The URL can be used to link to this page

Home My WebLink AboutAGMT - Charles King Company (Sewer SS0901) ,1G Recorded in Official Records, Orange County RECORDING REQUESTED BY Tom Daly, Clerk-Recorder AND WHEN RECORDED MAIL TO 1111111 H I IIIIIIIII IM II II 1111111 III III NO FEE I IIII $ CITY OF SEAL BEACH 2012000215255 2:23 pm 04116112 Attn: City Clerk 47 412 N12 1 211 - 8th Street 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Seal Beach, CA 90740 Space of above this line for Recorder's use. *** No Recording Fee Pursuant to Government Code Section 6103, 27383 **** if IP NOTICE OF COMPLETION Ne 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 March 23, 2012. The work was College Park East Sewer Rehabilitation Project No SS0901. 6. The name of the contractor(s), if any, for such improvement was: Charles King Company, Inc. The date of the Contract Award was June 27, 2011. 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: Various Locations, College Park East Neighborhood, City of Seal Beach. Date: tt hl l2 Director of Public Wo s, City 6,f Seal Beach Signature of owner or corpor- e 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 pen Ity of perjury the foregoing is true and correct. Executed on ?fa— , 2012, at Seal Beach, California. (Date of Signature) 0// 0,_......2,1 mnIP, '/- / Direr or of Public Works, City of eal Beach RECEIVED • C.K.C. PUz,LIC WORKS AGREEMENT COLLEGE P ' K EAST SEWER REHABILITATION PROJECT CIP NO. SS0901 between �RPOR,gTBFq�; 1;i1A16111"17,7. sue: City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 Charles King Company 2841 Gardena Avenue Signal Hill, CA 90755 562 426-2974 THIS AGREEMENT is made as of June 27, 2011, by and between the City of Seal Beach, a California charter city ("City"), and Charles King Company., a General Contractor ("Contractor"). 1 of 9 ; .. , . • RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the College Park East Sewer Rehabilitation Project CIP No. SS0901 ("Project") with respect to design criteria; and B. WHEREAS, Contractor has submitted a bid to City for the Project dated June 7, 2011 in the amount of $2,424,356 ("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. 2 of 9 � , 0 • 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 June 27, 2011 (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 $2,424,356 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. 4 of 9 0 • 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. 6.1.2 Exhibit D-2: Additional Insured Endorsement - Automobile Liability. 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. 5 of 9 0 • 6.2.5 Professional Liability insurance. Unless the City waives in the requirement for professional liability insurance, Contractor shall provide to City the standard form issued by the carrier. 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. 6.3.4 Professional Liability: (Please note that pursuant to Section 6.2.5, the City may waive the requirement that the Contractor carry professional liability insurance.) 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 of 9 0 • 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. 6.5.5 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:VIIl unless waived in writing by City's Risk Manager. 6.7 Verification of Coverage. 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 affecting 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. 7 of 9 • 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 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: 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 If to Contractor: Charles King Company. 2841 Gardena Avenue Signal Hill, CA 90755 Telephone: 562.426.2974 Attn: Debra King, President 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 8 of 9 0 • 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 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 CONTRACTOR: By: gh. • ld'Y1 By: Charles King Company ?. I Cit anager � � Name: Debra King Title: President Attest: By: �� J ( jf44,yqBy: £W1 U V L- l<< V (`o . inda Devine, Ci y Clerk Name: 0../A - Title: P i €- c r,vt. Approved as to Form: By: n M. Barrow, City Attorney 9 of 9 0 • EXHIBIT A FAITHFUL PERFORMANCE BOND Exhibit A, Page 0 • EXHIBIT B PAYMENT BOND Exhibit B, Page 1 0 • EXHIBIT C WORKERS' COMPENSATION INSURANCE CERTIFICATE Exhibit C, Page 0 S .. EXHIBIT D-1 ADDITIONAL INSURED ENDORSEMENT COMMERCIAL GENERAL LIABILITY [INSERT INSURANCE CERTIFICATE SHOWING COMMERCIAL GENERAL LIABILITY] Exhibit D-1, Page 0 • EXHIBIT D-2 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY [INSERT INSURANCE CERTIFICATE SHOWING AUTOMOBILE LIABILITY] Exhibit D-2, Page • EXHIBIT D-3 ADDITIONAL INSURED ENDORSEMENT [INSERT INSURANCE CERTIFICATE SHOWING PROFESSIONAL INSURANCE LIABILITY, IF REQUIRED] Exhibit D-3, Page 1 • EXHIBIT E ACKNOWLEDGMENT OF PENAL AND CIVIL PENALTIES CONCERNING CONTRACTOR LICENSING LAWS Exhibit E, Page 1 0 • EXHIBIT F LABOR LAW REQUIREMENTS Exhibit F, Page 1 } PREMIUM INCLUDED IN PERFORMANCE BOND Bond No. 024038390 EXECUTED IN DUPLICATE PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach.has awarded to Charles King Company, Inc. 2841 Gardena Ave., Signal Hill, CA 90755 (Name and address of Contractor) ("Principal").a contract(the"Contract")for the work described as follows: College Park East Sewer Rehabilitation project No. SS090I 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 _ First National Insurance Company of America 333 City Blvd_, West, #300, 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 hound unto the Public Agency in the penal sum of TWO MILLION FOUR HUNDRED TWENTY FOUR TIKRISANI) THREE HUNDRED FIFTY SIX AND NO/100************************** Dollars($ 2,424,356.00****************** this amount being not less than fifty percent (50°o)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 hind 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 Unemploy ment 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 suns 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 an 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 he 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. • .. . • • 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 belo%%. the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representatives)pursuant to authority of its governing body. Dated: "Principal" "Surety" Charles King Company, Inc. First National Insurance Company of America i By: — By: u ALL. ebia K. Kin President Rya, Mantle — Attorney in Fact • (Seal) (Seal) Note: This bond must he dated. all signatures must he notarized. and evidence of the authority of any person signing as attorney-in-fact must be attached. • • • 0 ! California All-Purpose Acknowledgement State of California} County of Los Angeles On iiii before me, Sarah Criscuolo ,a Notary Public personally appeared Debra King • who proved to me on the basis of satisfactory evidence to be the person(X whose name(i5 is/a* subscribed to the within instrument and acknowledged to me that r/ `av��tuumi,,,,, she/t)(4 executed the same in Xs/her/tXl r authorized �� C,CR1SC(�0''•,,,�� capacity(i�s), and that by t s/her/thlr signature( on `��y , 4,,ip the instrument the person(, or the entity upon behalf a `'i of which the person(y)acted,executed the instrument. if-6 2 , «`� = I certify under PENALTY OF PERJURY under the laws 'ice. �; j = of the State of California that the foregoing paragraph 'o c ti ��. is true and correct. ''��n� �E ire T``%%%%% WITNESS my hand and official seal. „....