HomeMy WebLinkAboutAGMT - Dominguez General Engineering It
Recorded in Official Records, Orange County "
Tom Daly, Clerk-Recorder
RECORDING REQUESTED BY I IIII III Ill iiH iIll iii iH IIO iII Hill H IN NO FEE
AND WHEN RECORDED MAIL TO * $ 8 0 0 0 5 0 7 2 4 1 3 3 *
2012000476989 8:30 am 08120112
CITY 276 422 N12 1
CY OF SEAL BEACH IT: City Clerk 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
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**** 1
if
NOTICE OF COMPLETION w'(
Notice pursuant to Civil Code Section 3093, must be filed within 10 days after completion.
Notice is hereby given that:
1. The undersigned is owner or corporate officer of the owner of the interest or estate stated
below in the property hereinafter described:
2. The full name of the owner is: City of Seal Beach.
3. The address of the owner is: 211 —8th 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 is described as substantially completed on
July 13, 2012. The work was 12-Inch Hellman Water Transmission Main Relocation Project.
No. WT0901.
6. The name of the contractor(s), if any, for such improvement was: Dominguez General
Engineering, Inc. The date of the Contract Award was March 12, 2012.
7. 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: Adolfo Lopez Drive.
Date: 2/`1//1Z— /
,,,,%/ii iii!
Director of Public 1-Fri,City of /-al Beach
Signature of owner or corporate officer of owner
named in paragraph 2 or agent.
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.
Executed on L /Yi 7-19/2__ , 2012, at Seal Beach, California.
Date of Signature)
i�ii 40
./ �/ f
Director of Public Works, City o4.al Beach
PU LIC V.ORKS AGREEMENT
F•R 12 INCH HELLMAN WATER
TRANSMISSION MAIN RELOCATION
CIP NO. WT0901
is
between
City of Seal Beach
211 - 8th Street
Seal Beach, CA 90740
&
Dominguez General Engineering, Inc.
3606 Strang Avenue
Rosemead, CA 91770
(626) 442 -7444
(626) 442 -7277 - FAX
THIS AGREEMENT is made as of February 27, 2012, by and between the City of Seal
Beach, a California charter city ( "City "), and Dominguez General Engineering, Inc., a
General Contractor ( "Contractor ").
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RECITALS
A. WHEREAS, the City Council has approved the plans and specifications for
the 12 -Inch Hellman Water Transmission Main Relocation Project, CIP No. WT0901
( "Project ") with respect to design criteria; and
B. WHEREAS, Contractor has submitted a bid to City for the Project dated
February 7, 2012 in the amount of $453,094 ( "Accepted Proposal" hereinafter). The
Accepted Proposal is attached hereto as Exhibit G and contains, among other things,
provisions defining the Project scope.
NOW, THEREFORE, in consideration of performance by the parties of the
mutual promises, covenants, and conditions herein contained, the parties hereto agree
as follows:
AGREEMENT
1. Contractor's Services.
1.1 Scope and Level of Services. For and in consideration of the
mutual promises set forth herein, and subject to the terms and conditions set forth in
this Agreement, Contractor shall perform and complete in good and workmanlike
manner all work ( "Work ") required by this Agreement and the documents listed in
Subsection 1.2 for the Project.
1.2 Contract Documents. The "Contract Documents" that comprise the
agreement between the City and the Contractor are the: Notice Inviting Bids,
Instructions to Bidders, Accepted Proposal, Non - Collusion Affidavit, Bid Schedule(s),
List of Subcontractors, Contractor's Industrial Safety Record, Contractor's Qualification
Statement, Bid Security Forms for Check or Bond, Specifications, General and Special
Provisions and documents referenced therein, all addenda as prepared prior to the date
of bid opening setting forth any modifications or interpretations of any of said
documents, this Agreement, Exhibits attached to this Agreement, including but not
limited to the Performance Bond (Exhibit A), Payment Bond (Exhibit B), Workers'
Compensation Insurance Certificate (Exhibit C), Insurance Endorsements (Exhibit D),
Acknowledgment of Penal and Civil Penalties Concerning Contractor Licensing Laws
(Exhibit E), Labor Law Requirements (Exhibit F), Accepted Proposal (Exhibit G) and any
and all supplemental agreements executed amending or extending the Work
contemplated and that may be required to complete the Work in a substantial and
acceptable manner. These Contract Documents are hereby incorporated into this
Agreement.
1.3 The Work shall be performed in accordance with the Plans,
Specifications and other Contract Documents. Contractor shall furnish at its own
expense all labor, materials, equipment and services necessary therefor, except such
labor, materials, equipment and services as are specified in the Contract Documents to
be furnished by City.
