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Home My WebLink AboutAGMT - R.E. Schultz Construction (Eisenhower Park Tot Lot Rehabilitation)RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO CITY OF SEAL BEACH Attn: City Clerk 211 - 8th Street Seal Beach, CA 90740 ; 9'/6 Recorded in Official Records, Orange County Hugh Nguyen, Clerk- Recorder 1111IIIIIIIIIIIIIIIIIIIII11111111IIIIIII1 11111111111IIEI1111I NO FEE *$ R 0 0 0 9 1 4 1 1 4 4$* 2017000112374 3:07 pm 0312011 (� 143 422 N12 1 W Lc �D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.0 MAR 2 7 2.017 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: CITY OF SEAL BEACH 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 December 19, 2016. The work was Eisenhower Park Tot Lot Rehabilitation Project. No. PR1602. 6 The name of "the contractor(s), if any, fur such improvement was: R.E. Schultz Construction-.— - -- The date of the Contract Award was May 23, 2016. 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: Eisenhower Park City of Seal Beach. Date: S 1 Signature of owner or corporrzI19 officer of owner named in paragraph 2 or agent. VERIFICATION I, the undersigned, say: the Director of Public Works declarant of the foregoing notice of completion; have read said notice of completion and know the contents thereof, the same is true of my own knowledge. I declare under Executed on 317512 oi-7 and correct. 2017, at Seal IT If NF PUBLIC WORKS AGREEMENT FOR EISENHOWER PARK TOT LOT REHABILITATION PROJECT CIP NO. PR1602 between City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 M R.E. Schultz Construction P.O. Box 6 Silverado, CA 92676 (714) 649 -2627 (714) 740 -5049 - FAX THIS AGREEMENT is made as of May 23, 2016 by and between the City of Seal Beach, a California charter city ( "City"), and R.E. Schultz Construction. a General Contractor ( "Contractor"). 1 of 9 RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the Eisenhower Park Tot Lot Rehabilitation Project CIP No. PR1602 ( "Project ") with respect to design criteria; and B. WHEREAS, Contractor has submitted a bid to City for the Project dated April 21, 2016 in the amount of $173,579 ( "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 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 May 23. 2016 (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 $173,579, 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 3of9 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 4of9 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. Automobile Liability. 6.1.2 Exhibit D -2: Additional Insured Endorsement - 6.1.3 Exhibit D -3: Additional Insured Endorsement. 6.2 Minimum Scope of Insurance. Unless otherwise approved by City, coverage shall be at least as broad as: 6.2.1 Insurance Services Office Commercial General Liability coverage (occurrence form CG 0001). 6.2.2 Insurance Services Office form number CA 0001 (Ed. 1/87) covering Automobile Liability, code 1 (any auto). 6.2.3 Insurance Services Office form number CG 20 10 11 85 (Ed. 11/85) covering Additional Insured— Owners, Lessees or Contactors (Form B). 5of9 6.2.4 Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 6.3 Minimum Limits of Insurance. Contractor shall maintain limits no less than 6.3.1 General Liability: $2,000,000 per occurrence and in the aggregate for bodily injury, personal injury and property damage. Commercial General Liability Insurance or other form with a general aggregate limit shall apply separately to this Agreement or the general limit shall be twice the required occurrence limit. 6.3.2 Automobile Liability: $2,000,000 per occurrence for bodily injury and property damage. 6.3.3 Employer's Liability: $1,000,000 per occurrence and in the aggregate for bodily injury or disease and Workers' Compensation Insurance in the amount required by law. 6.4 Deductibles and Self- Insured Retentions. Contractor shall inform City of any deductibles or self- insured retentions except with respect to any professional liability insurance. 6.5 Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: 6.5.1 City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor; products and completed operations of Contractor, premises owned, occupied or used by Contractor; or automobiles owned, leased, hired or borrowed by Contractor. The coverage shall contain no limitations on the scope of protection afforded to City, its officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials which are not also limitations applicable to the named insured. 6.5.2 For any claims related to this Agreement, Contractor's insurance coverage shall be primary insurance as respects City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials. Any insurance or self- insurance maintained by City, their officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials shall be excess of Contractor's insurance and shall not contribute with it. 6.5.3 Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. 6 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:VIII 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 7of9 regular business hours or by facsimile before or during Contractor's regular business hours; or (b) on the third business day following deposit in the United States mail, postage prepaid, to the addresses heretofore set forth in the Agreement, or to such other addresses as the parties may, from time to time, designate in writing pursuant to the provisions of this Section. All notices shall be addressed as follows: If to City: City Clerk City of Seal Beach 211 -8th Street Seal Beach, California 90740 Telephone: (562) 431 -2527 Fax: (562) 493 -9857 With a copy to: Public Works Director City of Seal Beach 211 -8th Street Seal Beach, California 90740 If to Contractor: R.E. Schultz Construction P.O. Box 6 Silverado, CA 92676 Telephone: (714) 649 -2627 Fax: (714) 740 -5049 Attn: Richard Schultz 10. Non - Assignability; Subcontracting. Contractor shall not assign, transfer, or subcontract any interest in this Agreement or the performance of any of Contractor's obligations hereunder. Any attempt by Contractor to so assign, transfer, or subcontract any rights, duties, or obligations arising hereunder shall be null, void and of no effect. 