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HomeMy WebLinkAboutAGMT - Doug Martin Contracting Company Inc (2016 Annual Slurry Seal Project CIP No. ST1601)'f�ECORDING REQUESTED BY AND WHEN RECORDED MAIL TO CITY OF SEAL BEACH Attn: City Clerk 211 - 8th Street Seal Beach, CA 90740 Recorded in Official Records, Orange County Hugh Nguyen, Clerk- Recorder I I11111 IIIIII III 1[111111111[ 1111I 111111111 11I1I I1111 1111I 111111111111 NO FEE r $ R 0 0 0 8 8 3 6 1 3 5 8+ 2016000553934 2:54 pm 11108/16 276 401 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Space of above this line for Recorder's use. "" No Recording Fee Pursuant to Government Code Section 6103, NOTICE OF COMPLETION Notice pursuant to Civil Code Section 3093, must be filed within 10 days after com Notice is hereby given that: NOV 15 2016 CITY CLERK :ITY 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 September 30, 2016. The work was 2016 Annual Slurry Seal Project. No. ST1601. 6. The name of the contractor(s), if any, for such improvement was: Doug Martin Contracting Co., Inc. The date of the Contract Award was June 27, 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: Citywide, City of Seal Beach. Date: Deputy Director of Public Works, City of Seal Beach Signature of owner or corporate officer of owner named in paragraph 2 or agent. VERIFICATION I, the undersigned, say: the Interim Director of Public Works declarant of the foregoing notice of completion; have read said notice of completion and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury the for Executed on 10 13 1 11 (p , (Date of Signature) is true and correct. at Seal Beach, California. /< � of Public Works, City of Seal Beach 66 I 0 rj PUBLIC WORKS AGREEMENT FOR 2016 ANNUAL SLURRY SEAL PROJECT CIP NO. ST1601 between City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 0 Doug Martin Contracting Co., Inc. 220 Foundation Avenue La Habra, CA 90631 (714) 441 -0513 (714) 441 -0541 - FAX THIS AGREEMENT is made as of June 27, 2016 by and between the City of Seal Beach, a California charter city ( "City "), and Doug Martin Contracting Co., Inc., a General Contractor ( "Contractor "). i OIC01 RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the 2016 Annual Slurry Seal Project CIP No. ST1601 ( "Project ") with respect to design criteria; and B. WHEREAS, Contractor has submitted a bid to City for the Project dated June 2, 2016 in the amount of $104,807.20 ( "Accepted Proposal" hereinafter). The Accepted Proposal is attached hereto as Exhibit G and contains, among other things, provisions defining the Project scope. NOW, THEREFORE, in consideration of performance by the parties of the mutual promises, covenants, and conditions herein contained, the parties hereto agree as follows: AGREEMENT 1. Contractor's Services. 1.1 Scope and Level of Services. For and in consideration of the mutual promises set forth herein, and subject to the terms and conditions set forth in this Agreement, Contractor shall perform and complete in good and workmanlike manner all work ( "Work ") required by this Agreement and the documents listed in Subsection 1.2 for the Project. 1.2 Contract Documents. The "Contract Documents" that comprise the agreement between the City and the Contractor are the: Notice Inviting Bids, Instructions to Bidders, Accepted Proposal, Non - Collusion Affidavit, Bid Schedule(s), List of Subcontractors, Contractor's Industrial Safety Record, Contractor's Qualification Statement, Bid Security Forms for Check or Bond, Specifications, General and Special Provisions and documents referenced therein, all addenda as prepared prior to the date of bid opening setting forth any modifications or interpretations of any of said documents, this Agreement, Exhibits attached to this Agreement, including but not limited to the Performance Bond (Exhibit A), Payment Bond (Exhibit B), Workers' Compensation Insurance Certificate (Exhibit C), Insurance Endorsements (Exhibit D), Acknowledgment of Penal and Civil Penalties Concerning Contractor Licensing Laws (Exhibit E), Labor Law Requirements (Exhibit F), Accepted Proposal (Exhibit G) and any and all supplemental agreements executed amending or extending the Work contemplated and that may be required to complete the Work in a substantial and acceptable manner. These Contract Documents are hereby incorporated into this Agreement. 1.3 The Work shall be performed in accordance with the Plans, Specifications and other Contract Documents. Contractor shall furnish at its own expense all labor, materials, equipment and services necessary therefor, except such labor, materials, equipment and services as are specified in the Contract Documents to be furnished by City. 2of9 1.4 In the event of any material discrepancy between the express provisions of this Agreement and the provisions of the other Contract Documents, the provisions of this Agreement shall prevail. 2. Effective Date. This Agreement is effective as of June 27, 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 $104,807.20, 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 4 of 9 the deposit with City, of any insurance policy or certificate required pursuant to this Agreement. 5.5 Waiver of Right of Subrogation. Contractor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation against the Indemnitees, while acting within the scope of their duties, from all claims, losses, and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor. 5.6 Survival. The provisions of this Section 5 shall survive the termination of the Agreement and are in addition to any other rights or remedies that Indemnitees may have under the law. Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision, and an entry of judgment against a Contractor shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. 6. Insurance. 6.1 Liability Insurance. Contractor shall procure and maintain in full force and effect for the duration of this Agreement insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the services hereunder by Contractor, and its agents, representatives, employees and subcontractors. The policy limits set forth below do not act as a limitation upon the amount of indemnification to be provided by Contractor. Contractor shall complete and execute the following documents attached as Exhibits hereto and incorporated herein by this reference: 6.1.1 Exhibit D -1 Commercial General Liability. Automobile Liability. 6.1.2 Exhibit D -2 Additional Insured Endorsement - 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. 11185) covering Additional Insured — Owners, Lessees or Contactors (Form B). 