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HomeMy WebLinkAboutAGMT - EBS General Engineering Inc (2017 Annual Concrete Repair Program)n A' RECORDING REQUESTED BY Recorded in Official Records, Orange County Hugh Nguyen, Clerk- Recorder AND WHEN RECORDED A LE ��tIC D� JI�NOFEE CITY OF SEAL BEACH $ R o n a 9 9 6 0 5 1 7 s Attn: City Clerk MAR 26 2018 2018000096320 2:27 PM 03119118 211 - 8th Street 65 422 N12 1 Seal Beach, CA 90740 CITY CL'RK 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 CITY OF SE' L BEACI Space of above this line for Recorder's use. No Recording Fee Pursuant to Government Code Section 6103, 27383 NOTICE OF COMPLETION Notice pursuant to Civil Code Section 3093, must be filed within 10 days after completion. t Notice is hereby given that: f / 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 January 31, 2018. The work was 2017 Annual Concrete Repair Program Proiect. No. ST1704. 6. The name of the contractor(s), if any, for such improvement was: EBS General Engineering, Inc. The date of the Contract Award was September 11 2017. 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: - G ! Alf441141" Dir t ub is Works, City of Seal Beach Sign ture of owner or corporate officer of owner - - -- - -- -- - — named - in- paragraph -2 -or agent. - - - - -- VERIFICATION I, the undersigned, say: the Director of Public Works declarant of the foregoing notice of completion; have read said notice of completion and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury the foregoing is true and correct. l Executed on 3 1 1 —tl , 2018, at Seal Beach, California. (Date of Signature) Director of Public Works, City 6f Seal Beach PUBLIC WORKS AGREEMENT FOR 2017 ANNUAL CONCRETE REPAIR PROGRAM PROJECT CIP NO. ST1704 between City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 EBS General Engineering, Inc. 1320 E. Sixth St., Ste. 100 Corona, CA 92879 (951) 279 -6869 (951) 279 -6832 - FAX THIS AGREEMENT is made as of September 11, 2017 by and between the City of Seal Beach, a California charter city ( "City'), and EBS General Engineering, Inc. a California corporation ( "Contractor "). irewel RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the 2016 Annual Concrete Repair Program Project CIP No. ST1704 ( "Project ") with respect to design criteria; and B. WHEREAS, Contractor, a general contractor, has submitted a bid to City for the Project dated July 20, 2017 in the amount of $48,450 ( "Accepted Proposal" hereinafter). The Accepted Proposal is attached hereto as Exhibit G and contains, among other things, provisions defining the Project scope. NOW, THEREFORE, in consideration of performance by the parties of the mutual promises, covenants, and conditions herein contained, the parties hereto agree as follows: AGREEMENT 1. Contractor's Services. 1.1 Scope and Level of Services. For and in consideration of the mutual promises set forth herein, and subject to the terms and conditions set forth in this Agreement, Contractor shall perform and complete in good and workmanlike manner all work ( "Work ") required by this Agreement and the documents listed in Subsection 1.2 for the Project. 1.2 Contract Documents. The "Contract Documents" that comprise the agreement between the City and the Contractor are the: Notice Inviting Bids, Instructions to Bidders, Accepted Proposal, Non - Collusion Affidavit, Bid Schedule(s), List of Subcontractors, Contractor's Industrial Safety Record, Contractor's Qualification Statement, Bid Security Forms for Check or Bond, Specifications, General and Special Provisions and documents referenced therein, all addenda as prepared prior to the date of bid opening setting forth any modifications or interpretations of any of said documents, this Agreement, Exhibits attached to this Agreement, including but not limited to the Performance Bond (Exhibit A), Payment Bond (Exhibit B), Workers' Compensation Insurance Certificate (Exhibit C), Insurance Endorsements (Exhibit D), Acknowledgment of Penal and Civil Penalties Concerning Contractor Licensing Laws (Exhibit E), Labor Law Requirements (Exhibit F), Accepted Proposal (Exhibit G) and any and all supplemental agreements executed amending or extending the Work contemplated and that may be required to complete the Work in a substantial and acceptable manner. These Contract Documents are hereby incorporated into this Agreement. 1.3 The Work shall be performed in accordance with the Plans, Specifications and other Contract Documents. Contractor shall furnish at its own expense all labor, materials, equipment and services necessary therefor, except such labor, materials, equipment and services as are specified in the Contract Documents to be furnished by City. 2 of 9 1.4 In the event of any material discrepancy between the express provisions of this Agreement and the provisions of the other Contract Documents, the provisions of this Agreement shall prevail. 2. Effective Date. This Agreement is effective as of September 11. 2017 (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 $48,450, subject to any additions and deletions pursuant to the terms of the Contract Documents. Said sum shall constitute payment in full for all work performed hereunder, including, without limitation, all labor, materials, equipment, tools and services used or incorporated in the Work, supervision, administration, overhead, expenses and any and all other things required, furnished or incurred for completion of the Work as specified in the Contract Documents. City shall make payments to Contractor on account of the contract sum at the time, in the manner, and upon the conditions specified in the Contract Documents. The City Manger may authorize extra work to fund unforeseen conditions up to the amount approved at the time of award by the City Council. Payment for additional work in excess of this amount requires prior City Council authorization. 4. Contractor's Personnel. 4.1 All Work shall be performed by Contractor or under Contractor's direct supervision, and all personnel shall possess the qualifications, permits, and licenses required by state and local law and by the Notice Inviting Bids /Instructions to Bidders to perform such Services, including, without limitation, a City of Seal Beach business license as required by the Seal Beach Municipal Code. 4.2 Contractor shall be responsible for payment of all employees' wages and benefits, and shall comply with all requirements pertaining to employer's liability, workers' compensation, unemployment insurance, and Social Security. Contractor shall fully comply with the workers' compensation law regarding Contractor and Contractor's employees. 4.3 Contractor shall indemnify and hold harmless City and its elected officials, officers, employees, servants, designated volunteers, and agents serving as independent contractors in the role of city officials, from any and all liabilities, damages, claims, costs and expenses of any nature to the extent arising from Contractor's alleged violations of personnel practices. 4.4 Contractor is, and shall at all times remain as to City, a wholly independent contractor. Contractor shall have no power to incur any debt, obligation, or liability on behalf of City or otherwise act as an agent of City. Neither City nor any of its agents shall have control over the conduct of Contractor or any of Contractor's employees, except as set forth in this Agreement. Contractor shall not, at any time, or 3 of 9 in any manner, represent that it or any of its officers, agents, or employees are in any manner employees of City. Contractor shall pay all required taxes on amounts paid to Contractor under this Agreement, and indemnify and hold City harmless from any and all taxes, assessments, penalties, and interest asserted against City by reason of the work performed pursuant to this Agreement. 4.5 City shall have the right to offset against the amount of any fees due to Contractor under this Agreement any amount due to City from Contractor as a result of Contractor's failure to promptly pay to City any reimbursement or indemnification arising under this Section 4. 5. Indemnification. 