-A-TAA--XIA- CAL 1.------- Notary Public Seal Notary Public Signature OPTIONAL Description of Attached Document 'n Title or Type of Document: I1'lJ'f( V n-C4Al 1 Eso'y-i elf Document Date: Number of Pages: Signer(s)Other than Named Above: Capacity(ies) Claimed by Signer(s) e U Individual lip U Individual u Thumbprint of Signer 1 hmbprint of Signer 2 orporate Officer: �`J T U Corporate Officer: U Partner- U Limited U General U Partner- U Limited U General U Attorney-in-Fact U Attorney-in-Fact U Trustee U Trustee U Guardian or Conservator U Guardian or Conservator U Other: U Other: Signer is Representing: Signer is Representing: •• 0 • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Orange On -7`"S 'J`l before me, Mary Martignoni — Notary Public Date Here Insert Name and Title of the Officer personally appeared Ryan Mantle Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose name( is/pa subscribed to the within instrument and acknowledged to me that fATIGNONr1 he/sf 'executed the same in his7hs tgeff authorized ' ice' COMM. # 1761251 x capacity( 1, and that by his jf edf signatureQ� on the Q ��.p�� < instrument the person, or the entity upon behalf of ,-y y NOTARY PUBLIC-CALIFORNIA x - ORANGE COUNTY which the personkacted, executed the instrument. My Comm.Expires Sept.9,2011 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signatur Place Notary Seal Above Signat votary 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: Document Date: Number of Pages: Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Ryan Mantle Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s): ❑ Partner—❑Limited ❑General RIGHT THUMBPRINT ❑Partner—❑Limited ❑General RIGHT THUMBPRINT IX Attorney in Fact OF SIGNER ❑Attorney in Fact Top OF SIGNER here Top of thumb here ❑Trustee p o ❑ Trustee ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: ❑Other: Signer Is Representing: Signer Is Representing: First National Insurance Company of America 02007 National Notary Association•9350 De Soto Ave.,P.O Box 2402•Chatsworth,CA 9131 3.2402•www.NatonalNotary.org Item#5907 Reorder Call Tot-Free 1-800-876-6827 � 1.11xC'1` V POWER First National Insurance Company ofAmerica Plat t luttiai. OF ATTORNEY Sute 4th ovenue Seattle,WA 98154 KNOW ALL BY THESE PRESENTS: No. 9018 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA,a Washington corporation,does hereby appoint ****"***********************LES M.MANTLE;RYAN MANTLE;Fullerton,California****************************** • its true and lawful attomey(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business,and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. • IN WITNESS WHEREOF,FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 21st day of March , 2009 . Dexter R.Legg,Secretary Timothy A.Mikolajewski,Vice President CERTIFICATE Extract from the By-Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V,Section 13.-FIDELITY AND SURETY BONDS...the President,any Vice President,the Secretary,and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys-in-fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business...On any instrument making or evidencing such appointment,the signatures may be affixed by facsimile.On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided,however,that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970. °On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V,Section 13 of the By-Laws,and (ii) A copy of the power-of-attorney appointment,executed pursuant thereto,and (iii) Certifying that said power-of-attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile,and the seal of the Company may be a facsimile thereof." I, Dexter R.Legg ,Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA.do hereby certify that the foregoing extracts of the By-Laws and of a Resolution of the Board of Directors of this corporation,and of a Power of Attorney issued pursuant thereto,are true and correct,and that both the By-Laws,the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the facsimile seal of said corporation this 5th day of July , 2011 . SV�kM�cO ,�y A St"' �' • NA' Y'� i SEAL s Y -;,1928 , 4* Dexter R.Legg,Secretary S-1049/DF 3/09 • • WEB PDF • • $23,942.00 PREMIUM.IS--FOR CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT BASED ON FINAL CONTRACT PRICE Bond No: 024038390 EXECUTED IN DUPLICATE PERFORMANCE BOND kN(rt ALL PERSONS BY ri tESt t'RES!N1:S that WHEREAS the City of Seal Beach.has awarded Charles King Company, Inc. 2841 Gardena Ave_, S_iggnal.Uill. CA 90755 (Name and address of Contractor) ("Principal").a contract(the"Contract")for the work described as follows: College Park East Sewer Rehabilitation Project No. SS090I WHEREAS. Principal is required under the terms of the Contract to furnish a bond for the faithful perthrmance of the Contract. NOW.THEREFORE. we.the undersigned Principal.and First National Insurance Company of America •333 City Blvd., West, #300. 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 TWO MILLION FOUR HUNDRED TWENTY FOUR THOUSAND THREE HUNDRED FIFTY SIX AND NO/10-01a9uw* ********** Dollars (S 2,424,356.00*****************). 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 hounded 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 pa} 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 he 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 f_overning body. Dated: July 5, 2011 • Charles Ring Company, Inc. First National Insurance Company of America Principal Surety LI`I Bv: - By: Debra R. Ring Rya. Mantle President Attorney in Fact (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. • • California All-Purpose Acknowledgement State of California} County of Los Angeles On .74' ill • before me, Sarah Criscuolo ,a Notary Public personally appeared Debra King who proved to me on the basis of satisfactory evidence to be the person((whose name(K is/aX subscribed to the within instrument and acknowledged to me that Pte/ ,``a�� ttitm uq,,, she/ executed the same in 1, s/her/tom authorized °sl% RiSC00": � capacity(iIs), and that by lXs/her/thhr signature(X) on A' �r �% the instrument the person(a, or the entity upon behalf $rte ; of which the personN acted,executed the instrument. $M �= I certify under PENALTY OF PERJURY under the laws V� i: of the State of California that the foregoing paragraph a ity cre,, is true and correct. �' C%i►Eidir SMa��`. WITNESS my hand and official seal. A M eA)111 �ht -- Notary Public Seal Notary Public Signature OPTIONAL Description of Attached Document Title or Type of Document: . (/1' 'F7JV YVI41/(L r �6/171 Document Date: Number of Pages: Signer(s)Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑Individual ❑Individual Thumbprint of Signer 1 Thumbprint of Signer 2 F , /;Corporate Officer• ❑Corporate Officer: ❑Partner- ❑Limited❑General ❑Partner- ❑Limited❑General ❑Attorney-in-Fact ❑Attorney-in-Fact ❑Trustee U Trustee ❑Guardian or Conservator ❑Guardian or Conservator ❑Other: ❑Other: Signer is Representing: Signer is Representing: • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ..�;:�.t,::AC�:,�s�..,�C-s�.�,.�.�.�-.'��,.%�t,.:�S f:��..�'�',.�'�=?��:�� .s��,.=.��=3�. �<,�<�C�'��..��:�.-\:,.oia.�'�i��=)5..��a.-�]5,��.:�'..��,��.,•,=?f,:�fs��.� State of California County of Orange On 7 L` before me, Mary Martignoni — Notary Public Date Here Insert Name and Title of the Officer personally appeared Ryan Mantle Name(s)w Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose name¢isle subscribed to the within instrument and acknowledged to me that MARY MARTIGNONI he/slexecuted the same in hiseff authorized ;• capacity, and that by hisff, betf signatureQ on the -• COMM. # 1761251 > > NOTARY PUBLIC-CALIFORNIA PD instrument the person, or the entity upon behalf of �i�;n,,;; ¢ �. which the person acted, executed the instrument. -zn ORANGE COUNTY My Comm.Expires Sept.9,2011 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signatur• ✓ Place Notary Seal Above .Lure of 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: Document Date: Number of Pages: Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Ryan Mantle Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s): ❑ Partner—❑Limited ❑General RIGHT THUlu78PRINT ❑Partner—❑Limited ❑General RIGHT THUMBPRINT ER IX Attorney in Fact OF SIGNER ❑Attorney in Fact roP of SIIGNE here El Trustee Top of thumb here ❑Trustee ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: ❑Other: Signer Is Representing: Signer Is Representing: First National Insurance Company of America .Y:�,:'f/c'.vi'•✓ ✓.'•✓.•✓F\::V'N<'y5'•✓:'e''ai'✓S'✓:ei'vi'!/:�.G'e,c'b:�:,.,"E..-.v'•✓'.Y'e.'J'.f,`d'N''.e.'tJ.'•✓.'`G 'e/S'•J.'el'•✓.•N•.Y'•✓G'•✓.'a'•'s' 02007 National Notary Assoaation•9350 De Soto Ave..P.O.Box 2402•Chatsworth,CA 91313-2402•www.NabonalNotary org Item#5907 Reorder:Call Toll-Free 1-800.876-6827 • • • t• � I.i )erty° POWER First National Insurance Company of Amenca Pam 1001 4th Avenue rt ; ' L�tu.i], OF ATTORNEY Suite 1700 Seattle,WA 98154 KNOW ALL BY THESE PRESENTS: No. 9018 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA,a Washington corporation,does hereby appoint ****************************LES M.MANTLE;RYAN MANTLE;Fullerton,California*******"-1-"********"*"*""*"*■* • its true and lawful attorney(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business,and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF,FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 21st day of March , 2009 • Dexter R.Legg,Secretary Timothy A.Mikolajewski,Vice President CERTIFICATE Extract from the By-Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V,Section 13.-FIDELITY AND SURETY BONDS...the President,any Vice President,the Secretary,and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys-in-fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business...On any instrument making or evidencing such appointment,the signatures may be affixed by facsimile.On any instrument conferring such authority or on any bond or undertaking of the company,the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided,however,that the seal shall not be necessary to the validity of any such instrument or undertaking Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970. 'On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V,Section 13 of the By-Laws,and (ii) A copy of the power-of-attomey appointment,executed pursuant thereto,and (iii) Certifying that said power-of-attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile,and the seal of the Company may be a facsimile thereof." I, Dexter R.Legg ,Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA.do hereby certify that the foregoing extracts of the By-Laws and of a Resolution of the Board of Directors of this corporation,and of a Power of Attorney issued pursuant thereto,are true and correct,and that both the By-Laws,the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the facsimile seal of said corporation this 5th day of July , 2011. swimmer co Its aip,roe4 s'i q SEAL sT Nfigr �� ( x • 1928 '# it Dexter R.Legg,Secretary ek -swat S-1049/DF 3/09 WEB PDF /1-\ 1.1ENDMENT T• PUtLUC WtRKS AGREEMENT COLLEGE PARK EAST SEWER RE1 A =0L TATOO PROJECT CBP NO.SS090I between V ..�� V 5EA/ gF+, \��pRPDRq jFO,, 0 to CW i?J% '� '""ztr •f+o °eFA?.? _�� `++,�0oni PCity of Seal Beach 211 - 8th Street • Seal Beach, CA 90740 • Charles King Company 2841 Gardena Avenue • Signal Hill, CA 90755 (562) 426-2974 (562) 426-9714— FAX THIS AMENDMENTis made as of July 9, 2012, by and between the City of Seal Beach, a California charter city ("City"), and Charles King Company, a General Contractor("Contractor"). 1 REC1T/';LS A. WHEREAS, the City Council approved the plans and specifications for the College Park East Sewer Rehabilitation Project, CIP No. SS0901 ("Project") with respect to design criteria; B. WHEREAS, Contractor has submitted a bid to City for the Project • dated June 27, 2011 in the amounts of $2,424,356for the Construction of new sewer lines in College Park East; 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 June 27, 2011 Agreement is hereby amended 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 $2,950,961.17, 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. 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 Charles King Company • a'. Ingram, City id ager Nam Title: .Pres�o(P,nv By: Name: • • Title: 2 • • Attest: By: Lind Devine, City Cler Approved as to Form: By: uinnM. Barro , .City Attorney • 3 - Ewwwwo d.Snow,JR. CCVIWAR CALIECRRIA �\, MA7111Ew RppRlpDli Water Boards LICREIRVr04 ar.RO+IrEr.ua P1M1[CIIp1r State Water Resources Control Board JUN 1 5 2012 Ms. Jill R. Ingram City Manager City of Seal Beach 211 81h Street Seal Beach, CA 90740 Dear Ms. Ingram: APPROVAL OF CONTRACT CHANGE ORDER (CO); CITY OF SEAL BEACH (CITY); SEWER CAPITAL IMPROVEMENT PROJECT(PROJECT); CLEAN WATER STATE REVOLVING FUND (CWSRF) PROGRAM PROJECT NO. C-06-5310-110 Thank you for submitting the City's request for contract CO approval. The CO request, received June 7, 2012, included information for various COs for the City's Project. The City had project COs totaling $659,536. The CWSRF Program limits the total amount of eligible contract COs to funds remaining in a Project's construction budget. CO costs incurred above a Project's construction budget amount are not eligible for CWSRF funding. Therefore, eligible CO costs may be approved up to the total CWSRF financing agreement amount. We have reviewed the contract COs for CWSRF program eligibility. Enclosed is a copy of the CWSRF CO approval form for the City's records. The contract COs are consistent with the approved