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1.4 In the event of any material discrepancy between the express
provisions of this Agreement and the provisions of the other Contract Documents, the
provisions of this Agreement shall prevail.
2. Effective Date. This Agreement is effective as of February 27, 2012(the
"Effective Date "), and shall remain in full force and effect until Contractor has rendered
the services required by this Agreement.
3. Payment. For performing and completing the Work in accordance with the
Contract Documents, City shall pay Contractor, in full compensation therefor, the
amount of $453,094, subject to any additions and deletions pursuant to the terms of the
Contract Documents. Said sum shall constitute payment in full for all work performed
hereunder, including, without limitation, all labor, materials, equipment, tools and
services used or incorporated in the Work, supervision, administration, overhead,
expenses and any and all other things required, furnished or incurred for completion of
the Work as specified in the Contract Documents. City shall make payments to
Contractor on account of the contract sum at the time, in the manner, and upon the
conditions specified in the Contract Documents.
4. Contractor's Personnel.
4.1 All Work shall be performed by Contractor or under Contractor's
direct supervision, and all personnel shall possess the qualifications, permits, and
licenses required by state and local law and by the Notice Inviting Bids /Instructions to
Bidders to perform such Services, including, without limitation, a City of Seal Beach
business license as required by the Seal Beach Municipal Code.
4.2 Contractor shall be responsible for payment of all employees'
wages and benefits, and shall comply with all requirements pertaining to employer's
liability, workers' compensation, unemployment insurance, and Social Security.
Contractor shall fully comply with the workers' compensation law regarding Contractor
and Contractor's employees.
4.3 Contractor shall indemnify and hold harmless City and its elected
officials, officers, employees, servants, designated volunteers, and agents serving as
independent contractors in the role of city officials, from any and all liabilities, damages,
claims, costs and expenses of any nature to the extent arising from Contractor's alleged
violations of personnel practices.
4.4 Contractor is, and shall at all times remain as to City, a wholly
independent contractor. Contractor shall have no power to incur any debt, obligation, or
liability on behalf of City or otherwise act as an agent of City. Neither City nor any of its
agents shall have control over the conduct of Contractor or any of Contractor's
employees, except as set forth in this Agreement. Contractor shall not, at any time, or
in any manner, represent that it or any of its officers, agents, or employees are in any
manner employees of City. Contractor shall pay all required taxes on amounts paid to
Contractor under this Agreement, and indemnify and hold City harmless from any and
3 of 9
all taxes, assessments, penalties, and interest asserted against City by reason of the
work performed pursuant to this Agreement.
4.5 City shall have the right to offset against the amount of any fees
due to Contractor under this Agreement any amount due to City from Contractor as a
result of Contractor's failure to promptly pay to City any reimbursement or
indemnification arising under this Section 4.
5. Indemnification.
5.1 Contractor's Duty. Contractor shall defend, indemnify, and hold the
City, its elected officials, officers, employees, volunteers, agents, and those City agents
serving as independent contractors in the role of City officials (collectively
"Indemnitees ") free and harmless from and against any and all claims (including, without
limitation, claims for bodily injury, death or damage to property), demands, obligations,
damages, actions, causes of action, suits, losses, bid protests, stop notices, judgments,
fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's
fees, disbursements and court costs) of every kind and nature whatsoever (individually,
a "Claim," collectively, "Claims "), in any manner arising out of or incident to the
performance of the Agreement, including without limitation, the payment of all
consequential damages and attorneys' fees and other related costs and expenses.
Further, Contractor shall appoint competent defense counsel, at Contractor's own cost,
expense and risk, to defend any and all such suits, actions or other legal proceedings of
every kind arising out of or incident to the performance of the Agreement that may be
brought or instituted against Indemnitees. Contractor shall pay and satisfy any
judgment, award or decree that may be rendered against City or the other Indemnitees
in any such suit, action, or other legal proceeding arising out of or incident to the
performance of the Agreement. Contractor shall reimburse the City and the other
Indemnitees, for any and all legal expenses and costs incurred by each of them in
connection therewith or in enforcing the indemnity herein provided. Contractor's
obligation to indemnify shall not be restricted to insurance proceeds, if any, received by
Contractor or Indemnitees. This indemnity shall apply to all Claims and liability
regardless of whether any insurance policies are applicable.
5.2 Bid Protests. In addition to its obligations pursuant to Section 5.1,
Contractor shall reimburse the City for all attorneys' fees and costs incurred by City in
connection with, arising out of or incident to any bid protest.
5.3 City's Sole Negligence. Nothing in Section 5.1 shall be construed
to require Contractor to indemnify Indemnitees for that portion of any Claim to the extent
arising from the sole negligence or willful misconduct of the Indemnitees.