5.1 Contractor's Duty. Contractor shall defend, indemnify, and hold the City, its elected officials, officers, employees, volunteers, agents, and those City agents serving as independent contractors in the role of City officials (collectively "Indemnitees ") free and harmless from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, bid protests, stop notices, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's fees, disbursements and court costs) of every kind and nature whatsoever (individually, a "Claim," collectively, "Claims "), in any manner arising out of or incident to the performance of the Agreement, including without limitation, the payment of all consequential damages and attorneys' fees and other related costs and expenses. Further, Contractor shall appoint competent defense counsel, at Contractor's own cost, expense and risk, to defend any and all such suits, actions or other legal proceedings of every kind arising out of or incident to the performance of the Agreement that may be brought or instituted against Indemnitees. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against City or the other Indemnitees in any such suit, action, or other legal proceeding arising out of or incident to the performance of the Agreement. Contractor shall reimburse the City and the other Indemnitees, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by Contractor or Indemnitees. This indemnity shall apply to all Claims and liability regardless of whether any insurance policies are applicable. 5.2 Bid Protests. In addition to its obligations pursuant to Section 5.1, Contractor shall reimburse the City for all attorneys' fees and costs incurred by City in connection with, arising out of or incident to any bid protest. 5.3 City's Sole Negligence. Nothing in Section 5.1 shall be construed to require Contractor to indemnify Indemnitees for that portion of any Claim to the extent arising from the sole negligence or willful misconduct of the Indemnitees. 5.4 Nonwaiver of Rights. Indemnitees do not, and shall not, waive any rights that they may possess against Contractor because of the acceptance by City, or 4 of 9 the deposit with City, of any insurance policy or certificate required pursuant to this Agreement. 5.5 Waiver of Right of Subrogation. Contractor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation against the Indemnitees, while acting within the scope of their duties, from all claims, losses, and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor. 5.6 Survival. The provisions of this Section 5 shall survive the termination of the Agreement and are in addition to any other rights or remedies that Indemnitees may have under the law. Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision, and an entry of judgment against a Contractor shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. 6. Insurance 6.1 Liability Insurance. Contractor shall procure and maintain in full force and effect for the duration of this Agreement insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the services hereunder by Contractor, and its agents, representatives, employees and subcontractors. The policy limits set forth below do not act as a limitation upon the amount of indemnification to be provided by Contractor. Contractor shall complete and execute the following documents attached as Exhibits hereto and incorporated herein by this reference: 6.1.1 Exhibit D -1: Additional Insured Endorsement - Commercial General Liability. 6.1.2 Exhibit D -2: Additional Insured Endorsement - Automobile Liability. 6.1.3 Exhibit D -3: Additional Insured Endorsement – Professional Liability (or Errors and Omissions Liability). 6.2 Minimum Scope of Insurance. Unless otherwise approved by City, coverage shall be at least as broad as: 6.2.1 Insurance Services Office Commercial General Liability coverage (occurrence form CG 0001). 6.2.2 Insurance Services Office form number CA 0001 (Ed. 1/87) covering Automobile Liability, code 1 (any auto). 6.2.3 Insurance Services Office form number CG 20 10 11 85 (Ed. 11/85) covering Additional Insured — Owners, Lessees or Contactors (Form B). 5 of 9 6.2.4 Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 6.2.5 Professional Liability insurance. Unless the City waives in the requirement for professional liability insurance, Contractor shall provide to City the standard form issued by the carrier. 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. 6.3.4 Professional Liability (or Errors and Omissions Insurance): $1,000,000 per claim /aggregate. 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 Except with regard to the Professional Liability (or Errors and Omissions) liability policy, 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 6 of 9 contractors in the role of City officials shall be excess of Contractor's insurance and shall not contribute with it. 6.5.3 Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. 6.5.4 Each insurance policy required by this Section 6 shall be endorsed to state that coverage shall not be canceled or materially modified except after 30 days prior written notice by first class mail has been given to City. 6.5.5 Each insurance policy, except for any professional liability policy, required by this Section 6 shall expressly waive the insurer's right of subrogation against City and its elected officials, officers, employees, servants, attorneys, designated volunteers, and agents serving as independent contractors in the role of city or agency officials. 6.6 Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VIII unless waived in writing by City's Risk Manager. 6.7 Verification of Coverage. All insurance coverages shall be confirmed by execution of endorsements on forms approved by the City. The endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All endorsements are to be received and approved by City before services commence. As an alternative to City forms, Contractor's insurer may provide complete, certified copies of all required insurance policies, including endorsements effecting the coverage required by these specifications. 7. Liquidated Damages. Should the Contractor fail to complete the project, or any part thereof, in the time agreed upon in the Contract, the Contractor shall reimburse the City for the additional expense and damage for each calendar day that the Contract remains uncompleted after the Contract completion date. It is agreed that the amount of such additional expense and damage incurred by reason of failure to complete the Contract is the per diem rate of $750.00 per calendar day. Such amount is hereby agreed upon as liquidated damages for the loss to the City resulting from the failure of the Contractor to complete the project within the allotted time and to the value of the operation of the works dependent thereon. It is expressly understood and agreed that this amount is a reasonable amount and is established in lieu of damages that are incapable of calculation at the inception hereof; and this amount is not to be considered in the nature of a penalty. The City shall have the right to deduct such damages from any amount due, or that may become due to the Contractor, or the amount of such damages shall be due and collectible from the Contractor or the Contractor's Surety. Progress payments made after the scheduled completion date shall not constitute a waiver of liquidated damages. 7 of 9 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 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 Manager City of Seal Beach 211 8th Street Seal Beach, California 90740 Telephone: (562) 431 -2527 Fax: (562) 493 -9857 With a copy to: Director of Public Works City of Seal Beach 211 8th Street Seal Beach, California 90740 If to Contractor: EBS General Engineering, Inc. 1320 E. Sixth St., Ste. 100 Corona, CA 92879 Telephone: (951) 279 -6869 Fax: (951) 279 -6832 Attn: Joseph A. Nanci 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. Claim Dispute Resolution. 11.1 In the event of any dispute or controversy with the City over any matter whatsoever, the Contractor shall not cause any delay or cessation in or of Work, but shall proceed with the performance of the Work in dispute. Contractor shall retain any and all rights provided that pertain to the resolution of disputes and protests between the parties. The Disputed Work will be categorized as an "unresolved dispute" and payment, if any, shall be as later determined by mutual agreement or a court of law. :. Contractor shall keep accurate, detailed records of all Disputed Work, claims and other disputed matters. 11.2 All claims arising out of or related to the Contract Documents or this Project, and the consideration and payment of such claims, are subject to the Government Claims Act (Government Code Section 810 et seq.) with regard to filing claims. All such claims are also subject to Public Contract Code Section 9204 and Public Contract Code Section 20104 et seq. (Article 1.5), where applicable. This Contract hereby incorporates those provisions as though fully set forth herein. Thus, Contractor or any Subcontractor must file a claim in accordance with the Government Claims Act as a prerequisite to filing a construction claim in compliance with Section 9204 and Article 1.5 (if applicable), and must then adhere to Article 1.5 and Section 9204, as applicable, pursuant to the definition of "claim" as individually defined therein. 