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HomeMy WebLinkAboutAGMT - RJ Noble Company (Westminster Bike Lane and Resurfacting Project) C RECORDING REQUESTED BY I Recorded in official Records, orange County ` Hu tN Clerk-Recorder AND WHEN RECORDED MAIL TQ lIIIIIIIIIIIIIIIIIIliIIIIIIII 111111111 NO FEE III!VIII III , * $ R 0 0 0 7 b 3 8 4 6 1 $ CITY OF SEAL BEACH I 2015000334160.10:.06 am 46/26115 Attn: City Clerk j 65 414 N92 7 211 -8th Street I 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 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: 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 April 23; 2015. The work was Westminster Avenue Bicycle Lane and Resurfacing lmproVements Project CIP No. ST1409. 6.' Th name,of the contractors); if any, for such improvement was: R.J. Noble Comtrany. The date of the Contract Award was December 8 2014. 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: Westminster Avenue. City of Seal Beach. Date: ! / irector of Public Works, City of Se each Signature of owner or corporate off' er of owner — — - ----named-in-paragraph.2 or agent. VERIFICATION 1, the undersigned, say: the Director of Public Works declarant of the foregoing 'notice of completion; have read said notice of completion and know the contents thereof; the same is true of my own knowledge. I declare under/penalty of perjury the foregoing is true and correct. Executed on �f` 2015, at Seal Beach, Ca Date of Signature) Director of Public Works, City of Val Beach i PUBLIC WORKS AGREEMENT FOR WESTMINSTER AVENUE BICYCLE LANE AND RESURFACING IMPROVEMENTS PROJECT CIP NO. ST1409 FEDERAL PROJECT NO. CML 5229 (015) between \�oePO&4 41,t *s `zJ yy�F Rno.\.s _- •''&,JUNTY,!'- City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 R.J. Noble Company 15505 E. Lincoln Avenue Orange, CA 92865 (714) 637-1550 (714) 637-6321 - FAX THIS AGREEMENT is made as of December 8, 2014 by and between the City of Seal Beach, a California charter city ("City"), and R.J. Noble Company, a General Contractor ("Contractor"). 1 of 9 RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the Westminster Avenue Bicycle Lane and Resurfacing Improvements Project CIP No. ST1409, Federal Proiect No. CML 5229 (015) ("Project") with respect to design criteria; and B. WHEREAS, Contractor has submitted a bid to City for the Project dated November 13, 2014 in the amount of $1,462,242.50 ("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 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 December 8, 2014 (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 $1,462,242.50, 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. The City Manger may authorize extra work to fund unforeseen conditions up to the amount approved at the time of award by the City Council. Payment for additional work in excess of this amount requires prior City Council authorization. 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 3 of 9 ■\ 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 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 4 of 9 the deposit with City, of any insurance policy or certificate required pursuant to this Agreement. 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). 5 of 9 6.2.4 Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 6.3 M inimum Limits of Insurance. Contractor shall maintain limits no less than: 6.3.1 General Liability: $2,000,000 per occurrence and in the aggregate for bodily injury, personal injury and property damage. Commercial General Liability Insurance or other form with a general aggregate limit shall apply separately to this Agreement or the general limit shall be twice the required occurrence limit. 6.3.2 Automobile Liability: $2,000,000 per occurrence for bodily injury and property damage. 6.3.3 Employer's Liability: $1,000,000 per occurrence and in the aggregate for bodily injury or disease and Workers' Compensation Insurance in the amount required by law. 6.4 Deductibles and Self-Insured Retentions. Contractor shall inform City of any deductibles or self-insured retentions except with respect to any professional liability insurance. 6.5 Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: 6.5.1 City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor; products and completed operations of Contractor; premises owned, occupied or used by Contractor; or automobiles owned, leased, hired or borrowed by Contractor. The coverage shall contain no limitations on the scope of protection afforded to City, its officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials which are not also limitations applicable to the named insured. 6.5.2 For any claims related to this Agreement, Contractor's insurance coverage shall be primary insurance as respects City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials. Any insurance or self-insurance maintained by City, their officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials shall be excess of Contractor's insurance and shall not contribute with it. 6.5.3 Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. 6 of 9 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 effecting the coverage required by these specifications. 7. Liquidated Damages. Should the Contractor fail to complete the project, or any part thereof, in the time agreed upon in the Contract, the Contractor shall reimburse the City for the additional expense and damage for each calendar day that the Contract remains uncompleted after the Contract completion date. It is agreed that the amount of such additional expense and damage incurred by reason of failure to complete the Contract is the per diem rate of $750.00 per calendar day. Such amount is hereby agreed upon as liquidated damages for the loss to the City resulting from the failure of the Contractor to complete the project within the allotted time and to the value of the operation of the works dependent thereon. It is expressly understood and agreed that this amount is a reasonable amount and is established in lieu of damages that are incapable of calculation at the inception hereof; and this amount is not to be considered in the nature of a penalty. The City shall have the right to deduct such damages from any amount due, or that may become due to the Contractor, or the amount of such damages shall be due and collectible from the Contractor or the Contractor's Surety. Progress payments made after the scheduled completion date shall not constitute a waiver of liquidated damages. 8. Suspension. City may, in writing, order Contractor to suspend all or any part of the Contractor's Services for the convenience of City or for work stoppages beyond the control of City or Contractor. A suspension of the Services does not void this Agreement. 9. Notices. Any notices, bills, invoices, or reports authorized or required by this Agreement shall be in writing and shall be deemed received on (a) the day of delivery if delivered by hand or overnight courier service during Contractor's and City's 7 of 9 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: Director of Public Works City of Seal Beach 211-8th Street Seal Beach, California 90740 If to Contractor: R.J. Noble Company 15505 E. Lincoln Avenue Orange, CA 92865 Telephone: (714) 637-1550 Fax: (714) 637-6321 Attn: Michael J. Carver 10. Non-Assignability; Subcontracting. Contractor shall not assign, transfer, or subcontract any interest in this Agreement or the performance of any of Contractor's obligations hereunder. Any attempt by Contractor to so assign, transfer, or subcontract any rights, duties, or obligations arising hereunder shall be null, void and of no effect. 11. Compliance with Laws. Contractor shall comply with all applicable federal, state and local laws, ordinances, codes and regulations in force at the time Contractor performs the Services. 12. Non-Waiver of Terms, Rights and Remedies. Waiver by either party of any one or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement. In no event shall the making by City of any payment to Contractor constitute or be construed as a waiver by City of any breach of covenant, or any default which may then exist on the part of Contractor, and the making of any such payment by City shall in no way impair or prejudice any right or remedy available to City with regard to such breach or default. 13. Attorneys' Fees. In the event that either party to this Agreement shall commence any legal action or proceeding to enforce or interpret the provisions of this Agreement, the prevailing party in such action or proceeding shall be entitled to recover its costs of suit, including all attorneys' fees incurred in connection therewith. 8 of 9 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: R,i. NOBLE COMPANY INK Air By: #a. , /A/. . By: X _ ./ Ilt�ot■ CI R. Ingram, City ager Name: CRAIG PORTE' -Attest: By By. Title: VICE PRESIDENT Linda Devine, City Clerk By: X u Name: STEVE NDOZA Approved as to Fors . Title: SECRETARY By: _ Ste' L. Flowe , City Attorney 9 of 9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 rcam c .cur.,�n.Ma - W.4 %Z-ea".,.M.n-,br XiCcrM..“c.-c.< ;M,itt5r.,)." State of California ?' County of Orange On 11/25/14 before me, J. Delongh, Notary Public q Itz Dale Here heart Name and Title of the Officer •bi personally appeared CRAIG PORTER g:, Name(s)of Signaes) 6 L)�,•{ who proved to me on the basis of satisfactory �,,evidence to be the person14 whose name(aj'is/are subscribed to the within instrument and acknowledged 1 to me that he/a4zoolitInw executed the same in n J. DEIONGH hisAirenWneiir authorized capacity0si and that by Commission # 19546to his/her/their signature(8f on the instrument the a a `'7 Notary Public - California z person(gf or the entity upon behalf of which the '�I li Orange County ' person acted, executed the instrument. fi y My Comm. Expires Oct 282015 `L _ -- » _ _ . » Expires_ . _ _ - »� I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Viii k WITNESS mD7r1 seal. IS a gi X nl f�, Signature: iiI Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is riot required by law. it may prove valuable to persons relying on the document Lip and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document fi Title or Type of Document: Document Date: 1 Number of Pages: - Tl S, Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: fi ❑ Corporate Officer — Title(s): l-1 Corporate Officer — Titie(s) ; ❑ Individual 'RIGHT-THUMBPRINT' ❑ Individual '-j OFHUMBRRINr, el c -`OF.SIGNER. �, �e'.OF SIGNER s ❑ Partner —❑Limited 0 General Top of thumb here Cl Partner — ❑ Limited El General Too of thumb here 4 ❑ Attorney in Fact El Attorney in Fact yy),, li-` ❑ Trustee 0 Trustee ❑ Guardian or Conservator ❑Guardian or Conservator }6, ❑ Other ❑Other: '3i Signer Is Representing: Signer Is Representing: __ _ §' 021Niioa INsia •N at iooaieotercBOO-USNherARY l-l300- 766827f tm# 9 (02010 National Notary Association�NetlonalNOta y.ary•1-BOO-US NOTARY(1 tlU0 676 6aD) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 u:m,�r �.nzrrn�rK V.;acrrem r.aSr-.�,- Oin c;aeg(i :ta -.cegcSC ttr. r.Tage:O=-�s-ezi:aemr,_^; State of California • Sr FCou my of Orange x' fi 54 On 11/25/14 before me, J.Delongh,Notary Public f" Date Here Insert Name and Title of the Officer fi personally appeared Steve Mendoza Namefs)of Signer(s) fg who proved to me on the basis of satisfactory 77g evidence to be the person(Bf whose name(sj'is/are 4 6 subscribed to the within instrument and acknowledged to me that he/spa* executed the same in n J. DEIONGH hisAtentreir authorized capacity and that by Commission # 1954670 his/her/their signature( on the instrument the >)I • i ::,1'11,i'?'-‘),:4.2); Notary Public - California ? person((sj or the entity upon behalf of which the q a :9 M orange county personcol acted, executed the instrument. 9 f y Comm. Expires Oct 28,2015 l'l' SL, I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing ' paragraph is true and correct. g a ig fiWITNESS m nd6ficial seal. fi Q fi Signature: i rcie rff, Place Notary Seal Above Signature of Notary Public OPTIONAL ZI :„. Though the information below is not required by law, it may prove valuable to persons relying on the document f and could prevent fraudulent removal and reattachment of this form to another document. ' Description of Attached Document z elf Title or Type of Document: I 1. Document Date: Number of Pages: Yi Signer(s)Other Than Named Above: iC Capacity(ies) Claimed by Signer(s) il Signer's Name: Signer's Name: p, ❑ Corporate Officer —Title(s): ❑Corporate Officer — Titie(s) ,4 ❑ Individual -RIGHr.rnumssRM1" gI OF.SIGNER K LJ Individual RIGHr THUMBPRINT:' ❑ Partner —Cl Limited ❑General ._ O of thumb hare :7 Ariorney in Fact ❑Attorney in Fact x li riff ❑ Trustee ❑Trustee i K t' ❑ Guardian or Conservator 1 ❑Guardian or Conservator .4 ❑ Other: ❑Other: i fi Signer Is Representing: Signer Is Representing: fi - - I I elq ©201 0 Nscoe ai Notary Association•HabonarvlN ota y org•1-s 0D-us N O TA RY(1 800 800-0]8-602]) i'%lSC:G^Pwy'LC'x%<'e%4"4'wo�c'CSr- Item 75907 EXHIBIT A FAITHFUL PERFORMANCE BOND EXHIBIT B PAYMENT BOND EXHIBIT C WORKERS' COMPENSATION INSURANCE CERTIFICATE EXHIBIT D-1 ADDITIONAL INSURED ENDORSEMENT (COMMERCIAL GENERAL LIABILITY) EXHIBIT D-2 ADDITIONAL INSURED ENDORSEMENT (AUTOMOBILE LIABILITY) EXHIBIT D-3 ADDITIONAL INSURED ENDORSEMENT EXHIBIT E ACKNOWLEDGMENT OF PENAL AND CIVIL PENALTIES CONCERNING CONTRACTOR LICENSING LAWS EXHIBIT F LABOR LAW REQUIREMENTS EXHIBIT G ACCEPTED PROPOSAL (NOTE: Exhibits will not be included with the contract at the time of award. The Contractor shall have 10 working days to submit all exhibits to the City after the award of contract. Failure to do so will result in voiding of the contract. The City will then have the right to cash the bid bond for the project and re- advertise for construction or award to the next lowest responsive bidder.) AC R CERTIFICATE OF LIABILITY INSURANCE DATE(MM DD YYYY) • ‘..--/ 12/15/2014_ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed: It 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 Patriot Risk & Insurance Services CONTACT 8105 Irvine Center Drive#400 PHONE FAX Irvine, CA 92616 -E-MALP.EX1 (949)486-7900 (ac,No): (949)486-7950 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC t/ Www.patrisk.com 0G55454 INSURER A: Zurich American Insurance Company 16535 INSURED INSURER e: American Guarantee and Liability Insurance Company 26247 R. J. Noble Company, Inc. 15505 Lincoln Avenue INSURER C: P.O. Box 620 INSURER D: Orange CA 92856-9020 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 22663462 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 I TYPE OF INSURANCE IADDL SUBR POLICY EFF I POLICY EXP LIMITS LTR INSD WVD POUCY NUMBER IMM/DOIYYYY) IMMIDDIYYYYf A I i COMMERCIAL GENERAL LIABILITY 7 ,7 GL0017436600 7/1/2014 7/1/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ✓ OCCUR PREMISES(Ea ocw ence) $ 300,000 MED EXP(Any one person) $ 5,000 ✓ Contractual Liability PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 4 2,000,000 ■ POLICY ✓ I Tai I LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BAP017436700 7/1/2014 7/1/2015 COMBINED SINGLE LIMIT 5 I✓ ✓ (Ea accident) BODILY INJURY(Per person) $ 1,000,000 ✓ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ — B UMBRELLA LIAB ✓ OCCUR AUC017437200 7/1/2014 7/1/2015 EACH OCCURRENCE $ 10,000,000 ✓ EXCESS LIAR CLAIMS-MADE Policy Follows Form Over AGGREGATE $ 10,000,000 DED RETENTION$ Underlying General Liab. $ — A WORKERS COMPENSATION ✓ WC017436300 7/1/2014 7/1/2015 ✓ STATUTE I I ORH I AND EMPLOYERS'LIABILITY Y I N No Deductible for Workers ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED' NIA Compensation — (Mandatory inNH) EL.DISEASE-EAEMPLOVE $ 1,000,000 It ee.deac1he untler (DESCRIPTION OF OPERATIONS below I EL.pISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Re: RJN#91490/Westminster Avenue Bicycle Lane&Resurfacing Improvements/Project No.ST1409 The City of Seal Beach,and its agents,representatives,employees,subcontractors and The City of Westminster are named as Additional Insured, includes Primary&Non-Contributory and as respects to General and Auto Liability per endorsements attached where required by written contract. Waiver of Subrogation applies to General Liability,Auto Liability and Workers'Compensation and in favor of Additional Insureds per the per attached endorsements. 30-days notice of cancellation, 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION City of Seal Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Office of the City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. 211 8th Street Seal Beach CA 90740 AUTHORIZED REPRESENTATIVE .wit �'`` n..a'.c --<. /t4rr�e--'--eT I Leonard E.Ziminsky ✓ "`///} ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CZET NC.: 2166 462 A nette Romero 12/15/2014 8,2e:16 AN (PST( . Page 1 of to This certi icate cancels and supersedes ALL previously issued certificates. Additional Insured —Automatic — Owners, Lessees Or ZURICH Contractors Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer No. Add'I.Pram Return Prem. GL0017436600 7/1/2014 7/1/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named InsuredR J.Noble Company, Inc. Address (including ZIP Code): 15505 Lincoln Avenue Orange CA 92856-9020 • This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II—Who Is An Insured is amended to include as an insured any person or organization who you are required to add as an additional insured on this policy under a written contract or written agreement. However, if you have entered into a construction contract or construction agreement with an additional insured person or organization, the insurance afforded to such additional insured only applies to the extent permitted by law. B. The insurance provided to the additional insured person or organization applies only to "bodily injury", "property damage" or"personal and advertising injury" covered under Section I— Coverage A— Bodily Injury And Property Damage Liability and Section I—Coverage B—Personal And Advertising Injury Liability, but only with respect to liability for"bodily injury", "property damage"or"personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, and resulting directly from your ongoing operations or"your work" as included in the"products-completed operations hazard", which is the subject of the written contract or written agreement. C. However, regardless of the provisions of Paragraphs A. and B.above: 1. We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contract or written agreement. D. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", "property damage" or"personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection,architectural or engineering activities. U-GL-1175-E CW(04/12) Page 1 of 2 CER'y' mo.: 22 63862 A,�ezze "�mer" zzii9rgu4RS, yAgL ed, gle of 1ppul7nee Services Office,Inc.,with its permission. This certificate cancels and supersedes ALL previously issued certificates. E. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an"occurrence"or offense that may result in a claim; 2. We receive written notice of a claim or"suit"as soon as practicable; and 3. A request for defense and indemnity of the claim or"suit' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. F. For the coverage provided by this endorsement: 1. The following paragraph is added to Paragraph 4.a. of the Other Insurance Condition of Section IV—Commercial General Liability Conditions: This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and non-contributory with respect to any other policy upon which the additional insured is a Named Insured. In that event, we will not seek contribution from any other such insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. 2. The following paragraph is added to Paragraph 4.b.of the Other Insurance Condition of Section IV—Commercial General Liability Conditions: This insurance is excess over. Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same"occurrence", offense, claim or"suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. G. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. All other terms and conditions of this policy remain unchanged. U-GL-1175-E CW(04/12) Page 2 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CENT NO.: 22563462 Anne¢e Romero 12/15/2014 8:28:]6 AM (PSTI Page 3 of 10 This certificate cancels and supersedes ALL previously issued certificates. R. J. Noble Company, Inc. POLICY NUMBER:GLO017436600 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ c?a7 NC.: 221,63462 Anne:te aosero 12/1s/2014 6:28:16 AM (esr) eaye 9 of ID Tries certificate cancels and supersedes ALL previously issued certificates. R.J.Noble Company, Inc. 0 Coverage Extension Endorsement ZURICH Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer No. Addl.Prem Return Prem. BAP017436700 7/1/2014 7/1/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II—Liability Coverage: The following are also"insureds": a. Any "employee" of yours is an"insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an"auto"referenced in Paragraphs a.and b. above. d. Any person(s) or organization(s) where required by written contract or written agreement executed prior to any"accident"provided the"accident"arises out of operations contemplated by such contract or agreement. 2. The following is added to the Other Insurance Provision in the Conditions Section: Coverage for any person(s) or organization(s) where required by written contract or written agreement executed prior to any"accident"will apply on a primary basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the coverage form. B. Amendment—Supplementary Payments Paragraphs a.(2) and a.(4)of the Coverage Extensions Provision in Section II—Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds(including bonds for related traffic law violations) required because of an "accident"we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the"insured"at our request, including actual loss of earnings up to$500 a day because of time off from work. C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II—Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section II—Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. U-CA-424E CW(0411) Page 1 of 5 c=.ZS YO.: 22¢6 462 n""ette Romez" 12,lSudes y led materia+c.f InauranceeServicesfofficet Inc..with its permission. This certificate cancels and superse a previous y issue cer i ica As. 2. The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV — Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total"loss"to a covered"auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. Any amount paid under the Physical Damage Coverage Section of the coverage form; and b. Any: (1) Overdue lease or loan payments at the time of the"loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans. F. Towing and Labor The following is added to Paragraph A.2.of the Physical Damage Coverage Section: We will pay up to$75 for towing and labor costs incurred each time a covered "auto"of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: If glass must be replaced, the deductible will be $100 or the deductible shown in the Declarations, whichever is less. If glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage—Increased Loss of Use Expenses The Loss Of Use Expenses Provision of the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered"auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is$100 per day, to a maximum of$3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to$750 for"loss"to personal effects which are: (1) Personal property owned by an"insured"; and U-CA-424-E CW(04-11) Page 2 of 5 cexr NO.: 22G63p62 Annette Romeo 12��i�eLcopy t�temlrnater�a4gf'n$srancce Services CHice,Inc,with its permission. This certrfrcate cancels and supersede$ L previous y rssue cert rf icates. (2) In or on a covered"auto". b. Subject to Paragraph a.above, the amount to be paid for"loss"to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records,discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same"loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph B.4.a. of Section III —Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.2.c. of Section IV— Physical Damage Coverage in the Motor Carrier Coverage Form do not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for"loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an"insured"; and (b) Are in a covered"auto"at the time of"loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such"loss". K. Airbag Coverage The Exclusion in Paragraph B.3.a.of Section III—Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.4.a. of Section IV— Physical Damage Coverage in the Motor Carrier Coverage Form do not apply to the accidental discharge of an airbag. L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or coverage form and by another policy or coverage form issued to you by us,the following applies for each covered "auto"on a per vehicle basis: 1, If the deductible on this policy or coverage form is the smaller(or smallest)deductible, it will be waived; or 2. If the deductible on this policy or coverage form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller(or smallest)deductible. M. Physical Damage—Comprehensive Coverage—Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos"damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all"loss"from any one cause is$5,000. u-CA-424-E CW(04-11) Page 3 of 5 CENT No.: 22661462 Annette Romero 126u persscopyr ightetl;meteriaLOHnsurance Services Office,Inc.,with Its permission. This certificate cancels and supersedes ALL previously issued certificates. N. Temporary Substitute Autos—Physical Damage 1. The following is added to Section I—Covered Autos: Temporary Substitute Autos—Physical Damage If Physical Damage Coverage is provided by this coverage form on your owned covered "autos", the following types of vehicles are also covered"autos"for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto"you do own but is out of service because of its: 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss"; or 5. Destruction. 2. The following is added to the Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos—Physical Damage We will pay the owner for"loss"to the temporary substitute"auto" unless the"loss"results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties In The Event Of Accident,Claim,Suit Or Loss Paragraph a.of the Duties In The Event Of Accident,Claim, Suit Or Loss Condition is replaced by the following: a. In the event of"accident', claim, "suit"or"loss", you must give us or our authorized representative prompt notice of the"accident', claim, "suit'or"loss". However, these duties only apply when the"accident", claim, "suit"or "loss"is known to you(if you are an individual), a partner(if you are a partnership), a member(if you are a limited liability company) or an executive officer or insurance manager Of you are a corporation). The failure of any agent, servant or employee of the"insured"to notify us of any"accident", claim, "suit"or"loss"shall not invalidate the insurance afforded by this policy. Include,as soon as practicable: (1) How,when and where the"accident"or"loss"occurred and if a claim is made or"suit"is brought, written notice of the claim or"suit"including, but not limited to, the date and details of such claim or"suit"; (2) The"insured's" name and address; and • (3) To the extent possible,the names and addresses of any injured persons and witnesses. If you report an"accident', claim, "suit"or"loss"to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident' or "loss", provided that the "accident" or"loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos—Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos"you own: U-CA-424-E CW(04-11) Page 4 of 5 CENT "o.: 22 63462 a,e::e Rater" �z a1M�4'd�s 1:.4BY�91dt?d,;R�teri.'11 pi�4gur�nce Services Office,Inc.,with its permission. This certificate cancels and supersedes ALL previously issued certificates. (1) Any covered "auto"you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee"or elected or appointed official with your permission while being operated within the course and scope of that "employee's"employment by you or that elected or appointed official's duties as respect their obligations to you. However, any"auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this coverage form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this coverage form; or (2) Make an error, omission, improper description of"autos"or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto—World Wide Coverage Paragraph (5)(a)of the Policy Period, Coverage Territory Condition is replaced by the following: (a) A covered"auto" is leased, hired, rented or borrowed for a period of 60 days or less; and T. Bodily Injury Redefined The definition of"bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. All other terms and conditions of this policy remain unchanged. U-CA424-E CW(04-11) Page 5 of 5 ceaT NO.- 22663462 Annette R omero iz1 � tactes cepyrig q teriatgaj iUrapce Services Office,Inc.,with its permission. This certificate cancels and supersedes ALL previously issued certificates. WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CALIFORNIA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following'attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 7/1/2014 • at 12:01 A.M. standard time,forms a part of (DATE) Policy No. WC017436300 Endorsement No. of the Zurich American Insurance Company (NAME OF INSURANCE COMPANY) issued to R.J.Noble Company, Inc. • Premium (if any)$ Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium otherwise due on such remuneration. Schedule Person or Organization Job Description • WC 252(4-84) WC 04 03 06(Ed.4-54) Page 1 of 1 CgRT YO.: 22G63462 Am,etre Romero 12/15/2014 8:2826 MI (PST) Page 10 of 10 This certificate cancels and supersedes ALL previously issued certificates. } Bond No. 58720945, Executed_in Duplicate Bond Premium.N/A PAYMENT BOND (LABOR AND MATERIALS) { KNOW ALL PERSONS BY THESE PRESENTS that: l { WHEREAS the City of Seal Beach,has awarded to -. ( R.1.NOBLE COMPANY,15505 E.LINCOLN AVENUE,ORANGE,CA 92865 i 1- (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows: Westminster Avenue Bicycle Lane and Resurfacing Improvements Project CIP No ST1409 WHEREAS,Principal is required under the terms of the Contract and the.California Civil Code to secure the payment of claims of laborers,mechanics,materialmen,and other persons as provided by law. NOW,THEREFORE,we,the undersigned Principal,and Western Surety Company,915 Wilshire Blvd.,Suite 1650, Los Angeles,CA 90017 _.. (Name and address of Surety) ("Surety")a,duly admitted surety insurer under the,laws of the State of California,as Surety,areheld and firmly bound..unto the Public Agency in the penal sum of One Million Four Hundred Sixty Two Thousand Two Hundred Forty Two Dollars and 50/100 Dollars(S 1,462,424.50 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,OUT 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 1 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 a the Unemployment Insurance $ Code;with respect to work or labor performed under the Contract,the Surety will pay for the same in an I}i amount not exceeding the penal sum specified in this bond;otherwise,this obligation shall become null and void. IThis bond shall insure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER,the Surety,for value received,hereby stipulates and agrees that no change,extension of time, alteration,addition or modification to the terms of the Contract,or of the work to be performed thereunder, or the specifications for the.same,shall in any way affect its obligations under this bond,and it does hereby waive notice of any such change,extension of time alteration,addition,:or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions.of California Civil Code§§'2845 and.2849. Page D-56 IN WITNESS WHEREOF, two(2) identical counterparts of this instrument,each of which shall for all purposes be deemed an origioalhereof, 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" RJ.NOBLE COMPANY Western Surety Company _. By; x By:__ IC tI.CARVER,PRESIDENT Jscottsalandi,Attorney-inrFact By: x �� D/y'-/-�� By: Its STEVE ENDOZ ,SECRETARY jtS (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. Page D-57 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 Rera..;s=^.E;C.„e C'Yt.C.�.c�hc .CV'sA-, --.; -. ,.(,.C,.KU'-.a2CaM.F`-.Ja..nT..ae`O,ai.2X..chA YF•,� ^.c:CK "uk;C .f:.`—..c [Z'^ ,e:Y+.f.Y'. .0 .IXir-Ans.. State of California �' ii County of Orange 1 It:E. On 12/15/14 before me, J.Delongh,Notary Public fiDate Here Insert Name and Title of the Officer ' p personally appeared Michael J.Carver It! Name(s)of Signer(s) T 4 z, fi who proved to me on the basis of satisfactory g evidence to be the personf df whose name(s)'is/are subscribed to the within instrument and acknowledged to me that he/sty- executed the same in k his/l2erseteir authorized capacity and that by 2�,? ✓ his/her/their signature( on the instrument the 5 J. DEIONGH 21 f commission # 1954610 person(4' or the entity upon behalf of which the 1. .. " erson(gj acted, executed the instrument. � 77r,I,' Notary Public - California Z P tz Orange County > t r My Comm. Expires Oct 2s,2015 I certify under PENALTY OF PERJURY under the la laws of the State of California that the foregoing y1 ✓ paragraph is true and correct. fi WITNESS d .nd official seal. Signatur: Place Notary Seal Above �� Signature of Notary Public OPTIONAL �1 Though the information below is not required by law, it may prove valuable to persons relying on the document l ,f and could prevent fraudulent removal and reattachment of this form to another document. 1„ Description of Attached Document cgs Title or Type of Document: • 6t I'• Document Date: x _ - Number of Pages: _ • Signer(s)Other Than Named Above: • ig Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: • ❑ Corporate Officer — Title(s): _ ❑Corporate Officer — Title(s):_., `,,3aa' ❑ Individual •RIGHT-THUMBPRINT= Li ,nN:OF.SIGNER? J IndlVld Ua RIGI0FSIGNER -n- i o of thumb hors. ❑ Partner —❑Limited I❑General Top of thumb here s1 El Partner — El Limited O General Top of thumb hors , ❑ . ❑ Attorney in Fact Attorney in Fact FFFF t,.,l 1$ El Trustee �� C Trustee 3' ❑ Guardian or Conservator - ❑Guardian or Conservator '£fir ❑ Other: ❑Other: pSigner Is Representing: Signer Is Representing: _ 1 (s).2010 Not 'S.ro`�5�-c taryo 1-800-USNOTARY' 00-876-6827-c.'o-c^u^u9w'�=w'y?c9�csu.`6'�S�-cX.c: m# 032010 National Notary Association NafionalNotary org•'1-800-US NOTARY(1-800 876-8827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 '. .,..rr..er;• .7vu=+ ..M.,i; r..cr..er..i-nA-eicnm..m. ,r..i�ac r r• .cr.., cr. •.rrk-:<:crnre..-:c�u-. me ^5! State of California h County of Orange ?'i j �i� on 12/15/14 before me, J. Delongh,Notary Public '�' Date Here Insert Name and Title of the Officer —' y, t, Steve Mendoza 71 personally appeared Name(s)of Signer(s) -} u< cfi who proved to me on the basis of satisfactory evidence to be the personff whose name(s')'is/are , } subscribed to the within instrument and acknowledged k: lc to me that he/sq executed the same in fi his/i erkileir authorized capacity05; and that by his/her/their signature(a'f on the instrument the J. oEloNS personX,, or the entity upon behalf of which the rson((f aceee instrumerc, 9jtCornrnn # i95z 4 G . Notary Public - California z t z 't$✓ _8 Orange County a I certify under PENALTY OF PERJURY under the R' My comet. expires oct 28,2015 laws of the State of California that the foregoing ir _ - paragraph is true and correct. g g F fi WITNE m n and official seal. Signat e: _ Place Notary Seal Above OPTIONAL Signature of Notary Public '� Though the information below is not required by law, it may prove valuable to persons relying on the document t and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document ?j Title or Type of Document: ci'S Document Date: _ Number of Pages: gl II ci Signer(s)Other Than Named Above: e 1. Capacity(ies) Claimed by Signer(s) Signer's Name: _ Signer's Name: _ r, y ❑ Corporate Officer — Title(s): El Corporate Officer — Title(s): >i I❑ Individual ;RIGHTtTHUMBPRINT: ❑ Individual RIGMTNUMBPRINr, ,,: I$, , OF,SIGNER; '. �;;y OF SIGNER zt �' ❑ Fanner —CI Limited ❑General Top of thumb here ❑ Partner — Cl Limited ci General Top or thumb here ff C] Attorney in Fact Li Attorney in Fact 6x I JI ❑ Trustee ❑Trustee J ❑ Guardian or Conservator ❑Guardian or Conservator e,I ❑ Other: ❑Other: I n Signer Is Representing: Signer Is Representing: ' ©i4;%.“.Ua4nat Notary 1'Association tiona.T•cm (,'rrg I-.Bcq-US N,O ("Y( ?876.6_[5<-C:4.".c%V^ `CtlocZcsO' cx.e.%4`g't5o i Jc` L:S�,Tre. oni#5907 (e'2010 National Notary Association•NationalNotary org•1-a00-US NOTARY Il 600-6]6.6827) Item#5907 ACKNOWLEDGMENT State of California County of Orange On December 12, 2014 before me, Kelly A. Vincent, a Notary Public (insert name and title of the officer) personally appeared James Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/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. 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. KELLY A.VINCENT �S_ N ,T`1t~%k COMM.#2029982 Z 8• ' NOTARYPtial AU TTC° _' ,• ti ='_¢ ORANGE COUNTY N MY CAMM.EXP.JUNE 21,2017 Signature \ • j.--w ' t • (Seal) • Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By'These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota.and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint James Scott Salandi, Leonard Ziminsky, David Jacobson, Individually of Irvine.CA.its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undmaakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 29th day of October.2014. air}« WESTERN SURETY COMPANY sp?zp909q'.?a? AV q%�6o`r°gyp aul T.Bruflat.Vice President State of South Dakota ss County of Minnehaha On this 29th day of October,2014.before me personally came Paul T.Bruflat.to me known,who,being by me duly sworn,did depose and sayi that he resides in the City of Sioux Falls. State of South Dakota: that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority. and acknowledges same to be the act and deed of said corporation. My commission expires i`e ' `• J.MOHR { t bile 23.2015 i 9EAt NOTAHT PUBLIC SEAL { { y SOUTH DAKOTA p { `-y_�/^ th i. . .r / / Ill 0✓�ti J.Mohr,Notary Public CERTIFICATE I, L. Nelson. Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation prirt�tl oil the reverse hereof is still in for e. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this - �° day of (I�.4 Pll V , &Oi q . C thk -WESTERN SURETY COMPANY 6r<°p99ajti at.� • 0,41. s;lrf SF px.iv,� �rM UAL°4 L.Nelson,Assistant Secretary Form 14280-7-2012 Bond No. 58720945, Executed in Duplicate Bond Premium N/A PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach,has awarded -:,R J.NOBLE COMPANY,15505 E.LINCOLN AVENUE,ORANGE,CA - - (Name and address of Contractor)" - - }I: ("Principal"),a contract(the"Contract")for the work described as follows: Westminster Avenue Bicycle Lane and Resurfacing Improvements Project CI?No.ST1409: WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW,THEREFORE,we,the undersigned Principal,and Western Surety.Company,915 Wilshire Blvd.,Suite 1650, Los Angeles,CA 90017 (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California, as Surety are held and finely bound unto the PublicAgency in the penal sum of One Million Four Hundred Sixty Two Thousand Two Hundred Forty Two Dollars and 50/100 Dollars (5 1,462,424.50 ), 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 Ml force and effect In case:suitt is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER,the Surety,for value received,hereby stipulates and agrees that no change,extension of time, alteration,addition or modification to the terms of the Contract,or of the work to be performed there under, or the specifications for the same,shall in any way affect its obligations under this bond,and it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to the terms of the Contract or to the work or to the specifications there under. Surety hereby waives the provisions of II California Civil Code §§'.2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto IN.WITNESS WHEREOF,two(2)identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof,;have been duly executed by Principal and Surety; on the date set forth.below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: "Principal" "Surety" Page D,53 R .NOBLE COMPANY Western Surety Company IMP ger By X -' By X p ( ICHAELI.CARVER,PRESIDENT ..••s . es Scott Salandi,Attorney-in-Fact By x �/�ll By: Its STEVE ME OZA, CRETARY Ib (Seal) (Seal) ,_;, Note: This bond must be dated, all signatures must be,notarize ; and, --. ` evidence of the authority of any person signing as attorney-in-fact=must bet et.; attached. it } {6p[ Page D-54 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 facrt-e� r.-,r.. . z -nn aa,^ a ^ , ri-:39<a r F e�a.^ 8b9 r ab0&(4.7 a<-c" F C,a;9 , State of California • County of Orange 2r / l ie On 12/15/14 before me, .1.Delongh,Notary Public Date Here Insert Name and Title of the()facer lli personally appeared Michael .Carver z �,,,r Namo(s)of Signer(s)•2,�r h 4' who proved to me on the basis of satisfactory tg fi evidence to be the personfsf whose name(s)'is/are subscribed to the within instrument and acknowledged to me that he/s+ w executed the same in his/tllheir authorized capacity and that by 9> his/her/their signature(a'f on the instrument the — erson ' J. DEIONGH p or the entity upon behalf of which the -A person(4 acted, executed the instrument. �I rt ., _ Commission # 7954610 g il.^f._j_- ,l Notary Public - California i ,k' . Orange county ' I certify under PENALTY OF PERJURY under the '' fo. 7, My Comm. Expires Oct 28, 2015 laws of the State of California that the foregoing 21 e ° ie paragraph i e and correct. � ig Z! g WITNES: my h and and official seal. / ` 1 Signatur-- j/r Place Notary Seal Above OPTIONAL Signature of Notary PublicI Though the information below is not required by law, it may prove valuable to persons relying on the document If and could prevent fraudulent removal and reattachment of this form to another document. ?, fiDescription of Attached Document 9. Title or Type of Document: tI Document Date: _ Number of Pages: •l gSigner(s) Other Than Named Above: ,. Capacity(ies) Claimed by Signer(s) xvi f', Signers Name: Signer's Name: _ i El Corporate Officer — Title(s): El Corporate Officer — Title(s): fry ❑ Individual :RIGHT-THUMBPRINT! El Individual RIGHTTHUMBPRINT, $' :q;;:OF.SIGNER-('t t OFSIGNER'::v! ❑ Partner — Ll Limited ❑General ~Top of thumb here El Partner — El Limited 0 General Top of thump here ❑ Attorney in Fact EJ Attorney in Fact n If El }Ka Trustee ❑Trustee 's ❑ Guardian or Conservator ❑Guardian or Conservator A ❑ Other: ❑Other: I gi Signer Is Representing: Signer Is Representing: tin11,,..w. ap Notary Association n.NetionalN.e-r.org sw-c-S NOI ar::ssc�ce;c. u-5827) -¢c,,-c '�=�-`�-reo:F^c,c-w e.,cx c ,<- c:t=F�:c:,a....w 1 --- ©2010 National Notary Association•NatinnalNotary org•1.800-US NO1ARY(1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 kre.i,c .ct..,r - r;•-- ..Z4(xo.N'u%yfcrnY e.C..2F:C..ch.K�.i zcra.k... ..,c:(.c t+ ,, -. .4G,e'rc�^.K-.[:<,.da eca.<-..t ., -e(.c".v' State of California h: County of Orange On 12/15/14 before me, J.Delongh,Notary Public Data Here Insert Name and Title of the Officer t r personally appeared Steve Mendoza Neme(s)of Signer(s) v} fi 14 who proved to me on the basis of satisfactory IF evidence to be the personfsf whose name(,aj'is/are , h subscribed to the within instrument and acknowledged to me that he/sA executed the same in 1 his/he,/thetr authorized capacity and that by 9 his/her/their signatures j on the instrument the f J. DEIONGH person(of, or the entity upon behalf of which the J. commission # ts54st0 z person0 acted, executed the instrument a _'= �tr Notary Public - California n z ',7-1 1�.,'- Orange County (Z My Comm. Expires Oct 23.2015 I certify under PENALTY OF PERJURY under the 4 ip j- - - - - - r — • — ° — — r - — ° ` - laws of the State of California that the foregoing 1 fi paragraph is true and correct. fi WITNES my and . • 'cial seal, t r Signature. Place Notary Seal Above ignalure of Notary Public OPTIONAL �, d Though the information below is not required by law, it may prove valuable to persons relying on the document iJ IfIr.and could prevent fraudulent removal and reattachment of this form to another document. , Description of Attached Document ij: Title or Type of Document: ' Document Date: Number of Pages: ,I Signer(s) Other Than Named Above: 7,4 fi Capacity(ies) Claimed by Signer(s) Signer's Name: Signers Name: X,1 ❑ Corporate Officer —Title(s): El Corporate Officer —Title(s): syyy�i ill Individual 'RIGHTTHUMBPRINT: f! Individual RIGHT THUMBPRINT X. Y SOF.SIGNERA,':..2 i;c ',_ OFSIGNER. . d, "S ❑ Partner — El Limited ❑General Top of thumb here ❑Partner — El Limited ❑General Top of thumb here ❑ Attorney in Fact ❑Attorney in Fact x, K El Trustee ❑Trustee ) f ❑ Guardian or Conservator ❑Guardian or Conservator El Other: [J Other: _ Signer Is Representing: Signer Is Representing: IF 0 @ 2010 National Notary Association-NatonalNotary.org•1.800-US NOTARY(1-800-876-61127) Item#5907 ACKNOWLEDGMENT State of California County of Orange On December 12, 2014 before me, Kelly A. Vincent, a Notary Public (insert name and title of the officer) personally appeared James Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/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. 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. ; ►r ti° KELLY A.VINCENT %G® cN / ' . COMM.#2029982 7 . ie, ; NOTARYPUBUC•CAUFOWdA Ce ' p ORANGE COUNTY N COMM EXP.JUNE21, Signature ` ' " - (Seal) STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business&Professions Code§ 7028.15] [Public Contract Code§20103.5] I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the entity on whose behalf this certification is given,hold a currently valid California contractor's license as set forth below(required at time of award): Business&Professions Code§7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefore, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or imprisonment in the county jail for not less than 10 days nor more than six months,or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the aggregate sum of the cost of materials and labor finished 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. (t) 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 Page D-68 • three business days. For purposes of this section, a telephone response by the board shall be deemed sufficient. Public Contract Code§20103.5: In all contracts subject to this part where federal funds are involved, no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However,at the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of this state. The first payment for work or material under any contract shall not be made unless and until the Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or contractor not so licensed shall be subject to all legal penalties imposed by law, including, but not limited to,any appropriate disciplinary action by the Contractors'State License Board. The agency shall include a statement to that effect in the standard form of pre-qualification questionnaire and financial statement. Failure of the bidder to obtain proper and adequate licensing for an award of a contract shall constitute a failure to execute the contract and shall result in the forfeiture of the security of the bidder. License No.: 782908 Class: A&C-12 Expiration Date: 08/31/2016 Date: 12/15/2014 Page D-69 AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code§§ 1720,1773.8,1775,1776,17775,1813,1860,1861,37001 The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the Following provisions of California law: 1. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter 1 (commencing with Section 1720)of the California Labor Code relating to public works and the awarding public agency("Agency")and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall,as a penalty to the Agency,forfeit not more than fifty dollars($50) for each calendar day, or portion thereof,for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1)keep accurate payroll records, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records.The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 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 subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2,Part 7,Chapter 1,Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861,Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code,and I will comply with such provisions before commencing the performance of the work of this contract." Date 12/15/2014 Signature X STEVE MENDO ,SECR ARY Page D-71 INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTION TITLE OF PROJECT OR WORK: Westminster Avenue Bicycle Lane and Resurfacing Improvements Project CIP No. ST1409 Indemnitor(s) (list all names): R.J. NOBLE COMPANY 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 coverage which may have been required under the Agreement or any additional insured endorsements which may extend to Indemnitees. Indemnitor,on behalf of itself and all parties claiming under or through it,hereby waives all rights of subrogation and contribution against the Indemnitees,while acting within the scope of their duties, from all claims,losses and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor regardless of any prior,concurrent, or subsequent active or passive negligence by the Indemnitees. In the event there is more than one person or entity named in the Agreement as art Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint and several. "Indemnitor" Name R.J. NOBLE co grANY Name: By: X � � By: Its IICHAELJ.CARVER, PRESIDENT Its Page D-73 City of Seal Beach Date Published: 10/23/14 10/30/14 BID OPENING Project: Westminster Ave Bicycle Lane & Resurfacing (Seal Beach Blvd to Bolsa Chica Rd) Project No. ST1409 Date: November 13, 2014 Time: 10:00 a.m. 1 . ,�X C1 � > l i y3 775- 2 a 44,L, 04 ' Jae-. /\ i47o6 3. el/rie curt ' 4 1 Le/Hi 4(4- N-1/4 5 . izeoi , 5. 6.