HomeMy WebLinkAboutAGMT - All American Asphalt (Lampson Ave. #50010, 50013)P '
RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO
CITY OF SEAL BEACH
Attn: City Clerk
2118" Street
Seal Beach, CA 90740
Space of above this line for Recorder's use.
* ** No Recording Fee Pursuant to Government Code Section 6103, 27383 * * **
Notice pursuant to Civil Code Section 3093, must be filed within 10 days after completion.
Notice is hereby given that:
1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the
property hereniafter described:
2. The full name of the owner is: City of Seal Beach
3. The address of the owner is: City of Seal Beach, 211 8' 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 described as completed on 09/18/02 The work
was: Lampson Avenue Rehabilitation Segment 1 & 2 from Seal Beach Blvd. To Seal Beach City
Limits #50010 & 50013.
6. The name of the contractor, if any, for such of improvement was A!1 American Asphalt_
7. The date of the Contract was: April 8, 2002.
8. 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: Lampson Avenue Pavement Rehabilitation
(Seal Beach Blvd. To East City Limits)
Date: 3 - 0 Z
Signaia of owns; or corporate officer of owner
named in paragraph 2 or his agent.
DEPUTY CITY ENGINEER
VERIFICATION
1, the undersigned, say: the Director of Public Works declarant of the foregoing notice of completion; have
read said notice of completion and know the contents thereof; the same is true of my own knowledge.
I declare under penalty of perjury the foregoing is true and correct.
Executed on 9" Z -S , 20 OZ , at Seal Beach, California.
(Date of Signature)
�dz
- r v ,, rector of Public Works
EXHIBIT "A"
'PLEASE COMPLETE THIS INFOR"'TION
s RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
See P"��c�c4 s6e-�
Recorded in Official Records, County
Darlene Bloom, Interim Clerk-Recorder
Orange
111111 IIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ►up SEE
,,, 45 R2820020875279 02.17pm 10109/02
0.00 0.00 0.00 0.00 0.00 o.00, 0.00 0.00
TITLE: �0�\ O� �} 1��nn U e t' �psq
LAMPSON AVENUE PAVEMENT REHABILITATION
PROJECTS 50010 and 50013
t�
THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION b
(Additional recording fee applies)
00� 11 /92 � O
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of
RECORDING REQUESTED BY A' NC ECORDING FEE PURSUANT TO
WHEN RECORDED MAIL TO: GG..�RNMENT CODE SECTIONS
CITY OF SEAL BEACH
6103 and 27383.
ATTN: CITY CLERK
211 — 8th STREET RESOLUTION NUMBER
SEAL BEACH, CA 90740
A RESOLUTION OF TILE CITY COUNCIL OF THE CITY OF SEAL
BEACH DECLARING WORK TO BE COMPLETED AS TO PLANS AND
SPECIFICATIONS FOR PROJECT #50010 & 50013 LAMPSON AVENUE
PAVEMENT REHABILITATION (SEAL BEACH BOULEVARD TO EAST
CITY LIMITS ENTERED INTO BETWEEN ALL AMERICAN ASPIIALT
AND THE CITY OF SEAL BEACH
WHEREAS, on April 8, 2002, the City of Seal Beach entered into a contract with All
American Asphalt.
WHEREAS, the City Engineer has detennined that the work has been substantially
completed in accordance with the contract documents.
NOW, THEREFORE BE IT RESOLVED by the City Council of the City of Seal Beach
as follows:
Section 1 . That the work required to be performed by said Contractor has been
completed.
Section 2 . That the total cost of said work is in the amount of $ 717,691.73.
Section 3 . That the work is hereby accepted and approved.
Section 4 . It is further ordered that a "Notice of Completion ", Exhibit "A ", be filed on
behalf of the City in the Office of the Orange County Recorder within 10
days of the date of this resolution.
PASSED, APPROVED AND AD!DXTED by )te ity Council of the City of Seal Beach
at a meeting thereof held on the 02 & day o Q , 2002 by the following vote:
AYES: Councilmember
NOES: Councilmember
ABSENT: Councilmember
Mayor
ATT T:
City. r
i
STATE OF CALIFORNIA)
COUNTY OF ORANGE )SS
CITY OF SEAL BEACH)
I, Joanne M. Yeo, City Clerk of Seal Beach, California, do hereby certify that the foregoing
resolution is the original copy of Resolution Nun' er.99ffl on file in the office of the City
Clerk, assed, approved, and adopted by the Cit Co nci of the City of Seal Beach, at a
regular i neeting thera,�fl�nheld on the % day ) 2002.