12. 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. 13. 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. 14. 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. 15. 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. 16. 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. 9 of 9 17. 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 By: Ji R. Ingram, City a e Attest: By: I q Robin oberts, City'Clerk, e ltlG us Approved as t or By: Cra . Steele, City Attorney 10of9 CONTRACTOR: EBS GENERAL ENGINEERING, INC. By: �— Name: Joseph A. Nand Title: President Name: Title: I ACTION AND RESOLUTION BY THE BOARD OF DIRECTOR OF EBS GENERAL ENGINEERING, INC A CALIFORNIA CORPORATION All of the Board of Directors of EBS General Engineering, Inc., desiring to insure that all the proper and authorized individuals, who have corporate authority to bind the said corporation to any and contracts executed by such authorized individuals, have been approved by the board of directors of EBS General Engineering, held a meeting on January 3, 2010. The Board, following a review of the foregoing malter, and upon motion made and seconded, the Board of Directors hereby determines and votes unanimously as follows: BE IT THEREFORE RESOLVED that Joseph Nanci is hereby designated, authorized and empowered, to be duly authorized with all the attendant powers and authorizations related thereto, to bind, obligate and commit EBS General Engineering, Inc. Lo any and all contracts executed by and between EBS General Engineering, Inc. and any other contracting party. There being no further or pending business before the Board, the meeting was adjourned. BOARD OF DIRECTORS Date: January 3, 2010 = i Z�' Josepl anci, Sole Director ATTESTATION I, being the Secretary of the above referenced corporation, do hereby certify that the above resolution is the resolution of the corporation. Dated: t 3 /O Josep r_ranci, Secretary EXHIBIT A FAITHFUL PERFORMANCE BOND Exhibit A, Page 1 EXECUTED IN TWO COUNTERPARTS Bond No. 4412256 Bond Premium $698 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS Ibat WHEREAS the City of Seal Beach, has awarded FBS GENERAL ENGINEERING, INC. 1320 E. SIXTH ST., SUITE 100 (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: 2017 ANNUAL. CONCRETE REPAIR PROGRAM Proiect No ST1704 WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW, THEREFORE, we, the undersigned Principal, and SURETEC INSURANCE COMPANY 3131 CAMINO DEL RIO N. SUITE 1450 SAN DTFGO CA 92108 (Name and address of Surety) ( "Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of FORTY EIGHT THOUSAND FOUR HUNDRED FIFTY AND NO /100 Dollars ($ 48, 450.00 ), this amount being not less than the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terns 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 lime, 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: SEPTEMBER 13, 2017 "Principal" "Surety" EBS GENERAL ENGINEERING. INC. SURETEC INSURANCE COMPANY Page D -38 By: � President [ts By: I is By:.� Its SPENCER FLAKE, ATTORNEY —IN —FACT 6y: Its (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence o, the authority of any person signing as attorney -in -fact must be attached.' Page D -39 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 9 -13 -17 before me, Lexie Sherwood Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake Name(s) of Signer(s) LEXIE SHERWOOD COMM. # 2203287 NOTARY PUBLIC - OIWFORNIA ORANGECOUNTY Comm. Exp. JULY 27, 2021 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official) seal. �� Signature Place Notary Seal Above Signature of Nobiry PubTc Lexie tiherwoocl OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s):_ ❑ Partner 11 Limited El General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 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 Riverside } On September 18, 2017 before me, K. Fairweather Notary Date Insert Name and Title of the officer Public, personally appeared Joseph Nanci Nome(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons) whose name(s) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. K.f WEATHER Mo1HY • California WITNESS my hand and official seal. er" County glvonfeo Coumy OMI Commkdon # 2149313 Comm. faints Apf 21, 2020 S' nature: ----------------------------- ------------------------------- OPTIONAL ------------------------------------------------------------ Though this section is optional, completing this information con deter alteration of the document or fraudulent attachment of this form to on unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other-Than Named Above: Capacity(ies) Claimed by Signer(s) Signers Name: Signers Name: ❑ Corporate Officer — Title(s) ❑ Corporate Officer— Title(s) U Partner - ❑ Limited ❑ General ❑ Partner - ❑ Limited ❑ General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑ Trustee ❑Guardian or Conservator ❑ Trustee ❑Guardian or Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: PoAg: 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company "), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles I. Flake, David I. Culbertson, Spencer Flake, Heather Wil s its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recogaizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Ten Million and 00/100 Dollars ($10,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment shall continue in force until 12J31t2010 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice - President, any Assistant Vice - President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 2e of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 8th day of August , A.D. eon 5 AANe� S7TEC Il E ANY : By: n= John Knox , resi nt w6tw yzi State of Texas ss: County of Harris ••• -•• ,t` On this 8th day of August , A.D. 2017 before me personally came John Knox Jr., to me known, who, being by me duly swom, did depose and say, that he resides m Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his time thereto by like order. r>oa,, - XENIA CHAVEZ n_Notary Public, Slate of Texas Comm. Expires 09 -10 -2020 '1'of 01"'' '1:,,,,,,F,a Notary ID 129117659 Xa a Notary Public `'rAy commission expires September 10, 2020 1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 7gdar of S P T E 2017 , A.D nt Be y, Assistant Se etary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812 -0800 any business day between 8:00 am and 5:00 pm CST. EXHIBIT B PAYMENT BOND Exhibit B, Page 1 1 EXECUTED IN TWO COUNTERPARTS Bond No. 4412256 Bond Premium INCLUDED IN PERFORMANCE BOND PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded to F.BS GENERAL ENGINEERING. INC. (Name and address ( "Principal "), a contract (the "Contract') for the work described as follows: 2017 ANNUAL CONCRETE REPAIR PROGRAM Project No ST1704 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 IMill (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 Dollars ($ 48,450.00 this amount being not less than fifty percent (50 %) of the total contract price, in lawful money of the United States of America, for the payment of which sum well 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 3 18 1 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 terns 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 -41 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: SEPTEMBER 13, 2017 "Principal" "Surety' EBS GENERAL E EE NG By: Its BY: Joseph A Nand, Pr cidPnt Its BY I SPSPENCER � KE, ATTORNEY —IN —FACT M Its (Seal) (Seal) " Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attomey -in -fact must be attached. Page D -42 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 9 -13 -17 before me, Lexie Sherwood Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the LEXIE SHERWOOD person(s), or the entity upon behalf of which the person(s) COMM. 02203287 t acted, executed the instrument. NDTARYPILNUX•CAUFORNIA ORANGE )W.JUL 27 1 certify under PENALTY OF PERJURY under the laws of Comm. t3xp. JULY 27, 2021 the State of California that the foregoing paragraph is true and correct. Witness my hand an /al `= ecLC�pe�' Signature Place Notary Seal Above Signature of 96tary Public Lexie herwoo OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document fraudulent the form to document. and could prevent removal and reattachment of another Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer— Title(s): ❑ Corporate Officer Title(s): ❑ Partner ❑ Limited ❑ General ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Attorney in Fact ❑ Trustee ❑ Trustee ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: 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 Riverside On September 18, 2017 before me, K. Fairweather Notary Date Insert Name and Title of the officer Public, personally appeared Joseph Nanci Nome(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Si re: K.FAMWEA HER Notary Public • CeIRorMs i . -� Rivenlae County Z Commission r 2149313 My Comm. Expires Apr 21. 