • ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Name and address of named insured ( "Named Insured "): Name and address of Insurance Company ( "Company "): OFFFICAL TITLE OF PROJECT: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy ") or in any endorsement now or hereafter attached thereto, it is agreed as follows: The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 1. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 2. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 3. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 4. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained or executed in conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 5. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non - renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 6. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. This endorsement and all notices given hereunder shall be sent to Public Agency at: Director of Public Works City of Seal Beach 211 8th Street Seal Beach CA 90740 7. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. 18 • TYPE OF COVERAGES TO WHICH LIMITS OF THIS ENDORSEMENT ATTACHES LIABILITY • POLICY PERIOD FROM/ TO Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Any Automobiles All Owned Automobiles Non -owned Automobiles Hired Automobiles Scheduled Automobiles Garage Coverage Truckers Coverage Motor Carrier Act Bus Regulatory Reform Act Public Livery Coverage 11. A deductible or self-insured retention (check one) of $ applies to all coverage(s) except: (if none, so state). The deductible is applicable per claim or per occurrence (check one). 12. This is an occurrence or claims made policy (check one). 13. This endorsement is effective on at 12:01 A.M. and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company: Executed , 19• Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( ) 19 • • ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY Name and address of named insured ( "Named Insured "): Name and address of Insurance Company ( "Company "): OFFICIAL TITLE OF PROJECT: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy ") or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnifica-tion and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non - renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. 20 • 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: Director of Public Works City of Seal Beach 211 8th Street Seal Beach CA 90740 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH LIMITS OF THIS ENDORSEMENT ATTACHES LIABILITY Following Form Umbrella Liability 10. Applicable underlying coverages: INSURANCE COMPANY AMOUNT 11. coverages: POLICY PERIOD FROM/TO POLICY NO. The following inclusions, exclusions, extensions or specific provisions relate to the above 12. A deductible or self-insured retention (check one) of $ applies to all coverage(s) except: (if none, so state). The deductible is applicable per claim or per occurrence (check one). 13. This is an occurrence or claims made policy (check one). 14. This endorsement is effective on at 12:01 A.M. and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed , 19 Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( ) 21 ACORD., CERTIFICATS OF LIABILITY INSURAE DATE PRODUCER 2 YEARGIN INSURANCE AGENCY SUITE B -201 15375 BARRANCA PXWY. POUCY NUMBER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED BROADBAND POWERING SERVS. INC 26051 MERIT CIRCLE #105 LAGUNA HILLS, CA 92653 rr , r -i = • .: , ,• . „ EMITIMIIIMIRMIMIMINIEMMIIIMil INSURER C: INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTA TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE , ,�„�„� POUCY EXPIRATION �c , LIMITS A GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY 3700000944011 12/01/2001 12/01/2002 EACH OCCURRENCE IIIIMIMI FIRE DAMAGE (Any one fire) :■ CLAIMS MADE I T 1 OCCUR MED EXP (Any one person) I I I PERSONAL & ADV INJURY ■ GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG imptryipi ■ POLICY ■ PRO- ■ LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) 8 ■ ■ BODILY INJURY (Per person) 9 ■ ■ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) 8 GARAGE UABIUTY ANY AUTO AUTO ONLY - EA ACCIDENT 8 ■ OTHER THAN EA ACC 9 AUTO ONLY AGG 9 B EXCESS UABIUTY 1TP0069208 12/06/2001 12/01/2002 EACH OCCURRENCE it OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION 8 9 ■ 8 ■ 8 WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ■ lig E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE 8 E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS ADDITIONAL INSUREDS