City
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CONTRACTOR TO PRINT COMPANY - Rt �i
NAME: i ti.u ml F' < O . # . 1
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CONTRACT DOCUMENTS
DOCUMENTS TO SUBMIT UPON AWARD:
❑ PUBLIC WORKS CONTRACT ❑ ACKNOWLEDGEMENT OF LICENSE
❑ PERFORMANCE BOND LAW
❑ PAYMENT BOND ❑ WORKMEN'S COMPENSATION
CERTIFICATE
❑ INDEMNIFICATION AND HOLD ❑ INSURANCE REQUIREMENTS
HARMLESS
❑ LABOR LAW REQUIREMENTS -Insert other requirements if applicable
FOR:
•
Lampson Avenue Rehabilitation — Segments 1. & 2:
From Seal Beach Blvd. to Seal Beach City Limits
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CITY PROJECT NUMBERS: { f • '.l l.i .
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FEDERAL PROJECT NUMBERS: V"..-""`' �;,�' "',°�
"1 r � a¢ :'d°n�5's�`s 4 '� �'�.*5 " =)` �'§ sF^.
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, �„ y r�d�. ::s +t, y , =H'r t sn �? ' � a,'�: i.7=,`�'.. " STPL — 5229 005 & :, , .-, a gt i ; ` ::. ) �� "''.``b.`'�`. `: �' 2`�a - *�F �N"'. *i' y : �V ; ,it ``i:�Yi �y.��y'F`.w�ty '<r�;, ,��
' .,,7',� t1 �.. -kax: = e ,� n "2M`sw.' ' "�"' =` - ;� - a c.`....d` «,'- . :... 41
av .- � :s ��.., Sad .* '.:,f,3 ":.f{`.`.' �i '�<` "i' : i
STPL — 5229 (006) ; ,a.. fi 7a .;
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These Contract Documents are the exclusive property of the Agency and shall not be used in any manner without prior consent of the
Agency. Any reuse of these plans and specifications by Others shall be at Other's sole risk and without liability to the Agency.
www. pub
CITY OF SEAL BEACH - 211 EIGHTH STREET -SEAL BEACH, CA 90740 -637
• .
sOOKIIfiOFIII 1
CONTRACT DOCUMENTS 1
DOCUMENTS TO SUBMIT UPON AWARD: 1
PUBLIC WORKS CONTRACT 3
PERFORMANCE BOND 5
INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND
WAIVER OF SUBROGATION AND CONTRIBUTION' 9
AGREEMENT TO COMPLY WITHCALIFORNIA LABOR LAW
REQUIREMENTS 10
STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES
CONCERNING THE CONTRACTORS' LICENSING LAWS 11
INSURANCE REQUIREMENTS 13
WORKER'S COMPENSATION CERTIFICATE OF INSURANCE 15
ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE
GENERAL LIABILITY 16
ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY
18
ADDITIONAL INSURED. ENDORSEMENT EXCESS LIABILITY 20
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PUBLIC WORKS CONTRACT
Lampson Avenue Rehabilitation — Segments 1 & 2: From Seal Beach Blvd. to Seal Beach City Limits
City Project No.s 50010 & 50013
STPL - 5229 (005) & STPL - 5229 (006) •
•
For the following project named
,in the City of Seal Beach.
THIS AGREEMENT, made and entered into this tJ day of 4�O,/( itlb7.1 by and
between the City of Seal Beach, California, hereinafter referred to as the "CITY," Party of the First Part,
and
ALL AMERICAN ASPHALT
hereinafter designated as the "CONTRACTOR," Party of the Second Part.
WITNESSETH: That the Parties do hereto mutually agree as follows:
ARTICLE I. For and in consideration of the payments and agreements hereinafter mentioned to be
made and performed by said CITY, the CONTRACTOR agrees with said CITY to perform and complete
in a good and workmanlike manner all the work pertaining thereto shown on the drawings and described in
the Specifications and Contract Documents, therefore, to furnish at his own proper cost and expense all
tools, equipment, labor and materials necessary therefore (except those materials expressly noted as to be
furnished by the CITY), and to do everything required by this Agreement and the said Specifications,
Drawings, and Contract Documents.