20201 ------ ---------------------I ----------------- -- ---------- OPTIONAL ------------------------------------------------------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent attachment of this form to on unintended document. Description of Attached Document Title or Type of Document: Document Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signers Name: • Corporate Officer— Title(s) • Partner - ❑ Limited ❑General • Individual ❑Attorney in Fact • Trustee ❑Guardian or Conservator ❑ Other: Signer is Representing: Signers Name: ❑ Corporate Officer— Title(s) ❑ Partner - ❑ Limited ❑ General ❑ Individual ❑Attorney in Fact ❑ Trustee ❑Guardian or Conservator ❑ Other: Signer is Representing: ronu: 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company "), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Spencer Flake, Heather Willis its true and lawful Attomey -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Ten Million and 00/100 Dollars ($10,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 12131/2019 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice - President, any Assistant Vice - President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20`" of April, 1999) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 8th day of August , A.D. eon . s an vcF SURETEC T! E ANY a,. ~' n John Knox ., resi nt State of Texas ss: �� County of Harris - - -- / On this 8th day of August , A.D. 2017 before me personally came John Knox Jr., to me known, who, being by me . duly swom, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. XENIA CHAVEZ �. ♦�... X �= Notary Public, State of Texas Comm. Expires 09 -10 -2020 Notary ID 129117659 , )a aVez, Notary Pub � r 11C �vly commission expires September 10, 2020 1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this da of PT 2017 A.D ei ry . Br nt Betty, Assistant Se Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812 -0800 any business day between 8:00 am and 5:00 pm CST. EXHIBIT C WORKERS' COMPENSATION INSURANCE CERTIFICATE Exhibit C, Page 1 EXHIBIT D -1 ADDITIONAL INSURED ENDORSEMENT COMMERCIAL GENERAL LIABILITY [INSERT INSURANCE CERTIFICATE SHOWING COMMERCIAL GENERAL LIABILITY] Exhibit D -1, Page 1 EXHIBIT D -2 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY [INSERT INSURANCE CERTIFICATE SHOWING AUTOMOBILE LIABILITY] Exhibit D -2, Page 1 EXHIBIT D -3 ADDITIONAL INSURED ENDORSEMENT (INSERT INSURANCE CERTIFICATE SHOWING PROFESSIONAL INSURANCE LIABILITY, IF REQUIRED) Exhibit D -3, Page 1 ACORD. CERTIFICATE OF LIABILITY INSURANCE 09/1 //2017 Y) 09/13/2017 PRODUCER LIC #OE28842 1 -949- 756 -4100 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Invensure Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE TYPEOFINSURANCE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 17991 Cowan ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LIMITS A Irvine, CA 92614 Bob Parent INSURERS AFFORDING COVERAGE NAIC N INSURED EBB General Engineering, Inc. INSURER A'. LIBERTY NOT FIRE INS CO 23035 INSURER B: LIBERTY INS CORP 42404 1320 E. Sixth St. #100 INSURER C: INSURERD: Corona, CA 92879 INSURER E' PERSONAL& ADV INJURY $ 1,000,000 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTq DD' IINSR TYPEOFINSURANCE POLICYNUMBER POLICYEFFECTIVE DATE M D V POLICY EXPIRATION DATE MM D LIMITS A GENERAL LIABILITY TB2 -Z91- 454286 -016 09/28/16 09/28/17 EACH OCCURRENCE $1,000,000 PREMISES Ea ocourence $ 100,000 X COMMERCIAL GENERAL LIABILITY GLAIMSMADE OCCUR MEDEXP(Anyonepemon) $5,000 PERSONAL& ADV INJURY $ 1,000,000 X $5,000 Deductible GENERALAGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIEB PER: PRODUCTS - COMP /OPAGG $2,000,000 POLICY X PRO- LOC JECT A AUTOMOBILE X LIABILITY ANY AUTO M2 -Z91- 454286 -026 09/28/16 09/28/17 COMBINED SINGLE LIMIT (Ea accitlenl) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON- OWNEDAUTOS X PROPERTY DAMAGE (Peraccibenl) $ GARAGE LIABILITY AUTOONLY- EAACCIDENT S OTHERTHAN EAACC $ ANY AUTO $ AUTOONLY: AGO B EXCESSNMBRELLAUABILITY TH7 -Z91- 454286 -046 09/28/16 09/28/17 EACH OCCURRENCE $4,000,000 X OCCUR CLAIMS MADE AGGREGATE $4, 000, 0 0 D $ DEDUCTIBLE $ X RETENTION $ 10,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER /EXECUTIVE WC2- Z91- 454286 -036 09/28/16 09/28/17 X CSTATU- OTH- T W RV LIMIT ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE 31,000,000 OFFICER /MEMBER EXCLUDED? X If yes, describe under SPECIAL PROVISIONS below EL .DISEASE - POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS --Certificate holder is additional insured per forms CG2037 04 13 & CG2033 04 13, CA2048 10 13, Printery wording LC 2420 02 13, Blanket GL waiver of subrogation CC2404 05/09, Blanket WC waiver of subrogation WC040306 4/84 E Auto Waiver of Subrogation CA 04 44 10 13 apply per attached. • *City of Seal Beach, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are additional insureds. Project: 2017 Annual Concrete Repair; CIP STI704 CERTIFICATE HOLDER CANCELLATION -except 10 days notice for non - payment. ACORD 25 (2001/08) klopez © ACORD CORPORATION 1988 50766653 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Seal Beach DATE THEREOF, THE ISSUING INSURER WILL elAT7G19 MAIL 30• DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 211 8th St. Seal Beach, CA 90740 AUTHORIZED REPRESENTATIVE USA ACORD 25 (2001/08) klopez © ACORD CORPORATION 1988 50766653 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 0161101l lhtd=I 1 The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. qs r9nnunm POLICY NUMBER: AS2 -Z91- 454286 -026 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organlzati0n(S): Any person or organization whom you agreed in venting as an additions: insured, but only for the coverage and minimum limits of insurance required by the written agreement, and in an event to exceed either the scope of coverage or the limits of insurance provided in This policy Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Forth. CA 20 48 10 13 ® Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: AS2 -Z91- 454286 -026 COMNERCIALAUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): As required by written contract or agreement entered into prior to loss. (Premium. $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 1013 0 Insurance Services Office, Inc., 2011 Page 1 of 1 Policy No. TB2-Z91- 454286 -016 COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional 'insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or 'personal and advertising injury" caused, in whole or in part, by; 1. Your acts oromissions: or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury', "property damage' or "personal and advertising injury" .arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury' or "property damage ", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. CG 20 33 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 2 2. 'Bodily injury" or 'property damage' occurring after. a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to As intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 33 0413 POLICY NUMBER: TB2 -Z91- 454286 -016 COWERCIAL GENERAL LIABILITY CG 20 37 0413 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 PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". However. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Name Of Additional Insured Person(s) Or Organization(s): Blanket where required by written contract executed prior to a loss or occurrence. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. SCHEDULE Location And Description Of Completed Operations Any Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 0413 C Insurance Services Office, Inc., 2012 Page 1 of 1 Policy Number TB2 -Z91- 454286 -016 Issued by Liberty Mutual Fire Ins. Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE AMENDMENT — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Person or Organization: All persons with whom you have a written agreement to include them as Additional Insured, which is signed in advance of the "Occurrence" or offense for which the Additional Insured seeks coverage. If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization shown in the Schedule of this endorsement that qualifies as an additional insured on this policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV - Conditions will not apply. If the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV - Conditions will govern. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same "occurrence ", claim or "suit ". LC 24 20 02 13 ® 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organiration named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us,) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.0% of the California workers compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Where required by contract or written agreement prior to loss and allowed by law, Issxdby Liberty Mutual Fire Insurance Company For attachment to Policy No .WC2 -Z91- 454286 -036 Effective Date 9/28/16 Premium$ Issued to EBS General Enghwing, Inc. WC 04 03 06 page 7 of 7 ED: 04/7964 EXHIBIT E ACKNOWLEDGMENT OF PENAL AND CIVIL PENALTIES CONCERNING CONTRACTOR LICENSING LAWS Exhibit E, Page 1 STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business & Professions Code § 7028.151 [Public Contract Code § 20103.5] 1, the undersigned, certify that I am aware of the following provisions of California law and that 1, or the entity on whose behalf this certification is given, hold a currently valid California contractor's license as set forth below (required at time of award): Business & Professions Code § 7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefore, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or imprisonment in the county jail for not less than 10 days nor more than six months, or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be performed. (c) This section .shall not apply to a joint venture license, as required by Section 7029.1. However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to this section with respect to his or her individual licensure. (d) This section shall not affect the right or ability of a licensed architect, land surveyor, or registered professional engineer to form joint ventures with licensed contractors to render services within the scope of their respective practices. (e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non - responsive and shall be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any purchase order issued to, a contractor who is not licensed pursuant to this chapter is void. (f) Any compliance or noncompliance with subdivision (e) of this section, as added by Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect. (g) A public employee or, officer shall not be subject to a citation pursuant to this section if the public employee, officer, or employing agency made an inquiry to the board for the purposes of Page D -53 verifying the license status of any person or contractor and the hoard 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-tile 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.; 79-COW Class: A Expiration Date: :?7/ Date: _°I/a 2-b-7 Page D -54 EXHIBIT F LABOR LAW REQUIREMENTS Exhibit F, Page 1 AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS (Labor Code §§ 1720,t773.8, 1775,1776 ,1777.5,1813,1860,1861,.37001 The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the Following provisions of California law: I. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter I (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency ( "Agency ") and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency, forfeit twenty-five dollars ($25) for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2, Part 7, Chapter 1, Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with theprovisions -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 cl �2Z><% Signature Page D -56 EXHIBIT G ACCEPTED PROPOSAL Exhibit G, Page 1 Section C PROPOSAL Bidders Name EBS General Engineering, Inc. TO THE HONORABLE MAYOR AND CITY COUNCIL OF THE CITY OF SEAL BEACH The undersigned, as bidder, declares that: (1) -this proposal is made without collusion with any other person, firm or corporation, and that the only persons or parties interested as principals are those named herein as swom in the attached Non - Collusion Affidavit; (2)- bidder has carefully examined the project Plans, Specifications, Instructions To Bidders, Proposal, Notice Inviting Sealed Bids and all other contract documents and information furnished therefore and the site of the proposed work; and (3)-bidder has investigated and is satisfied as to the conditions to be encountered, the character, quality and quantities of work to be performed and materials to be furnished. Furthermore, bidder agrees that submission of this proposal shall be conclusive evidence that such examination and investigation have been made and agrees, in the event this contract be awarded to bidder, to enter into a contract with the City Council of the CITY OF SEAL BEACH, to perform said proposed work in accordance with the Plans, if any, and the terms of the Specifications, in the time and manner therein prescribed, and to furnish or provide all materials, labor, tools, equipment, apparatus and other means necessary so to do, except such thereof as may otherwise be furnished or provided under the terms of said Specifications, for the following stated unit prices or lump sum price as submitted on the Bid Sheet herein. The bidder shall submit as part of this proposal a completed copy of the Contractor's Industrial Safety Record. This Safety Record must include all construction work undertaken in the State of California by the bidder and any partnership, joint venture or corporation that any principal of the bidder participated in as a principal or owner for the last five calendar years and the current calendar year prior to the date of bid submittal. Separate information shall be submitted for each such partnership, joint venture, or corporate or individual bidder. The bidder may attach any additional information or explanation of data which he would like to be taken into consideration in evaluating the safety record. An explanation of the circumstances surrounding any and all fatalities must be attached. Accompanying this proposal is (Circle one "cash ", "a Cashier's Check ", "a certified check ", or on in the form furnished by the City ", as the case may be) in the amount of $ 10% bid amo unt an amount equal to at least ten percent (10 %) of the total aggregate bid price based on the quantities shown and the unit prices quoted. The undersigned bidder agrees that should bidder be awarded the Contract on the basis hereof and thereafter fail or refuse to enter into a Contract and provide the required evidence of insurance and bonds within 15 calendar _days after written notice of the award, the cash, check or bond shall be Forfeited to the city in accordance with Public Contract Code section - 20172, except as otherwise provided in Public Contract Code section - 20174. The undersigned agrees that in the event of such failure, the actual amount of damages to the City would be impractical and extremely difficult to determine. In compliance with the Notice Inviting Sealed Bids, the undersigned hereby agrees to enter into a contract to furnish all labor, materials and supplies for this project in accordance with the Specifications, Plans other Contract Documents which are on file in the office of the City Engineer of the CITY OF SEAL BEACH, to the satisfaction and under the direction of the City Engineer, at the following prices: completed by the undersigned is fixed at 30 WORKING DAYS starting from the day after the issuance of the Notice to Proceed. Page C -I PROPOSAL FOR 2017 ANNUAL CONCRETE REPAIR PROGRAM PROJECT CIP NO. ST1704 R U Item Unit Price Extended Price No Description Unit Quantity (in Figures) (in Figures) Sawcut remove & reconstruct 4" PCC sidewalk or parkway per Section 17 4,000 $ 7 $ 3S 1 SF Special Provisions; complete and in place. Perform root pruning/grinding per 2 Section 17 Special Provisions; EA 17 complete and in place. Sawcut, remove & reconstruct PCC 17 Special LF 50 $ $ 3 curb & gutter per Section Provisions; complete and in place. Sawcut, remove & replace 4" PCC driveway approach per Section 17 SF 300 $� $ i� 4 Special Provisions; complete and in place. TOTAL BID PRICE (ITEMS NO. 1 THROUGH 7) $ WORDS 0G, i o 51+ LU1 i 1[jr FIGURES t Sd IN CASE OF DISCREPANCY BETWEEN WORDS AND FIGURES, THE WORDS SHALL PREVAIL Page C -2 NOTE: The City reserves the right to award a contract to the lowest responsible bidder in parts or in its entirety and reserves the right to reject all bids and re- advertise, as appears to be in