5 of 9 6.2.4 Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 6.3 Minimum Limits of Insurance. Contractor shall maintain limits no less than 6.3.1 General Liability: $2,000,000 per occurrence and in the aggregate for bodily injury, personal injury and property damage. Commercial General Liability Insurance or other form with a general aggregate limit shall apply separately to this Agreement or the general limit shall be twice the required occurrence limit. 6.3.2 Automobile Liability: $2,000,000 per occurrence for bodily injury and property damage. 6.3.3 Employer's Liability: $1,000,000 per occurrence and in the aggregate for bodily injury or disease and Workers' Compensation Insurance in the amount required by law. 6.4 Deductibles and Self- Insured Retentions. Contractor shall inform City of any deductibles or self- insured retentions except with respect to any professional liability insurance. 6.5 Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: 6.5.1 City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor; products and completed operations of Contractor; premises owned, occupied or used by Contractor; or automobiles owned, leased, hired or borrowed by Contractor. The coverage shall contain no limitations on the scope of protection afforded to City, its officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials which are not also limitations applicable to the named insured. 6.5.2 For any claims related to this Agreement, Contractor's insurance coverage shall be primary insurance as respects City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials. Any insurance or self- insurance maintained by City, their officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials shall be excess of Contractor's insurance and shall not contribute with it. 6.5.3 Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. • • 6.5.4 Each insurance policy required by this Section 6 shall be endorsed to state that coverage shall not be canceled or materially modified except after 30 days prior written notice by first class mail has been given to City. 6.5.5 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 7 of 9 regular business hours or by facsimile before or during Contractor's regular business hours; or (b) on the third business day following deposit in the United States mail, postage prepaid, to the addresses heretofore set forth in the Agreement, or to such other addresses as the parties may, from time to time, designate in writing pursuant to the provisions of this Section. All notices shall be addressed as follows: If to City: City Clerk City of Seal Beach 211 -8th Street Seal Beach, California 90740 Telephone: (562) 431 -2527 Fax: (562) 493 -9857 With a copy to: Public Works Director City of Seal Beach 211 -8th Street Seal Beach, California 90740 If to Contractor: Doug Martin Contracting Co., Inc. 220 Foundation Avenue La Habra, CA 90631 Telephone: (714) 441 -0513 Fax: (714) 441 -0541 Attn: Doug Martin 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 CONTRACTOR: ou Martin Contracting Company, Inc. By: ((,Yl By: Ji I . Ingram, City Man_,z Name: Doug4artin M Approved as M A. Steele, City Attorney 9 of 9 Title: President Name: /f ai-ti�j Title: Dixie Martin. Secretary Issued in Triplicate Bond No. 024065816 KNOW ALL PERSONS BY THESE. PRESENTS that: Premium $602.00 PERFORMANCE BOND WHEREAS the City of Seal Beach, has awarded and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: 2016 Annual Slurry Seal Proiect CEP# ST1601 WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW, THEREFORE, we, the undersigned Principal, and (Name and address of Surety) ( "Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of One Hundred Four Thousand Eight Hundred Seven and 20/100- - - Dollars ($ 104,807.20--- ), 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 hews, 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: June 14, 2016 "Principal" "Surety" Doug Martin Contracting Company, Inc. Liberty Mutual Insurance Company Page D -47 By: Its Toug Martin, President By; Its Charise Eberhard, ttorney -in -Fact By: L LI l tc. M OAJ_ b — By: Its Dixie Martin, Secretary (Seal) Its (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached. Page D-48 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 } On June 15. 2016 before Me, Heather M. Martin, Notary Public ere msen name an personally appeared Doug Martin and Dixie Martin who proved to me on the basis of satisfactory evidence to be the perso s whose nam is� subscribed to the within instr cent and acknowled a to me that he /sh t executed the same in his /he their authorized capaci I and that by his/her their ignature sDon the instrument the persona& or the entity upon behalf of which the persons acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. _ ;. HEATHER M. MARTIN V ITNESS my hand and official seal. . . commission No. z szes NOTARY PUBLIC - CALIFORNIA e Illn ORANGE COUNTY \ �iSN l�/ ✓ l - I.�W 1. \/( My Comm. Expires JUNE 79 2919 otuy Public Signature (Notary Public Seal) IN{-UKRgA 1 I THE ATTACHED DOCUMENT (Title or description of attached document)) (Title or description of Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) O Corporate Officer (Title) • Partner(s) • Attorney -in -Fact ❑ Trustee(s) E-1 Other L_ INSTRUCTIONS FOR COMPLETING THIS FORM :) N This jorm complies with current Ca forma .statures regarding notes v wo ding and, fneeded, should be completed and attached to The documenl. Acdmmvledgmenis f?onu other states rnrry be completed for documents being sett to that state so long a, the ,carding does not require the Cal ybrina nalary to violate Cal Jarnm notary Ia.. • State and County imorm Ainumost. he the State and County where the dcewncut signer(s) personally appeared before the notary public for acknowledgment • Date of notarization most be the dale that the signer(s) personally appeared elnich must eIw be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears widlin his or her commission R Iklied by a comma and then you title (nomrypubiu;). • Pant the nama(s) of document signals) who personally appear at tine tine of notarization. • Lndicale the correct singular or plural farms try crossing off incorrect forms (i e. ppts}reiiYhey; is /are ) or circling the enrrect loons. Failure to correctly indicate this information min lead to rejection of document recording. • Tile rotary seal inipmssion must be clear and photographically reproducible, hilimssion must not corer text or lines. If seal impression smudges, re -seat if a sufficient area permits, otheniise complete a different acknowledgment forth. • Signature of the notary public must match the signature on file with the office of the county clerk. + Additional information is not required but could help to ensure this uckrowkxtgmrnl is not misused or Alactxxl to a different document. ;. Indicate title or type ofamiched document, number of pages and date. v Indicate the capacity claimed by the silver. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. ACKNOWLEDGMENT 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 On June 14, 2016 before me, Cynthia S. Wozney, Notary Public (insert name and title of the officer) personally appeared Charise Eberhard who proved to me on the basis of satisfactory evidence to be the person(so whose name( is /are- subscribed to the within instrument and acknowledged to me that4ie1sKe/t4iey executed the same in - his/her, it authorized capacity(ie ), and that by h`s /her /their signature( on the instrument the person( or the entity upon behalf of which the person(o 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. (Seal) CYNTHIA S. WOZNEY Commission * 2077374. Notary Public.- California Orange County M Comm. irea Se 5, 2018+ -THIS:POWER OF ATTORNEY'IS NOT ^VALID UNLESS IT IS PRINTED ON REDZACKGROUND , This Powerof Attorney . limits the acts, - of.those named herein; and they tiave no authority to bind the Company eicept in the manner and to the extent herein stated. CenificaleNO. 73zz210 .American Fire and Casualty Company - Liberty Mutuallnsurance Company - - The Ohio Casualty lnsurance Company - _ ,West American Insurance.Company - POWER OF- ATTORNEY _ KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire ,& Casualty Company and The Ohio Casualty:Insurance.Company are corporations duly organized under the laws of - _ - -__she State of New Hampshire, that Libeity.lkli Insurance Company is a corporation tluly organized under the laws of the State of Massactiusefls, and WestAmencarj insurance Company c is a corporation" duly organized under the laws of the State of Indiana (herein collectivelyrcalled the " Companies "), pursuant to andby au tin hd,hereln set f_orth,_rois hereby name, constitute and appoint, - - Charise. Eberhard; Cynthia 2 WO`iney Denise Bennett Jon M. Garrett PaulA Bland S1eJen C Mosier = ' all of the city of .Irvine state of CA- each individually if there be more than one named, Its tme and lawful attorney -in -fact to make;`execute, seal, acknowledge and deliver; for and on its behalf as surety and as its act and deed, any and all undertakings, bonds recognizances and other surety obligations, In pursuance of these presents-and-shall -- _ be as binding upon the Companies as if they have been duly signed;by the president and attested by the secretary of the Companies m their own proper persons. _ IN WITNESS WHEREOF, this Power of Adomey has been subscribed by an'authorized officer or -official of the Companies and the corporate seals of the Companies have been affixed thereto this 11th day of April - PNO cqs� `nv INSp _ �tNSUR ,,,rsuq - American Fire and Casualty Company The Ohio Casualty Insurance Company' _ Liberty. Mutual Insurance-Company- West - a 1906- o 0 19t9 n E - -1912 ° a 1991 9 - — - - - me_ncan Insurance Company - _ Ul bW`<- y` "nn,+ ✓,s * ?a' °- y"ww�MVS� �aa - s> °'ncev �< - �' row,:: ;+ _ p - _ d 4 t 4 f t C STATE OF PENNSYLVANIA ss - - David M: Care Assistant Secretary .Jr, COUNTY OF MONTGOMERY 11th - Aril -2016 - If � � Onthis_ day of P ,before me personally appeared DavidM. Carey, who acknowledgedhimself to Assistant Secretary. Amencan�Fde and O d Casualty Company, Liberty Motual Insurance Company, The Ohio Casualty Insurance Company, and West American Insurance Company,and that he as "such,-being-authorized so to do., p m .execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorised officer. - _ ` I d > IN WITNESS WHEREOF, I have hereunto subscribed m name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written. -O l6 P.pg3p COMMONWEALTH OF PENNSYLVANIA o�y-a FCC - Nolanal Seal w Oy u s >• Teresa Pastella Notary Public ,By; A W OF Plymouth Twp;, MonlgameryA0 - - - O -Teresa Pastella Notary y Pap My Commission Expires March 28, 2017 - 3; 61 O - ��xe' -Membe Pennsylvania Association of Nmenes O- .a m This Power ofAttomey is made and executed pursuant to an_ by authority of the following By -laws and Authorizationsof AmencanFlreandCasualtyCompany ,TheOhio Casualty Insurance . yr Company, Liberty Mutual Insurance Company, and WestAmericanlnsurance Company which resolutions are now In full force and effect reading as follows:- - = - - - . - :E Or` ;ARTICLE IV- OFFICERS — Section l2. Power of Attorney: Any officeror.olher-officialof the Corporation authorized for thatpurpose mwriting bythe Chairman or,lhe President, and subject. .O' to such limitation as the Chairman or the President may prescribe; shall appoint such attorneys-in fact as may necessary lo. act n'behalf of the Corporation to make,-:ex`ecule seat' O C acknowledge and deliver as surety any and all undertakings ,bonds, recognizances and other surety obligattons.- Such attorneys -in -fact, subject to the limitations "setforth in their respective a; E «6 .powers of:attorrey; shall have full power.to bind.the Corporation; by tfieu signature and execution of an such instruments and'to attach thereto the seal: of the Corporation. =When so. �- O rp executed, uch instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey -in -fact under >: w ~ the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers' granhng such power or authority: " :N to O ARTICLE XIII- Execution of Contracts - SECTION 5. Surety. Bonds and Undertakings. Any, officer of the Company authorized forthat purpose invading by.the chairman or the president ;Ea > and subject to such limitations as the chairman bathe president may prescribe, shall appoint such attomeys -in -fact; as may be necessary to act in behalf of the Company to make; execute; O j seal acknowledge and deliver. as surety any and all undertakings bonds, recognizances and other surety obligatlons."Such attorneys -in -fact, subject tothe;limlt6tii set forth In their . Z O respective powers of attorney, shall have full power to bindifie Company by their signature and execution of any such instruments and to attach thereto the seal of the Co`mpary When so -0 executed such instruments shall be as binding as if signed by the president and attested by the secretary , -- - - Ot .Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David Ma Carey Assistant Secretary to appoint such attomeys in- _~ fact as may be necessary to act on behalf of the Company to make, execule;:seal, acknowledge and deliver as surety any and all undertakings, bonds,.recogoizances and other surety obligations. -. .- : - _ _ Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of anyassistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company In connection with surety h6iels,sha0 be valki binding upon the Company with the same force and effect as though manually affixed,- - - - I, Gregory W. Davenport, the undersigned Assistant Secretary, of American Fire and Casualty. Company The Ohio Casualty Insurance Company, Liberty Mutual) Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct; copy of the Power of Attorney executed by said - Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my: hand and affixed the seals of said Cornpanies this day of AN I b- 2�i6� , 20 `✓PND 4gS���s y Pc` eanWi�gKy Fti PW �'rc". ' F� PN IrggM1r - r 1906 0 0 1919 r 7912 _ 1991 � Y� _ Gregory W. Dav nport Assistant Secretary_ 5 of 500 LMS_12873_122013 Issued in Triplicate Bond No. 024065816 Bond Premium included in the Performance Bond PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded to Doug Martin Contracting Company, Inc. 20 E. Foundation Avenue La Habra, CA 90631 (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: 2016 Annual Slurry Seal Proiect CIP #ST1601. WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics; materialmen, and other persons as provided by law. NOW, THEREFORE, we, the undersigned Principal, and Liberty Mutual Insurance (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 Four Thousand Eight Hundred Seven and 201100--- Dollars (S 104,807.20--- this amount being not less than fifty percent (50 %) of the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to work or labor performed under the Contract, the Surety will pay for the same in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and void. This bond shall insure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give aright of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond, Surety further agrees to pay all, court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be, performed thereunder, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. 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 Page D -50 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: June 14, 2016 "Principal" "Surety" Doug Martin Contracting Company In By: Its D�� yy,,$ Martin, President By: V�SZ��t WI2A—.U; _ Its Dixie Martin, Secretary Liberty Mutual Insurance Company _ � �IJIJ_I(�j` +� Its Unanse Eberhard, Its (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached. Page D -51 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 On June 15. 2016 before me, Heather M. Martin Notary Public (Here name an Ia eT—lo t ems, w��r, personally appeared Doug Martin and Dixie Martin who proved to me on the basis of satisfactory evidence to be the persor (@s whose name is/(g subscribed to the within inst ent and acknowledged to me that he /she a executed the same in his /her the authorized capaci ies and that by his /iTe t e ignatureo on the instrument the person or the entity upon behalf of which the persore 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. _ HEATHER M. MARTIN WITNESS my hand and official seal. ?• Commission No.2116253 NOTARY PUBLIC - CALIFORNIA ORANGE COUNTY My Comm. Expires JUNE 19. 2028 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL iNFORMATt DESCRIPTION OF THE ATTACHED DOCUMENT (Tile or desciabon of attached document (Tile or descrip0on at attached docaurnent continued). Number of Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER ❑ individual (s) • Corporate Officer (Title) • Partner(s) • Attomey -in -Fact ❑ Trustee(s) ❑ Other o :. . ..r -a.aGP viJ -H7>: INSTRUCTIONS FOR COMPLETING THIS FORM N This form complies with current California statutes regarding notary warding and. if needed, ,shoald he completed and attached to the documreaL Acknowledgments firom other states may be completed for documents being sent to drat state so long as the warding does nai require The Calterra notary to violate California notary lax•. • Sreta and Caun[y infiimmtino.muwt he the Slate and Couniy Omit, the dec urmt signer(s) personally appeared before the notary public for acknowledgment. • Dale of noWrization must be Ilse duce that the signer(s) personally appeared aluch utust also; be the same date the acknowledgment is completed: • The notary public must print his or her name as it appears within his or her conunission followed by a comma mid then your title (notary public) • Point the muncis) of doomnern sigrteos) who personally appear at the tithe of notarization. • indicate the minuet singular or plural forms by crossing off incorrect forms (i.e. huTSheRhey; is lara) or circling the correct fors. Failure to correctly indicate this information may lead to rejection of document recording. • The mrimy ecal impression must he clear and photographically reproducible: Impression must not cmcr teat or fines. If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different acknowledgment for. • Signature of the notary public must match the signature on file with the office of die county clerk. •T Additional information is not required but could help to ensure Kris wkrwtiletigmern is nix ramused or atlachad to e different domamal. Indicate title or type of attached document. number of pages and date. {• Indicate the capacity claimed by the sigrcr. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. ACKNOWLEDGMENT 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 On June 14, 2016 before me, Cynthia S. Wozney, Notary Public (insert name and title of the officer) personally appeared Charise Eberhard who proved to me on the basis of satisfactory evidence to be the subscribed to the within instrument and acknowledged to me tha fisher /their authorized capacity(ie), and that by- his/her /t4eir sig person(), or the entity upon beha f of which the person(ls) acted, whose name islare- -v- executed the same in on the instrument the 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. E$ Ew", II CYNTHIA S. WOZNEY Commission ♦ 2077374 Notary Public - California oranpe County M Comm. EKpIM Sep 5 2018+ _KNOWN ALLF ._ the State of Ne is a corpoiatior and appoint,._ AT;TORNEy ISNOTVALID UNLESS ITIS;PRINTED ON RED BACKGROUND: _ limits the actsbfthose named herein; and they have no autliority.tb bind the Company ekept in _6e manner and to the extent herein stated. _ Certificate No. 7922211 American Fire and Casualty Company' :: -- -Liberty Insurance Company.. - theOhioCasualtyInsuranceCompany ` -West Amen can Insurance. Company POWER OF-ATTORNEY BY THESE PRESENTS: That American Fire & Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of - iire, that Liberty Mutual Insurance Company is a cor5bration duly organized under the laws of the State of Massachusetts, and WestAmericanlnsurance_Company nized under the laws of the State of lndia6a in erein collectively called the * Companies'), pursuant to andby authorityherein set forth does hereby riame; coristitute: a. Eberhard; Cynthia`s: WoirieY`- Denise Bennett Johrri Mi Garrett;. PautABland <StevenC Mosier all of the city of Irvine - state of CA. : each individually if there . be more than one named Its true and lawful attorney -in -fact to make; execute seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed any and all undertakings, bonds, race nizailces and other surety obligations, In pursuance of these presents and sha_tl be as binding upon the Companies as-if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. = - IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an'authorized officer or official of the Companies and the corperate`seals of the Companies have been affixed - thereto this nth -- - day of April - : c .2016 - ANOCAgU American Fire and Casualty Company e`✓own�,�9�� - ,�o?�e,„��y ��,�ti�� ���„� ��, _ The Ohio Casualty Insurance:Company_ z _ Liberty. Mutual Insurance Corl _ o o c 1912 ° r 1991 a Insurance_ Company STATE OF PENNSYLVANIA - as David M: Care Assistant Secretary - - COUNTY OF MONTGOMERY - - - - ti On this 11th day of April 2016 before me ersonall a' eared David M. Carey, who acknowled ed himself to the _Assistant Secretary .of American Fire and ✓a Y .p. _ .. Y_ appeared Y 9. _ _ o N Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Insurance Company,. and West American Insurance Company,--and that he, as -such; being authorized so to do, *6.2 execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. d > IN WITNESS WHEREOF, Ihave hereunto subscribed m name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above. written. R - p,pg3p COMMONWEALTH OF PENNSYLVANIA �Q, o�porvwFq F<� ' Notarial Sea Pu r / C'y o i v Teresa Pastelia, Notary Public By; A N or - Plymouth Twin, Montgomery County p My Commission Expires March- 28,20fl' _ - Teresa Pastels, Notary Public. HWN- P,���' Member Pennsylvania Association -of Notaries - cR This Power ofAttorney is made and executed pursuant [o an.byauthoaty of the following By -laws and Authorizations of American Fire and Casualty Company, The Ohio Casualty Insurance Company,; Liberty Mutual Insurance Company, and West American Insurance Company which-resolutions are now in full force and effect reading as follows:. to 4) ARTICLE IV- OFFICERS - Section 12. Power ofAttorney. Anyofficer or other officiafof the Corporation authorized for that purpose In writing by the Chairman or the President, and subject .d. to such limitation as the ChairmanorthePresidentmayprescribe, shall appoint such attorneys -in- fact,: as may be necessary to act in behalf of the Corporation to make - execute, seal; O acknowledge and deliver as surety any and all undertakings, Ponies, recogmzances and other surety , obligations. Such aftorneys -in fact subject to the hmitations`set forth in their respective E may' powers of attorney; shall have full power to bind the Corporation by their signature and execution- of any su&i adf urnents and to attach :thereto the seal of the Corporation:.; When so 10 ` executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary: Any power or authorty granted to any representative or aflomey -in -fact under T the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.;- - O ARTICLE XIII — Execution of Contracts — SECTION 5. Sure[ Bonds and Undertakings An officer of the Com an authorized for that a ose in writin b the chairman_or the resident; � c Y 9. Y P Y_ - P rP _ g ,ythe P > d and subject to such limitations as the chairman or the president may prescrbe, shall appoint such attorneys -in -fact, as may be necessary to-act in behalf. of the Company to make; execute( , Z u seal;acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety - obligations. Suchlaftorneys- imfacfsubjectJolhe limitations set forth m their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach:thereto the seal of the Company. Whehso executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation —.The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, attorneys -in= Assistant Secretary to appoint such attorn fact as may be necessary to act on behalf of the Company to make, execute; seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. - - - - - - - Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appealing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds; shall be valioand ti_ini ing upon the Company with the same force and effect as though manually affixed.:- - - - - I, Gregory W. Davenport, the undersigned, Assistant Secretary, of American Fire and Casualty: Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney: of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said - Companies, is in full force and effect and has not been revoked. - - - - IN TESTIMONY WHEREOF, Ihave hereunto set my hand and affixed the seals of said Companies this day of .SUN 14 2016 , 20 ND CAS SY INSU Y\NSUq p \NSUq � _ �¢`� woW xU9�� PJP�ocvoMf�Nti �JP.Peaoxl�ANr y.O�eerr..Q �� a 19.06 0 0 1919 r 1912 1991 e B Y: it Gregory W. Davenport Assistaant,Sf cretary 6 of 500 LMS 128]3 122013 WORKER'S COMPENSATION CERTIFICATE OF INSURANCE WHEREAS, the CITY OF SEAL BEACH has required certain insurance to be provided by Doug Martin Contracting Company NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insureds and that the same are in force at this time. I. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL, BEACH, CA 90740 -6379. 2. The insureds under such policy or policies are: Doug Martin Contracting Company 3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of California covering all operations of the named insureds, as follows: POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 4TJUB- 8119P58 -6 -16 04/01/16 04/01/17 4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability, unless and until thirty ays' advanc written notice thereof has been served upon the City Clerk of the CITY OF SEAL BEU. A By_ ichard L. Wells Its Authorized Representative ✓-L - Page D -53 ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY Doug Martin Contracting Co., Inc. 220 E Foundation Ave La Habra CA 90631 Name and address of named insured ( "Named Insured "): Travelers One Tower Square, Hartford Connecticut 06183 Name and address of Insurance Company (`Company "): OFFICIAL TITLE OF PROJECT: 2016 ANNUAL SLURRY SEAL PROJECT CIP No. ST1601 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: L The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained in or executed in conjunction with the written aereement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non- renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereof. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: Page D -55 City Engineer City of Seal Beach 211 8th Street, 2n' Floor Seal Beach CA 90740 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive; alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. Each Occurrence $1,000,000 TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OFDamage to Rented Premises ( Ea THIS ENDORSEMENT ATTACHES FROM/TO 04/01/16- 04/01/17 LIABILITYoccurrence) $300,000 General Liability Med Exp( Any One person) $5,000 IL Scheduled items or locations are to be identified on an attached sheet. The following inch Pton °snot & ADV Injury $1,000,000 relate to the above covemoes. Includes: eneml Aggregate $2,000,000 .- Products - Comp /OP AGO $2,000,000 Lx Contractual Liability Explosion Hazard Ix Owners/Landlords/Tenants L Collapse Hazard x Manufacturers /Contractors 0 Underground Property Damage .x Products /Completed Operations n; Pollution Liability x' Broad Form Property Damage R Liquor Liability . Extended Bodily injury ❑ id Broad Form Comprehensive ❑ L General Liability Endorsement 12. A Lx deductible or ❑ self - insured retention (check one) of S 2,500 applies to all coverages) except: None (if none, so state). The deductible is applicable ❑ per claim or ❑ per occurrence (check one). 13. This is an Lx occurrence or ❑ claims made policy (check one). 14. This endorsement is effective on 06/13/2016 at 12:01 A.M. and fors a part of Policy Number 4T22- CO- 8119P586 -T T -16 I, Richard L. Wells (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed June 13th 120 16 _. Z�o Richard L. Wells Signature of uthorized Rep • e tative (Original signature only; no facsimile signature or initialed signature accepted) Phone No._ ( 714 ) 257 -9644 Page D-56 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Doug Martin Contracting Co. Inc. 220 E Foundation Ave La Habra CA 90631 Name and address of named insured ( "Named Insured "): Travelers Corp. One Tower Square Hartford Connecticut 06183 Name and address of Insurance Company ( "Company "): OFFICIAL TITLE OF PROJECT: 2016 ANNUAL SLURRY SEAL PROtECTCIPNO. ST1601 Notwithstanding any inconsistent statement in the policy to which flail endorsement is attacked (the "Policy') or in any endorsement now or hereafter attached thereto, it is agreed ar 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 211 8th Street, 2nd Floor Seal Beach CA 90740 7. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. Page D -58 TYPE OF COVERAGES TO WHICH LIMITS OF THIS ENDORSEMENT ATTACHES LIABILITY Covered Autos Liability $1,000,000 POLICY PERIOD 04/01/16-04/01/17 FROM / TO Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Lx Any Automobiles ❑ All Owned Automobiles iX Non -owned Automobiles I-x Hired Automobiles ❑ Scheduled Automobiles G Garage Coverage ❑ Truckers Coverage ❑ Motor Carrier Act ❑ Bus Regulatory Reform Act ❑ Public Livery Coverage F'1 0 11. A rX deductible or 0 self - insured retention (check one) of S NONE applies to all coverage(s) except: (if none, so state). The deductible is applicable 0 per claim or ❑ per occurrence (check one). 12. This is an % occurrence or 0 claims made policy (check one). 13. This endorsement is effective on 06/13/16 at 12:01 A.M. and forms a part of Policy Number BA- 8119P586- 16 -CNS 1, Richard L. Wells (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed June 13th 20 16 ___ '�f* Signature of Authorized Representative ft 0 Richard L. Wells (Original signature only; no facsimile signature or initiated signature accepted) Phone No.: ( 714 ) Page D -59 ACOR-I a L� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 611312016 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 have ADDITIONAL INSURED provisions or 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 Adamson R McGoldrick Insurance Solutions 1800 E. Lambert Rd., Ste 225 Brea, CA 92821 NAME: Gloria Gabriel PHONE FAX 714- 257 -9644 INC, Ext): AC No: 714- 257 -9833 LO ADDRESS: ggabriel@snains.com INSURERS) AFFORDING COVERAGE NAICp $ 1,000,000 INSURERA: The Travelers Indemnity Company. of Connecticut 25682 www.snains.com INSURED Doug Martin Contracting Co., Inc. 220 E. Foundation Avenue INSURER B: INSURER C: INSURER D: La Habra CA 90631 NSURER E: PREMISES Ea om once) NSURER F: COVERAGES CERTIFICATE NUMBER: 30374014 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSq POLICY NUMBER MMDDYIYYYY POLICY/YYYY LIMITS R A � COMMERCIALGENERAL LIABILITY ,� 4T22- CO- 8119P586- TCT -16 4/1/2016 411/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1�1 OCCUR PREMISES Ea om once) $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY � PRO LOG PRODUCTS - COMP /OP AGO $ 2.000,000 $ OTHER: A AUTOMOBILE LIABILITY ✓ J - -6 COMBINED S INGLE LIMIT Ea acitlent $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acci den t $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ A ,/ UMBRELIALIAB ,/ OCCUR 4TSM- CUP- 8119P586- TIL -16 4/1/2016 4/1/2017 EACH OCCURRENCE Is 4000,000 AGGREGATE $ 4,000,000 E %CESS LVIB CLAIMS -MADE DED RETENTION$None $ I 'A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE YIN 4TJ- UB- 8119P586 -16 4/1/2016 4/1/2017 X STATUTE EORH PER E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED? NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remark$ Schedule, may be attached if more space is required) 2016 Annual Slurry Seal Project, CIP# ST1601 Cityof Seal Beach, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials are named additional insured, this insurance is primary and non - contributory,waiver of subrogation applies,as required by written contract per endorsements attached. CERTIFICATE HOLDER CANCELLATION 2016 Annual Slurry Seal Project, CIP# ST1601 City of Seal Beach y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Engineer 211 8th Street, 2nd Floor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Seal Beach CA 90740 ALIT HORI RE R ENTATWE ©1988 -2015 ACORD ORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD t/ 30314014 I LOUGM -1 I No Signature 16/17 GL /AUTO /UMB /WC I emaoandal 1 6/13/2016 2:37:33 PM (PDT) I Paae : of 8 Doug Martin Contracting Co., Inc. 4T22 -C O -8119 P586- TCT -16 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury ", "property damage" or "personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance ", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: L The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products- completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance ", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non - contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance ". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D2 46 08 05 © 2005 The St. Paul Travelers Companies, Inc. 30374014 I DOUGH -1 I No Signature 16 /11 GWAUTO /UM /WC I emagandal 1 6/13/2016 2:31:33 PM (PDTI I Paa= 2 of 8 Page 1 of 2 COMMERCIAL GENERAL LIABILITY I. How, when and where the 'occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the 'occurrence" or offense. b) If a claim is made or "suit' is brought against the additional insured, the additional insured must: I. Immediately record the specifics of the claim or "suit' and the date received; and H. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit' to Page 2 of 2 any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to 'other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. © 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 30394034 1 DOUGM -1 I No Signature 16/17 GL /AUTO /LIMB /WC I emacandal 1 6/13/2016 2:37:33 PM (POT) I Page 3 of 6 Doug Martin Contracting Co., Inc. 6/13/2016 POLICY NUMBER: 4T22- CO- 8119P586- TCT -16 COMMERCIAL GENERAL LIABILITY CG 20 12 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of Seal Beach, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to opera- tions performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or au- thorization. CG 20 12 05 09 2. This insurance does not apply to: a. 'Bodily injury", "property damage" or "personal and advertising injury' arising out of operations performed for the federal government, state or municipality; or b. 'Bodily injury" or "property damage" included within the "products- completed operations hazard ". © Insurance Services Office, Inc., 2008 30374014 1 DOUGH -1 I No 54goatgl2 16/11 GL /AUT01UM3 1WG I ert,agandal 1 6/13/2016 2:37:33 FM IPDT) I Paqe 4 of 2 Page 1 of 1 ❑ BA- 8119P586 -16 6/13/2016 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsemert, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be exrJuded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest or your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC 8. EMPLOYEE HIRED AUTO EQUIPMENT- INCREASED LIMIT C. EMPLOYEES AS INSURED 1. WAIVER OF DEDUCTIBLE - GLASS 0. SUPPLEMENTARY PAYMENTS - INCREASED J. PERSONAL EFFECTS LIMITS K. AIRBAGS E. TRAILERS - INCREASED LOAD CAPACITY L. AUTO LOAN LEASE GAP F. HIRED AUTO PHYSICAL DAMAGE M. BLANKET WAIVER OF SUBROGATION G. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II - LIABILITY COV. ERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or 'property damage" occurs and that is in effeC: during the policy period, to be named as an addi. lional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or• ganization qualifies as an "insured' under the Who Is An Insured provision ccntained in Section it. B. EMPLOYEE HIRED AUTO 1. The fallowing is added to Paragraph A.1„ Who Is An Insured, of SECTION II - LI. ABILITY COVERAGE: An "employee" of yours is an "insured" while operating a covered "auto' hired Or rented under a contract or agreement in that "em- ployee's" name, with your permission, while performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV - BUSI- NESS AUTO CONDITIONS: In. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos- you own: (1) Any covered "auto- you lease, hire, rent or borrow; and (2) Any covered "auto' hired or rented by your "employee" under a contract in that individual 'employee's- name, with your permission, while perforrm- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto'. C. EMPLOYEES AS INSURED The following is added to Paragraph A,1„ Who Is An Insured, of SECTION 11 - LIABILITY COV- ERAGE: CA T4 20 07 10 07010 The Traaelers Ind a nnity Company. All rights toSONad. Includes capyrighled material of Insuranco Sere ee Offide.Inc, with its permission. 30379014 1 UOUGM -1 I No Slgaacure 16/17 GL /AUTO /UM6/WC I emagandal 1 6/13/2016 2:37:33 PM IPDTI I Page 5 Of 3 Page 1 of 3 COMMERCIAL AUTO a E. F Any "employee- of yours is an insured' while us- ing a covered 'auto' you don't own, hire or borrow in your business or your personal affairs. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION II - LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The fallowing replaces Paragraph A.2.a.(4) of SECTION II - LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured- at our request, including actual loss of earnings up to 5500 a day be- cause of time off from work. TRAILERS - INCREASED LOAD CAPACITY The following replaces Paragraph C.1, of SEC- TION I - COVERED AUTOS: 1. 'Trailers' with a load capacity of 3.000 pounds or less designed primarily for travel on public roads. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph A.4„ Cover- age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage If hired 'autos' are covered "autos' for Liability Coverage but not covered 'autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an owned - auto', then the Physical Damage Coverage is extended to -autos that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss' in any one -accident- to a hired, rented or borrowed 'auto" is the lesser of; (a) $50,000; (b) The actual cash value of the damaged or stolen property as of the time of the ' loss "; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total 'toss ". (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A. deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto ". (5) This Coverage Extension does not apply to: (a) Any "auto' that is hired, rented or bor- rowed with a driver, or (b) Any 'auto" that is hired, rented or bor- rowed from your "employee". G. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES -INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III - PHYSICAL DAMAGE COVER- AGE: We will pay up to S50 per day 10 a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT- INCREASED LIMIT Paragraph C.2,. Limit Of Insurance, of SEC- TION III - PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVER OF DEDUCTIBLE - GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III - PHYSICAL DAMAGE COVERAGE: No deductible for a covered 'auto" will apply to glass damage if the glass is repaired rather than replaced. J. PERSONAL EFFECTS The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Personal Effects Coverage We will pay up to 5400 for -loss" to wearing ap- parel and other personal effects which are: (1) Owned by an "insured "; and (2) In or on your covered 'auto . This coverage only applies in the event of a total theft of your covered "auto". No deductibles apply to Personal Effects cover. age. Page 2 of 3 C 2010 The Travelers Ineemniry Company. Al nghis reserved- CA T4 20 07 10 Indodes eopytighted materiel of Insurance ServirAs Ocoee. Inc. vier its pennlssien. 30394014 1 DOUGM -1 I No Siunatore 16 /17 GL /AUTO /UMP /K I emauaudal 1 6/13/2016 2:39:33 PM (PDT) I Paoe 6 of 8 K. L. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION 111 — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss' to one or more airbags in a covered "auto' you own that in- Slate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto' is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of S1,000 for any one "loss ". AUTO LOAN LEASE GAP The following is added to Paragraph A.4., Cover. age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto' less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that 'auto'; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of the "loss "; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior to any "accident" or "toss ", pro- vided that the " accident" or'loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. CA T4 20 07 10 A 2010 The Travelers Indemnity Company. All rights res awed. Page 3 of 3 includes copyrighted material of Insurance Services Office, Inc. with its permission. 30374014 1 UOUGM -1 I No Signatn Ce 16/17 G6/AOTO /UM /WC I emauantlal 1 6/13/2016 2:37:33 PM (PUT) I Paqe 7 of 8 STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business & Professions Code § 7028.15] [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 furnished and the cost of completing the work to be performed. (c) This section shall not apply to a joint venture license, as required by Section 7029.1. However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to this section with respect to his or her individual licensure. (d) This section shall not affect the right or ability of a licensed architect, land surveyor, or registered professional engineer to form joint ventures with licensed contractors to render services within the scope of their respective practices. (e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non - responsive and shall be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any purchase order issued to, a contractor who is not licensed pursuant to this chapter is void. (f) Any compliance or noncompliance with subdivision (e) of this section, as added by Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect. (g) A public employee or officer shall not be subject to a citation pursuant to this section if the public employee, officer, or employing agency made an inquiry to the board for the purposes of 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 the forfeiture of the security of the bidder. License No.: 470131 Class: Date: June: 15 , 2016 C -12 Page D -63 Expiration Date: March 31, 2017 AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code §§ 1720, 1773.8,1775, 1776 ,1777.5,1813,1860,1861,37001 The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the Following provisions of California law: I. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency ( "Agency ") and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency, forfeit twenty -five dollars ($25) for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2, Part 7, Chapter I, Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self - insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract." Date June 15, 2916 Signature k L,( ,1 k(, M Dixie Martin, Secretary Page D -65 INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTION TITLE OFPROJECT OR WORK: 2016 Annual Slurry Seal Project, CIP# ST1601. Indemnitor(s) (list all names): DOUG MARTIN CONTRACTING COMPANY, INC. 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" Doug Martin Contracting Company, Inc. Name Name: By. By. — Its president Page D -67 Section C PROPOSAL. Bidders Name Doug Martin Contracting Co., Inc. TO TILE 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 swom 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 furnish or provide all materials, labor, tools, equipment, apparatus and other means necessary so to do, except such thereof as may otherwise be furnished 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 Contractor's 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 certi hec ", r "a Bidder's Bond in the fort furnished by the City ", as the case may be) in the amount of $`�� o )did an amount equal to at least ten percent (10 9/6) 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 detemtine. 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 30 Working Days starting from the day after the issuance of the Notice to Proceed. Page C -1 FOR: 2016 ANNUAL SLURRY SEAL PROJECT CIP No. ST1601 BID SHEET Item Description Unit Quantity Unit Price Extended Price No. (in Figures) (in Figures) 1 Unclassified Excavation; complete CY 45 > oG d0 and in place. Furnish and Install Crushed 2 Aggregate Base (CAB); complete CY 30 $ ilo,00 $ 3 and in place. 3 Furnish and Install Asphalt Concrete (A.C.) Pavement PG 64- TON 30 $ / 1%/. $ 2 3G 10; complete and in place. Furnish and Install Tire Rubber Modified Slurry Seal (TRMSS) - 4 Type 2, including but not limited to: street sweeping, traffic control, SF 338,300 $ construction BMP's, crack sealing and public convenience and safety; complete and in place. Furnish and Install Striping Stop 5 Bar and Legend with 2 coats of EA 18 $ 60 paint; complete and in place. 6 Furnish and Install 4" Dash Yellow Centerline with 2 coats of paint; LF 290 $ $ 6,2 5, J-0 complete and in place. 7 Furnish and Install 4" Solid Double Yellow Line with 2 coats of paint; LF 500 $ �S ` $ 41 0 7 S. n complete and in place. 8 Furnish and Install 12" Crosswalk White Line with 2 coats of paint, LF 270 $ -50 $ complete and in place. Mobilization and Demobilization, including but not limited to, 9 complete punch list, preparation of LS 1 00 od $T 940 — a Water Pollution Control Plan (WPCP); complete and in place. TOTAL BID PRICE (ITEMS NO. 1 THROUGH 9) ONE RicsXjr..6-V 704e'0 Z6 �" �ihr+C' S�v> Q'- a =7✓%t! �fY+✓%S $ L✓ / �fJ cs WORDS FIGURES Page C -2 July 26, 2016 Doug Martin Contracting Co., Inc. 220 Foundation Avenue La Habra, CA 90631 Attn: Doug Martin RE: Agreement for 2016 Annual Slurry Seal Project CIP No. ST1601 Dear Mr. Martin: 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.gov 562 - 431 -2527 Ext.1304 Enclosure