Project Facilities Plan Approval and the final financing agreement eligibility determinations. The total funding provided may not exceed the CWSRF financing agreement amount of $2,644,356. We hereby approve the City's COs for CWSRF funding in the amount of $328,187, provided the City satisfactorily complies with the conditions noted in the CWSRF funding agreement. If you have any questions regarding this letter, please contact Ms. Crysten R. Samudio at (916) 341-5693, or by email at csamudio @waterboards.ca.gov. Sincerely, Crysten R. Samudio Water Resources Control Engineer Enclosure cc: Mr. Michael Ho City,of Seal Beach CHARLES R.HOPPIN,CHAIRMAN 1 THOMAS HOWARD, EXECUTIVE DIRECTOR 1001 1 Street,Sacramento.CA 9581, I Melting Address:P.O.Box 100,Sacramento,CA 05812.0100 1 www.waterooards.ca.gov 0 RECYCLED PAPER Clean Water State Revolving Fund Program Change Order(CO)Approval Form Name of Agency: City of Seal Beach Project No: C-06-5310-111 Date Received: 6/7/2012 Approved Construction Budget: $2,644,356.00 Positive Approved CO CO Amount CO Number CO Description Amount($) ($) 1 Add State Water Board Construction Sign $1,338 $0 2 Unmarked Time Warner Utility Lines $9,961 $0 3 Unknown, unmarked utility conduits on Lampson Avenue $4,257 $0 4 XO Communications conduit in wrong location $4,430 $0 5 Gas utility line located incorrectly. Needed to hand dig twice $4,751 $0 6 Water Line marked incorrectly on wrong side of road $5,987 $0 7 New thrust block poured for incorrectly marked water line $2,585 $0 8 Bracing to cross old AC water line for safety against main break $7,848 $0 • 9 4 inch power conduit unmarked in field on Ironwood Avenue $1,715 $0 10 Water Line crossing at Elder and Ironwood not marked on plans $1,931 $0 11 Unknown, unmarked utility conduits on Elder Avenue $1,133 $0 12 3 unknown, unmarked conduits on Elder Avenue $1,452 $0 13 Patching and sweeping of Elder Avenue for December 2011 $5,273 $0 15 Paving Lampson Avenue to lane limits $8,722 $0 18 Patching and sweeping of Elder Avenue for January 2012 $2,380 $0 19 Calcium removal in pipes to be CIPP Lined $3,083 $0 20 remove old peeling lining from manholes to be newly lined $10,528 $0 21 Raise manhole lids, water valves and gas valves on Aster Street $2,680 $0 23 Full reconstruction of Elder Avenue $555,981 • $328,187 24 water seal manholes to be lined $23,500 $0 Total:1 $659,5361 $328,187 Summary Remaining Construction Budget: $940,049 Pending Funding Requests: $611,862 Approved CO: $328,187 • Balance Remaining: $0 The agency is responsible for notifying the State Water Resources Control Board(SWRCB)if the cumulative value of change orders exceeds the available funds in the approved construction budget. SWRCB is not obligated to pay for costs incurred in excess of the approved construction budget, as indicated in Table 2 of exhibit A-1,of the financing agreement. The decision contained herein is considered a staff eligibility decision by the • SWRCB and is not subject to further appeal unless within 30 days you request a final staff eligibility decision from the Division of Financial Assistance. The agency must ensure that any deductive COs are reflected on the final Form 259. Remarks: • Recommended by Project Manager Ms. Crysten R. Samudio epiyn c9. Name / Signature Date Approv fo funding by Senior WRCE Mr. Robert Pontureri P.E. r (/�^/•////� Name Signature Date S:\Funding Programs\SRF\Projects\Seal Beach, City of\Seal Beach 5310-110\Project Management\Change Order Approval Docs\Seal Beach 5310-110 CO Form Revised 10/31/11 • S CEDE AoC"®p® DATE(MM/DDYYYY)CERTO�OCATE OF LOAB O� ON URA CE 6/22/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ^-ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED ..C.PRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER (888)825-4322 CONTACT Denise Cerna Bowermaster&Associates 1A/C, ,e:n:714-733-6200 219 FAX P.O. Box 6026 E-MAIL (NC,No):714-252-8253 10805 Holder Street-Suite 350 PRODUCER cerna@bowermaster.com Cypress,CA 90630 CUSTOMER ID#,CHAKIN-001 INSURER(S)AFFORDING COVERAGE NAIC II INSURED Charles King Company, Inc. INSURER A:Travelers Indemnity Company 2841 Gardena Avenue INSURER B:Travelers Property&Casualty Co of Amer. Signal Hill,CA 90755 INSURER C:Chartis Specialty Insurance INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP 'W LTR I INSR VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X X DT22C03452N743TCT11 3/30/2011 3/30/2012 DAMAGE TO RENTED 300,000 PREMISES(Ea oceurrence) $ , CLAIMS-MADE X OCCUR _MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY n TRC n LOC $ AUTOMOBILE LIABILITY X X COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO DT8103452N743TCT11 3/30/2011 3/30/2012 (Ea BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ _ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 B DTSMCUP3452N743TIL11 3/30/2011 3/30/2012 — — _ DEDUCTIBLE _ $ — X RETENTION $ 10,000 $ WORKERS COMPENSATION X WC STATU- 0TH- AND EMPLOYERS'LIABILITY TORY LIMITS ER Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE X DTJUB3452N74311 6/2/2011 6/2/2012 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Pollution Liability CPL3850939 3/30/2011 3/30/2012 $5,000,000/Ded:$10,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) City of Seal Beach,its officers,officials,employees,designated volunteers and agents serving as independent contractors in the role of City officials,are Additional Insured with respects to General Liability per attached endorsement form CGD2460805.Priamry and Non-Contributory included.Waiver of Subrogation applies per attached endorsement form CGD3160704.With respects to Auto Liability per attached endorsement form CAT3530609.Waiver of Subrogation included.Waiver of Subrogation applies to WorkComi per attached endorsement form WC990376. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Seal Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. 211 8th Street Seal Beach,CA 90740- AUTHORIZED REPRESENTATIVE I ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ` • Named Insured: Charles King Company, Inc. Policy Number: DT22C03452N743TCT11 • Policy Period: 03/30/2011 to 03130!2012 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED– (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you "property damage"or"personal injury";and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time For of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to•the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the .= "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" 0.