the best interests of the City. A bid is required for this entire work, the estimated quantities set forth in this Bid Sheet being solely for the purpose of comparing bids, and final compensation under the Contract will be based upon the actual quantities of work satisfactorily completed. The unit and/or lump sum prices bid shall include all appurtenant expenses, taxes, royalties, and fees. In the case of discrepancies in the amount bid, unit prices shall govern over extended amounts, and words shall govem over figures. The City reserves the right to increase or decrease the amount of anv quantity shown and to delete any item from the Contract. The undersigned bidder agrees that, if awarded the Contract, bidder will complete all work according to the contract documents. The undersigned bidder is licensed in accordance with the requirements of the Business and Professions Code, California Contractor's License No. -_ 720016 Class A (REQUIRED AT TIME OF AWARD). Legal Business Name of Bidder ESS General Engineering, Inc. Business Address Tel. No. 1320 E. Sixth St., Ste 100 Corona CA 92879 - 279 -6869 Title Signature Date Signature Date If bidder is an individual, name and signature of individual must be provided, and, if he is doing business under a fictitious name, the fictitious name must be set forth. If bidder is a partnership or joint venture, legal name of partnership /joint venture must be provided, followed by signatures of all of the partners /joint venturers or of fewer than all of the partners /joint venturers if submitted with evidence of authority to act on behalf of the partnership /joint venture. If bidder is a corporation, legal name of corporation must be provided, followed by signatures of the corporation President or Vice President and Secretary or Assistant Secretary, and the corporate seal. Signatures of partners, joint venturers, or corporation officers must be acknowledged before a Notary Public, who must certify that such partners, joint venturers, or officers are known to him or her to be such, and, in the case of a corporation, that such corporation executed the instrument pursuant to its bylaws or a resolution of its Board of Directors. Page C -3 California All - Purpose Acknowledgement State of California } County of Orange On —i t q - t 1 before me, William E. Ellis Jr a Notary Public Personally Joseph A. Nanci WILLIAM E. ELLIS JR. Commission # 2127998 = a Notary Public - California s Z. orange County Comm. 6 Tres Oct 23 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator 0 Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the person(s) whose nameXis /arer subscribed to the within instrument and acknowledged to me that he/ ehekhgy executed the same in histhorltheir authorized capacity0a,Q, and that by his /herftheir signature on the instrument the person(sL or the entity upon behalf of which the persons} acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. U Notary Public Signature Of OPTIONAL ❑ Individual a Corporate Officer: CJ Partner - 0 Limited ❑ General Ci Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: ACTION AND RESOLUTION BY THE.BOARD OF DIRECTOR OF EBS GENERAL ENGrNEERING, I11C A CAL (FORNIA CORPORATION All of the Board of Directors of EBS General Engineering, Inc.. desiring to insure that all the proper and authorized individuals, who have corporate authority to bind the said corporation to any and contracts executed by such authorized individuals, have been approved by the board of directors of EBS General Engineering, held a meeting on January 3, 2010. The Board, following a review of the foregoing matter, and upon motion made and seconded, the Board of Directors hereby determines and votes unanimously as follows: BE IT THEREFORE RESOLVED that Joseph Nanci is hereby designated, authorized and empowered, to be duty authorized with all the attendant powers and authorizations related thereto, to bind; obligate and commit EBS General Engineering, Inc. to any and all contracts executed by and between EBS General Engineering; Inc. and any other contracting party. There being no further or pending business before the Board, the meeting was adjourned. BOARD OF DIRECTORS Date: January 3; 2010 Joseply? /anci, Sole Director ATTESTATION I, being the Secretary of the above referenced corporation, do hereby certify that the above resolution is the resolution of the corporation. Dated: 1 3 /O J07114111 anci, Secretary INFORMATION REQUIRED OF BIDDER Bidder certifies under penalty of perjury under the laws of the State of California that the following information is true and correct: Name of individual Contractor, Company or Corporation: Business Address: 1320 E. Sixth St. Ste 100 Corona CA 92879 Telephone and Fax Number: 951- 279 -6869 / 951- 279 -6832 California State Contractor's License No. and Class: 720016 A (REQUIRED AT TIME OF AWARD) Original Date Issued: p 3/3 1/9 x iration Date: 3/31/18 List the name and title /position of the person(s) who inspected for your firm the site of the work proposed in these contract documents: Joseph A. Nanci, President The following are the names, titles, addresses, and phone numbers of all individuals, firm members, partners, joint ventures, and company or corporate officers having a principal interest in this proposal: Name Title Address Telephone Joseph A Nanci President - 1320 E. Sixth St Ste 100 Corona CA 92879 (951) 279 -6869 Corporation organized under the laws of the State of CA The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this proposal are as follows: N/A Page C4 All current and prior D.B.A.'s, aliases, and fictitious business names for any principal having interest in this proposal are as follows: Elite Bobcat Service, Inc. For all arbitrations, lawsuits, settlements or the like (in or out of court) you have been involved in with project owners (public agencies, private companies, etc...) in the past five years (Attach additional Sheets if necessary) provide: Provide the names, addresses and telephone numbers of the parties; N/A Briefly summarize the parties' claims and defenses; N/A State the tribunal (i.e., Superior Court, American Arbitration Association, etc.) the matter number and outcome. N/A Have you ever had a contract terminated by the owner /agency? If so, explain. No Have you ever failed to complete a project? If so, explain. No Have you ever been terminated for cause and then had it converted to a "termination of convenience "? If so, explain. No For any projects you have been involved with in the last 5 years did you have any claims or actions: Circle One 1. By you against the owner? Yes /©o 2. By the owner against you? Yes / G10 Page C -5 3. By any outside agency or individual for labor compliance (i.e. failure to pay prevailing wage, falsifyin certified payrolls, etc..) 4. Yes / 5. By Subcontractors (Stop Notices. etc.) Yes / 6. Are an}daims or actions unresolved or outstanding? Yes /(5 If yes to any of the above, explain. (Attach additional sheets. if necessary) Failure of the bidder to provide ALL requested information in a complete and accurate manner may be considered non - responsive. Subscribed and swom to before me By This day of 120 (print name of Owner or President of orporation/C pany) (Signature of Notary Republic) (Signature) President (Title) (SEAL) 7/12/17 (Date) (Signature of Secretary of Corporation) Page C -6 California All- Purpose Acknowledgement State of California ) County of Orange On I ° 1q - 1. 1 before me, William E. Ellis Jr a Notary Public Personally Joseph A. Nanci WILLIAM E. ELLIS JR. Commisslon 1 2127998 Notary Public - Caftmia i Orange County > M Comm. Expires Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: CapacitAies) Claimed by Signer(s) Cl Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney-in-Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the person) whose nameXis /arfsubscribed to the within instrument and acknowledged to me that he/ shsAh" executed the same in hisifim*heif authorized capacity(1as,), and that by his/fter(their signature on the instrument the person(, or the entity upon behalf of which the persons acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. IN 1 Notary Public Signature of Pages: OPTIONAL 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee O Guardian or Conservator 0 Other: Signer is Representing: REFERENCES: Contractor must use this formM Please print or type. Bidders Name EBS GENERAL ENGINEERING, INC FAILURE OF THE BIDDER TO PROVIDE ALL REQUIRED INFORMATION IN A COMPLETE AND ACCURATE MANNER MAY BE CONSIDERED NON - RESPONSIVE. For all public agency projects you have worked on (or are currently working on) in the past 2 years in excess of $15,000, provide the following information: 1 Project Name /Number 2014/2015 City Wide Curb, Gutter, Sidewalk and Driveway Repairs Project Description concrete Approximate Construction Dates From to Agency Name City of Riverside at various locations 11/2014 - 2/2015 Contact Person DannyCwiak Telephone ( ) 951- 377 -5514 Original Contract Amount $ 407,628 Final Contract Amount $ 343,510 If final amount is different from original, please explain (change orders, extra work, etc.) order Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. 