5.4 Nonwaiver of Rights. Indemnitees do not, and shall not, waive any
rights that they may possess against Contractor because of the acceptance by City, or
the deposit with City, of any insurance policy or certificate required pursuant to this
Agreement.
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5.5 Waiver of Right of Subrogation. Contractor, on behalf of itself and
all parties claiming under or through it, hereby waives all rights of subrogation 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.
5.6 Survival. The provisions of this Section 5 shall survive the
termination of the Agreement and are in addition to any other rights or remedies that
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 a Contractor shall be conclusive in favor of the Indemnitee's right to
recover under this indemnity provision.
6. Insurance.
6.1 Liability Insurance. Contractor shall procure and maintain in full
force and effect for the duration of this Agreement insurance against claims for injuries
to persons or damages to property which may arise from or in connection with the
performance of the services hereunder by Contractor, and its agents, representatives,
employees and subcontractors. The policy limits set forth below do not act as a
limitation upon the amount of indemnification to be provided by Contractor. Contractor
shall complete and execute the following documents attached as Exhibits hereto and
incorporated herein by this reference:
6.1.1 Exhibit D -1: Additional Insured Endorsement -
Commercial General Liability.
Automobile Liability.
6.1.2 Exhibit D -2: Additional Insured Endorsement -
6.1.3 Exhibit D -3: Additional Insured Endorsement.
6.2 Minimum Scope of Insurance. Unless otherwise approved by City,
coverage shall be at least as broad as:
6.2.1 Insurance Services Office Commercial General Liability
coverage (occurrence form CG 0001).
6.2.2 Insurance Services Office form number CA 0001 (Ed.
1/87) covering Automobile Liability, code 1 (any auto).
6.2.3 Insurance Services Office form number CG 20 10 11 85
(Ed. 11/85) covering Additional Insured — Owners, Lessees or Contactors (Form B).
6.2.4 Workers' Compensation insurance as required by the
State of California and Employer's Liability Insurance.
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6.3 Minimum Limits of Insurance. Contractor shall maintain limits no
less than:
6.3.1 General Liability: $2,000,000 per occurrence and in the
aggregate for bodily injury, personal injury and property damage. Commercial General
Liability Insurance or other form with a general aggregate limit shall apply separately to
this Agreement or the general limit shall be twice the required occurrence limit.
6.3.2 Automobile Liability: $2,000,000 per occurrence for bodily
injury and property damage.
6.3.3 Employer's Liability: $1,000,000 per occurrence and in
the aggregate for bodily injury or disease and Workers' Compensation Insurance in the
amount required by law.
6.4 Deductibles and Self- Insured Retentions. Contractor shall inform
City of any deductibles or self- insured retentions except with respect to any professional
liability insurance.
6.5 Other Insurance Provisions. The general liability and automobile
liability policies are to contain, or be endorsed to contain, the following provisions:
6.5.1 City, its officers, officials, employees, designated
volunteers and agents serving as independent contractors in the role of City officials,
are to be covered as additional insureds as respects: liability arising out of activities
performed by or on behalf of Contractor; products and completed operations of
Contractor; premises owned, occupied or used by Contractor; or automobiles owned,
leased, hired or borrowed by Contractor. The coverage shall contain no limitations on
the scope of protection afforded to City, its officers, officials, employees, designated
volunteers or agents serving as independent contractors in the role of City officials
which are not also limitations applicable to the named insured.
6.5.2 For any claims related to this Agreement, Contractor's
insurance coverage shall be primary insurance as respects City, its officers, officials,
employees, designated volunteers and agents serving as independent contractors in the
role of City officials. Any insurance or self- insurance maintained by City, their officers,
officials, employees, designated volunteers or agents serving as independent
contractors in the role of City officials shall be excess of Contractor's insurance and
shall not contribute with it.
6.5.3 Contractor's insurance shall apply separately to each
insured against whom claim is made or suit is brought, except with respect to the limits
of the insurer's liability.
6.5.4 Each insurance policy required by this Section 6 shall be
endorsed to state that coverage shall not be canceled or materially modified except
after 30 days prior written notice by first class mail has been given to City.
6 of 9
6.5.5 Each insurance policy, except for any professional
liability policy, required by this Section 6 shall expressly waive the insurer's right of
subrogation against City and its elected officials, officers, employees, servants,
attorneys, designated volunteers, and agents serving as independent contractors in the
role of city or agency officials.
6.6 Acceptability of Insurers. Insurance is to be placed with insurers
with a current A.M. Best's rating of no less than A:VIII unless waived in writing by City's
Risk Manager.
6.7 Verification of Coveraqe. All insurance coverages shall be
confirmed by execution of endorsements on forms approved by the City. The
endorsements are to be signed by a person authorized by that insurer to bind coverage
on its behalf. All endorsements are to be received and approved by City before
services commence. As an alternative to City forms, Contractor's insurer may provide
complete, certified copies of all required insurance policies, including endorsements
effecting the coverage required by these specifications.
