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HomeMy WebLinkAboutAGMT - Golden State Constructors (2016 Annual Concrete Repair Program Project CIP No ST1604);, .: `7''6RDING 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 111111IIIIIIIIII111111111111IIIIIII 111111111IIIl� 111IIIIII111111111111 NO FEE 2016000553933 2:54 pm 11108116 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, 27383["IR0 2CIEmE I NOTICE OF COMPLETION i'NOV 15 2016 Notice pursuant to Civil Code Section 3093, must be filed within 10 days after Notice is hereby given that: 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 Concrete Repair Program Project. No. ST1604. 6. The name of the contractor(s), if any, for such improvement was: Golden State Constructors, 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 foreglbin� is true and correct. Executed on 1013 1 � l l0 2016, t Seal Bea A cji, California. (Date of Signature) I I Director of Public Works, City of Seal Beach /V3 IT . • • PUBLIC WORKS AGREEMENT FOR 2016 ANNUAL CONCRETE REPAIR PROGRAM PROJECT CIP NO. ST1604 between City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 N Golden State Constructors 208 E. Orangethorpe Avenue Placentia, CA 92870 (714) 625 -8758 (714) 625 -8295 - FAX THIS AGREEMENT is made as of June 27. 2016 by and between the City of Seal Beach, a California charter city ( "City "), and Golden State Constructors. a General Contractor ( "Contractor "). 1 of 9 1\ 0 0 RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the 2016 Annual Concrete Repair Program Project CIP No. ST1604 ( "Project ") with respect to design criteria; and B. WHEREAS, Contractor has submitted a bid to City for the Project dated June 7, 2016 in the amount of $67,993 ( "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 $67,993, subject to any additions and deletions pursuant to the terms of the Contract Documents. Said sum shall constitute payment in full for all work performed hereunder, including, without limitation, all labor, materials, equipment, tools and services used or incorporated in the Work, supervision, administration, overhead, expenses and any and all other things required, furnished or incurred for completion of the Work as specified in the Contract Documents. City shall make payments to Contractor on account of the contract sum at the time, in the manner, and upon the conditions specified in the Contract Documents. The City Manger may authorize extra work to fund unforeseen conditions up to the amount approved at the time of award by the City Council. Payment for additional work in excess of this amount requires prior City Council authorization. 4. Contractor's Personnel. 4.1 All Work shall be performed by Contractor or under Contractor's direct supervision, and all personnel shall possess the qualifications, permits, and licenses required by state and local law and by the Notice Inviting Bids /instructions to Bidders to perform such Services, including, without limitation, a City of Seal Beach business license as required by the Seal Beach Municipal Code. 4.2 Contractor shall be responsible for payment of all employees' wages and benefits, and shall comply with all requirements pertaining to employer's liability, workers' compensation, unemployment insurance, and Social Security. Contractor shall fully comply with the workers' compensation law regarding Contractor and Contractor's employees. 4.3 Contractor shall indemnify and hold harmless City and its elected officials, officers, employees, servants, designated volunteers, and agents serving as independent contractors in the role of city officials, from any and all liabilities, damages, claims, costs and expenses of any nature to the extent arising from Contractor's alleged violations of personnel practices. 4.4 Contractor is, and shall at all times remain as to City, a wholly independent contractor. Contractor shall have no power to incur any debt, obligation, or liability on behalf of City or otherwise act as an agent of City. Neither City nor any of its agents shall have control over the conduct of Contractor or any of Contractor's employees, except as set forth in this Agreement. Contractor shall not, at any time, or 3 of 9 in any manner, represent that it or any of its officers, agents, or employees are in any manner employees of City. Contractor shall pay all required taxes on amounts paid to Contractor under this Agreement, and indemnify and hold City harmless from any and all taxes, assessments, penalties, and interest asserted against City by reason of the work performed pursuant to this Agreement. 4.5 City shall have the right to offset against the amount of any fees due to Contractor under this Agreement any amount due to City from Contractor as a result of Contractor's failure to promptly pay to City any reimbursement or indemnification arising under this Section 4. 5. Indemnification. 5.1 Contractor's Duty. Contractor shall defend, indemnify, and hold the City, its elected officials, officers, employees, volunteers, agents, and those City agents serving as independent contractors in the role of City officials (collectively "Indemnitees") free and harmless from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, bid protests, stop notices, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's fees, disbursements and court costs) of every kind and nature whatsoever (individually, a "Claim," collectively, "Claims "), in any manner arising out of or incident to the performance of the Agreement, including without limitation, the payment of all consequential damages and attorneys' fees and other related costs and expenses. Further, Contractor shall appoint competent defense counsel, at Contractor's own cost, expense and risk, to defend any and all such suits, actions or other legal proceedings of every kind arising out of or incident to the performance of the Agreement that may be brought or instituted against Indemnitees. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against City or the other Indemnitees in any such suit, action, or other legal proceeding arising out of or incident to the performance of the Agreement. Contractor shall reimburse the City and the other Indemnitees, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by Contractor or Indemnitees. This indemnity shall apply to all Claims and liability regardless of whether any insurance policies are applicable. 5.2 Bid Protests. In addition to its obligations pursuant to Section 5.1, Contractor shall reimburse the City for all attorneys' fees and costs incurred by City in connection with, arising out of or incident to any bid protest. 5.3 City's Sole Negligence. Nothing in Section 5.1 shall be construed to require Contractor to indemnify Indemnitees for that portion of any Claim to the extent arising from the sole negligence or willful misconduct of the Indemnitees. 5.4 Nonwaiver of Rights. Indemnitees do not, and shall not, waive any rights that they may possess against Contractor because of the acceptance by City, or 4 of 9 0 0 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. 11/85) covering Additional Insured — Owners, Lessees or Contactors (Form B). 5of9 0 0 6.2.4 Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 6.3 Minimum Limits of Insurance. Contractor shall maintain limits no less than: 6.3.1 General Liability: $2,000,000 per occurrence and in the aggregate for bodily injury, personal injury and property damage. Commercial General Liability Insurance or other form with a general aggregate limit shall apply separately to this Agreement or the general limit shall be twice the required occurrence limit. 6.3.2 Automobile Liability: $2,000,000 per occurrence for bodily injury and property damage. 6.3.3 Employer's Liability: $1,000,000 per occurrence and in the aggregate for bodily injury or disease and Workers' Compensation Insurance in the amount required by law. 6.4 Deductibles and Self- Insured Retentions. Contractor shall inform City of any deductibles or self- insured retentions except with respect to any professional liability insurance. 6.5 Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: 6.5.1 City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor; products and completed operations of Contractor; premises owned, occupied or used by Contractor; or automobiles owned, leased, hired or borrowed by Contractor. The coverage shall contain no limitations on the scope of protection afforded to City, its officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials which are not also limitations applicable to the named insured. 6.5.2 For any claims related to this Agreement, Contractor's insurance coverage shall be primary insurance as respects City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials. Any insurance or self- insurance maintained by City, their officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials shall be excess of Contractor's insurance and shall not contribute with it. 6.5.3 Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. 6 of 9 • • 6.5.4 Each insurance policy required by this Section 6 shall be endorsed to state that coverage shall not be canceled or materially modified except after 30 days prior written notice by first class mail has been given to City. 6.5.5 Each insurance policy, except for any professional liability policy, required by this Section 6 shall expressly waive the insurer's right of subrogation against City and its elected officials, officers, employees, servants, attorneys, designated volunteers, and agents serving as independent contractors in the role of city or agency officials. 6.6 Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VIIl unless waived in writing by City's Risk Manager. 6.7 Verification of Coverage. All insurance coverages shall be confirmed by execution of endorsements on forms approved by the City. The endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All endorsements are to be received and approved by City before services commence. As an alternative to City forms, Contractor's insurer may provide complete, certified copies of all required insurance policies, including endorsements effecting the coverage required by these specifications. 7. Liquidated Damages. Should the Contractor fail to complete the project, or any part thereof, in the time agreed upon in the Contract, the Contractor shall reimburse the City for the additional expense and damage for each calendar day that the Contract remains uncompleted after the Contract completion date. It is agreed that the amount of such additional expense and damage incurred by reason of failure to complete the Contract is the per diem rate of $750.00 per calendar day. Such amount is hereby agreed upon as liquidated damages for the loss to the City resulting from the failure of the Contractor to complete the project within the allotted time and to the value of the operation of the works dependent thereon. It is expressly understood and agreed that this amount is a reasonable amount and is established in lieu of damages that are incapable of calculation at the inception hereof; and this amount is not to be considered in the nature of a penalty. The City shall have the right to deduct such damages from any amount due, or that may become due to the Contractor, or the amount of such damages shall be due and collectible from the Contractor or the Contractor's Surety. Progress payments made after the scheduled completion date shall not constitute a waiver of liquidated damages. 8. Suspension. City may, in writing, order Contractor to suspend all or any part of the Contractor's Services for the convenience of City or for work stoppages beyond the control of City or Contractor. A suspension of the Services does not void this Agreement. 9. Notices. Any notices, bills, invoices, or reports authorized or required by this Agreement shall be in writing and shall be deemed received on (a) the day of delivery if delivered by hand or overnight courier service during Contractor's and City's 7 of 9 • i 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: Golden State Constructors 208 E. Orangethorpe Avenue Placentia, CA 92870 Telephone: (714) 625 -8758 Fax: (714) 625 -8295 Attn: Ronnie Cochran 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. MOMS 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 CONTRAC OR- By: By: ngram, me: loQoi(5- n 6� Alle title: "i 2�RT Robin Roberts, City C[ WY- As's=y cTSZ+ Name: Approved as to m: Title: By: Cra tee e, City Attorney 9 of 9 THE FINAL PREMWM Is PREDICATED ON To FINAL CONTRACT PRICE Bond No. 2206249 KNOW ALL PERSONS BY THESE PRESENTS that 0 Bond Premium $1,700.00 PERFORMANCE BOND Bond No.: 2206249 (One of Three Originals) WHEREAS the City of Seal Beach, has awarded Golden State Constructors, 208 E. Orangethorpe Ave., Placentia, CA 92870 (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: 2016 Annual Concrete Repair Program Project No. ST1604 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 North American Specialty Insurance Company, 6 Hutton Centre Drive. Suite 850, Santa Ana, CA 92707 (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 Sixty Seven Thousand Nine Hundred Ninety Three and 00/100 Dollars (S ), this amount being not less than the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed there under, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications there under. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: "Principal" "Surety" Golden State Constructors North American Specialty Insurance Company Page D -39 • • By: 1� ! By: Its Its Attorney -in -Fact, Matthew . Dobyns M Its Its -- (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and'ev'id n6c of the authority of any person signing as attorney -in -fact must be attached. Page D -40 NASSURETYGROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY TI -II?SE PRI- SFNTS.'fl -IAT North American Specialty Insurance Company_ a corporation duly organized and existing under laws of the State of New I- latipshire. and having its principal oflice in the City of Manchester. New Ilannpshine. and Washington International Insurance Company_ a corporation organized and existing under the laws of the State of New I- lannpshire and haying its principal office in the City of Schaumburg_ Illinois, each does hereby make. constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOINTLY OR SIEVIERALLY Its true and lawful Atlorney(s) -in -Pact. to make. execute. seal and deliver. for and on its behalfand as its act and deed. bonds or other writings obligator in the nature of bond on behalf of each of said Companies. as surety, on contracts ol'suretyship its are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or sureb ship executed under this authority shall exceed the amount of: FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9'h of May. 2012: " RESOLVI3D. that any t ro of the Presidents. any Managing Director. any Senior Vice President. amt Vice President. any Assistant Vice President. the Secretan or am Assistant Secretary be. and each or am' ofthem hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given lower of Attorney to execute on behalf of the Company bonds. undertakings and all contracts of surely. and that each or amt of them hereby is authorized to attest to the execution of any such Power ofAttomey and to attach therein the seal offhe Company: and it is PUR'I'HER RESOLVED. that the signature of such officers and the seal of the Company mar be affixed to any such PcONci of Attorney or to any certificate relating thereto by facsimile. and any such Power of Attorney or certificale bearing such l acsimile signatures or facsimile seal shall be binding upon the Compam, when so affixed and in the future with regard to any bond. undertaking or contract of surety to which it is attached." nunillnrn �a `NypaStt AIIiYi 1p"�M Qp 110 a`y YYY Oise +. Lq'4 �A_. �(/,y 13\. 14�F.(P0.FOi�eSLg `rt SEAL .n= Sol]., P.sna.r.nn. Sc. -Vice Prc,mc�lniW:,,hincom mlernnann.nn,nrenrecnmmmo 222' SEAL -vW4ty%y 1979 yiQ` & senior %ice Pneiaeni orNorth American Specialo Insorznee Compano O pm 13y ..W... *tVa ]nana,l ,\.Im,3mnor C me P�rs:T1., CfiT1nT� S Senior \ire P —ident of 6o-th Amencan S,cinlp Insurance Counra . IN WIIN'ESS WI- IEREOI7. North American Specially Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed. and these presents to be signed by their authorized officers this I Oth day of May _ 2016 . North American Specialh' Insurance Company Washington International Insurance Company Stale of Illinois County of Cook ss. On this 10th day of May _ 20 16 , bellxe me, a Nolan Public personally appeared Steven P. Anderson , Senior Vice ]'resident of Washington International Insurance Company and Senior Vice ]'resident of North American Specialty Insurance Company and Michael A. Ito . Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company. personally known to me. who being by me duly sworn. acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the Voluntary act and deed of their respective companies OFFICIAL SEAL M �t NY v NOTANY PUBUC, S7ATE OFIWNOIS M. KCnny, Notary Public 1 A1Y COMMISSION E7NIPES t710 112 0 1 1 I. Jeffrey Coldbere .the duly elected Assistant Secrelary of-North American Specialh' Itlsurance Company and Washington International Insurance Connpanv, do hereby certify that the abo%c and Ibregoing is a true and correct copy tifa Power of Attorney given by said North American Specialh• Insurance Company and Washington International Insurance Company, which is still -in °hii free and effect. IN WITNI'SS WHEREOF. I ]face set my hand and atfixed the seals of the Companies this 17111 day of June_ 20. 16 . Jeffrec Goldberg, Via, `,,,dent @ A,csistant Secremp of R's l uo.n l.oc —oonal h'w.'n a ('o oTipar, A, North Americus speclalp' Insurmee Company 0 CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT 0 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 17", 2016 before me, ERIKA GUIDO, NOTARY PUBLIC, personally appeared MATTHEW R. DOBYNS ® who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity (ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. 'ERI1cP GUIDOu i WITNES hand and official seal. COMM. # 2022671 f NOTARY PUBLIC CALIFORNIA ORANGE COUNTY May 5, 20R 91 M��omm. expires L- --.- -- ature otary ®P�T�I01V?AL below is not required by law, it may prove valuable to persons relying on the document and rThoughthe udulent reattachment of this form. CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN /CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: _ NAME OF PERSON(S) OR ENTITY(IES) 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 —1 l —I b before me, Claudia Cochran, Notary Public ero -insed nacre and Ude of e officer) personally appeared Ronnie Cochran who proved to me on the basis of satisfactory evidence to be the person(*whose name(&) isfefe subscribed to the within instrument and acknowledged to me that he/sbeAhey executed the same in his /heF/4heiF authorized capacity(leg), and that by hisilheikFieir signature(&) on the instrument the person(&), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ClAUO1A COCNRAN COMM N 2095862 WITNESS nd ial seal. Z ORANGE COUNTY Q e� NOTARY PUBLIC- CAUFORNIA z MY COMMISSION EXPIRES / JAN. J0, 2019 Notary Ic ignature (Notary Public sea, ADDITIONAL OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or of Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer rte ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Thisfonn enmplies with current California statute., regarding notary wording and, ifneeded, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the Culifornia notan• to violate California notary law. • State and County information must he the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the dale that the signer(s) personally appeared which must 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 commission followed by a comma and then your title (notary public). • Print the names) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural fortes by crossing off incorrect forms (i.e. he/she /they- is /ere) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different acknowledgment form. • 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 acknowledgment is not misused or attached to a different document. •} Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CFO, CFO, Secretary). • Securely attach this document to the signed document with a staple. 0 0 (One of Three Originals) Bond No. 2206249 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 Golden State Constructors, 208 E. Orangethorpe Ave., Placentia, CA 92870 (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: 2016 Annual Concrete Repair Propsam, Project No, ST1604 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 North American Specialty Insurance Company, 6 Hutton Centre Drive, Suite 850, Santa Ana, CA 92707 (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 Thirty Three Thousand Nine Hundred Ninety Six and 50/100 uouars (a J ,VyU.Du 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 a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. 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-42 0 name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: "Principal" Golden State Constructors By: Lt 1A "Surety" North American Specialty Insurance Company By:� Its Attorney -in -Fact, Mat he . Dobyn, By: By: — _ -'Its , 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-43 NAS SURETY CROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL P0NVER OF ATTORNEY KNOW ALL NIEN BY'Hi17SE PRESENTS_ TTTA'f North American Specialty Insurance Company, a corporation Flak' organized and existing under laves ofthe State of New I- Iampshire. and having its principal office in the City of Manchester. New I lanipshire. and Washington International Insurance Company, a corporation organized and existing under the Imes ofthe Slate of New Hampshire and having its principal office in the City of Schaumburg. Illinois-. each does hereby make. constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOIN "I'LY OR SEVERALLY Its true and lawful Atiorney(s) -in -Fact, to make, execute, seal and deliver. for and on its behalf and as its act and deed. bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies. as surety. on contracts of suretyship as are or mac be required or permitted by law. regulation. contract or otherwise. provided that no bond or undertaking or contract or suretvship executed under this authority shall exceed the amount of FIFTY MILLION IS50.000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and be the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9'h of May. 2012: °RHSOLVED. that any two of the Presidents, any Managing Direclor, am' Senior Vice President, any Vice President. any Assistant Vice President. the Secretary or any Assistant Secretart' be. and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalfof the Company bonds. undermkings and all contracts of surely, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney, and to attach therein the seal of the Company: and it is PUR 'I I IER RESOINI'D, that the signature of such officers and the seal of the Company map be affixed to any such Power of Anonlcy or to any certificate relating thereto by facsimile. and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to am• bond. undertaking or contract of'surety to which it is attached. -' `\SO \pia wry, Iph aw p altlW YC o 'kSL \pT10N,tt/ �Tp•.Q R a`�rQ�,.p0.PONfLg g rr�i > sn, ml Seri., I we sen,idcnIe North vnrwmhlnpmn lmernaaeacll..) emm�an, pW'n� 6Senior \ "ico Prc�idcm of NnrtM1 Amrnran 5pcciahr lnwrance Cr Cnngmn) � m AlNael A. Flo. Senior\ "ire P:esulenlofno,hinRlon Inlernanonal lonnwnce Ca:nPnq 3 senior wire IceQ1ol of Nam: Amedenn Spcciabl I-orn ice eompan. IN WITNESS WI- IERFOF. North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed. and these presents to be signed by' their authorized officers this 10111 day of May . 7016 North American Sp cialty Insurance Company Washington International Insurance Compam" State of Illinois County of Cook ss' On this I Oth dap of Mav . 2016 . before me. a Notary Public personally appcered Steven P. Anderson _ Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Compam' and Michael A. Ito . Senior Vice President of Washington International Insurance Company and Senior Vice President ofNonh American Specialty Insurance Company. personally known to me who being by are duty sworn. acknowledged that they signed the abovr power of Attorney as oIf icers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M KENNY NOTARY PURl1C, STATE OF IWNOIS MY COMMISSION EXPIRES 72048017 L M. Kenny, Notary Public 1 1..Icfl}cv Goldberg . the duly elected Assistant Secretary of Noah American Specialty Jnsurance Company and Washington International Insurance Company- do hereby certify that the above and foregoing is it true and correct ropy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in Gall force and effect. IN WITNESS WI- IEREOP. I have set ntv hand and affixed the seals ofthe Companies this 17101 day cf - !!jurre .20 16 :c F:esidenr& A,,..' Secremry or Inwiaoce ComMlp' R Noah American SVec,d1v I.,.nnce Company '} l • 0 CALIFORNIA ALL - PURPOSE 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 17th, 2016 before me, ERIKA GUIDO, NOTARY PUBLIC, personally appeared MATTHEW R. DOBYNS ® who proved to me on the basis of satisfactory evidence to be the persol whose name(ej is/are subscribed to the within instrument and acknowledged to me that he /slle /they executed the same in his /heF /t+leir authorized capacity (ies , and that by his/hl signature(s_} on the instrument the persol or the entity upon behalf of which the person ¢ s -} acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ER�IKAGUIDO COMM. # 2022671 NOTARY PUBLIC CALIFORNIA c WITNE my hand and official seal. ORANGE COUNTY " \ � expires May 5l ature o tary OPTIONA;I. ' Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN /CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: _ NAME OF PERSON(S) OR ENTITY(IES) 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 before me, Claudia Cochran, Notary Public ere insert name ttral role of too, o cer personally appeared Ronnie Cochran who proved to me on the basis of satisfactory evidence to be the person(*whose name(&) isk-" subscribed to the within instrument and acknowledged to me that he/shefthey executed the same in his/hAF414POFauthorized capacity(ae�, and that by his /*erR4w- f signature(&) on the instrument the person(-4, or the entity upon behalf of which the person(* acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correq�— WITNESS rny-ha.Qd and official seal. yQ -•rF Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL IN OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) of Pages Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer de • Partner(s) • Attorney -in -Fact ❑ Trustee(s) ❑ Other CLAUDIA COCHRAN COMM # 2095862 ORANGE COUNTY NOTARY PUBLIC-CALIFORNIA Z My COMMISSION EXPIRES JAN.30,2019 INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California tmtary to violate California rmtary law. • State and County information must be the State and County where the document signers) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must 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 commission followed by a comma and then your title (notary public). • Print the names) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plum] forms by crossing off incorrect fors (i.e. fie /shehl+eyr is lave) or circling the correct fors. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. •S Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. 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. 0 0 WORKER'S COMPENSATION CERTIFICATE OF INSURANCE WHEREAS, the CITY OF SEAL BEACH has required certain insurance to be provided by NDA- G�� NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insureds and that the same are in force at this time. 1. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL BEACH, CA 90740 -6379. 2. The insureds under such policy or policies are: (:Z9 eQe0 SCAN Z- G.`ya 5 :Y�NC�oh -S 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 6%- 0wG�0 0t'S2- 2 -(�. -t0 Z -6 -li 4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability, unless and until thirty days' advance tten notice thereof has been served upon the City Clerk of the CITY OF SEAL BEACH. Page D -45 0 EXHIBIT D -1 0 ADDITIONAL INSURED ENDORSEMENT COMMERCIAL GENERAL LIABILITY [INSERT INSURANCE CERTIFICATE SHOWING COMMERCIAL GENERAL LIABILITY] NaV D -46 ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY Name and address of named insured ( "Named Insured "): A,�n4_s (L"-YZ- Name and address of Insurance Company ( "Company "): OFFICIAL TITLE OF PROJECT: 2016 ANNUAL CONCRETE REPAIR PROGRAM CIP No. ST1604 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: 1. 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 agreement(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 -47 City Engineer City of Seal Beach 21 l 8th Street, 2 "a 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. TYPE OF COVERAGES TO WHICH POLICY PERIOD t - &l_t6 LIMITS OF THIS ENDORSEMENT ATTACHES FROM /TO I -11 -I+ LIABILITY (,90OP -`aD IL Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: ❑ Contractual Liability ❑ Owners /Landlords /Tenants ❑ Manufacturers /Contractors ❑ Products /Completed Operations 0 Broad Form Property Damage ❑ Extended Bodily Injury ❑ Broad Form Comprehensive k General Liability Endorsement ❑ Explosion Hazard ❑ Collapse Hazard ❑ Underground Property Damage ❑ Pollution Liability ❑ Liquor Liability 0 11 A Kf deductible or ❑ self - insured retention (check one) of $ Z15-00 applies to all coverage(s) except: (if none, so state). The deductible is applicable 0 per claim or ❑ per occurrence (check one ). 13. This is an q" occurrence or 0 claims made policy (check one). 14. This endorsement is effective on 7-31-16 at 12:01 A.M. and forms a part of Policy Number oop 5j :v 6 4 —y (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 Signature of Authorized Representative 20 16' (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( T1 ) 9qZ- Z Page D -48 • ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Name and address of named insured ( "Named Insured "): Name and address of Insurance Company ( "Company "): OFFICIAL TITLE OF PROJECT: 2016 ANNUAL CONCRETE REPAIR PROCRAm CIP No. STI604 Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy') or in any endorsement now or hereafter attached thereto, it is agreed as follows: The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. I. 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 shalt 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 taws 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 shalt be sent to Public Agency at: City Engineer City of Seal Beach 211 8th Street, 2 °d 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 -50 E EXHIBIT D -2 40 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY [INSERT INSURANCE CERTIFICATE SHOEING AUTOMOBILE LIABILITY] Page D -49 0 TYPE OF COVERAGES TO WHICH LIMITS OF THIS ENDORSEMENT ATTACHES LIABILITY • POLICY PERIOD FROM / TO "_ IG .10 Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Y Any Automobiles JJC—All Owned Automobiles ❑ Non -owned Automobiles ❑ Hired Automobiles ❑ Scheduled Automobiles ❑ Garage Coverage ❑ Truckers Coverage ❑ Motor Carrier Act ❑ Bus Regulatory Reform Act ❑ Public Livery Coverage ❑ 11. A fl deductible or ❑ self - insured retention (check one) of S — 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 0 occurrence or 21 claims made policy (check one). 13. This endorsement is effective on L-�-lG at 12:01 A.M. and forms a part of Policy Number l(JAAS 51U9 I, (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 a— 6 , 20 ((o Signature of Aut orized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( �1 1 ) g01 I— 6783 Page D -51 EXHIBIT D -3 ADDITIONAL INSURED ENDORSEMENT [INSERT INSURANCE CERTIFICATE SHOWING PROFESSIONAL INSURANCE LIABILITY, IF REQUIRED] Page D -52 a OP ID: MH ac�o,RC� CERTIFICrTE OF LIABILITY INSURANCE DATE1211(2 16 06!211201 fi 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 pollcy(les) must he endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Huntington Pacific Ins. Agency 7901 Professional Circle NAME. Mark Heberden PHONE PAX aC if. ER.714- 841 -6283 Arc. Na: 714 -542 -2538 EMAIL I mark huntpacificinsurance.com Huntington Beach, CA 92699 Mark Heberden CLSmweR " GOLDENS 00051764 -4 INSURER (S) AFFORDING COVERAGE NAIC P INSURED Golden State Constructors, Inc INSURERA .James River Ins. Company 12203 208 E. Orangethorpe Ave. INSURER B: Liberty Mutual Insurance Co. 23043 Placentia, CA 92870 INSURER c: NOMARD Insurance Co. 25844 INSURER 0'. Id CG C- -F; °n�cna F'-ar) INSURER E NSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE PEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AODL SURR POLICY EFr POLICY EXP LTR TYPE OF INSURANCE IHSR VAID POLICY NUMBER- Immomyyyyj (MwnrvWwj LIMBS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. GENERAL LIAB Trf Seal Beach, CA 90740 AUTHORIZED REPRESENTATIVE LAC1!"_JJtY. -NCL S 1,000,00 A _ X rC.r,NEgr AL C.EPI=:pL UpE L -r X 00051764 -4 01/31/2016 01:31/2017 °U °'= oPLF tc PeFG sFS :F:. •,•:'.� 50,00 CLIW—, I E Lx— ']CCUE Id CG C- -F; °n�cna F'-ar) 1,000,00 X $2500 Deductible Cr IE-,ALACCZEr ATE 2,000,00 ELPI'L ?3GV:-3AI-LASI1 A. -n'L L_NLN.: I'ROCVCI3 ! 'MPILPACC b 2,001),00 AUTOMOBILE LIABILITY COId DIVCC iINO_C_v T 1,000,00 1 Eo scriJeie B X eII� AUTO BAA56352859 02/06/2016 02/0612017 Dr 411NJJF' iF'sr o =rscni ' nl ,1WPI- �:�.� J. UC_p_I IItl IJF- 'Pe'attl�ert7 _CL- DULEDAL ACS PPUPE?Pi DAMAGE I IF CL AUTrS NLR AC CLNI: ' Deductible LcN-ONI,. Druns UMBRELLA LIAR ;rfGIIP CAC I OC]U;R -'ACC - AG1FF1TF EXCE9SLIAB ^I .'.IMSF'i.f.= LLLJLI LL= n ETEP.I -C.V S C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY :,nY= ,rr,IFroF�.tem= .TZFC.ITO= YIN GOWC700132 02106/2016 02106/2017 OTh- X LIMI -i El c._.cu <cotrr_ a 1,000,00 .- FIC =R;LfER- XCLLDED' C ME J (MarNLoryln NHn NIA L._. UI _trait - ALNIIF_0'rtL 3 1,000,00 I'ee= cescriCa irrr C I E._DI SEAYE - _h LY 1`.1- 1,000,00 DESCRIPTION OF OPERATION9l LOCATIO NS1bepaiS (Attach fte marks Schedule,Smore cpaw is nR1+Iredj 2016 Annual Concrete Repair Program Project - CIP No. 5T1609 ram Project ity of Seal Beach,its officers ,officials,employees,designated volunteers and agents are named as Additional Insured in respects to the General 5 Auto Liability. CERTIFICATE HOLDER CANCELLATION SEAL001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Seal Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 211 8th Street, 2nd Floor Seal Beach, CA 90740 AUTHORIZED REPRESENTATIVE ©1988 -2009 ACORD CORPORATION. All fights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following, ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work' which is imputed to such person or organization ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US 11 -06 Page 1 of 1 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ ITCAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contractor written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031US 04 -10 Page 1 of 1 0 POLICY NUMBER 00051764 -4 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Where required by written contract or written All operations of the Named Insureds agreement Information required to complete this Schedule, if not shown above will be shown in the Declarations A. Section II — Who Is An Insured is amended to include as an additional insured the persons) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by. 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury° or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed, or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization oth- er than another contractor or subcontractor engaged in performing operations for a princi- pal as a part of the same project CG 20 10 07 04 0 ISO Properties, Inc.: 2004 Page 1 of 1 ❑ 0 0 POLICY NUMBER' 010051764-4 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization (s): Location And Description Of Completed Opera - tions Where required by written contract or written All operations of the Named Insureds agreement 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 include as an additional insured the person(s) or organiza- tion(s) shown in the Schedule, but only with respect to liability for "bodily injury' or "property damage" caused, in whole or in part. by "your work" at the location desig- nated and described in the schedule of this endorse- ment performed for that additional insured and included in the "products - completed operations hazard CG 20 37 07 04 © ISO Properties, Inc_, 2004 Page 1 of 1 ❑ 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PREMIUM AUDIT CONDITIONS AMENDED This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTSICOMPLETED OPERATIONS COVERAGE SECTION IV -- COMMERCIAL GENERAL LIABILITY CONDITIONS, Item 5. Premium Audit. is deleted and replaced with the following: 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. c. The first Named Insured must keep records of the information we need for premium computation. and send us copies at such times as we may request. We have the right; but not the obligation, to conduct a physical audit of records needed for premium computation after the expiration of this policy_ d. Your refusal to maintain or provide needed records, or to allow us to conduct a physical audit of needed records, will result in our developing and calculating a final audit premium based on information available to us and without your cooperation If final premium audits calculated without your cooperation result in additional premium, you are obligated to pay such additional premium. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP1013US 10-05 Page 1 of 1 • COMMERCIAL AUTO CA 88 10 01 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGEINDEX SUBJECT ADDITIONAL INSURED BY CONTRACT. AGREEMENT OR PERMIT ACCIDENTAL AIRBAG DEPLOYMENT AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS AMENDED FELLOW EMPLOYEE EXCLUSION AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE BROAD FORM INSURED BODILY INJURY REDEFINED EMPLOYEES AS INSUREDS (including employee hired auto) EXTENDED CANCELLATION CONDITION EXTRA EXPENSE - BROADENED COVERAGE GLASS REPAIR- WAIVER OF DEDUCTIBLE HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) HIRED AUTO COVERAGE TERRITORY LOAN /LEASE GAP PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) PERSONAL EFFECTSCOVERAGE PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE RENTAL REIMBURSEMENT SUPPLEMENTARY PAYMENTS TOWING AND LABOR TWO OR MORE DEDUCTIBLES UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US PROVISION NUMBER 3 12 19 5 13 1 22 2 23 10 15 6 20 14 16 11 8 8 4 7 17 18 20 SECTION II - LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However. "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisdlon or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self - insured retention plan available to that organization: V 2013 Liberty Mutual Insurance CA 138 10 01 13 Includes copyrighted material of Insurance Services Office: Inc.. with its permission. Page 1 of 7 • • (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "properly damage" that occurred before you anquired of formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include the following as an insured f. Any "employee' of yours while using a covered "auto" you do not own, hire or borrow, but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee ". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee ". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include the fallowing as an insured: In. Any person or organization with iespecl to the operation, maintenance of use of a uuvered "auto ", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured ". However, such person or organization is an "insured': (1) Only with respect to the operation, maintenance or use of a covered "auto "; (2) Only for "bodily injury' or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION If - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3 :OOD for cost of bail bonds (including bends for related traffic violations ) required because of an 'accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to a the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II - LIABILITY, exclusion B.S. FELLOW EMPLOYEE does not apply if the 'hodily injury" results from the use of a covered 'auto" you own or hire. SECTION III -PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III -PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired 'autos" are covered "autos" for Liability Coverage, and if Comprehensive. Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos ": a. You hire, rent or borrow; or ® 2013 Liberty Mutual Insurance CA BS 10 01 13 Includes copyrighted material of Insurance Services Office, Inc..with its permission, Page 2 of 7 9. RENTAL REIMBURSEMENT SFCTIDN III - PHYSICAI DAMAGF COVFRAGF, A. COVFRAGF, is ame.ndnd by adding the. following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss ", to an "auto' for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicte with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses Incurred by you lu remove and replace your Tools and equipment from the covered "auto ". d. This coverage does not apply unless you have a business necessity that other "autos" avalk able for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials arid equipment do not include "personal effects' as defined in provision 11. 10. EXTRA EXPENSE - BROADENED COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the cxpensc of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible. up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V- DEFINITIONS is amended by adding the following: For flw purposes of this provision. "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or secunbcs. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ng: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for u "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE. B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: 9 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc..with Its permission. Page 4 of 7 b. Your "employee' hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $K000; or (2) The actual cash value of the damaged cr stolen property as of the time of the 'loss "; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that ° coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $1,000 per "accident ", we will also cover the actual loss of use of the hired "auto" if it results from an "accident ", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: - (1) Any "auto" that is hired, rented or borrowed with a driver, or (2) Any "auto" that is hired, rented or borrowed from your "employee'. For the purposes of this provision, SECTION V- DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. s 7. TOWING AND LABOR SECTION III - PHYSICAL DAMAGE COVERAGE. paragraph A.2. Towing, is amended by the addition of the fallowing: We will pay towing and labor costs Incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks ", we will pay up to $50 per disablement" "Light trucks' are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For "medium trunks" , we will pay up to $150 per disablement. 'Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 - 20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of S50 per day and a maximum limit of $1,500 0 2013 Liberty Muhial Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Ine.,with its permission. Page 3 of 7 Exclusion 4.c. and 4.d. do riot apply to: a. Flecdronir wluipment that receives or transmits, audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered 'auto" at the time of the 'loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the cnvered "auto" and physical damage coverages are provided for the covered "auto ": or If the "loss" occurs solely to audio. visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. �. 14. LOAN 1 LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a 'total loss" to a covered "auto" owned by or leased to you in any Y one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss ", h. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health. Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, s e. Final payment due under a "Balloon Loan ", I. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto ", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto ", I. Any amount representing taxes: j. Loan or lease termination fees', or 2. The actual cash value of the damage or stolen property as of the time of the "loss ". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss ". This adjustment is not applicable in Texas. " B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred fine loss. C. SECTION V- DEFINITIONS is changed by adding the following: As used in this erxtoisement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. ® 20131-iberty Mutual Insurance CA 88 10 01 13 Includes oopyrighted material of Insurance Services Office, Inc..with its permission. Page 5 of 7 a 9 • 15. GLASS REPAIR- WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAI DAMAGF COVFRAGF is amended by the addition of the following: No deductible applies to glass damage f the glass is repaired rather then replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured "; b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any loss" if the covered "auto' is in the charge of any person or organization engaged in the automobile business. 17. TWO OR MORE DEDUCTIBLES Under SECTION III PHYSICAL DAMAGE COVERAGE, it two or more company policies or coverage forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group. SECTION IV - BUSINESS AUTO CONDITIONS is amended as follows: 18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph 8.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 19. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident ", claim, "suit" or 'loss ", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. Member. if you are a limited liability company, 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. ® 2013 Liberty Mutual Insurance CA BB 10 01 13 includes copyrighted material of Insurance Services Office, Ine.,wlth its permission. Page 5 of 7 • To the extent possible, notice to us should include: (1) How, whr-xi and where. the °aumdvint" of "Invti' inok playa_ (2) The "insureds" name and address: and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss ", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territorv, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory Is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit ", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V - DEFINITIONS is amended ssfollows: 22. BODILY INJURY REDEFINED Under SECTION V- DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury. shock, fright or death resuldng from any of these at any time. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS. paragraph A - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. V 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office. Ine..with its permission. Page 7 of 7 AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code §§ 1720, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861, 37001 Me untlersigneEl Contractor certifies ttiat it is aware of and llerel5y agrees to y comply witil tne Following provisions of California law: 1. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency ( "Agency ") and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency, forfeit twenty -five dollars ($25) for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2, Part 7, Chapter 1, Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self - insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract" Date Signature Page D -57 0 EXHIBIT G E INDEMNIFICATION AND HOLD HARMLESS AGREEMENT Page D -58 0 0 INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTION TITLE OFPROJE TOR WORK: 2016 Annual Concrete Repair Pro,-ram, ST1604. Indemnitor(s) (list all names): flaOrol, T- n. UDC444U&J 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 m entity named in the Agreement as an Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint and several. " Indemnitor" Name Ito < Name: ey: 11141__� By: US r (2a Uj(q&j � Page D -59 APPENDIX B 2016 Annual Concrete Locations List Page D -60 0 0 STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business & Professions Code § 7028.15] [Public Contract Code § 20103.5] I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the entity on whose behalf this certification is given, hold a currently valid California contractor's license as set forth below (required at time of award): Business & Professions Code § 7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefore, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or imprisonment in the county jail for not less than 10 days nor more than six months, or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the aggregate sum of the cost of materials and labor 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 shalt 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 -54 0 EXHIBIT E 6-1 ACKNOWLEDGMENT OF PENAL AND CIVIL PENALTIES CONCERNING CONTRACTOR LICENSING LAWS Pne D -53 i • 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. LicenseNo.: 9W4-O(®O Date: )1-11 —) 6 Class: 1416, 6-8 Expiration Date: 3-3t,1�- Page D -55 EXHIBIT F LABOR LAW REQUIREMENTS Page D -56 Section C IL, V (-j T Bidders Name�3(tu �'uj/vei1 TO = HONORABLE iVIAYOR AND CITY COUNCIL OF THE CITY OF SEAL BEACH: The undersigned, as bidder, declares that: (I) -this proposal is made without collusion with any other person, firm or corporation, and that the only persons or parties interested as principals are those named herein as sworn in the attached Non - Collusion Affidavit; (2)- bidder has carefully examined the project Plans, Specifications, instructions To Bidders, Proposal, Notice inviting Sealed Bids and all other contract documents and information famished 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 contact be awarded to bidder, to enter into a contract with the City Council of the CITY OF SEAL BEACH, to perform said proposed work in accordance with the Plans, if any, and the terms of the Specifications, in the time and manner therein prescribed, and to famish or provide all materials, labor, tools, equipment, apparatus and other means necessary so to do, except such thereof as may otherwise be 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 hike to be taken into consideration in evaluating the safety record. An explanation of the circumstances surrounding any and all fatalities must be attached. Accompanying this proposal is (Circle one "cash ", "a Cashier's Check ", "a certified check ", or "4 iddei' (1§-o—nctin the form finnished by the City ", as the case may be) in the amount of $ JPC-P- an amount "Zrmg to at Ieast ten percent (10 %) of the total aggregate bid price based on the quantities shown and the unit prices quoted. The undersigned bidder agrees that should bidder be awarded the Contract on the basis hereof and thereafter fail or refuse to enter into a Contract and provide the required evidence of insurance and bonds within l5 calendar days after written notice of the award, the cash, check or bond shall be forfeited to the city in accordance with Public Contract Code section - 20172, except as otherwise provided in Public Contract Code section - 20174. The undersigned agrees that in the event of such failure, the actual amount of damages to the City would be impractical and extremely difficult to determine. In compliance with the Notice inviting Sealed Bids, the undersigned hereby agrees to enter into a contract to furnish all labor, materials and supplies for this project in accordance with the Specifications, Plans other Contract Documents which are on file in the office of the City Engineer of the CITY OF SEAL BEACH, to the satisfaction and under the direction of the City Engineer, at the following prices: completed by the undersigned is fixed at 30 WORDING DAYS starting from the day after the issuance of the Notice to Proceed. Page C -I • i PROPOS_A -L FOR 2116 A_NNUIAL CONCRETE REPAIR PROGRkNi PROTECT CTP NO. ST1604 Item Description Unit Quantity lJmt Price Extended Price Nc. (in Figures) (in Figures) i Sawcut, remove & reconstruct 4" PCC 17 I i sidewalk or parkway per Section SF 5,950 Special Provisions; complete and in place Perform root grinding per Section 17 I 2 Special Provisions; complete and in EA 25 $ $ Jt place. I Perform selective root removal per I EA 1 � �, $ ) $ ? to 3 Section 17 Special Provisions; complete and in place. 4 Sawcut, remove &reconstruct PCC curb & per Section 17 Special LF 100 f .gutter iProvisions; complete and in place. Perform tree and stump removal 13- 17 Special TREE 1 $ '7 $ I 5 18" dsh* per Section Provisions; complete and in place. Sawcut, remove & replace 4" PCC I 5 1 driveway approach per Section 17 1 SF 400 I $ ,� J{` j $ ' Special Provisions; complete and in I j place. 7 Adjust brick/pavers in parkway to grade per Section 17 Special Sr 100 $ D $ ! t Provisions; complete and in the place. I TOTAL BID PRICE (ITEMS NO. 1 THROUGH 7) i 'FORDS FIGURES � 'dsh - Diameter at Standard Height. IN CASE OF DISCREPANCY SET14VEEN WORDS AND FIGURES, THE WORDS SHALL PREVAIL Page C -2