2 ProjectName/Number Annual Concrete Repair (FY2014 -2015) Project Description Remove and replace sidewalk Approximate Construction Dates From 4/2015 to 5/2015 Agency Name City of Rancho Santa Margarita Contact Person Terry Gregory Telephone ( ) (949) 635 -1800 Original Contract Amount $ 55,620.75 Final Contract Amount .$ 55,620.75 If final amount is different from original, please explain (change orders, extra work, etc.) Page C -7 Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. No 3 Project Name/Number Annual Concrete at Various Locations Project Description Concrete Repairs Approximate Construction Dates From 4/2016 to 8/2016 - AgencyName City of West Hollywood Contact Person Sharon Perlstein Telephone ( ) 323.848.6383 Original Contract Amount $ 349,000 Final Contract Amount $ 362,962.12 If final amount is different from original, please explain (change orders, extra work, etc.) change order Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. No ProjectName/Number FY 15/16 Curb Access Ramp Installation Project Description Construct curb ramp, curb access ramp, install domes Approximate Construction Dates From 5/2016 to Agency Name City of Huntington Beach Contact Person Dave Verone Telephone( ) 714- 375 -8471 Original Contract Amount $ 327,200 Final Contract Amount $ 327,200 If final amount is different from original, please explain (change orders, extra work, etc.) Did you file any claims against the Agency? Did the Agency file any claims against you /Contractor? If yes, briefly explain and indicate outcome of claims. Page C -8 Project Name/Number Annual Concrete at Various Locations Project Description R &R curb + gutter, sidewalk, driveway Approximate Construction Dates From 12/2015 to 4/2016 Agency Name City of Orange Contact Person Tviarrhpw T nrpn7pn ___Telephone( ) 714 - 744 -5544 Original Contract Amount $ 506,500 Final Contract Amount $ 588,577.52 If final amount is different from original, please explain (change orders, extra work; etc.) Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. No 6 Project Name/Number Washington Square Project Description Construct Approximate Construction Dates Agency Name City of Santa Ana Contact Person Michael Ortiz curb + "tter, sidewalk etc From 4/2016 to 3/2017 Telephone ( 714 - 647 -5076 Original Contract Amount $ 984,925 Final Contract Amount $ 992,584 If final amount is different from original, please explain (change orders, extra work, etc.) order Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. No Page C -9 Attach additional sheets if necessary. Attach to this Bid the experience resume of the person who will be designated as General Construction Superintendent or on -site Construction Manager for the Contractor. Attached Upon request, the Contractor shall attach a financial statement and other information sufficiently comprehensive to permit an appraisal of the Contractor's current financial conditions. Page C -10 William E. Ellis, Jr. 1320 E. Sixth Street Ste 100 Corona, CA 92879 Cell: (714) 448 -1136 Current Position: EBS General Engineering, INC. Corona, CA Project Manager 2005- Present Insurance Claims Liaison 2007 - Present Safety Officer 2008 - Present Prior Experience: Seal Black /Helmick Asphalt Operations Manager Foreman Operator Bay Alarm Company Foreman Laborer Capabilities /Experience: • Customer Relations /Service • Communications • Project Supervisor • Project Cost Estimation • Project Comprehension • Project Management • Materials Submittals /Compliance • Asphalt Paving Management • Concrete Masonry Management • Industrial Security Systems Installation Garden Grove, CA Oakland, CA July 2005 — Present April 1987 — July 2005 • Project Safety Supervisor • Employee Safety Liaison • Change Order Execution • BIT Compliance • Traffic Control Planning • SWPPP Planning /Compliance • Railroad Safety Courses • OSHA Compliance • CPR Certified • Tail -Gate Safety Meeting Organizer 1979-1987 William (Willie) has 30 plus years experience in multiple areas of the construction industry. His experience with industrial and infrastructure construction has afforded him a skill -set of high productivity within the organization. As a project manager at EBS, Willie executes contract compliance, purchase orders and sub - contracts, project review, material submittals and compliance, and coordination with various agencies, contractors, developers and engineering firms. He also helps EBS to obtain the necessary encroachment and building permits, city standards and plans, and safety programs for all projects big and small. During Willie's 30 years in the industry, he has also been intermittently certified on various safety programs such as railroad safety programs, OSHA Certified Safety programs, and CPR certification classes. His extensive and comprehensive construction background makes Willie a pivotal component of EBS's organizational structure. DESIGNATION OF SURETIES Bidder's name EBS General Engineering, Inc. Provide the names, addresses, and phone numbers for all brokers and sureties from whom Bidder intends to procure insurance and bonds (list by insurancelbond type): Bonds: Culbertson Insurance Services 5500E Santa Ana Canyon Rd Ste 201 Anaheim CA 92807 (714) 921 -0530 Insurance: Invensure Insurance Brokers 17991 Cowan Irvine CA 92614 (949) 756 -4100 Page C -11 ACKNOWLEDGEMENT OF ADDENDA Bidder's name EBS General Engineering, Inc. The bidder shall signify receipt of all Addenda here, if any: Date Received Page C -12 CONTRACTOR'S INDUSTRIAL SAFETY RECORD TO ACCOMPANY PROPOSAL Bidder's Name EBS General Engineering, Inc. Record Last Five (5) Full Years Current Year of Record The information required for tnese items is me same as regmrou rur cummus � w u, wuc iv, P., Vum Injuries, Summary— Occupational Injuries and Illnesses, OSHA No. 102. Legal Business Name of Bidder EBS. General Engineering, Inc Business Address: 1320E Sixth St., Ste 100 Corona CA 92879 Business Tel. No.: c)51 ,79_6g69 State Contractors License No. and Classification: 720016 A Title President The above information was compiled from the records that are available to me at this time and I declare under penalty of perjury that the in�)rmation is true�and accurate within the limitations of those records. Signature of bidder Date Title Signature of bidder Date Title Signature of bidder Date Title Signature of bidder Date Title President Page C -13 Current 2 2 2 2 2 Year of 0 0 0 0 0 Total Year Record 1 6 5 5 1 4 1 3 1 2 No. of contracts 100 151 144 145 122 176 838 Total dollar Amount of 22823 16735 22993 Contracts (in 14857 , 112,158 Thousands of$) 19804 1494 No. of fatalities 0 0 No. of lost Workday 0 4 6 1 1 2 14 Cases No. of lost workdav cases involving permanent 0 0 0 0 0 0 0 transfer to anotherjob or termination of employment The information required for tnese items is me same as regmrou rur cummus � w u, wuc iv, P., Vum Injuries, Summary— Occupational Injuries and Illnesses, OSHA No. 102. Legal Business Name of Bidder EBS. General Engineering, Inc Business Address: 1320E Sixth St., Ste 100 Corona CA 92879 Business Tel. No.: c)51 ,79_6g69 State Contractors License No. and Classification: 720016 A Title President The above information was compiled from the records that are available to me at this time and I declare under penalty of perjury that the in�)rmation is true�and accurate within the limitations of those records. Signature of bidder Date Title Signature of bidder Date Title Signature of bidder Date Title Signature of bidder Date Title President Page C -13 If bidder is an individual, name and signature of individual must be provided, and, if he is doing business under a fictitious name, the fictitious uarne must be set forth. If bidder is a partnership or joint venture, legal name of partnership /joint venture must be provided, followed by signatures of all of the partners /joint ventures or of fewer than all of the partners /joint ventures if submitted with evidence of authority to act on behalf of the parmership /joint venture. If bidder is a corporation, legal name of corporation must be provided, followed by notarized signatures of the corporation President or Vice President or President and Secretary or Assistant Secretary, and the corporate seal. Signatures of partners join venturers, or corporation officers must be acknowledged before a Notary Public, who must certify that such partners/joint venturers, or officers are known to him or her to be such, and, in the case of a corporation, that such corporation executed the instrument pursuant to its bylaws or a resolution of its Board of Directors. Page C -14 NON - COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California )SS. County of Riverside Joseph A. Nand , being first duly swom, deposes and says that he or she is Preddent of EBSCeneralEngmeedng.Inc., the party making the foregoing bid, in accordance with Public Contracts Code Section 7106, declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. 