= surance". This endorsement shall not in- available to the additional insured which covers 0-, crease the limits of insurance described in that person or organization as a named insured Section III–Limits Of insurance, for such loss, and we will not share with that "other insurance". But the insurance provided to b) The insurance provided to the additional in- the additional insured by this endorsement still is I sured does not apply'to 'bodily injury", "prop- excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional Insured under such "other insur- ° i. The preparing, approving, or failing to ance". _ prepare or approve, maps, shop draw 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, m— approving, or failing to prepare or ap- a) The additional insured must give us written prove,drawings and specifications; and notice as soon as practicable of an "occur- = rence" or an offense which may result in a ii. Supervisory, inspection, architectural or claim. To the extent possible, such notice engineering activities. should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 009039 • • COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the"occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or"suit"is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. i. Immediately record the specifics of the —DEFINITIONS: claim or"suit"and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement under which you are required to include a The additional insured must see to it that we person or organization as an additional in- receive written notice of the claim or"suit"as sured on this Coverage Part, provided that soon as practicable. the "bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the"personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or"suit", cooperate a. After the signing and execution of the with us.in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender the de- agreement is in effect; and fense and indemnity of any claim or"suit"to c. Before the end of the policy period. . .Page 2 of 2 0 2005 The St.Paul Travelers Companies, Inc. CG D2 46 08 05 Named Insured: Charles King C pang, Inc. Policy Number: DT22C03452N743TCT11 Policy Period:03/30/2011 to 03/3012012 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE–Provisions A.-H. and J.-N.of this endorsement broaden coverage, and provision I. of this endorsement may limit coverage. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the PROVISIONS of this endorsement carefully to determine rights,duties, and what is and is not covered. A. Broadened Named Insured H. Additional Insured–State or Political Subdivisions B. Extension of Coverage–Damage To Premises I. Other Insurance Condition Rented To You J. Increased Supplementary Payments ° Perils of fire,explosion,lightning,smoke,water ° Cost of bail bonds increased to$2,500 ° Limit increased to$300,000 ° Loss of earnings increased to$500 per day C. Blanket Waiver of Subrogation K. Knowledge and Notice of Occurrence or Offense D. Blanket Additional Insured–Managers or Lessors L. Unintentional Omission of Premises M. Personal Injury–Assumed by Contract E. Incidental Medical Malpractice N. Blanket Additional Insured–Lessor of Leased F. Extension of Coverage–Bodily Injury Equipment G. Contractual Liability–Railroads •= PROVISIONS 3. This Provision A. does not apply to any per- °= A. BROADENED NAMED INSURED son or organization for which coverage is ex- = cluded by endorsement. 1. The Named Insured in Item 1. of the Declare- °= tions is as follows: B. EXTENSION OF COVERAGE – DAMAGE TO PREMISES RENTED TO YOU The person or organization named in Item 1. • of the Declarations and any organization, 1. The last paragraph of COVERAGE A. BOO- °—° other than a partnership, joint venture or lim- ILY INJURY AND PROPERTY DAMAGE LI- ited liability company, of which you maintain ABILITY (Section I – Coverages) is deleted ownership or in which you maintain the major- and replaced by the following: ity interest on the effective date of the policy. Exclusions c.through n.do not apply to dam- However, coverage for any such additional age to premises while rented to you, or tem- a= organization will cease as of the date, if any, porarily occupied by you with permission of during the policy period, that you no longer the owner,caused by: maintain ownership of, or the majority interest a. Fire; in, such organization. b. Explosion; 2. WHO IS AN INSURED (Section II) Item 4.a. C. Lightning: is deleted and replaced by the following: ° a. Coverage under this provision is afforded d. Smoke resulting from such fire,explosion, only until the 180th day after you acquire or lightning; or or form the organization or the end of the e. Water. policy period,whichever is earlier. A separate limit of insurance applies to this coverage as described in Section III Limits Of Insurance. CO D3 16 07 04 Copyright,The Travelers Indemnity Company,2004 Page 1 of 6 000040 • • • COMMERCIAL GENERAL LIABILITY 2. This insurance does not apply to damage 10 5. This Provision B. does not apply if coverage premises while rented to you, or temporarily for Damage To Premises Rented To You of occupied by you with permission of the COVERAGE A. BODILY INJURY AND owner, caused by: PROPERTY DAMAGE LIABILITY(Section 1— a. Rupture, bursting, or operation of pres- sure relief devices; C. BLANKET WAIVER OF SUBROGATION b. Rupture or bursting due to expansion or We waive any right of recovery we may have swelling of the contents of any building or against any person or organization because of structure, caused by or resulting from wa- payments we make for injury or damage arising ter; out of: premises owned or occupied by or rented c. Explosion of steam boilers, steam pipes, or loaned to you; ongoing operations performed steam engines,or steam turbines. by you or on your behalf, done under a contract with that person or organization; "your work"; or 3. Paragraph 6. of LIMITS OF INSURANCE "your products". We waive this right where you (Section III) is deleted and replaced by the have agreed to do so as part of a written contract, following: executed by you before the "bodily injury" or Subject to 5. above, the Damage To Prem- "property damage"occurs or the "personal injury" ises Rented To You Limit is the most we will or"advertising injury"offense is committed. pay under COVERAGE A. for the sum of all D. BLANKET ADDITIONAL INSURED — MANAG- damages because of "property damage" to ERS OR LESSORS OF PREMISES any one premises while rented to you, or temporarily occupied by you with permission WHO IS AN INSURED(Section ii) is amended to of the owner, caused by: fire; explosion; light- include as an insured any person or organization Wing; smoke resulting from such fire, explo- (referred to below as "additional insured") with sion, or lightning; or water. The Damage To whom you have agreed in a written contract,exe- Premises Rented To You Limit will apply to all cuted before the "bodily injury" or"property dam- "property damage" proximately caused by the age" occurs or the "personal injury" or "advertis- same "occurrence", whether such damage ing injury" offense is committed, to name as an results from: fire; explosion; lightning; smoke additional insured, but only with respect to liability resulting from such fire, explosion, or light- arising out of the ownership, maintenance or use ping; or water, or any combination of any of of that part of any premises leased to you,subject these causes. to the following provisions: The Damage To Premises Rented To You 1. Limits of Insurance. The limits of insurance Limit will be the higher of: afforded to the additional insured shall be the limits which you agreed to provide in the writ- e. $300,000; or ten contract, or the limits shown on the Decla- b. The amount shown on the Declarations rations, whichever are less. for Damage To Premises Rented To You 2. The insurance afforded to the additional in- Limit. sured does not apply to: 4. Paragraph a. of the definition of"insured con- a. Any "bodily injury" or "property damage" tract" (DEFINITIONS — Section V) Is deleted that occurs,or"personal injury"or"adver- and replaced by the following: tising injury" caused by an offense which a. A contract for a lease of premises. How- is committed, after you cease to be a ten- ever, that portion of the contract for a ant in that premises; lease of premises that indemnifies any b. Any premises for which coverage is ex- person or organization for damage to cluded by endorsement;or premises while rented to you, or tempo- rarily occupied by you with permission of c. Structural alterations, new construction or the owner, caused by: fire; explosion; demolition operations performed by or on lightning; smoke resulting from such fire, behalf of such additional insured. explosion, or lightning; or water, is not an 3. The insurance afforded to the additional in- "insured contract"; sured is excess over any valid and collectible Page 2 of 6 Copyright, The Travelers Indemnity Company,2004 CG D3 16 07 04 Named Insured: Charles King pany, Inc. • • Policy Number: DT8103452N743TCT11 Policy Period: 03/30/2011 to 03/30/2012 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights,duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE—INCREASED LIMIT B. BLANKET ADDITIONAL INSURED I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT C. EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS E. SUPPLEMENTARY PAYMENTS — INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS OR LOSS F. HIRED AUTO — LIMITED WORLDWIDE M. BLANKET WAIVER OF SUBROGATION COVERAGE--INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED executed by you before the "bodily injury" or The following is added to Paragraph A.1., Who Is "property damage" occurs and that is in effect An Insured, of SECTION II — LIABILITY COV- during the policy period, to be named as an addi- ERAGE: tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance Any organization you newly acquire or form dur- applies and only to the extent that person or or- ing the policy period over which you maintain ganization qualifies as an "insured" under the 50% or more ownership interest and that is not Who Is An Insured provision contained in Section separately insured for Business Auto Coverage. Il Coverage under this provision is afforded only un C EMPLOYEE HIRED AUTO til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- 1. The following is added to Paragraph A.1., ever is earlier. Who Is An Insured, of SECTION II — LI- B. BLANKET ADDITIONAL INSURED ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION II —LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission,while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 06 09 02009 The Travelers Companies,Inc. Page 1 of 4 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. 0 • COMMERCIAL AUTO 2. The following replaces Paragraph b. In B.5., United States of America applies to and pro- Other Insurance, of SECTION IV — BUSI- hibits the transaction of business with or NESS AUTO CONDITIONS: within such country or jurisdiction,for Liability b. For Hired Auto Physical Damage Cover- Coverage for any covered "auto" that you age, the following are deemed to be cov- lease, hire, rent or borrow without a driver for ered"autos"you own: a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from (1) Any covered "auto" you lease, hire, any of your"employees", partners (if you are rent or borrow; and a partnership), members (if you are a limited (2) Any covered"auto" hired or rented by liability company) or members of their house- your "employee" under a contract in holds. that individual "employee's" name, (1) With respect to any claim made or "suit" with your permission, while perform- brought outside the United States of ing duties related to the conduct of America, the territories and possessions your business. of the United Slates of America, Puerto However, any"auto"that is leased, hired, Rico and Canada: rented or borrowed with a driver is not a covered "auto (a) You must arrange to defend the "insured"against, and investigate D. EMPLOYEES AS INSURED or settle any such claim or "suit" The following Is added to Paragraph A.1.,Who is and keep us advised of all pro- An Insured, of SECTION 11 — LIABILITY COV- ceedings and actions. ERAGE: (b) Neither you nor any other in- Any "employee"of yours is an Insured"while us- vowed "insured" will make any ing a covered"auto"you don't own, hire or borrow settlement without our consent. in your business or your personal affairs. (c) We may, at our discretion, par- ticipate in defending the "insured" E. SUPPLEMENTARY PAYMENTS — INCREASED against, or in the settlement of, LIMITS any claim or"suit". 1. The following replaces Paragraph A.2.a.(2), (d) We will reimburse the"insured": of SECTION II—LIABILITY COVERAGE: (i) For sums that the "insured" (2) Up to $3,000 for cost of bail bonds (in- legally must pay as damages cluding bonds for related traffic law viola- because of "bodily Injury" or lions) required because of an "accident" "property damage" to which • we cover. We do not have to furnish this insurance applies, that these bonds. the "insured" pays with our 2. The following replaces Paragraph A.2.a.(4), consent, but only up to the of SECTION II—LIABILITY COVERAGE: limit described in Paragraph C., Limit Of Insurance, of (4) All reasonable expenses incurred by the SECTION II — LIABILITY "insured" at our request, including actual COVERAGE; loss of earnings up to $500 a day be- cause of time off from work. (II) For the reasonable expenses incurred with our consent for F. HIRED AUTO — LIMITED WORLDWIDE COV- your investigation of such ERAGE—INDEMNITY BASIS claims and your defense of The following replaces Subparagraph e. in Para- the "insured" against any graph B.7., Policy Term, Coverage Territory, of such"suit", but only up to and SECTION IV—BUSINESS AUTO CONDITIONS: included within the limit de- e. Anywhere in the world, except any country or scribed in Paragraph C., Limit jurisdiction while any trade sanction, ern- bargo, Of Insurance, of SECTION II or similar regulation Imposed by the — LIABILITY COVERAGE, Page 2 of 4 ®2009 The Travelers Companies,Inc. • CA T3 53 06 09 Includes the copyrighted material of Insurance Services Office.Inc.with its permission. S • COMMERCIAL AUTO and not in addition to such I. PHYSICAL DAMAGE — TRANSPORTATION limit. Our duty to make such EXPENSES—INCREASED LIMIT payments ends when we The following replaces the first sentence in Para- have used up the applicable graph A.4.a.,Transportation Expenses, of SEC- limit of Insurance in payments TION III—PHYSICAL DAMAGE COVERAGE: for damages, settlements or defense expenses. We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- (2) This insurance is excess over any valid curred by you because of the total theft of a cov- and collectible other insurance available ered"auto"of the private passenger type. to the "insured" whether primary, excess J. PERSONAL EFFECTS contingent or on any other basis. {3} This insurance is not a substitute for re- The following is added to Paragraph A.4., Cover- qulred or compulsory insurance in any age Extensions, of SECTION III — PHYSICAL country outside the United States, its ter- DAMAGE COVERAGE: ritories and possessions, Puerto Rico and Personal Effects Canada. We will pay up to $400 for "loss" to wearing ap- You agree to maintain all required or parel and other personal effects which are: compulsory insurance in any such coun- (1) Owned by an"insured";and try up to the minimum limits required by (2) In or on your covered"auto". local law. Your failure to comply with compulsory insurance requirements will This coverage applies only in the event of a total not invalidate the coverage afforded by theft of your covered"auto". this policy, but we will only be liable to the No deductibles apply to this Personal Effects same extent we would have been liable coverage. had you complied with the compulsory in- K. AIRBAGS surance requirements. The following is added to Paragraph B.3., Exclu- (4) It is understood that we are not an admit- sions, of SECTION III — PHYSICAL DAMAGE ted or authorized insurer outside the COVERAGE: United States of America, its territories Exclusion 3.a. does not apply to "loss" to one or and possessions, Puerto Rico and Can- more airbags in a covered "auto"you own that in- ada. We assume no responsibility for the flate due to a cause other than a cause of"loss" furnishing of certificates of insurance, or set forth in Paragraphs A.1.b. and A.1.c., but for compliance in any way with the laws of other countries relating to insurance. only: a. If that "auto" Is a covered "auto"for Compre- G. WAIVER OF DEDUCTIBLE—GLASS hensive Coverage under this policy; The following is added to Paragraph D., Deducti- b. The airbags are not covered under any war- ble, of SECTION III — PHYSICAL DAMAGE ranty; and COVERAGE: c. The airbags were not intentionally inflated. No deductible for a covered "auto" will apply to We will pay up to a maximum of $1,000 for any glass damage if the glass is repaired rather than one"loss". replaced. H. HIRED AUTO PHYSICAL DAMAGE—LOSS OF L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS USE—INCREASED LIMIT The following is added to Paragraph A.2.a., of The following replaces the last sentence of Para- SECTION IV—BUSINESS AUTO CONDITIONS: graph A.4.b., Loss Of Use Expenses, of SEC- TION III—PHYSICAL DAMAGE COVERAGE: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- However, the most we will pay for any expenses plies only when the "accident"or "loss" is known for loss of use is $65 per day, to a maximum of to: • $750 for any one"accident". (a) You (if you are an individual); CA T3 53 06 09 ®2009 The Travelers Companies,Inc. Page 3 of 4 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. • 0 • COMMERCIAL AUTO (b) A partner(if you are a partnership); tent required of you by a written contract (c) A member (if you are a limited liability corn- signed and executed prior to any "accident" or"loss", provided that the"accident"or'loss" pany); arises out of operations contemplated by (d) An executive officer, director or insurance such contract. The waiver applies only to the manager(if you are a corporation or other or- person or organization designated in such ganizatlon); or contract. (e) Any"employee"authorized by you to give no- N. UNINTENTIONAL ERRORS OR OMISSIONS tice of the "accident"or"loss". The following is added to Paragraph B.2., Con- M. BLANKET WAIVER OF SUBROGATION cealment, Misrepresentation, Or Fraud, of The following replaces Paragraph A.5., Transfer SECTION IV—BUSINESS AUTO CONDITIONS: Of Rights Of Recovery Against Others To Us, The unintentional omission of, or unintentional of SECTION IV — BUSINESS AUTO CONDI- error in, any information given b TIONS: Y 9 by you shall not prejudice your rights under this insurance. How- 5. Transfer Of Rights Of Recovery Against ever this provision does not affect our right to col- . Others To Us lecl additional premium or exercise our right of We waive any right of recovery we may have cancellation or non-renewal. against any person or organization to the ex- Page 4 of 4 p 2009 The Travelers Companies,Inc. CA T3 53 06 09 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. ti • TRAVELERS r WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76( A)— 001 POLICY NUMBER: WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA • (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 3 .0 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. • • This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 06/02/2011 Policy No. DTJUB3452N7431 Endorsement No. Insured Charles King Company.Inc. // Prem Insurance Company Countersigned by DATE OF ISSUE: ST ASSIGN: Page 1 of 1 • S CO r i r.1®ICI POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions: A. Cancellation during the policy period and up to three years 1. The first Named Insured shown in the Decla- afterward. rations may cancel this policy by mailing or D. Inspections And Surveys delivering to us advance written notice of 1. We have the right to: cancellation. a. Make inspections and surveys at any 2. We may cancel this policy or any Coverage time; Part by mailing or delivering to the first Named Insured written notice of cancellation b. Give you reports on the conditions we at least: find; and a. 10 days before the effective date of can- c. Recommend changes. cellation if we cancel for nonpayment of 2. We are not obligated to make any inspec- premium; or tions, surveys, reports or recommendations b. 30 days before the effective date of can- and any such actions we do undertake relate cellation if we cancel for any other rea- only to insurability and the premiums to be son. charged. We do not make safety inspections. 