AS PER FORM ECG 20 501 12 99 ATTACHED. PROJECT: SEAL BEACH TRAFFIC SIGNAL FIBER OPTIC INTERCONNECT -CITY PROJECT # 50011. CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CITY OF SEAL BEACH 211 EIGHTH STREET SEAL BEACH, CA 90740 -6379 V SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR UABIUTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATI E t!Z ACORD 25 -S (7/97) ® ACORD CORPORATION 1988 • • POLICY NUMBER : 3700000944011 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS ( FORM B) (CG 20 10 11 85) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: The City of Seal Beach, it's elected officials, officers, attorneys, agents, employees, and volunteers. Project: Seal Beach Traffic Signal Fiber Optic Interconnect- City Project # 50011 (If no entry appears above, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of "your work" for that insured by or for you. Primary Insurance Wording It is agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured(s) shown shall be primary insurance, and any other insurance maintained by the Additional Insured(s) shall be excess and non - contributory, but only as respects any claim, loss or liability arising out of the operations of the Named Insured(s) or it's subcontractors, and only if such claim, loss or liability is determined to be solely the negligence or responsibility of the Named Insured(s). Waiver of Subrogation It is agreed that we waive any right of recovery we may have against the person or organization shown in the schedule because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". The waiver applies only to the person or organization shown in the schedule. Hold Harmless Clause It is agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured shown shall indemnify and hold harmless the Additional Insured, but only as respects any claim, loss or liability arising out of the operations of the named insured(s)or it's subcontractors. Copyright, Everest Reinsurance Company, 1998 Includes copyrighted material of Insurance Services office, Inc. Used with it's permission. ECG 20 501 12 99 Copyright, Insurance Services Office, Inc. 1984 CERTIFIC , 04/18/02 PRCOUCER GEN INSURANCE SERVICES 0722 ARROW • -UITE 116 • CUCAMONGA, CA 61730 09/941-0167 ISSUED AS A MATTER OF • - • ONLY • CONFERS NO UPON THE CERTIFICATE HOLDER. DOES • AMEND, EXTEND OR COVERAGE AFFORDED POLICIES • AFFORDING COVERAGE COMPANIES COMPANY . • COMPANY COMPANY ROADBAND POWERING ,ERVICES INC • 1 51 MERIT CIRCLE, #105 AGUNA HILLS CA 92653 COMPANY •• LEITER IJ COMPANY COVERAGES • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEDAOTWITHSTANDING 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. «• LTA • r •• :o- • D• .. • y .• GENERAL UABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMprops • PERSONAL • • • R'S PROT. OCCURRENCE FIRE DAMAGE (Any one fire) $ MED. EXPENSE (Any we person) r. Alin:MOBILE UABIUTY AC3007598 01 01/16/02 01/16/03 COMBINED ANY • ALL OVVNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OVVNED AUTOS GARAGE LIABILITY :•• BODILY PROPERlY DAMAGE EXCESS UABIUTY EACH OCCURRENCE UMBRELLA FORM OTHER THAN UMBRELLA FORM AGGREGATE $ • ^ COMPENSATKIN ' EMPLOYERS' UABILITY • EACH ACCIDENT $ DISEASE-POLICY DISEASE-EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNENCLESSPECIAL ITEMS ITY OF • • • • . r‘GENT,EMPLOYEE VOLUNTEER DD • CERTIFICATE • . CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ITY OF SEAL BEACH EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 11 EIGHTH STREET LEFT, BUT FAILURE TO MAIL SUCH NOTICE S . ALL IMPOSE NO OBLIGATION OR EAL BEACH CA ') LIABILITY OF •• •- 1 1 AUTHORIZED REPRESENTATIVE BART A. NUGEN AllIPPIIIII ACORD 25-S (7/90) ..- _ ACORD CORPORATION 1990 • • ADDITIONAL INTEREST ENDORSEMENT This endorsement applies to insurance provided under the following. BUSINESS AUTO COVERAGE GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE -FORM SECTION II -- LIABILITY COVERAGE is changed as follows: We agree that this insurance (both for BODILY INJURY AND PROPERTY DAMAGE) shall also apply to each additional interest named above, but only with respect to liability for the Named Insured's maintenance, use or operation of a covered "auto" resulting in an "accident ", and only to the extent of that liability. This endorsement does not increase our limits of liability. SCHEDULE POLICY NO: NAC 3007598 01 NAMED INSURED: BROADBAND POWERING SERVICES INC ISSUE DATE: 04/18/02 ADDITIONAL INTEREST: CITY OF SEAL BEACH, EACH MEMBER THEREOF, EVERY OFFICER, OFFICIAL, ATTORNEY, AGENT, EMPLOYEE VOLUNTEER NAC 13030 (B-95)