11. Compliance with Laws. Contractor shall comply with all applicable federal, state and local laws, ordinances, codes and regulations in force at the time Contractor performs the Services. 12. Non - Waiver of Terms. Rights and Remedies. Waiver by either party of any one or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement. In no event shall the making by City of any payment to Contractor constitute or be construed as a waiver by City of any breach of covenant, or any default which may then exist on the part of Contractor, and the making of any such payment by City shall in no way impair or prejudice any right or remedy available to City with regard to such breach or default. 13. Attorneys' Fees. In the event that either party to this, Agreement shall commence any legal action or proceeding to enforce or interpret the provisions of this Agreement, the prevailing party in such action or proceeding shall be entitled to recover its costs of suit, including all attorneys' fees incurred in connection therewith. 14. Construction. The validity, interpretation, and performance of this Agreement shall be controlled by and construed under the laws of the State of 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 9 of 9 CONTRACTOR: By: �� sd l t l& 4 Name: 1iG�1GlkK if GV1U�t2 Title: Pvesld-evi+ Name: Title: 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.) (Premium subject to adjustment based on final contract price) Bond No. 71790775 Bond Premium$ 5 , 207 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that WHEREAS the City of Seal Beach, has awarded Richard E. Schultz dba R.E. Schultz Construction (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: Eisenhower Park Tot Lot Rehabilitation Proiect, CIP# PR1602 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 (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 Seventy—Three Thousand Dollars ($ 179,579.00 ), this amount being not less than the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed there under, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications there under. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: "Principal" Richard E. Schultz da ,Surety" R.E. Schultz Construction Western Sure 2914 E Katella #102 101 S Reid #3 Orange, CA 92867 Sioux Falls, SD 57103 Page D -47 By: Its Owner /Pro rietor Richard E. Schultz —,h Bond No. 71790775 GI 1 By: Its Attorney -in -fact Blake A. Pfister By: Its <" (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attomey -in -fact must be attached. Page D -48 r, CODE CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL A notary public or other officer completing this certificate verifies only the identity of the individual who signed the !, document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) OnMay 27, 2016 beforeme, Lianne Nahina, Notary Public Date Here Insert Name and Title of the Officer personally appeared Blake A- Pfister Name(s) of Signers) who proved to me on the basis of satisfactory evidence to be the person(4) whose name(s) is/AV subscribed to the within instrument and acknowledged to me that he /6r executed the same in his/ON##;* authorized capacity(to, and that by hisirWOO&W signature(fl) on the instrument the person #A, or the entity upon behalf of which the person($) acted, executed the instrument. r +. LIANNE NAHINA N a COMM. # 2134629 XJ - d NOTARY PUBLIGCALIFCRNIA N ORANGE COUNTY N �.,• MY COMM. EXP. DEC 5, 2019 I certify under PENALTY OF PERJURY under the laws of the State of Califomia that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signat re Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bond 71790775 Document Date: May 27, 2016 Number of Pages: 2 Signer(s) Other Than Named Above: N/A None Capacity(ies) Claimed by Signer(s) Signer's Name: Blake A. Pfister ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual 0 Attorney in Fact ❑ Trustee ❑ Guardian or Conservator l Other: Signer Is Representing: Western Surety Company Signer's Name: - - - - - -- 0 Corporate Officer — Title(s): Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Western Surety Company POWER OF ATTORNEY - CERTIFIED COPY Bond No 71790775 Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company "), does by these presents make, constitute and appoint _ BLAKE A PFISTER its true and lawful attorney(s) -in -fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its behalf as Surety, bonds for: Principal: Richard E. Schultz dba R.E. Schultz Construction Obligee: City of Seal Beach Amount: $500,000.00 and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s) -in -fact may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety Company which remains in full force and effect. "Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of July 31 2016 , but until such time shall be irrevocable and in full force and effect. Iq$ Western Surety Company has caused these presents to be signed by its Vice President, Paul T. Bruflat, and its cor &3U'tb'bs.p. "this 27th day of May 2016 •,� �� =;q•� WEST R SURE COMPANY rs; / Gam- SQUTFI,>'A 1 Paul T. ruflat, Vice President COLItd`4=t £fl(iRYj�Ei�HA On this 27th day of May , in the year 2016 , before me, a notary public, personally appeared Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and deed of said corporation. }bb4444b4bbbb444444b44b44} a r J. MOHR i EAL SEAL NOTARY PUBLIC SOUTH DAKOTA �a Notary Public -South Dakota i }bb444bbbb44bbbb44b444+ My Commission Expires June 233, , 2021 I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as set forth in the Power of Attorney is now in force. In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 27th day of May 2016 > WEST R SURE COMPANY _ / J Paul T. Xruflat, Vice President To validate bond authenticity, go to www.enasurety com > Owner /Obligee Services > Validate Bond Coverage. Form F5306.1 -2016 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of pyorT On Mid 32016 before me, N 61 Al K Notary Public, personally appeared, who proved to me on the basis of satisfactory evidence to be the person(f4 whose name(s4 is /a€e subscribed to the within instrument and acknowledged to me that h executed the same in his /ha4#il& authorized capacity( and that by his i€ signature( on the instrument the person(s4, or the entity upon behalf of which the person(&) acted, executed the instrument. I certify under penalty of perjury under the laws of the State of California that the foregoing paragraph is true and correct. CHELSEA MAE SVIR ` o COMM. # 2097883 g 3 NOTARY PUBLIC CALIFORNIA C ORANGE COUNTY itMy comm. expires Jan. 24, 2019 t WITNESS my hand and official seal. PJA LL JW& Chelsea Svir Notary Public, Orange County Commission #2097883 Expires 01 -24 -2019 O If marked, then attached pages will bear embossment of above I Optional: Not required by law, however, may prove valuable to persons relying on the I document and could prevent fraudulent reattachment of this form. Signature Authority of Signer: ❑ Individual Q( Corporate Officer(s) Kf&(U r' I os • r lv► (Title) • Partner (Limited or General) • Attorney In Fact • Trustee(s) • Guardian /Conservator • Other Description of Attached Documents: Title or type of Document: Number of Pages: Date of Document: Signer(s) other than Named Above: 0 Copyright 2015 California Notary Academy, PO Box ]29, Oakley, California 94561 - www.californianotaryacademy.com Bond . 71790775 Bond Premium included in Perfo ma PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHER LAS the City of Seal Beach, has awarded to Richard E. Schultz dba R.E. Schultz Construction 2914 E. Katella #102 Oran e CA 92867 (Name and address of Contractor) ( "Princi )al"), a contract (the "Contract') for the work described as follows: Eisenho Ner Park Tot Lot Rehabilitation Pro'ect CIP# PR1602. WHER, AS, Principal is required under the terms of the Contract and the California Civil Code to secu a tha paymen of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW, THEREFORE, we, the undersigned Principal, and Western Surety Company 101 S Reid 4300 Sioux Falls, SD 57103 (Name and address of Surety) ("Sure t)") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and irml) bound u to the Public Agency in the penal sum of One Hundred Seventy —Three Thousa d Five Hundred Seventy—Nine ----------------------------------- Do S 179,579.00 this amount being not less than fifty percent (50 %) of the total contract price, in lawful money of the United States of America, for the payment of which sum well at d truly to e made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE C NDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or it; heirs, a ecutors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons na ed it Section 3181 of the California Civil Code, or any amounts due under the Unemployment Insurance Codt witt respect o work or labor performed under the Contract, or for any amounts required to be deducted, withheld, am paid ov r to the Employment Development Department from the wages of employees of the Principal ant subcont actors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to work or labo perform ,e] under the Contract, the Surety will pay for the same in an amount not exceeding the penal sum sp cifiec in this b )nd; otherwise, this obligation shall become null and void. This bo d shall insure to the benefit of any of the persons named in Section 3181 of the California Civil Code so a to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is b ough upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed Dy thi court. FURTI ER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time alteratio i, addition or modification to the terms of the Contract, or of the work to be performed thereunder, r thi specific ; itions for the same, shall in any way affect its obligations under this bond, and it does hereby waive otic( of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or io flu work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 28z 5 anc 2849. IN Will ESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all pin pose! be deery ed an original hereof, have been duly executed by Principal and Surety, on the date set forth belo , tht Page D -50 nce Bond Bond No. 71790775 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: pp "Sure ty„ Riciiard E. Schultz dba R.E.iSchultz Construction Western Surety Company S. Kate a 101 S Re'd #300 Orange, CA 92868 Sioux Fa 1 , SD 57103 By: �C �LC�Gt W1�//L V 1/I (p By: Its Owner roprietor Its Atttorney -in -fact, 'By:_ I Richard E. Schultz By: Blake A. Pfister Its Its (Seal) (Sea]) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attomey -in -fact must be attached. Page D -51 CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Oranges ) On May 27, 2016 Date personally appeared beforeme, Lianne Nahina, Notary Public Here Insert Name and Title of the Officer Blake A. Pfister Name(s) of Signers) who proved to me on the basis of satisfactory evidence to be the person(rp) whose name(s) islV* subscribed to the within instrument and acknowledged to me that he /ft0hilili executed the same in his/ authorized capacity( , and that by his/9*15W signature(0) on the instrument the persona, or the entity upon behalf of which the person(ij 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. ° " +. LIANNE NAHINA N a COMM. # 2134629;0 @< NOTARY PUBLIC-CALIFORNIA � Signat �- �� T ORANGE COUNTY N Signature of Notary Public +u MY COMM. EXP. DEC 5, 2019 Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bond 71790775 Document Date: May 27, 2016 Number of Pages: 2 Signer(s) Other Than Named Above: N/A None Capacity(ies) Claimed by Signer(s) Signer's Name: Blake A. Pfister • Corporate Officer — Title(s): • Partner — ❑ Limited ❑ General • Individual M Attomey in Fact ❑ Trustee O Guardian or Conservator ❑ Other: Signer Is Representing: Western Surety Company Signer's Name: ------- ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator O Other: Signer Is Representing: 02014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1 -800-876-6827) Item #5993 Western Surety Company POWER OF ATTORNEY - CERTIFIED COPY Bond No 7179077 Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company "), does by these presents make, constitute and appoint BLAKE A PFISTER its true and lawful attorney(s) -in -fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its behalf as Surety, bonds for: Principal: Richard E. Schultz dba R.E. Schultz Construction Obligee: City of Seal Beach Amount: $500,000.00 and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s) -in -fact may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety Company which remains in full force and effect. "Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of July 31 2016 , but until such time shall be irrevocable and in full force and effect. stern Surety Company has caused these presents to be signed by its Vice President, Paul T. Brunet, and its is 27th day of May 2016 WEST R SUURRE 'Y COMPANY Ir -. -s ac - !-� /. S__ d1 +a�.. ss Paid T. ruflat, Vice President COU15�4j�'dR�i$�{IIA r:2ffiEE3FEtsFE On this 2 7 th day of May , in the year 2016 , before me, a notary public, personally appeared Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and deed of said corporation. }44Y4444Y4bbbb4b44b444Y4b} J J. MOHR / � +tf AbL NOTARY PUBLIC SEAL Notary Public -South Dakota SOUTH DAKOTA a rr �VVYYbV VYY4V4Y4444444444 + My Commission Expires June 23, 2021 I the undersigned officer of Western Surety Company, a stack corporation of the State of South Dakota, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as set forth in the Power of Attorney is now in force. _ In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 27th day of Mav 2016 - To validate bond authenticity, go to www.cnasurety corn Form F5306 -1 -2016 WEST R /SURE COMPANY Paul T. frullat, Vice President > Owner /Obligee Services > Validate Bond Coverage. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of brang On 2016 before me, _ Notary Public, personally appeared, who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is /e€e subscribed to the within instrument and acknowledged to me that heAsheAhe executed the same in his /hefi%liak authorized capacity( and that by his /4s signature(s4 on the instrument the personal, or the entity upon behalf of which the personal 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. CHELSEAMAESVIR ` ti COMM. # 2097883 NOTARY PUBLIC CALIFORNIA 3 ORANGECOUNTY ro My comm. expires Jan. 24, 2019 WITNESS my hand and official seal. PlLL A� Chelsea Svir Notary Public, Orange County Commission #2097883 Expires 01 -24 -2019 o IT marKeo, tnen attacneo pages wiii Dear embossment OT aoove notary. Optional: Not required by law, however, may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. Signature Authority of Signer: ❑ Individual C9'�Corporate Officer(s) VIM OVVVt eV (Title) • Partner (Limited or General) • Attorney In Fact • Trustee(s) • Guardian /Conservator • Other Description of Attached Documents: Title or type of Document: Number of Pages: Date of Document: Signer(s) other than Named Above: 0 Copyright 2015 California Notary Academy, PO Box 129, Oakley, California 94561 - —a californianotaryacederry.com ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY %0iklf16s1 Name and address of named in urcd C- \anted k OFFICIAL TITLE OF PROJECT EISENH0A1 ER P ARIC TO "r LOT kEHA BILITATION PROJECI'CIP Not PR 1602 \or,%ahstandin_ an} inconsistent statement in the policq to %% hi-fi (his endorsement is attached I the -Polio' i or in am endorsement note or hereafter attached thereto. it is aereed is follows: i. the Ci;c of Seal Beach. its elected officials. officer. at(orri N. agents. employ ces. and wluniecrs are additional insureds ;the abote named additional insureds are hereafter referred to xs the -Additional Insureds "1 under the Police in relation to those actnitics described _cnerelh above with regard to operations performed b} or on behalf of the Named Insured. The Additional Insureds hate no liability for the pay ntent of am premiums or assessments under the Policy. _. the insurance eot,raaci afforded the .additional Insureds under the Pohcv shall be prunan insurance. and no other insurance maintained bt the Additional Iniurcds shall be called upon to contribute with the insurance coaera_es prof ided'by the Policy Each insurance cu%erate under tine Policy .hall apply separaiek to each Wditional Insured a_!aimr whom claim is made or sun is brought except w rah respect to the limits of the C'ompanc s liability. 3. \othrmt in ;Ion unuact of uuurao :c shall bra vnsimed to preclude co, :rage of a claim by one insured under the ptdre, against another insured under the polo :\Il such claims shall cotercd as third -par, clains, re.. in the same manner as it separate mlkn: , had been issued to each insured. \othinv Contained in this pro,ision shall operate to increase or repicatc the Crnnpam's linris of liability as prof ided under the pol ict the msurance afforded of cite Polict for coinracival habiiit+ insurance ;subject to the terms. condiuons and csclusiom applicable to such insuraneei includes liabilih assumed by the ,flamed Insured under [he ndenuuficalion andor hold harmless protisiomsl contained in or executed in cunjancumn with the wrnlell uvrcer.:ennsr or permiuor desivnawd abote. be,tecn [he Named Insured and the Wditional Insured, . 6- The poha to .cluch this .ndvrscntcm is attached ,hall not be subject fo cancellation, change in Coverage, reduction of limits ie\eept as tine result of the patmcnt of zlaimsr. or non - renewal except after tariuen notice to Public , \_ency, bt eenihed mail. return receipt requested. out less than thirty 110) days prior to the ettectite date thereof. 1n the event of Company's failure to cumph, with this notice procrsion, the policy as imt ally dratted will conunuc in full fore: and ettect until compliance wide this notice rcquircmem- Cumpnm hereby wilkQs all right., of suhrosalron and cuntrthutiun agmna the Additional Insureds. while acting within the scope . f their duties, front all clauni. loises and liabilities arismiz out of or inadcnl to the perils inxucd against in relation to those actin hies described _encralk abose with regard to operauons performed bt or on behalf of the Named Insured regardless of ant prior, concurrent. or suhsequent acme or passe neghgenee ht the \dditional Insured,. S It t, hcreht agreed that the laws of the State of ( ahlorma shall applt to and govern the talidits. construction. interpretation. and cutor :emcnt of this Contract of : nsurance. Page Uci 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: Ciro Ellmneer Girt of Seal Beach 211 8th Street - 2 :' Floor Seat Beach CA 90740 10. Except as stated above and not in conflict with this endotscintm- nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to uhicll this endorsement is attached. TYPE OF CO',,- ERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM, TO LIABILITY C0?t1it,ti~� ' r"f' �tA kE �t zri �fz211ra 4447 S -per 1 1. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Contractual Liability Owners Landlords; Tenants Manufacturers!Contractors Producra/CompIcted Operations Broad Form Property Damage Extended Bodily Injury Broad Form Comprehensiae General Liability Endorsement v Explosion Hazard _q Collapse Hazard r Lnderground Propam' Damage Pollution Liability __. Liquor Liability '. ?. A deductible or self -insured retention tcheck one) of S applies to all coveragets) except, _ hJlZk— _ _ _ tit' none. so state). The dxductibie is applicable per claim or per oecurence one). 13. This is an occurrence or claims made policy (check one), 14. This endorsement is effe(-dve on ` UA 6 at 12:01 A.M1, and forms a part of Policy t, a_W !.I /a i/1'"�'�/ :�t'� _ - _,_-„- (print name). hereby declare under penalt? of perjury under the laws of the State of Callfornin, that I have the authurit;' to bind the Company to this endorsement and that by my execution hereof, t do io bind the Company - Execured 0. 9r/ _off ._.20. f9 ` Signature of .Authorized Rep ?eaentmive �- (Original signature only, no facsimile signature or initialed signature accepted) Phone %Q.: ( )._.__ Page O -i6 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY ( "Named Insured "): Name Lv /JCenS /n ©n e 67"1 erc Sun Pro.rfcv taficonStn - n3j`1- OFFICIAL TITLE OF PROJECT: EISENHOWER PARK TOTLOTREHABILITA TION PROJECT CIPNO. PR1602 Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy) or in any endorsement now or hereafter attached thereto, it is agreed as follows: The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 1. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 2. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 3. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 4. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained or executed in conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 5. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non - renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 6. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. This endorsement and all notices given hereunder shall be sent to Public Agency at: City Engineer City of Seal Beach 21 l 8th Street, 2nd Floor Seal Beach CA 90740 7. Except as stated above and not in conflict with [his 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. Page D -i8 TYPE OF COVERAGES TO WHICH LIMITS OF THIS ENDORSEMENT ATTACHES LIABILITY POLICY PERIOD FROM /TO =i /7.s //L To 51.,117 Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: '7 Any Automobiles ❑ All Owned Automobiles C Non -owned Automobiles Y Hired Automobiles 7 Scheduled Automobiles ❑ Garage Coverage ❑ Truckers Coverage ❑ Motor Carrier Act C1 Bus Regulatory Reform Act n Public Livery Coverage 11. A 4 deductible or G self - insured retention (check one) of S /'000 applies to all coverage(s) except: Mel I (if none, so state). The deductible is appli able ❑ per claim br ■ per occurrence (check one). 12. This is an n occurrence or ❑ claims made policy (check one). 13. This endorsement is effective on at 12:01 A.M. and forms a part of Policy Number 1, S!e ✓e n II. CG r r. wn y (print name), hereby declare under penalty of pedury under the Iahs of the State of California, that I have the authority to bind the Company to this endorseme d that by my a tion h reof, I do so bind the Company. Execute 20 /6 Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: (76s) 7. 3y .�r/j- o? Page D -59 WORKER'S COMPENSATION CERTIFICATE OF INSURANCE WHEREAS, the CITY OF SEAL BEACH has required certain insurance to be provided by R E Schultz Construction, Inc 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. L 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 StarStone National Ins. Co. 3. Workers 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 T20160710 4 -14 -2016 EXPIRATION DATE 4 -14 -2017 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 Kerry Hulett Its Authorized Representative Page D -53 Policy Number: Date Entered: 04/14/2016 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE ( MMIDDMYY) 2016 5/2/2016 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. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER The Hulett Agency 13959 Saddlewood Drive Poway, CA 92064 - CONTACT NAME: PMCNE No .(858)618 -5442 FAX (858) 61-5444 8 E-MAIL hulettagency8 sbcglobal. net ADDRESS: INSURERS) AFFORDING COVERAGE NAILr INSURER A: StarStone NatlOndl InBUranL:e, CO CL AIMS -MADE OCCUR INSURED R E Schultz Construction, Inc. INSURER B: INSURER L DAMAGE TO RENTED e RE PREMISES (IRS urmnce) INSURER D: P G BOX 6 INSURER E: Silverado, CA 92676 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rypE OF INSUMNCE ADDLISUBR', POLICY EFF POLICY E%P LIMITS LTR INSD WVDI POLICY NUMBER MMMDIYW MMIDDIYW THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Seal Beach, CA 90740 COMMERCIAL GENERAL LIABILITY AUTHORIZED REPRESENTATIVE MCIORIUDREYMSENTAM EACH OCCURRENCE E CL AIMS -MADE OCCUR DAMAGE TO RENTED e RE PREMISES (IRS urmnce) E E MEG EXP (Anyone person) PERSONAL S ADV INJURY E AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE E GEN'L POLICY 1:1 JEST [:] LOC PRODUCTS - COMPIOP AGO E E OTHER. TY AUTOMOBILE LIABILITY C SINGLE LIMIT IEa accitlen0 E BODILY INJURY /Per Derson) E ANY AUTO ALL OWNED SCHEDULED AUTOS ACTOR BODILY INJURY (Per ecctlenU E PROPERTY NON-OWNED HIRED AUTOS eriden /DAMAGE IE E UMBRELLA LAO OCCUR EACH OCCURRENCE E EXCESS LIAR CLAIMS -MADE AGGREGATE E OED RETENTION E E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATUTE ERH El EACH ACCIDENT E 1,000,000 - A ANV PROPRIETORNARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? © NIA T20160619 04/14/2016 04/14/2017 EL DISEASE - EA EMPLOYEE E . DISEASE POLICY LIMIT (MandatoryinNH) DESCRIPTION OF OPERATIONS below $_l , 0 00, 000 I E DESCRIPTION OF OPERATIONS/ LOCATIONS IVEHICLES (AGORD101,A4dINenal R4mmds SCNedule,mry De]N]cbedNmOmepac4 it mquimtl) Project If 2016006 Eisenhower Park Blanket Waiver of Subrogation Attached. CERTIFICATE HOLDER CANCELLATION City of Seal Beach 211 Eighth Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Seal Beach, CA 90740 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE MCIORIUDREYMSENTAM /�] /, /, /,�� ACORD 25 (2014/01) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Produmdusing Forms Boss Plus wltware.www. FmmsBoss mmlmpmAAiWPublisbing 8D(S2G9 -1977 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver of Subrogation As respects to all CA jobs performed by the named insured during the policy period where by written contract a waiver of subrogation is required prior to the commencement of work. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 04 -14 -2016 Policy No.: T20160619 Endorsement No.: Insured: R E Schultz Construction, Inc. Insurance Company: StarStone National Insurance Company Countersigned By� ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. RESCH -1 OP ID: CS acoRO° CERTIFICATE OF LIABILITY INSURANCE DATE /03/2016 OSI03/2016 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. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Cooper Insurance Service, Inc Playground Book P.O. Box 638 Lapel, IN 46051 NAMEACT Steve B. Carraway --- PHONE FA% ac No EX1:765534 -3152 ac No: 765534 -2067 EA UL ADDRESS: INSUREF4S) AFFORDING COVERAGE NAICN Steve B. Carraway INSURERA: Western Heritage Insurance Co. 37150 INSURED R.E. Schultz Construction INSURERB:General Casualty Co. of 24414 Inc. P.O. Box 6 INSURER C: National Union Fire Ins Co 19445 INSURER D: SCP1017392 Silverado, CA 92676 INSURER E, PRE" MSES Eaoccunence INSURER F: MED EXP(Any one person) COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTA TYPE OF INSURANCE II NSD UBR POLICY NUMBER MMIDDY/YYYY MOMIW/YYYY LIMITS A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE 111 OCCUR X X SCP1017392 0412212016 0412212817 PRE" MSES Eaoccunence $ 100,00 MED EXP(Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,08 EEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,00 POLICY JECOT � LOC PRODUCTS - COMPIOP AGO $ 2,000,80 E &O $ 1,000,00 OTHER. AUTOMOBILE UAMU'rf COMBINED SINGLE LIMIT Ea amdent $ 1,000,00 BODILY INJURY (Per Person) $ B X ANY AUTO X X CBA1283972 0412212016 04122/2017 BODILY INJURY (Per amdent) S ALL OMvNED SCHEDULED AUTOS AUTOS HIREDAUTOS AUTOS EO Per a¢de DAMAGE $ $ UMBRELLh UAB X OCCUR EACH OCCURRENCE $ 1,000.00 AGGREGATE $ 1,000,00 G X EXCESS DAB CLAIMS -MADE BE019595088 0412212016 04122/2017 DELI RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'UABIUTY YIN ANY PROPRIETORIPARTNEWEXECUTIVE SER ER E. L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L. DISEASE -EA EMPLOYE $ It yes, describe under DESCRIPTION OF OPERATIONS belay E.L. DISEASE - POLICY LIMIT IS IS Equipment Floater CIM1293972 0412212016 0412212017 Value: 250,00 Leased /Rented DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Rennui s Schedule, may be attached If more space is epuired) RE: Eisenhower Park for the City of Seal Beach --City of Seal Beach, it's officers, officials, employees, designated volunteers and agents serving as independent contractors In the role of city officials are additional insured regarding the general liability coverage including completed operations on a primary and noncontributory basis with a waiver of subrogation per written CERTIFICATE HOLDER CANCELLATION SEALBEA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI Of Seal Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 211 Eighth Street Seal Beach, CA 90740 AUTHORIZED REPRRESENTAME ACORD 25 (2014101) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTEPAD: HOLDER CODE SEALBEA RESCH -1 PAGE INSURED'SNAME R.E. Schultz Construction OP ID: CS Date 06/0312016 contract and forms WHI21 -1124 and CG2037 attached. Form WHI21 -0480 applies to general liability per attached. City of Seal Beach, it's officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of city officials are additional insured regarding the automobile liability coverage with a waiver of subrogation per written contract. ( '' Western Heritage Insurance Company ENDORSEMENT NO. ATTACHED TO AND FORMING A PART OF R ENDORSEMENT EFFECTNE DATE NAMED INSURED AGENT NO. POLICY NUMBER (1 A.M. STANDARD TIME) SCP1017392 04/22/2016 R.E. Schultz Construction Inc. (The above information is required only when this endorsement is issued subsequent to preparation of the policy.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU INCLUDING PRIMARY OR PRIMARY AND NON - CONTRIBUTORY AND LIMITED WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ERRORS AND OMISSIONS COVERAGE PART A. SECTION II —WHO IS AN INSURED is amended to include as an additional insured any person or organization for whom you are performing operations and you and such person or organization have executed a written contract or agreement prior to the time of an "occurrence" giving rise to a claim that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury," "property damage," "error or omission" or "personal and advertising injury" caused, in whole or in part, by: 1. Your negligent acts or omissions; or 2. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury," "property damage," "error or omission" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or sur- veying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or Includes copyrighted material of ISO Properties, Inc., with its permission. Copyright, ISO Properties, Inc., 2004 WHI 21 -1124 (06 -15) Page 1 of 2 b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to SEC- TION III — LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. D. Under SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS; subparagraphs a. Pri- mary Insurance and b. Excess Insurance of paragraph 4. Other Insurance are amended as follows: If you have agreed in a written contract and executed such a contract or agreement prior to the time of an "occurrence" giving rise to a claim, that this policy will be afforded on a primary or primary and non - contributory basis and without right of contribution from any insurance in force for the liability in the performance of your ongoing operations for the additional insured(s), then this insurance will be afforded on a primary or primary and non - contributory basis, and we will not seek contribution from any other such insurance. E. Under SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to paragraph 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against an additional insured if you have agreed in a written contract, and executed such a contract or agreement prior to the time of an "occurrence" giv- ing rise to a claim, but only with respect to liability for "bodily injury," "property damage," "error or omission" or "personal and advertising injury" caused by: 1. The named insured's negligent acts or omissions; or 2- The negligent acts or omissions of those acting on the named insured's behalf; in the performance of the named insured's ongoing operations for the additional insured. All other Terms and Conditions of this Policy remain unchanged. STEVEN B CARRAWAY / 04/22/2016 AUTHORIZED REPRESENTATIVE DATE Includes copyrighted material of ISO Properties, Inc., with its permission. Copyright, ISO Properties, Inc., 2004 WHI 21 -1124 (06 -16) Page 2 of 2 POLICY NUMBER: SCP1017392 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of Seal Beach, it's officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of city officials Blanket when required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by '.your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law, and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to required by a contract or will pay on behalf of the amount of insurance: the additional insured is agreement, the most we additional insured is the 1. Required by the contract or agreement, or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 0 Insurance Services Office, Inc., 2012 Page 1 of 1 Aft WIRT Western Heritage Insordere ComOdny ATTACHED TO AND EN DORSBMENT EFFECTIVE OATS FORMING A PART OF POLICY NOMpER fl::01 A.M. STANDARD TIME) I NAMED INSURED AGENT NO. SCP1017392 4/22/16 R.E. Schultz Construction Services 34 nD (The above information is required only when this endorsement is issued subsequent to preparation of the policy.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS - AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Paragraph 9. of SECTION V - DEFINITIONS is replaced by b. A sidetrack agreement; the following: 9. "Insured Contract" means: a. A contract for lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permis- sion of the owner is not an "Insured contract "; All other Terms and Conditions of this Policy remain unchanged. Steven B c. Any easement or license agreement, except in connection with construction or demolition op- erations on or within SO feet of a railroad; d. An obligation, as required by ordinance, to in- demnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement. / 4/22/16 AUTHORIZED REPRESENTATIVE DATE Indudes copynghlen matenal of ISO Properties, Inc., whh its permission. Copynght, ISO Properties. Inc., 2003 NMI 21-0480 (02/05) TNSOREO STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business & Professions Code § 7028.151 [Public Contract Code § 20103.51 1, 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 fumished 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 ajoint 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 Page D-62 verifying the license status of any person or contractor and the board failed to respond to the inquiry within 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�lthe forfeiture of the security of the bidder. License No.:J VD 11-15 Class: A Expiration Date: 9/506-1 Date: U/z7/IV Page D -63 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 provisions of Division 2, Part 7, Chapter I (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 u' ug i i.o Signature Page D -65 INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTION TITLE OF PROJECT OR WORK. Eisenhower Park Tot Lot Rehabilitation Proieet CIP No. PRI602. Indemnitor(s) (list all names): l�C,�al�d Ucdnu(fiz 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 an Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint and several. "Indemnitor" Name _K:I Qvd Name: BY _ By: Its 0 — Page D -67 ..I r'1 J Section C PROPOSAL Bidders Name R E. a,hu 14E (,on 6n TO THE HONORABLE MAYOR AND CITY COUNCIL OF THE CITY OF SEAL BEACH: The undersigned, as bidder, declares that: (1) -this proposal is made without collusion with any other person, firm or corporation, and that the only persons or parties interested as principals are those named herein as sworn in the attached Non - Collusion Affidavit; (2)- bidder has carefully examined the project Plans, Specifications, Instructions To Bidders, Proposal, Notice Inviting Sealed Bids and all other contract documents and information furnished therefore and the site of the proposed work; and (3)- bidder has investigated and is satisfied as to the conditions to be encountered, the character, quality and quantities of work to be performed and materials to be furnished. Furthermore, bidder agrees that submission of this proposal shall be conclusive evidence that such examination and investigation have been made and agrees, in the event this contract be awarded to bidder, to enter into a contract with the City Council of the CITY OF SEAL BEACH, to perform said proposed work in accordance with the Plans, if any, and the terms of the Specifications, in the time and manner therein prescribed, and to famish or provide all materials, labor, tools, equipment, apparatus and other means necessary so to do, except such thereof as may otherwise be famished or provided under the terms of said Specifications, for the following stated unit prices or lump sum price as submitted on the Bid Sheet herein. The bidder shall submit as part of this proposal a completed copy of the Contractors Industrial Safety Record. This Safety Record must include all construction work undertaken in the State of California by the bidder and any partnership, joint venture or corporation that any principal of the bidder participated in as a principal or owner for the last five calendar years and the current calendar year prior to the date of bid submittal. Separate information shall be submitted for each such partnership, joint venture, or corporate or individual bidder. The bidder may attach any additional information or explanation of data which he would like to be taken into consideration in evaluating the safety record. An explanation of the circumstances surrounding any and all fatalities must be attached. Accompanying this proposal is (Circle one "cash ", "a Cashier's Check ", "a certified check ", or "a on ' r the form furnished by the City", as the case may be) in the amount of an amount equal to at least ten percent (10 %) of the total aggregate bid price based on the quantities shown and the unit prices quoted. The undersigned bidder agrees that should bidder be awarded the Contract on the basis hereof and thereafter fail or refuse to enter into a Contract and provide the required evidence of insurance and bonds within 15 calendar days after written notice of the award, the cash, check or bond shall be forfeited to the city in accordance with Public Contract Code section - 20172, except as otherwise provided in Public Contract Code section - 20174. The undersigned agrees that in the event of such failure, the actual amount of damages to the City would be impractical and extremely difficult to determine. In compliance with the Notice Inviting Sealed Bids, the undersigned hereby agrees to enter into a contract to furnish all labor, materials and supplies for this project in accordance with the Specifications, Plans other Contract Documents which are on file in the office of the City Engineer of the CITY OF SEAL BEACH, to the satisfaction and under the direction of the City Engineer, at the following prices: completed by the undersigned is fixed at 60 WORKING DAYS starting from the day after the issuance of the Notice to Proceed. Page C -I 4 D FOR: EISENHOWER PARK TOT LOT REHABILITATION PROJECT CIP No. PR1602 BID SHEET Item Description Unit Quantity Unit Price Extended Price No. (in Figures) (in Figures) Mobilization and Demobilization, including but not limited to: Water Pollution Control Program 1 (WPCP); construction parking permit and placement of LS 1 $110-, 2 Z2 construction period BMP's, in accordance with the contract specifications; complete and in lace. Demolition and Removals, as 2 shown on the construction plans and in accordance with the LS 1 $112H - $ `1,,11 contract specifications; complete and in place. Construct Concrete flatwork, as 3 shown on the construction plans and in accordance with the SF 750 $ $ 12� X60 contract specifications; complete and in place. Furnish and install Gate, as shown 4 on the construction plans and in accordance with the contract EA 3 specifications; complete and in lace. Furnish and install Umbrella Shade Structure (12'x12'), as shown on 5 the construction plans and in EA 2 $ � 2 )D- $ SOO- accordance with the contract specifications; complete and in lace. Furnish and install Precast Bench, 6 as shown on the construction plans and in accordance with the EA 6 $ 1'4�sb— $ ? 27 DD contract specifications; complete and in place. Furnish and install Play Structure, 7 as shown on the construction plans and in accordance with the LS 1 2 �,�f2 $ 21, OgZ2 contract specifications; complete and in place. Page C -2 0 TOTAL BID PRICE (ITEMS NO. 1 -11) bnf NUnjmd Tfydd4 lei? "Wo -Fiv -e $ WORDS �V06frfd 5 CY)tU Y))Y_�C ° /loo dollal'S . FIGURES IN CASE OF DISCREPANCY BETWEEN WORDS AND FIGURES, THE WORDS SHALL PREVAIL Page C -3 Furnish and install Swings, as 8 shown on the construction plans and in accordance with the EA 1 1 contract specifications; complete and in place. Furnish and install Precast Sea Lion Play Feature, as shown on g the construction plans and in EA 2 n/] lT� $ 2�, '�o 2 accordance with the contract specifications; complete and in lace. Construct Rubberized Play Surface.(Poured.in Place), as 10 shown on the construction plans SF 1,800 $ 24 -l�7 and in accordance with the contract specifications; complete and in place. Furnish and install Beach Sand — min. _1.2" depth, as shown on the 11 construction plans and in LS 1 2+'_W $ accordance with the contract specifications; complete and in lace. TOTAL BID PRICE (ITEMS NO. 1 -11) bnf NUnjmd Tfydd4 lei? "Wo -Fiv -e $ WORDS �V06frfd 5 CY)tU Y))Y_�C ° /loo dollal'S . FIGURES IN CASE OF DISCREPANCY BETWEEN WORDS AND FIGURES, THE WORDS SHALL PREVAIL Page C -3 July 26, 2016 R.E. Schultz Construction P.O. Box 6 Silverado, CA 92676 Attn: Richard Schultz RE: Agreement for Eisenhower Park Tot Lot Rehabilitation Project CIP No. PR1602 Dear Mr. Schultz: CITY HALL 211 EIGHTH STREET SEAL BEACH, CA 90740 (562) 431 -2527 www.sealbeachca.gov Enclosed is fully executed copy of the above referenced agreement. We have kept two copies for our records. If you have any questions regarding same, please contact the City Clerk's office at 562- 431 -2527. Ext. 1305. Sincerely, Winnie Bell Part-Time Executive Assistant City Clerk's Office City of Seal Beach wbell @ sealbeachca.aov 562 - 431 -2527 Ext.1304 Enclosure