2017 Annual Concrete Repair Program Project Name: EBS General Engineering, Inc. Legal Business Name of Bidder 1320E Sixth St. , Ste 100 Corona CA 92879 Business Address Title Signature ofbidder Title Date: Subscribed and Sworn to before me on (Notary Sea]) Signature Notary Public Page C -15 California All - Purpose Acknowledgement State of California ) County of Orange On I - t ' 11 before me, William E. Ellis, Jr. a Notary Public Personally appeared A. Nanci WILLIAM E. ELLIS JR. Commission # 2127998 z i Notary Public • California n Z orange County M Comm. Ex ires Oct 23, 2019 f who proved to me on the basis of satisfactory evidence to be the person) whose nameXis /arEsubscribed to the within instrument and acknowledged to me that he/ sheRll€y executed the same in histhcr/their authorized capacity0as), and that by hishaaftheir signatureNon the instrument the personK or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Seal Notary Public Signature Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: CapacitAies) Claimed by Signer(s) 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: Of OPTIONAL 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: LIST OF SUBCONTRACTORS TO ACCOMPANY PROPOSAL In compliance with the provisions of Public Contract Code Section -4104, the undersigned bidder submitting this bid proposal sets forth the name, place of business and the portion of the work to be performed by: (I) -each subcontractor who will perform work or labor or render service to the bidder (as general Contractor) in or about the construction of the work or improvement; and (2) -each subcontractor licensed by the State of California who, under subcontract to the bidder, specially fabricates and installs a portion of the work or improvement according to detailed drawings contained in the plans and specifications, in an amount in excess of one -half of one percent of the bidder's total bid or, in the case of bids or offers for the construction of streets, highways or bridges, in excess of one -half of one percent of the bidder's total bid or ten thousand dollars ($10,000), whichever is greater. Subcontractor's Name, Address, Telephone # Bid Item Number Percent Of Total Bid Description of Work Percent of Total Bid KSI N. 6 P U 3 rh - Doh LCA N A 10W = v J Page C -16 Bond No. 3 —B Bond Premium NIL BID BOND TO ACCOMPANY PROPOSAL KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has issued an invitation for bids for the work described as follows: 2017 ANNUAL CONCRETE REPAIR PROGRAM Project CIP No ST1704 WHEREAS EBS GENERAL ENGINEERING. INC. 1320E SIXTH STREET, SUITE 100 CORONA CA 92879 (Name and address of Bidder) ( "Principal"), desires to submit a bid to Public Agency for the work. WHEREAS, bidders are required under the provisions of the California Public Contract Code to furnish a form of bidder's security with their bid. NOW, THEREFORE, we, the undersigned Principal, and SURETEC INSURANCE COMPANY 3131 CAMINO DEL RIO N #1450 SAN GO� CA 92108 (Name and address of Surety) ( "Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of TEN PERCENT OF AMOUNT RID Dollars ($ 10% ), being not less than ten percent (10 %) of the total bid 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 is awarded a contract for the work by the Public Agency and, within the time and in the manner required by the bidding specifications, enters into the written form of contract included with bidding specifications, furnishes the required bonds, one to guarantee faithful performance and the other to guarantee payment for labor and materials, and furnishes the required insurance coverage, 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 incurred by the Public Agency in the suit and reasonable attorneys' fees in an amount fixed by the court. Surety hereby waives the provisions of California Civil Code § 2845. Page C -17 IN WITNESS WHEREOF, this instrument has 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: JULY 12 2017 "Principal" Surety" a 1 u' e J By: BY j� Its osep anti, President Its ATTORNEY —IN —FACT / SPENCER FLAKE Its (Seal) 0 Its (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached. Page C -18 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 7 -12 -17 before me, Lexie Sherwood Notary Public, Dale Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to the within instrument and acknowledged to me that he /she /they "x executed the same in his /her /their authorized capacity(ies), LEXIE SHERWOOD and that by his /her /their signature(s) on the instrument the . COMM #2031782 9 person(s), or the entity upon behalf of which the person(s) }(q NOTARY PUBLIC -CALIFORNIA acted, executed the instrument. ORANGE COUNTY 0 Comm. Exp. JULY 27, 2017 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature Place Notary Seal Above Signature of Notary Public Lexie bherwood OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and fraudulent the form to document. could prevent removal and reattachment of another Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer — Title(s): ❑ Corporate Officer Title(s): ❑ Partner ❑ Limited ❑ General ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact M. ❑ Attorney in Fact ❑ Trustee o ❑ Trustee • . ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: V7 roAU: 510123 SureTec Insurance Company LMTED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company "), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Spencer Flake its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attomey -in -Fact may do in the premises. Said appointment shall continue in force until 12/31n019 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice - President, any Assistant Vice - President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or Indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attomey or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 2e of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 12m day of April , A.D. zon . 2017 .F SURETEC 7!!2;E ANY ter.. c ra By: John Knox resi nt State of Texas ss: County of Harris .1 _� ` * .- On this 12th day of April , A.D. 2017 before me personally came John Knox Jr, to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. am u, .nr <, 1,� XENIA CHAVEZ :: °,• n= Notary Public, State of Texas Comm. Expires 09 -10 -2020 �iiFOF tF'�� Notary ID 129117659 X� to avez, Notary Public x—IGIy commission expires September 10, 2020 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a truc and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect Given under my hand and the seal of said Company at Houston, Texas this 7pda of UL 2017 p.D nt Be , Assistant Se 'try Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812 -0800 any business day between 8:00 am and 5:00 pm CST. California All - Propose Acknowledgement State of California ) County of Orange On H - � beforeme, William E. Ellis Jr a Notary Public Personally Joseph A. Nanci mmELLIS JR. 2127998 California = outlty Oct 29, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Doctiment Signer(s) Other than Named Above: CapacitAies) Claimed by Signer(s) Q Individual Q Corporate Officer: Q Partner - Q Limited Q General Q Attorney -in -Fact Q Trustee Q Guardian or Conservator Q Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the persons) whose nameXis /are subscribed to the within instrument and acknowledged to me that he/ ehefthey executed the same in hishmT /their- authorized capacity0as,), and that by hisfirm*heir signaturels), on the instrument the persons), or the entity upon behalf of which the persons) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature OPTIONAL Q Individual Q Corporate Officer: Q Partner - Q Limited Q General D Attorney -in -Fact Q Trustee Q Guardian or Conservator Q Other: Signer is Representing: