HomeMy WebLinkAboutAGMT - Pavement Coatings Co. (FY 06-07 Street Sealing, Project #50190) Recorded in Official Records, Orange County
RECORDING REQUESTED BY Tom Daly, Clerk iRecordeor
IiIIIIIlIR11111111IIPIIIIIIIIIIVIIIIIIIIIIIIIWIIIIIIVIII IIIIIIIIINO FEE
AND WHEN RECORDED MAIL TO 2006000645399 08:17am 09128106
213 160 N12 1
CITY OF SEAL BEACH 0.00 0.00 0.00 0.00 0.0 0 00 0.00 0.00
Attn: City Clerk
211 8th Street
Seal Beach, CA 90740
- Space of above this line for Recorder's use.
*** No Recording Fee Pursuant to Government Code Section 6103,27383 ****
NOTICE OF COMPLETION
Notice pursuant to Civil Code Section 3093, must be filed within 10 days after completion.
Notice is hereby given that:
1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the
property hereinafter described: P
2. The full name of the owner is: City of Seal Beach
3. The address of the owner is: City of Seal Beach.211 e Street, Seal Beach, CA 90740 l
The nature of the interest or estate of the owner is; liffee. The City of Seal Beach.—
5. A work of improvement on the property hereinafter is described as substantially completed on August
11.2006.The work was: Annual Street Seal Program. Project 50177.
6. The name of the contractor, if any, for such improvement was: Pavement Coatings Co. The date of the
Contract was: March 13.2006.
7. The property on which said work of improvement was completed in the City of Seal Beach, County of
Orano , S to of California, and is described as follows: Annual Street Seal Program, Project 50177
Date: g ll
'/�i��
/r
Signature of owner or corpo ZIF ficer of owner
named in paragraph 2 or his 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.p
Executed on O ',3a " ,2006, at Seal Beach, California.
(Date of Signature)
Director of Public Works
,/
s
• •
.J
BOOK H OF III
a .
CONTRACT DOCUMENTS
DOCUMENTS TO SUBMIT UPON AWARD:
PUBLIC WORKS CONTRACT, PERFORMANCE BOND, PAYMENT BOND,
INDEMNIFICATION AND HOLD HARMLESS, LABOR LAW REQUIREMENTS,
ACKNOWLEDGEMENT OF LICENSE LAW, WORKMEN'S COMPENSATION
CERTIFICATE, ADDITIONAL INSURED
(COMPREHENSIVE,AUTO, EXCESS
FOR:
FY: 06/07 STREET SEALING
PROJECT
No. 50190 : ; � �_ i t a, 1.L. ,4
r�.yg„ ig-6;• i 1x , t4-7-2,.t r fra -` P; �`� ��j `. ',.. ®I
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These Contract Documents are the exclusive property of the Agency and shall not be used in any manner
without prior consent of the Agency. Any reuse of these plate and specifications by Others shall be at
Other's sole risk and without liability to the Agency.
CITY OF SEAL BEACH - 211 EIGHTH STREET - SEAL BEACH, CA 90740-6379.
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V 1 •
FY: 06/07 STREET SEALING PROJECT 50190
For FY: 06/07 STREET SEALING PROJECT 50190, in the City of Seal Beach.
THIS AGREEMENT, made and entered into this . day of , 20 , by and
between the City of Seal Beach, California, hereinafter referred to as the "CITY," Party of the First Part,
and PAVEMENT COATINGS CO.
hereinafter designated as the "CONTRACTOR," Party of the Second Part.
WITNESSETH: That the Parties do hereto mutually agree as follows:
ARTICLE I. For and in consideration of the payments and agreements hereinafter mentioned to be
made and performed by said CITY, the CONTRACTOR agrees with said CITY to FY: 06/07 STREET
SEALING PROJECT 50190,and to perform and complete in a good and workmanlike manner all the work
pertaining thereto shown on the drawings and described in the Specifications and Contract Documents,
therefore, to furnish at his own proper cost and expense all tools, equipment, labor and materials necessary
therefore (except those materials expressly noted as to be furnished by the CITY), and to do everything
required by this Agreement and the said Specifications,Drawings,and Contract Documents.
ARTICLE II. For furnishing all said materials and labor, furnishing and removing all plant, temporary
works or structures, tools and equipment and doing all the work contemplated and embraced in this
Agreement, also for all loss and damage arising out of the nature of the work aforesaid, or from the action
of the elements, or from any unforeseen difficulties which may arise or be encountered in the prosecution
of the work until its acceptance by said CITY, and for all risks of every description connected with the
work; also for all expenses incurred by or in consequence of the suspension or discontinuance of work;
except such as in the said Specifications are expressly stipulated to be borne by the said CITY and
faithfully completing the work and the whole thereof, in the manner shown and described in the said
Drawings, Specifications, and Contract Documents and in accordance with the requirements of the
Engineer, said CITY will pay and the CONTRACTOR shall receive in full compensation, therefore, the
unit prices and the lump sum prices named in the Schedule of Work Items of the Proposal.
ARTICLE III. The CITY hereby promises and agrees with said CONTRACTOR to employ and does
hereby employ said CONTRACTOR to provide the materials and to do the work according to the terms and
conditions herein contained and referred to for the price aforesaid, and hereby contracts to pay the same, at
the time,in the manner and upon the conditions set forth in the Specifications and Contract Documents, and
the said parties for themselves, their heirs, executors, administrators, successors and assigns, do hereby
agree to the full performance of the covenants herein contained.
ARTICLE IV. The advertisement for Bids,the Proposal, the Specifications, and the Drawings mentioned
therein, and all addenda issued by the CITY with respect to the foregoing prior to the opening of bids, are
hereby incorporated in and made a part of this Agreement.
ARTICLE V. The statement of prevailing wages appearing in the General Prevailing Wage Rates is
hereby specifically referred to and by this reference is made a part of this contract. It is further expressly
agreed by and between the parties hereto that should there be any conflict between the terms of this
instrument and the bid of proposal of said CONTRACTOR, then this instrument shall control and nothing
herein shall be considered as an acceptance of the said terms of said proposal conflicting herewith.
ARTICLE VI. By my signature hereunder, as CONTRACTOR, I.certify that I am aware of the provisions
of Section 3700 of the Labor Code which require every employer to be insured against liability for
workmen's compensation or to undertake self-insurance in accordance with the provisions of that code, and
I will comply with such provisions before commencing the performance of the work of this contract.
IN WITNESS WHEREOF: The Parties hereto have caused this contract to be executed the day and year
first above written.
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• •
CITY OF SEAL BEACH, CALIFORNIA
Party of the First Part
BY ► • . r1_,. ,_ ,' _
City Manager \
ATtTT]I�EST: (\k
nikt City Clerk
BY
CONTRACTOR-Party of the Second Part
Title
Address
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•
Bond No. 08863493
Premium: $854.00
PERFORMANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS that:
WHEREAS the City of Seal Beach,has awarded Pavement Coatings Co.
P.O. Box 1491.Cypress.CA 90630
(Name and address of Contractor)
("Principal"), a contract(the"Contract")for the work described as follows:
Project Number 50190 - FY 06/07 Street Sealing Project
WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful
performance of the Contract.
NOW,THEREFORE,we,the undersigned Principal, and
Fidelity and Deposit Company of Maryland
801 North Brand Blvd..Glendale, CA 91203
(Name and address of Surety)
("Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and
firmly bound unto the Public Agency in the penal sum of One Hundred Forty Two Thousand Seven Hundred
Seventy Two and 40/100ths
Dollars ($ 142 772.40 - ), this amount being not less than the total
contract price, in lawful money of the United States of America, for the payment of which sum well and
truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly
and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal,his,her
or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and
well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the
Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and
•
performed, all within the time and in the manner therein specified, and in all respects according to their true
intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and
others as therein provided,then this obligation shall become null and void; otherwise, it shall be and remain
in full force and effect.
In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys'
fees in an amount fixed by the court.
FURTHER,the Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder,
or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby
waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the
Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of
California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all
rights of a party hereto. IN WITNESS WHEREOF,two (2) identical counterparts of this instrument, each
of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and
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.
11-4
• •
Dated:
"Principal" "Surety"
Pavement Coatings Co. Fidelity and Deposit Company of Maryland
By: Mrt�-� �iYlbi y: Salk.
Its IO It Lisa ton.Attorney i Fact
By: - 9II I j By:
Its MARSHA 'COOLIDGE Its
President
Secretary & CFO
(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.
•
•
II-5
• •
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of Orange
On May 9, 2007 before me, Van P. Duncan, Notary Public, personally
appeared Marsha Coolidge personally known to me (or 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/her/their authorized capacity(ies),
and that by his/her/their signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s) acted, executed the
instrument.
WITNESS my hand and official seal.
VAN P. DUNCAN : ✓ - ,u� ea,,�
o Ce�1 COMM. #1689434 Van P. Duncan, Notary Public
NOTARY PUBLIC-CALIFORNIA p
ORANGE COUNTY
4 ... - My Commission Expires SEPTEMBER 21,2010 Z
• •
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of Los Angeles
On ma OR 9nn71 before me, Marina Tapia, Notary Public,
personally appeared Lisa L. Thornton personally known to me (or
- - • - . - - - -) to be the
person(s) whose name(s) is/are subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or the entity upon
behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Marina Tapia
•.
MARINA TAPIA
COMM.#1728314
M I i®-tat NOTARY PUBLICS CALIFORNIA 1
LOS ANGELES CGUNTY
�, My Comm.Expires March 30.2011
a�J�lA+ae.�
• • Na.08863493
Premium included with Performance Bond
PAYMENT BOND
• (LABOR AND MATERIALS)
KNOW ALL PERSONS BY THESE PRESENTS that:
WHEREAS the City of Seal Beach,has awarded to Pavement Coatings Co.
P.O.Box 1491, Cypress, CA 90630
(Name and address of Contractor)
("Principal"), a contract(the"Contract")for the work described as follows:
Project Number 50190-FY 06107 Street Seating Project
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
Fidelity and Deposit Company of Maryland
801 North Brand Blvd., Glendale.CA 91203
(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 One Hundred Forty Two Thousand Seven Hundred
Seventy Two and 40/100ths
Dollars ($ 142772.40 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 inure to.the benefit of any of the persons named in Section 3181 of the California Civil •
Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In
case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys'
fees in an amount fixed by the court.
FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder,
or the specifications for the same, shall in any way affect its obligations under this bond,and it does hereby
waive notice of any such change, extension of time, alteration, addition,or modification to the terms of the
Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of
California Civil Code §§ 2845 and 2849.
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• •
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"
Pavement Coatings Co. Fidelity and Deposit Company of Maryland
By: ,, JO- /�9 J B i�� �
By: JI /, //��� r Its L.Thornt m, �ttorney in F ct
U�j/ i �y�'1 d� By:
Its MARSHA COOSOGE Its
President
Secretary & CFO
(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.
•
•
II-7
•
0
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of .California
County of Orange
On May 9, 2007 before me, Van P. Duncan, Notary Public, personally
appeared Marsha Coolidge personally known to me (or 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/her/their authorized capacity(ies),
and that by his/her/their signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s) acted, executed the
instrument.
WITNESS my hand and official seal.
• VAN P, DUNCAN �"`
o .. COMM. #1689434 3 Van P. Duncan, Notary Public
;NG' NOTARY PUBLIC•CALIFORNIA 5
, to ORANGE COUNTY t
• X41.11 My CammRS4n Eapiu SEPTEMBER 21,2010
•
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of Los Angeles
On MAY 08 2001i before me, Marina Tapia, Notary Public,
personally appeared Lisa L. Thornton personally known to me (or•
. . - - • - - • - - - - - -) to be the
person(s) whose name(s) is/are subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or the entity upon
behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Marina Tapia
MARINATAPIA
5 ,. -0.$3 COMM.#1728314
m + " " • NOTARY PUBLIC CALIFORNIA 0
- - LOS ANGELES COUNTY
M � ,My Comm.E,otreessMarch 30.2011
Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland, by PAUL C. ROGERS, Vice President.and T. E. SMITH, Assistant Secretary, in
pursuance of authority granted by Article VI, Section 2, of the By-Laws of said Company,w . t- set forth on the reverse
side hereof and are hereby certified to he in full force and effect on the date hereof du,s 4. , 4 I . • nate,constitute and
appoint Lisa L.THORNTON,of Los Angeles,California, its true anc �r z n Ti u'. • tto Fact, to make.
execute, seal and deliver, for,and on its behalf as surety,and ' - r ytid'ui. .: a : . t i : .,` d undertakings,and
the execution of such bonds or undertakings in purl •o • ' e-a en�t --:1 d.. - g upon said Company, as fully
and amply,to all intents and purposes, a- 1 �. .my e G' ' • wledged by the regularly elected officers
of the Company at its office in t, r 14 U- ;-in Suer p ns. This power of attorney revokes that issued on
behalf of Lisa L. THO • ' • d:o. a '
The said Assistant , 'c o.. le .. hat the extract set forth on the reverse side hereof is a true copy of Article VI,
Section 2,of the By- , '°..'o party.and is now in force.
IN WITNESS W • R OF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 4th day of August,
A.D. 2003.
ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND
to DIP osc,
,:eat. O
1y w. 3
. 13111 at
By:
T. E. Smith Assistant Secretary Paul C. Rogers Vice President
State of Maryland
ss:
City of Baltimore
On this 4th day of August, A.D. 2003, before the subscriber, a Notary Public of the State of Maryland, duly
commissioned and qualified, came PAUL C. ROGERS, Vice President, and T. E. SMITH, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same. and being
by me duly sworn,severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid,
and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of
the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
e.0xsOi
, ;2;;j;1--
Dennis R. Hayden Notan, Public
My Commission Expires: February I,2009
POA-F 012-3265C
• •
EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND
"Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice-President, or any of the Senior
Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee,
shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident
Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to
authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations,
policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in
the nature of mortgages,...and to affix the seal of the Company thereto."
CERTIFICATE
I. the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify
that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that
the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized
by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND.
This Power of Attorney and Certificate may he signed by facsimile under and by authority of the following resolution of the
Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on
the 10th day of May, 1990.
RESOLVED: That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically
reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or
hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall he valid and
binding upon the Company with the same force and effect as though manually affixed."
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company,
•
this day of MAY 0 u 2007
d.sstslan t Secretary
•
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
AND WAIVER OF SUBROGATION AND CONTRIBUTION
FY: 06/07 STREET SEALING PROJECT 50190
Indemnitor(s)(list all names):
PAVEMENT COATINGS CO.
To the fullest extent permitted by law, Indemnitor hereby agrees, at its sole cost and expense, to defend,
protect, indemnify, and hold harmless the City of Seal Beach and its elected officials, officers, attorneys,
agents, employees, volunteers, successors, and assigns (collectively "Indemnitees") from and against any
and all damages, costs, expenses, liabilities, claims, demands, causes of action, proceedings, expenses,
judgments, penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys,
or other.professionals and all costs associated therewith (collectively "Liabilities"), arising or claimed to
arise, directly or indirectly, out of, in connection with, resulting from, or related to any act, failure to act,
error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors,
materialmen, suppliers or their officers, agents, servants or employees, arising or claimed to arise, directly
or indirectly, out of, in connection with, resulting from, or related to the above-referenced contract,
agreement, license, or permit (the "Agreement") or the performance or failure to perform any term,
provision, covenant, or condition of the Agreement, including this indemnity provision. This indemnity
provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by
Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. This indemnity
provision shall survive the termination of the Agreement and is in addition to any other rights or remedies
which Indemnitees may have under the law. Payment is not required as a condition precedent to an
Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an
Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision.
Indemnitor shall pay Indemnitees for any attorneys fees and costs incurred in enforcing this
indemnification provision. Notwithstanding the foregoing, nothing in this instrument shall be construed to
encompass (a) Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying
Agreement is subject to Civil Code§ 2782(a)or(b)the contracting public agency's active negligence to the
limited extent that the underlying Agreement is subject to Civil Code § 2782(b). This indemnity is
effective without reference to the existence or applicability of any insurance coverages which may have
been required under the Agreement or any additional insured endorsements which may extend to
Indemnitees.Indemnitor, on behalf of itself and all parties claiming under or through it, hereby waives all
rights of subrogation and contribution against the Indemnitees, while acting within the scope of their duties,
from all claims, losses and liabilities arising out of or incident to activities or operations performed by or on
behalf of the Indemnitor regardless of any prior, concurrent, or subsequent active or passive negligence by
the Indemnitees. In the event there is more than one person or entity named in the Agreement as an
Indemnitor, then all obligations, liablilities, covenants and conditions under this instrument shall be joint
and several.
`Indemnitor"
Name PAVEMENT COATINGS CO. Name: PAVEMENT COATINGS COo
Li `
By: By: j��Y — a�<�
Its MARSHA C•• 'i:" Its MARSHA CO OE
President CFO President
• Secretary Secretary & CFO
11-8
• •
AGREEMENT TO COMPLY WITH
CALIFORNIA LABOR LAW REQUIREMENTS
[Labor Code§§ 1720, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861,3700]
The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the
Following provisions of California law:
1. Contractor acknowledges that this contract is subject to' the provisibns'of-sDivision 2, Part 7,
Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the
awarding public agency("Agency")and agrees to be bound by all the provisions thereof as though set forth
in full herein.
2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which
requires the payment of travel and subsistence payments to each worker needed to execute the work to the
extent required by law.
3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775
concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay
prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50)
for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined
by the Director of Industrial Relations for the work or craft in which the worker is employed for any public
work done under the contract by Contractor or by any subcontractor.
4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which
require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such
payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the
location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of
its subcontractors.
5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5
concerning the employment of apprentices on public works projects, and further agrees that Contractor is
responsible for compliance with Section 1777.5 by itself and all of its subcontractors.
6. Contractor agrees to comply with the provisions of California Labor Code Section 1813
concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency,
forfeit twenty-five dollars ($25) for each worker employed in the execution of the contract by the
Contractor or by any subcon-tractor for each calendar day during which such worker is required or
permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in
violation of the provisions of Division 2,Part 7, Chapter I,Article 3 of the California Labor Code.
7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to
secure the payment of compensation to its employees. In accordance with the provisions of California
Labor Code Section 1861,Contractor hereby certifies as follows:
"I am aware of the provisions of Section 3700 of the Labor Code which require every employer to
be insured against liability for worker's compensation or to undertake self-insurance in accordance with the
provisions of that code, and I will comply with such provisions before commencing the performance of the
work of this contract."
Date Signature i°,i;,r ,;
II-9
• •
STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES
CONCERNING THE CONTRACTORS' LICENSING LAWS
[Business&Professions Code §7028.15]
[Public Contract Code §20103.5]
I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the
entity on whose behalf this certification is given, hold a currently valid California contractor's license as set
forth below:
Business&Professions Code § 7028.15:
(a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage
in the business or act in the capacity of a contractor within this state without having a license therefor,
except in any of the following cases:
(I) The person is particularly exempted from this chapter.
(2) The bid is submitted on a state project governed by Section 10164 of the Public
Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public
Contract Code.
(b) If a person has been previously convicted of the offense described in this section, the
court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person
performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or
imprisonment in the county jail for not less than 10 days nor more than six months,or both.
In the event the.person performing the contracting work has agreed to furnish materials
and labor on an hourly;basis,.?t`the;price,ofthe contract" for the purposes of this subdivision means the
aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be
performed.
(c) This section shall not apply to a joint venture license, as required by Section 7029.1.
However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to
this section with respect to his or her individual licensure.
(d) This section shall not affect the right or ability of a licensed architect, land surveyor, or
registered professional engineer to form joint ventures with licensed contractors to render services within
the scope of their respective practices.
(e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a
contractor who is not licensed in accordance with this chapter shall be considered non-responsive and shall
be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency
shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly
licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of
the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a
public entity who knowingly awards a contract or issues a purchase order to a contractor who is not
licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall
be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any purchase order issued
to, a contractor who is not licensed pursuant to this chapter is void.
(f) Any compliance or noncompliance with subdivision (e) of this section, as added by
Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency
during which time that subdivision was in effect.
(g) A public employee or officer shall not be subject to a citation pursuant to this section if
the public employee, officer, or employing agency made an inquiry to the board for the purposes of
verifying the license status of any person or contractor and the board failed to respond to the inquiry within
II-10
three business days. For purposes of this section, a telephone response by the board shall be deemed
sufficient.
Public Contract Code §20103.5:
In all contracts subject to this part where federal funds are involved, no bid submitted shall be
invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However, at
the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of
this state. The first payment for work or material under any contract shall not be made unless and until the
Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board
indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or
contractor not so licensed shall be subject to all legal penalties imposed by law; including, but not limited
to, any appropriate disciplinary action by the Contractors' State License Board. The agency shall include a
statement to that effect in the standard form of prequalification questionnaire and financial statement.
Failure of the bidder to obtain proper and adequate licensing for an
award of a contract shall constitute a failure to execute the contract and
shall result in the forfeiture of the security of the bidder.
License no.: ab3fao? Class: /41 0-32_ Expiration date: ilia
Date 5 7 Signature MAK-Jot-
MARSHA C001.p6Z
President
Secretary & CFO
•
•
II-11
•
. .
• INSURANCE REQUIREMENTS FOR CITY OF SEAL BEACH
PUBLIC WORKS CONTRACT
LIABILITY INSURANCE
The Contractor shall at all times during the terms of the Contract carry, maintain, and keep in full force and
effect a policy or policies of comprehensive general liability insurance in which the City, along with its
City Council and each member thereof, and every officer, official, agent, attorney, employee or volunteer
of the City, is the named insured or is named as an additional insured with the Contractor in accordance
with Section 7-3 of the Standard Specifications. The insurance company issuing such policy(ies) must be
acceptable to, and approved by, the City Engineer and City Attorney. Contractor shall maintain limits of
no less than One Million Dollars ($1,000,000) combined single limit coverage per occurrence for personal
injury or death or property loss or damage which may arise from or relate directly or indirectly to the acts,
operations or omissions of the performance of the Contractor and/or its subcontractors and/or the
employees, agents, officers, officials or volunteers of either, in the performance of this Public Works
Contract. Such insurance shall include coverage for all automobiles utilized by Contractor's or any
subcontractor's employees or agents in the performance of the Contract. Contractor shall also provide an
endorsement in substantially the form set forth below.
ENDORSEMENT
•
IT IS HEREBY UNDERSTOOD AND AGREED THAT THE CITY OF SEAL BEACH, ITS CITY
COUNCIL AND EACH MEMBER THEREOF, AND EVERY OFFICER, OFFICIAL, AGENT,
EMPLOYEE OR VOLUNTEER OF CITY SHALL BE NAMED AS JOINTLY AND SEVERALLY
INSURED AS RESPECTS CLAIMS ARISING OUT OF THE FOLLOWING PROJECT:
FY: 06/07 STREET SEALING PROJECT 50190
IT IS FURTHER AGREED THAT THE FOLLOWING INDEMNITY AGREEMENT BETWEEN THE
CITY OF SEAL BEACH AND THE NAMED INSURED IS COVERED UNDER THE POLICY:
CONTRACTOR AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS CITY
COUNCIL AND EACH MEMBER THEREOF AND EVERY OFFICER, OFFICIAL, EMPLOYEE,
ATTORNEYS, AGENT, AND VOLUNTEER OF CITY FROM AND AGAINST ANY AND ALL
LIABILITY OR FINANCIAL LOSS RESULTING FROM ANY SUITS, CLAIMS, LOSSES OR
ACTIONS BROUGHT AGAINST, AND FROM ALL COSTS AND EXPENSES OF LITIGATION
BROUGHT AGAINST, CITY, ITS CITY COUNCIL AND ANY MEMBER THEREOF, AND ANY
OFFICER, OFFICIAL, EMPLOYEE, AGENT, ATTORNEY OR VOLUNTEER OF CITY WHICH
RESULTS, IN WHOLE OR IN PART, DIRECTLY OR INDIRECTLY, FROM ANY WRONGFUL OR
NEGLIGENT ACT OR OMISSION OF CONTRACTOR OR ANY SUBCONTRACTOR, OR AN
OFFICER,EMPLOYEE OR AGENT OF EITHER, OR ANYONE FOR WHOSE ACTS ANY OF THESE
MAY BE LIABLE, WHILE ENGAGED IN THE PERFORMANCE OF THIS CONTRACT, EXCEPT
WHERE SUCH LIABILITY OR LOSS IS SOLEY CAUSED BY THE NEGLIGENCE OR WILLFUL
MISCONDUCT OF THE CITY.
THE INSURANCE COVERAGE SHALL APPLY SEPARATELY TO EACH INSURED AGAINST
WHOM A CLAIM IS MADE OR SUIT IS BROUGHT, EXCEPT THAT THE INCLUSION OF MORE
THAN ONE INSURED SHALL NOT OPERATE TO INCREASE THE LIMITS OF THE COMPANY'S
LIABILITY.
THE INSURANCE COVERAGE SHALL NOT BE SUSPENDED, VOIDED, CANCELED, REDUCED
IN COVERAGE OR IN LIMITS, OR OTHERWISE MATERIALLY CHANGED, UNLESS THIRTY(30)
DAYS ADVANCE WRITTEN NOTICE BY CERTIFIED MAIL/RETURN RECEIPT REQUESTED
HAS BEEN GIVEN TO THE CITY.
THE INSURANCE COVERAGE PROVIDED BY CONTRACTOR AS SET FORTH HEREIN SHALL
BE PRIMARY INSURANCE WITH RESPECT TO THE CITY, ITS CITY COUNCIL AND ANY
MEMBER THEREOF, AND ITS OFFICERS, OFFICIALS, ATTORNEYS, AGENTS, EMPLOYEES
I1-12
AND VOLUNTEERS. ANY INSURANCE OR SELF-INSURANCE MAINTAINED BY THE CITY,ITS
CITY COUNCIL OR ANY MEMBER THEREOF, OR ITS OFFICERS, OFFICIALS, ATTORNEYS,
AGENTS, EMPLOYEES AND VOLUNTEERS SHALL BE IN EXCESS OF THE CONTRACTOR'S
INSURANCE AND SHALL NOT CONTRIBUTE WITH IT. INSURER WAIVES ANY RIGHT OF
CONTRIBUTION WITH SUCH OTHER INSURANCE WHICH MAY BE AVAILABLE TO THE CITY.
INSURER WAIVES ALL RIGHTS OF SUBROGATION FOR LOSSES AGAINST THE CITY, ITS
CITY COUNCIL OR ANY MEMBER THEREOF OR ITS OFFICERS, OFFICIALS, AGENTS,
EMPLOYEES AND VOLUNTEER
II-13
• •
• Page Intentionally Left Blank
II-I4
NCd $7 •
•
WORKER'S COMPENSATION
CERTIFICATE OF INSURANCE
WHEREAS,the CITY OF SEAL BEACH has required certain insurance to be provided by
NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy
or policies described below to the following named insureds and that the same are in force at this time.
1. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL
BEACH, CA 90740-6379.
2. The insureds under such policy or policies are:
3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of
California covering all operations of the named insureds, as follows:
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability,
unless and until thirty days' advance written notice thereof has been served upon the City Clerk of the
CITY OF SEAL BEACH.
By:
Its Authorized Representative
•
II-15
•
• WORKER'S COMPENSATION •
CERTIFICATE OF INSURANCE
WHEREAS,the CITY OF SEAL BEACH has required certain insurance to be provided by
PAVEMENT COATINGS COMPANY , p,0, BOX 1491 , CYPRESS, CA 90630
NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy
or policies described below to the following named insureds and that the same are in force at this time.
I- This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL
BEACH, CA 90740-6379.
2. The insureds under such policy or policies are: PAVF,URNT COATTNGS COMPANY •
3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissionerof
California covering all operations of the named insureds,as follows:
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
46-8637 1 /1407 1 /1 /08 _
4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability,
unless and until thirty days' advance written notice thereof has been served upon the City Cleric of the
CITY OF SEAL BEACH. - /
By: —�7!'L_-. t,�i%� r L-_�-
Its`/C• .orized Representativ6 \/
CALIFORNIA STATE COMPENSATION
INSURANCE FUND
I.I-15
• •
ADDITIONAL INSURED ENDORSEMENT
• COMPREHENSIVE GENERAL LIABILITY
PAVEMENT COATINGS COMPANY P o- 1:10X 1491 CYPRESS CA 91163
Name and address of named insured("Named insured".):
TfITRWSTATR FTRF AN11 CASTJAT.TY COMP'Iv, 1551 N.TUSTIN n rl -.SANTA ANA,CA
Name and address of Insurance Company("Company"):
FY: 06/07 STREET SEALING PROJECT 50I90
Notwithstanding any inconsistent statement in the policy CO which this endorsement is attached
(the`Policy')or in any endorsement now or hereafter attached thereto,it is agreed as follows:
I. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are
additional insureds (the above named additional insureds are hereafter referred to as the "Additional
Insureds") under the Policy in relation to those activities described generally above with regard to
operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability
for the payment of any premiums or assessments under the Policy.
2. The insurance coverages afforded the Additional insureds under the Policy shall be primary insurance,
and no other insurance maintained by the Additional insureds shall be called upon to contribute with
the insurance coverages provided by the Policy.
3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against
whom claim is made or suit is brought except with respect to the limits of the Company's liability.
4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured
under the policy against another insured under the policy_ All such claims shall covered as third-party
claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing
contained in this provision shall operate to increase or replicate the Company's limits of liability as
provided under the policy.
5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms,
conditions and exclusions applicable to such insurance) includes liability assumed by the Named
Insured under the indemnification and/or hold harmless provision(s) contained in or executed in
conjunction with the written agreements) or permit(s) designated above,between the Named Insured
and the Additional Insureds.
6. The policy to which this endorsement is attached shall not be subject to cancellation, change in
coverage, reduction of limits (except as the result of the payment of claims);or non-renewal except
after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty
(30) days prior to the effective date thereof. In the event of Company's failure to comply with this
notice provision, the policy as initially drafted will continue in full force and effect until compliance
with this notice requirement.
7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,
while acting within the scope of their duties, from all claims, losses and liabilities arising out of or
incident to the perils insured against in relation to those activities described generally above with
regard to operations performed by or on behalf of the Named Insured regardless of any prior,
concurrent,or subsequent active or passive negligence by the Additional Insureds.
8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity,
construction, interpretation,and enforcement of this contract of insurance.
9. This endorsement and all notices given hereunder shall be sent to Public Agency at:
Director of Public Works
City of Seal Beach
211 Sth Street
Seal Beach CA 90740
•
II-I6
•
• •
10. Except as stated above and not to conflict with this endorsement, nothing contained herein shall be
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this
endorsement is attached.
TYPE OF COVERAGES TO WHICH POLICY PERIOD
THIS ENDORSEMENT ATTACHES FROM/TO LIMITS OF
GENERAL LIABILITY LIABILITY
I L Scheduled items or locations arc to b eidrn�ed on an attached sheet, $e ,000,000 l g i
relate to the above coverages. Includes: The following inclusions
IR Contractual Liability
E Owners/Landlords/Tenants Explosion Hazard
Manufacturers/Contractors Collapse Hazard
of Products/Completed Operations i
U Undergo La Property Damage
1 Broad Form Property Damage ❑ Pollution Lability• ❑ Liquor Liability
❑ Extended Bodily Injury
❑
IR Broad Form Comprehensive
❑ General Liability Endorsement 0
❑
12. A gl-deducti ble or ❑ self-insured retention (check one) of $
applies to all coverage(s)except A. •al 0
(if none, so state). The deductible is applicable g per claim or ❑per occurrence (check
one)_
13. This is ao} oceun•enee or 0 claims made policy(check one).
14. This endorsement is effective on_g/2 7�0 -
of Policy Number at 12:01 A.M.and forms a pan
R67.tR00306
1,
declare under penalty of perjury under the laws of the State of California, (Print name), hereby that have the the Company to this endorsement and that by my execution hereof, I do so bind the Company. - bind
Executed
- j•
—Signature of Authorized-Representative //
•
t%
(Original signature only; no facsint-ile signature or initialed signature
accepted)
Phone No: (71 4 )
—138=922S�y.
II-17
• •
ADDITIONAL INSURED ENDORSEMENT
AUTOMOBILE LIABILITY
PAVEMENT COATINGS COMPANY, P.O. BOX 1491 , CYPRESS, CA 90630
Name and address of named insured("Named Insured"):
FMC INSUPANf E COMPANY—,--23382 0 MILL CREEK DR-. , CA
Name and address of Insurance Company(' ompany"):
FY:06/07 STREET SEALING PROJECT 50190
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached
(the'Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows:
The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are
additional insureds (the above named additional insureds are hereafter referred to as the `Additional
Insureds") under the Policy in relation to those activities described generally above with regard to
operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for
the payment of any premiums or assessments under the Policy.
1. The insurance coverages afforded the Additional insureds under the Policy shall be primary insurance,
and no other insurance maintained by the Additional Insureds shall be called upon to contribute with
the insurance coverages provided by the Policy.
2. Each insurance coverage under the Policy shall apply separately to each Additional Insured against
whom claim is made or suit is brought except with respect to the limits of the Company's liability.
3. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured
under the policy against another insured under the policy. All such claims shall covered as third-party
claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing
contained in this provision shall operate to increase or replicate the Company's limits of liability as
provided under the policy.
4. The insurance afforded by the Policy for contractual liability insurance (subject to the terms,
conditions and exclusions applicable to such insurance) includes liability assumed by the Named
insured under the indemnification and/or hold harmless provision(s) contained or executed in
conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured
and the Additional Insureds.
5. The policy to which this endorsement is attached shall not be subject to cancellation, change in
coverage,reduction of limits (except as the result of the payment of claims), or non-renewal except
after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty
(30) days prior to the effective date thereto. In the event of Company's failure to comply with this
notice provision, the policy as initially drafted will continue in full force and effect until compliance
with this notice requirement
6. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,
while acting within the scope of their duties, from all claims, losses and liabilities arising out of or
incident to the perils insured against in relation to those activities described generally above with
regard to operations performed by or on behalf of the Named Insured regardless of any prior,
concurrent,m subsequent active or passive negligence by the Additional Insureds.
it is hereby agreed that the laws of the State of California shall apply to and govern the validity,
construction,interpretation,and enforcement of this contract of insurance.
This endorsement and all notices given hereunder shall be sent to Public Agency at:
Director of Public Works
City of Seal Beach
211 8th Street
Seal Beath CA 90740
zI-Is
• •
7. Except as stated above and not in conflict with this endorsement, nothing contained
' herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to
which this endorsement is attached.
TYPE OF COVERAGES TO WHICH _ • POLICY PERIOD
LIMITS OF $1 , 000, 000 •
THIS ENDORSEMENT ATTACHES PROW TO
AUTO LIABILITY
10/1 /06-07
Scheduled items or locations are to be identified on an attached sheet. The following inclusions
relate to the above coverages. Includes:
ki Any Automobiles ❑ Truckers Coverage
❑ All Owned Automobiles _ ❑ Motor Carrier Act
❑ Non-owned Automobiles ❑ Bus Regulatory Reform Act
❑ Hired Automobiles ❑ Public Livery Coverage
o Scheduled Automobiles ❑
❑ : -Le Co - ..
11. A%deductible or ❑ self-insured retention(check one) of$ I poc• pi;b. applies to all
coverage(s)except. NcbJ€.
(if none,so state). The deductible is applicable g per claim or❑per occurrence(cheek one)_
12. This is an occurrence or ❑claims made policy(check one).
13. This endorsement is effective on 4/27/07 at 12:01 A.M. and forms a part of
Policy Number OX-81 5 8 8 0 7 •
I, THOMAS F. SHIPKEY (print name),
hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to
bind the Company to this endorsement and that by my execution hereof,I do so bind the Company.
Executed APRIL 27 ,20 07
Signature Authorized �?c.7 2„ [ k
of Representatives / tom= /// \iy
(Original signature only; no facsimile signature or initialed signature
accepted)
PhoneNo.: ( 714) 838-9225
II-19
r •
ADDTIIONAL INSURED ENDORSEMENT
EXCESS LIABILITY
PAVEMENT COATINGS COMPANY, P.O. BOX 1491 , CYPRESS, CA 90630
Name and address of named insured("Named Insured"):
TAMPq INSURANCE co , .Z1 1'30- T,FM FOR PCP .FIR CTF.
Name and address of Insurance Company("Company"): e RICHMOND, VA
FY: 06/07 STREET SEALING PROJECT 50190
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached
(the"Policy')or in any endorsement now or hereafter attached thereto,it is agreed as follows:
I• The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and
volunteers are additional insureds (the above named additional insureds arc hereafter referred to as the
"Additional Insureds")under the Policy in relation to those activities described generally above with regard
to operations performed by or on behalf of the Named Insured, The Additional Insureds have no liability
for the payment of any premiums or assessments under the Policy.
2. The insurance coverages afforded the Additional Insureds under the Policy shall be
primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to
contribute with the insurance coverages provided by the Policy.
3•. Each insurance coverage under the Policy shall apply separately to each Additional
Insured against whom claim is made or suit is brought except with respect to the limits of the Company's
liability
4- Nothing in this contract of insurance shall be construed to preclude coverage of a claim
by one insured under the policy against another insured under the policy All such claims shall covered as
third-party claims,i.e.,in the same manner as if separate policies had been issued to each insured. Nothing
contained in this provision shall operate to increase or replicate the Company's limits of liability as
provided under the policy.
5. The insurance afforded by the Policy for contractual liability insurance (subject to the
terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named
- Insured under the indemnifica-lion and/or hold harmless provision(s) contained in or executed in
conjunction with the written agreements) or permit(s)designated above., between the Named Insured and
the Additional Insureds,
6. The policy to which this endorsement is attached shall not be subject to cancellation,
change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal
except after written notice to Public Agency, by certified mail,return receipt requested,not less than thirty
(30) days prior to the effective date thereto. In the event of Company's failure to comply with this notice
provision, the policy as initially drafted will continue in full force and effect until compliance with this
notice requirement.
7. Company hereby waives all rights of subrogation and contribution against the Additional
Insureds,while acting within the scope of their duties,from all claims, losses and liabilities arising out of or
incident to the perils insured against in relation to those activities described generally above with regard to
operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or
subsequent active or passive negligence by the Additional Insureds.
It is hereby agreed that the laws ol'the State of California shall apply to and govern the
validity,construction, interpretation,and enforcement of this contract of insurance.
II-20
•
r 9- This endorsement and di notices given hereunder shall be sent to Public Agency at:
Director of Public Works
City of Seal Beach
211 8th Street
Seal Beach CA 90740
10. Except as stated above and not in conflict with this endorsement, nothing contained
herein shall be held to waive, alter or extend any of the Iimits, agreements, or exclusions
of the policy to which this endorsement is attached.
TYPE OF COVERAGES TO WHICH POLICY PERIOD
L..MITSOP $1 000, 000
THIS ENDORSEMENT ATTACHES • FROM/I'0
EXCESS LIABILITY
0 Following Form 10/1 /06-07
D Umbrella Liability
9 EXCESS LIABILITY
10. Applicable underlying coverages:
INSURANCE COMPANY INTERSTATE FIRE POLICY NO.
AMOUNT SGL100306
$1 , 000,000 / $2,000,000 AGGREGATE
EMC INSURANCE CO. $1 ,000,000 CSL POLICY NO. OX81588-07
11. The following inclusions, exclusions,extensions or specific provisions relate to the above
coverages:
12. A O deductible or D self-insured retention(check one)of$
applies to all coverage(s) except:
(if none,so state). The deductible is applicable [7 per claim or O per occurrence(cheek one).
13. This is an jgl occurrence or D claims made policy(check one).
14. This endorsement is effective on 4/27/0 7 at 12:01 A.M. and forms a
part of Policy Number 0 0 018979
I _ T1jMA8 F. SHTPKEY (print name), hereby declare
under penalty of perjury under the laws of the State of California, that I have the authority to bind the
Company to this endorsement and that by my execution hereof,I dose bind the Company.
Executed APRIL 27 ,20 07
SignattueofAuthorized-Representative 2 ,
(Original signature only; no facsim-ile signature or initialed signature
accepted)
Phone No.: ( 714) 83a-9225
II.-21