7. Liquidated Damages. Should the Contractor fail to complete the project,
or any part thereof, in the time agreed upon in the Contract, the Contractor shall
reimburse the City for the additional expense and damage for each calendar day that
the Contract remains uncompleted after the Contract completion date. It is agreed that
the amount of such additional expense and damage incurred by reason of failure to
complete the Contract is the per diem rate of $750 per calendar day. Such amount is
hereby agreed upon as liquidated damages for the loss to the City resulting from the
failure of the Contractor to complete the project within the allotted time and to the value
of the operation of the works dependent thereon. It is expressly understood and agreed
that this amount is a reasonable amount and is established in lieu of damages that are
incapable of calculation at the inception hereof; and this amount is not to be considered
in the nature of a penalty. The City shall have the right to deduct such damages from
any amount due, or that may become due to the Contractor, or the amount of such
damages shall be due and collectible from the Contractor or the Contractor's Surety.
Progress payments made after the scheduled completion date shall not constitute a
waiver of liquidated damages.
8. Suspension. City may, in writing, order Contractor to suspend all or any
part of the Contractor's Services for the convenience of City or for work stoppages
beyond the control of City or Contractor. A suspension of the Services does not void
this Agreement.
9. Notices. Any notices, bills, invoices, or reports authorized or required by
this Agreement shall be in writing and shall be deemed received on (a) the day of
delivery if delivered by hand or overnight courier service during Contractor's and City's
regular business hours or by facsimile before or during Contractor's regular business
hours; or (b) on the third business day following deposit in the United States mail,
postage prepaid, to the addresses heretofore set forth in the Agreement, or to such
7 of 9
other addresses as the parties may, from time to time, designate in writing pursuant to
the provisions of this Section. All notices shall be addressed as follows:
If to City:
If to Contractor:
City Clerk
City of Seal Beach
211 -8th Street
Seal Beach, California 90740
Telephone: (562) 431 -2527
Fax: (562) 493 -9857
With a copy to:
Public Works Director
City of Seal Beach
211 -8th Street
Seal Beach, California 90740
Dominguez General Engineering, Inc.
3606 Strang Avenue
Rosemead, CA 91770
(626) 442 -7444
(626) 442 -7277 - FAX
Attn: Adolfo Dominguez
10. Non - Assignability; Subcontracting. Contractor shall not assign, transfer,
or subcontract any interest in this Agreement or the performance of any of Contractor's
obligations hereunder. Any attempt by Contractor to so assign, transfer, or subcontract
any rights, duties, or obligations arising hereunder shall be null, void and of no effect.
11. Compliance with Laws. Contractor shall comply with all applicable federal,
state and local laws, ordinances, codes and regulations in force at the time Contractor
performs the Services.
12. Non - Waiver of Terms, Rights and Remedies. Waiver by either party of
any one or more of the conditions of performance under this Agreement shall not be a
waiver of any other condition of performance under this Agreement. In no event shall
the making by City of any payment to Contractor constitute or be construed as a waiver
by City of any breach of covenant, or any default which may then exist on the part of
Contractor, and the making of any such payment by City shall in no way impair or
prejudice any right or remedy available to City with regard to such breach or default.
13. Attorneys' Fees. In the event that either party to this Agreement shall
commence any legal action or proceeding to enforce or interpret the provisions of this
Agreement, the prevailing party in such action or proceeding shall be entitled to recover
its costs of suit, including all attorneys' fees incurred in connection therewith.
14. Construction. The validity, interpretation, and performance of this
Agreement shall be controlled by and construed under the laws of the State of
8 of 9
California. In the event of any asserted ambiguity in, or dispute regarding the
interpretation of any matter herein, the interpretation of this Agreement shall not be
resolved by any rules of interpretation providing for interpretation against the party who
causes the uncertainty to exist or against the party who drafted the Agreement or who
drafted that portion of the Agreement.
15. Entire Agreement. This Agreement, including any other documents
incorporated herein by specific reference, represents the entire and integrated
agreement between Contractor and City. This Agreement supersedes all prior oral or
written negotiations, representations, or agreements. This Agreement may not be
amended, nor any provision or breach hereof waived, except in a writing signed by the
parties which expressly refers to this Agreement.
16. Severability. The invalidity in whole or in part of any provisions of this
Agreement shall not void or affect the validity of the other provisions of this Agreement.
IN WITNESS WHEREOF, the parties, through their respective authorized
representatives, have executed this Agreement as of the date first written above.