3. We will mail or deliver our notice to the first We do not undertake to perform the duty of Named Insured's last mailing address known any person or organization to provide for the health or safety of workers or the public. And to us. we do not warrant that conditions: 4. Notice of cancellation will state the effective a. Are safe or healthful; or date of cancellation. If the policy is cancelled, that date will become the end of the policy b. Comply with laws, regulations, codes or period. If a Coverage Part is cancelled, that standards. date will become the end of the policy period 3. Paragraphs 1. and 2. of this condition apply as respects that Coverage Part only. not only to us, but also to any rating, advi- 5. If this policy or any Coverage Part is can- sory, rate service or similar organization celled, we will send the first Named Insured which makes insurance inspections, surveys, any premium refund due. If we cancel, the re- reports or recommendations. fund will be pro rata. If the first Named In- 4. Paragraph 2. of this condition does not apply sured cancels, the refund may be less than to any inspections, surveys, reports or rec- pro rata. The cancellation will be effective ommendations we may make relative to certi- even if we have not made or offered a re- fication, under state or municipal statutes, or- fund. dinances or regulations, of boilers, pressure 6. If notice is mailed, proof of mailing will be vessels or elevators. sufficient proof of notice. E. Premiums B. Changes 1. The first Named Insured shown in the Decla- This policy contains all the agreements between rations: you and us concerning the insurance afforded. a. Is responsible for the payment of all pre- The first Named Insured shown in the Declare- miums; and tions is authorized to make changes in the terms b. Will be the payee for any return premi- of this policy with our consent. This policy's terms can be amended or waived only by endorsement urns we pay. issued by us as part of this policy. 2. We compute all premiums for this policy in C. Examination Of Your Books And Records accordance with our rules, rates, rating plans, premiums and minimum premiums. The pre- We may examine and audit your books and mium shown in the Declarations was corn- . records as they relate to this policy at any time puted based on rates and rules in effect at IL TO 01 01 07 (Rev.06-09) Includes the copyrighted material of Insurance Services Office,Inc.with its permission . Page 1 of 2 • 0 • the time the policy was issued. On each re- acting within the scope of duties as your legal newal continuation or anniversary of the ef- representative. Until your legal representative is fective date of this policy, we will compute appointed, anyone having proper temporary cus- the premium in accordance with our rates tody of your property will have your rights and and rules then in effect. duties but only with respect to that property. F. Transfer Of Your Rights And Duties Under This Policy G. Equipment Breakdown Equivalent to Boiler Your rights and duties under this policy may not and Machinery be transferred without our written consent except On the Common Policy Declarations, the term in the case of death of an individual named in- Equipment Breakdown is understood to mean sured. and include Boiler and Machinery and the term If you die, your rights and duties will be trans- Boiler and Machinery is understood to mean and ferred to your legal representative but only while include Equipment Breakdown. This policy consists of the Common Policy Declarations and the Coverage Parts and endorsements listed in that declarations form. In return for payment of the premium, we agree with the Named Insured to provide the insurance afforded by a Coverage Part forming part of this policy. That insurance will be provided by the company indicated as insuring company in the Common Policy Declarations by the abbreviation of its name opposite that Coverage Part. One of the companies listed below (each a stock company) has executed this policy, and this policy is counter- signed by the officers listed below: The Travelers Indemnity Company(IND) The Phoenix Insurance Company(PHX) The Charter Oak Fire Insurance Company(COF) Travelers Property Casualty Company of America (TIL) The Travelers Indemnity Company of Connecticut(TCT) The Travelers Indemnity Company of America (TIA) Travelers Casualty Insurance Company of America (ACJ) Gt/ /' Le_„.C � �� v '�" Secretary President Page 2 of 2 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. IL TO 01 01 07(Rev.06-09) • RESOLUTION NO. 00-29 A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF SEAL BEACH APPROVING HEIGHT VARIATION 00-3, PERMITTING THE CONSTRUCTION OF A COVERED ROOF ACCESS STRUCTURE IN CONJUNCTION WITH AN ADDITION TO AN EXISTING SINGLE FAMILY RESIDENCE THE PLANNING COMMISSION OF THE CITY OF SEAL BEACH DOES HEREBY • RESOLVE: Section 1. On July 18, 2000 Michael Levin ("The Applicant") submitted an application for Height Variation 00-3 with the Department of Development Services. The applicant is proposing to construct a covered roof access structure (CRAS)leading to a roofdeck in excess of the height limit in conjunction with the construction of a major addition to an existing single family residence at 1608 Ocean Avenue. Section 2. Pursuant to 14 Calif. Code of Regs. § 15025(a) and § II.A of the City's Local CEQA Guidelines, staff has determined as follows: The application for Height Variation No. 00-3 is categorically exempt from review pursuant to the California Environmental Quality Act pursuant to 14 Calif. Code of Regs. § 15303(a) (New Construction of Small Structures), because the application is for the construction of three (3) or less single family dwellings in an urbanized area; § 15305 (Minor Alterations in Land Use Limitations) because the request is for a minor alteration in land use limitations in an area with an average slope of less than 20% and no changes in land use or density are involved; and,pursuant to § 15061(b)(3), because it can be seen with certainty that there is no possibility that the approval may have a significant effect on the environment. Section 3. A duly noticed public hearing was held before the Planning Commission on August 23, 2000 to consider Height Variation 00-3. Section 4.. The record of the hearing indicates the following: (a) On July 18, 2000, Michael Levin submitted an application for Height Variation 00-3. (b) The applicant is requesting to construct a CRAS in conjunction with an addition to an existing single family dwelling located at 1608 Ocean Avenue. (c) The subject property is described as Orange County Assessor's Parcel Number 199-094-05 and is located within"Old Town." (d) The subject property is rectangular in shape with a lot area of 2500 square feet. • • , 410 Planninimmission Resolution No. 00-29 proposed project into compliance with the City's approved Covered Roof Access Structure Policy Guidelines. Said structure shall not exceed 62.25 square feet. 3. There shall be no habitable space permitted within the covered roof access structure. 4. The BBQ area shall be removed entirely from the plans. 5. This Height Variation shall not become effective for any purpose unless an "Acceptance of Conditions"form has been signed by the applicant in the presence of the Director of Development Services, or notarized and returned to the Planning Department; and until the ten(10) day appeal period has elapsed. PASSED,APPROVED AND ADOPTED by the Planning Commission of the City of Seal Beach at a meeting thereof held on the 23`d day of August, 2000, by the following vote: AYES: Commissioners Hood, Brown, Cutuli, Lyon, Sharp NOES: Commissioners ABSENT: Commissioners David Hood, Ph.D., Chairman Planning Commission Lee Whittenberg, Secretary Planning Commission Page 3