CITY OF SEAL BEACH
By:
Attest:
By:
. Ingram, CityA:ger
CONTRACTOR: C)Om, nG'vcZ 1j+1_ e,&tc,
By:
o
Name: ,,k,:cn, -7)0 w.A...tr. v.,7
J
Title:
Lihda Devine, City Clerk .
Name: o \%, 'Dow,. lir.Z
Approved as to Form:
By:
Quinn M. Barrow, City Attorney
9 of 9
Title: Scc v c.-+c..v.
VC
CALIFORNIA ALL - PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Los Angeles
On Feb. 14, 2012
before me,
N. Dominguez, Notary Public
(Here insert name and title of the officer)
personally appeared Adolfo Dominguez
who proved to me on the basis of satisfactory evidence to be the person(s) whose name 0 . - subscribed to
the within instrument and acknowledged to me that 0... - - executed the same in I� • - • -' authorized
'!'
capacity(ies), and that by - - - signature(s) on the instrument the person(s), or the entity upon behalf of
which the persons) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
WITNESS my h,�nd and official seal.
Signature of Notary Pu is
•
(Notary Seal)
N. DOMINGUEZ
COMM: # 1857083 Z
T NOTARY P
UBUC - CALIFORNIA C
LOS ANGELES COUNTY -"
My Comm. Expires July 9, 2013
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
Title or description
(Title or description of attached document)
Title or description continued
(Title or description of attached document continued)
Number of Pages Document Date
(Additional information)
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
•
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
document is to be recorded outside of California. In such instances, any alternative
acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
California (i.e. certifying the authorized capacity of the signer). Please check the
document carefully for proper notarial wording and attach this form if required.
• State and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
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Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete a different acknowledgment form
• Signature of the notary public must match the signature on file with the office of
the county clerk
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10 07 800 - 873 -9865 www.NotaryClasses.com
EXHIBIT A
FAITHFUL PERFORMANCE BOND
EXHIBIT B
PAYMENT BOND
EXHIBIT C
WORKERS' COMPENSATION INSURANCE CERTIFICATE
EXHIBIT D -1
ADDITIONAL INSURED ENDORSEMENT
(COMMERCIAL GENERAL LIABILITY)
EXHIBIT D -2
ADDITIONAL INSURED ENDORSEMENT
(AUTOMOBILE LIABILITY)
EXHIBIT D -3
ADDITIONAL INSURED ENDORSEMENT
EXHIBIT E
ACKNOWLEDGMENT OF PENAL AND CIVIL PENALTIES CONCERNING
CONTRACTOR LICENSING LAWS
EXHIBIT F
LABOR LAW REQUIREMENTS
EXHIBIT G
ACCEPTED PROPOSAL
(NOTE: Exhibits will not be included with the contract at the
time of award. The Contractor shall have 10 working days to
submit all exhibits to the City after the award of contract. Failure
to do so will result in voiding of the contract. The City will then
have the right to cash the bid bond for the project and re-
advertise for construction or award to the next lowest
responsive bidder.)
AMENDMENT NO. 1
TO PUBLIC WORKS AGREEMENT
12-INCH HELLMAN WATER TRANSMISSION MAIN
RELOCATION PROJECT CIP NO. WT0901
between
OF SEAL Bp,
:(=I .Q;kipbb,
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11
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City of Seal Beach
211 - 8th Street
Seal Beach, CA 90740
Dominguez General Engineering, Inc.
3606 Strang Avenue
Rosemead, CA 91770
(626) 442-7444
(626) 442-7277 — FAX
THIS AMENDMENT is made as of August 13, 2012, by and between the City of
Seal Beach, a California charter city ("City"), and Dominguez General
Engineering, Inc., a General Contractor ("Contractor").
1
RECITALS
A. WHEREAS, the City Council awarded a contract in the amount of
$453,094 to Dominguez General Engineering, Inc. for the 12-Inch Hellman Water
Transmission Main Relocation Project, CIP No. WT0901 ("Project");
B. WHEREAS, During construction, additional costs were incurred;
AGREEMENT
NOW, THEREFORE, in consideration of performance by the parties of the
mutual promises, covenants, and conditions herein contained, the parties hereto
agree as follows:
1. Section 3 (Payment) of the February 27, 2012 Agreement is hereby
amended to increase by $4,670.43, the contract amount to $457,764.43, to read
as follows:
"3. Payment. For performing and completing the Work in accordance
with the Contract Documents, City shall pay Contractor, in full
compensation therefor, the amount of $457,764.43, subject to any
additions and deletions pursuant to the terms of the Contract Documents.
Said sum shall constitute payment in full for all work performed hereunder,
including, without limitation, all labor, materials, equipment, tools and
services used or incorporated in the Work, supervision, administration,
overhead, expenses and any and all other things required, furnished or
incurred for completion of the Work as specified in the Contract
Documents. City shall make payments to Contractor on account of the
contract sum at the time, in the manner, and upon the conditions specified
in the Contract Documents.
2. Except as amended herein, the terms and provisions of the
Agreement shall remain in full force and effect.
3. The City Clerk is hereby directed to attach to the Agreement this
Amendment as Exhibit H thereto.
2
•r r N ,
IN WITNESS WHEREOF, the parties, through their respective authorized
representatives, have executed this Amendment as of the date first written
above.
CITY OF SEAL BEACH Dominguez eral E gineering, Inc.
By: il!' • 11404 By:
W. Ingram, City -ger Name: Ado( f5'ef-"'f
Title: Sec..- ' ea,v.t
By:
Name: r1-olo l 4 awt••,e).oZ
Title: .1 "1-}e4 sure.
Attest:
By: tea i �.. I, ,
Lin. . Devine, di y Clerk
Approved as to Form:
By:
uinn M. Barrow, City Attorney
3
(CAILILIFORN1{A ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Los Angeles
On July 26,2012 before me, N. Dominguez, Notary Public
(Here insert name and title of the officer)
personally appeared Adolfo Dominguez
who proved to me on the basis of satisfactory evidence to be the person(s)whose name '(B= = subscribed to
the within instrument and acknowledged to me that executed the same in Si- - authorized
capacity(ies),and that I"�� - - signature(s)on the instrument the person(s),or the entity upon behalf of
which the person(s)acted,executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct. rwmag...timmidevoso
N. DOMINGUEZ
WITN SS and and official seal. _,: COMM. # 1857083 z
y _°" NOTARY p1TUC-CALIFORNIA
' LOS ANGELES COUNTY
My Comm.Expires July 9,2013
(Notary Seal)
Signature of Notary Public
ADDITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
Title or description document is to be recorded outside of California.In such instances,any alternative
(Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
Title or description continued California(i.e. certifying the authorized capacity of the signer). Please check the
(Title or description of attached document continued) document carefully for proper notarial wording and attach this form if required.
Number of Pages Document Date o State and County information must be the State and County where the document
ag signer(s)personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s)personally appeared which
must also be the same date the acknowledgment is completed.
(Additional information) • The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title(notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e.
❑ Individual(s) he/she/theyr is/are)or circling the correct forms.Failure to correctly indicate this
information may lead to rejection of document recording.
❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges,re-seal if a
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
❑ Partner(s) • Signature of the notary public must match the signature on file with the office of
the county clerk.
❑ Attorney-in-Fact 4 Additional information is not required but could help to ensure this
❑ Trustee(s) acknowledgment is not misused or attached to a different document.
❑ Other + Indicate title or type of attached document,number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer,indicate the title(i.e.CEO,CFO,Secretary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com
(1 of 2 Originals)
Bond No. 2147984 Bond Premium $9,121.00
THE FINAL PREMIUM IS
PREDICATED ON THE PERFORMANCE BOND
FINAL CONTRACT PRICE
KNOW ALL PERSONS BY THESE PRESENTS that:
WHEREAS the City of Seal Beach, has awarded Dominguez General Engineering,Inc.,
P.O.Box 6234,Rosemead,CA 91770 .
(Name and address of Contractor)
("Principal"), a contract(the"Contract")for the work described as follows:
2-inch Hellman Water Transm'ssion MALn Relocation CIP No.WT0901
WBZREA,S,Principal is required under the terms of the Contract to flattish a bond fbr the thtthfiml performance of
the Contract
NOW, THEREFORE, we, the undersigned Principal, and
North American Specialty Insurance Company,
681 S.Parker Street,#130,Orange,CA 92868
(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
Four Hundred Fifty-Three Thousand Ninety-Four and 00/100
Dollars ($453,094.00 ), 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 shalt 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.
Exhibit A, Page 1
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 there under, 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 there under. 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 instillment, 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: '
"Principal» "Surety"
Dominguez General Engineering,Inc. North American Specialty Insurance Company
•
By: e el-e.„.4- B
Its Its Matthew R.Dobyns
Attorney-In-Fact
By: Tr t to i v r t y By:
Its 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,
Exhibit A, Page 2
•
CALOORMA ALL-PURPOSE
(C]ERTEFI CATIE OF ACKNOWLEDGMENT
State of California
County of Los Angeles
On April 5,2012 _ before me, N. Dominguez, Notary Public
(Here insert name and title of the officer)
personally appeared Adolfo Dominguez
who proved to me on the basis of satisfactory evidence to be the person(s)whose name ., - subscribed to
the within instrument and acknowledged to me that lt' �•.- - - - executed the same in I� - - - authorized
capacity(ies), and that by l '- - signature(s)on the instrument the person(s), or the entity upon behalf of
which the person(s)acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct. we,. N. DOMINGUEZ
COMM. # 1857083
- :�� 7' NOTARY°UBLIC-CALIFORNIA
WITNE hand and o icial seal. ,,.+ LOS ANGELES COUNTY
My Comm.Ex
pi:July 9,2013
C (Notary Seal)
Signs ire of Notary Public
AID tITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
Title or description document is to be recorded outside of California. In such instances,any alternative
(Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
Title or description continued California (i.e. certifying the authorized capacity of the signer). Please check the
(Title or description of attached document continued) document carefully for proper notarial wording and attach this form if required.
Number of Pages Document Date • State and County information must be the State and County where the document
>; signer(s)personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s)personally appeared which
must also be the same date the acknowledgment is completed.
(Additional information) • The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title(notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e.
❑ Individual(s) he/she/they,is/are)or circling the correct forms.Failure to correctly indicate this
information may lead to rejection of document recording.
❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-seal if a
—
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
❑ Parmer(s) • Signature of the notary public must match the signature on file with the office of
the county clerk.
❑ Attorney-in-Fact fr Additional information is not required but could help to ensure this
El Trustee(s) acknowledgment is not misused or attached to a different document.
❑ Other .;: Indicate title or type of attached document,number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer,indicate the title(i.e.CEO,CFO,Secretary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com
NAS SURETY GROUP
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS,TI-IAT North American Specialty Insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International
Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of
Schaumburg,Illinois,each does hereby make,constitute and appoint:
RANDY SPOHN and MATTHEW R.DOBYNS
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: FIFTY MILLION($50,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 24th of March,2000:
"RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
ounuuppn'i
T.!V.G 4ION,1t By
V? SEAL Steven P.Anderson.President&Chief Executive Officer of Washington International Insurance Company r SEAL 4.
s 22
y�yt; 1tI73 yr.qq_ &Senior Vice President of North American Specialty Insurance Company B 6! tm
nimnanto0 By '*
David M.Layman,Senior Vice Presiden of Washington International Insurance Company
&Vice President of North American Specialty Insurance Company
iN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their
official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 15th day of September ,20 11
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois
County of Cook ss:
On this 15th day of September 20 11 1..before me,a Notary Public personally appeared Steven P.Anderson ,President and CEO of
Washington International insurance Company and Senior Vice President of North American Specialty Insurance Company and David M.Layman,
Senior Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company,
personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrument to be the voluntary act and deed of their respective companies.
OFFICIAL SEAL
D JILL NELSON u,(J kte.-411/24--
MARY PUBLIC-STATE OF ILLINOIS D.Jill ION E%PIE .'OSWVI2 Notary Public
I. James A.Carpenter , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington
international Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North
American Specialty Insurance Company and Washington international Insurance Company,which is still in full force and effect.
IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 3rd day of April ,20 12
James A Carpenter,Vice President&Assistant Secretary of Washington International Insurance Company&
North Amencan Specialty Insurance Company
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of CALIFORNIA
Coun of ORANGE
On before me, ERIKA GUIDO, NOTARY PUBLIC,
personally appeared MATTHEW R. DOBYNS
® who proved to me on the basis of satisfactory evidence to be the persons)
whose names) is/are subscribed to the within instrument and
acknowledged to me that he/sire/they executed the same in his/ /thcir
authorized capacity (ics), and that by his/ice/thcir signatures) on the
instrument the person(s), or the entity upon behalf of which the persons)
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of
California that the foregoing paragraph is true and correct.
ERIKA GUIDO
o COMM.#1843731 WITNESS and • . official seal.
2' � NOTARY PUBLIC CALIFORNIA
�": ORANGE COUNTY s
My omet.expires May t 2013
gnatur*Notary
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
(1 of 2 Originals)
2147984
Bond No. Bond Premium Included on Performance Bond.
PAYMENT BOND •
(LABOR AND MATERIALS)
KNOW ALL PERSONS BY THESE PRESENTS that
WHEREAS the City of Seal Beach, has awarded to Dominguez General Engineering,Inc.,
P.O.Box 6234,Rosemead,CA 91770
(Name and address of Contractor)
•("Principal"), a contract(the°Contract")for the work described as follows:
12-inch Hellman Water Transmission Main Relocation CIP No.WT9901
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
North American Specialty Insurance Company, 681 S.Parker Street,#130,Orange,CA 92868
(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
Four Hundred Fifty-Three Thousand Ninety-Four and 00/100 •
Dollars($ 453.094.00 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 labor 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
Exhibit B, Page 1 •
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 there under, 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 there under. 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 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;
"Principal" °Surety"
Dominguez General Engineering,Inc. North American Specialty Insurance Company
By: etcw { By: teaie: �
Its Its Matthew R.Dobyns
Attorney-In-Fact
By: Tr SS rev By:
Its Its
•
(Seal) (Seat)
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.
Exhibit A, Page 2
(CAILIIIFORNJIA AILL°PURIPOSIE
CIERTI{IFII(CATJE O F ACK1NOWILEDGMENT
State of California
County of Los Angeles
On April 5, 2012 before me, N. Dominguez, Notary Public
(Here insert name and title of the officer)
personally appeared Adolfo Dominguez
who proved to me on the basis of satisfactory evidence to be the person(*)whose name - subscribed to
the within instrument and acknowledged to me that let.-- - executed the same in el-- --• authorized
capacity(ies), and that by et-- --• signature(*)on the instrument the person(s), or the entity upon behalf of
which the person( acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct. -
0,,; N. DOMINGUEZ
, 1 4 COMM.# 1857083 z
WITNESS m and and official seal. z Y• NOTARY R+IBLIC-CALIFORNIA5,
� L �
Y LCS a,N;FEES COUNTY
My Comm.:zxplres July 9,2013
(Notary Seal)
Signature of Notar+Public
AIDIDITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
Title or description document is to be recorded outside of California. In such instances. any alternative
(Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
Title or description continued California (i.e. certifying the authorized capacity of the signer). Please check the
(Title or description of attached document continued) document carefully for proper notarial wording and attach this form if required.
e State and County information must be the State and County where the document
Number of Pages Document Date signer(s)personally appeared before the notary public for acknowledgment.
o Date of notarization must be the date that the signer(s)personally appeared which
must also be the same date the acknowledgment is completed.
(Additional information) Y The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title(notary public).
o Print the name(s) of document signers) who personally appear at the time of
notarization.
CAPACITY CLAIMED BY THE SIGNER u Indicate the correct singular or plural forms by crossing off incorrect forms(i.e.
❑ Individual(s)
he/she/they,-is/are)or circling the correct forms.Failure to correctly indicate this
information may lead to rejection of document recording.
❑ Corporate Officer a The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges,re-seal if a
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
❑ Partner(s) a Signature of the notary public must match the signature on file with the office of
the county clerk.
❑ Attorney-in-Fact Additional information is not required but could help to ensure this
❑ Trustee(s) acknowledgment is not misused or attached to a different document.
❑ Other y Indicate title or type of attached document,number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer,indicate the title(i.e.CEO,CFO,Secretary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com
f
1 •
NAS SURETY GROUP
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY TI-IESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International
Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of
Schaumburg.Illinois,each does hereby make,constitute and appoint:
RANDY SPOHN and MATTHEW R.DOBYNS
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver, for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: FIFTY MILLION($50,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 24th of March,2000:
"RESOLVED,that any two of the Presidents,any Managing Director.any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
x fT" r:��y_ B`' / te h L Qr.�'�OftPnR�r
at. SEAL :A Stesen P.Anderson.President&Chief Executive Officer of Washington International Insurance Company 4.1 SEAL\°
ut
StN Vt/ 197$,k7
�0
&Senior Vice President of North American Specialty Insurance Company
(t.i4,700,43".?
�MUmaa�ua\ .rra
By
David M.Layman,Senior Vice Presiden of Washington International Insurance Company
&Vice President of North American Specially Insurance Company
IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their
official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 15th day of September 20 I 1
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois
County of Cook ss:
On this 15th day of September 20 111 ..before me,a Notary Public personally appeared Steven P.Anderson ,President and CEO of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M.Layman
Senior Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company,
personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrument to be the voluntary act and deed of their respective companies.
OFFICIAL SEAL
D JILL NELSON i.ILJ
NOTMKPUBLIC-STATE OFIWN0IS D.Jill elson,Notary Public
SIV COMM*EfWG�S.'0II0LI2
I. James A.Carpenter . the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington
International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North
American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect.
IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 3rd day of April ,20 12 .
James A Carpenter,Vice President&Assistant Secretary of Washington International Insurance Company&
North American Specialty Insurance Company
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of CALIFORNIA
Coun of ORANGE
On 13D1((lJ V before me, ERIKA GUIDO, NOTARY PUBLIC,
personally appeared MATTHEW R. DOBYNS
® who proved to me on the basis of satisfactory evidence 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/#ef/thcir
authorized capacity(ics), and that by his/# ef/thcir signature(s) on the
instrument the person(), or the entity upon behalf of which the person(s)
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of
California that the foregoing paragraph is true and correct.
ERIKA QUIDO WITNESS and and official seal.
fICOM131
' i1 NOTARY PUBUC CALIFORNIA Q '
ORANGE COUNTY ro
91 My comm.expires May 5,2013 '
p (11
natur- if otary
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)