ARTICLE II. For furnishing all said materials and labor, furnishing and removing all plant, temporary
works or structures, tools and equipment and doing all the work contemplated and embraced in this
Agreement, also for all loss and damage arising out of the nature of the work aforesaid, or from the action
of the elements, or from any unforeseen difficulties which may arise or be encountered in the prosecution
of the work until its acceptance by said CITY, and for all risks of every description connected with the
work; also for all expenses incurred by or in consequence of the suspension or discontinuance of work;
except such as in the said Specifications are expressly stipulated to be borne by the said CITY and
faithfully completing the work and the whole thereof, in the manner shown and described in the said
Drawings, Specifications, and Contract Documents and in accordance with the requirements of the
Engineer, said CITY will pay and the CONTRACTOR shall receive in full compensation, therefore, the
unit prices and the lump sum prices named in the Schedule of Work Items of the Proposal.
ARTICLE III. The CITY hereby promises and agrees with said CONTRACTOR to employ and does
hereby employ said CONTRACTOR to provide the materials and to do the work according to the terms and
conditions herein contained and referred to for the price aforesaid, and hereby contracts to pay the same, at •
the time, in the manner and upon the conditions set forth in the Specifications and Contract Documents, and
the said parties for themselves, their heirs, executors, administrators, successors and assigns, do hereby
agree to the full performance of the covenants herein contained.
ARTICLE IV. The advertisement for Bids, the Proposal, the Specifications, and the Drawings mentioned
therein, and all addenda issued by the CITY with respect to the foregoing prior to the opening of bids, are
hereby incorporated in and made a part of this Agreement.
F
• ARTICLE V. The statement of prevailing wages appearing in the General Prevailing Wage Rates is
hereby specifically referred to and by this reference is made a part of this contract. It is further expressly
agreed by and between the parties hereto that should there be any conflict between the terms of this
instrument and the bid of proposal of said CONTRACTOR, then this instrument shall control and nothing
herein shall be considered as an acceptance of the said terms of said proposal conflicting herewith.
ARTICLE VI. By my signature hereunder, as CONTRACTOR, I certify that I am aware of the provisions
of Section 3700 of the Labor Code which require every employer to be insured against liability for
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workmen'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.
IN WITNESS WHEREOF: The Parties hereto have caused this contract to be executed the day and year
first above written.
CITY OF SEA ACH, CALIFORNIA
Party ofth- i :.rt
BY •
City Man yr
AT
BY
CONTRA TOR - Party of the Second Part ", im( I)
•
VICE PRESIDE �!
Title
p.o•3 �� - CoRo►JA CA.ga3 -Aaa9
Address
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CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
4, _ . . . . . - - .- •..• •- • - - - ^�
State of California >>
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l vE1 'Si b�
(�; County of k ; > >
On t f/P-Q / ��- before me, PE duo s \/ AvES, 10 - 1Al2V 7861 o,, .
j Date ( amnd Title of Officer (e g ne Doe, Notary Public') 4 personally appeared R B 6 7 ___.Name a
7 A p L EY , > >
Name(j) of Sgner(
rt A' personally known to me '
<<: ❑ ,
( e : - evideese. >>
<< to be the person(4 whose name(8) is /fir€ >>
4 subscribed to the within instrument and ,'
acknowledged to me that heLshg/Per9 executed ',
( .;i - DENNIS JONES the same in his /j efljir authorized ,..
< <`: ;! "; Commission # 1200094 Z capacitypet§), and that by his/1104/6'r ;)
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$ - � : � .� ■ Notary Public- California $ signature(sr)'on the instrument the person(e'J, or j
4 A � Riverside C ounty the entity upon behalf of which the person(e ;A
(�;
( y �
*� N ,yCcun.bspa ,Oct30,2W2 acted, executed the instrument.
WITNESS my hand and official seal. A
1, Signature of Notary is v �
4 OPTIONAL
4 Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent >>
4 fraudulent removal and reattachment of this form to another document.
: �
Description of Attached Document
Title or Type of Document: r/ 0 /UT?Z# �T AG M5 /� / — > f�EA- 6H > >
< < Document Date: i ii a -q /O Number of Pages: O4iE PA-66 j� Signer(s) Other Than Named Above: Nolo E :,
<< CapacityClaimed by Signer >>
<<' Signer's Name: It 0 2 t -T C. ' %�
RIGHT THUMBPRINT ; ��
OF SIGNER
r << ❑ Individual Top of thumb here J �
<<: $1 Corporate Officer — Title(ef: VICE PRESIDENT ; >>
<<. ❑ Partner — ❑ Limited ❑ General >>
<<; ❑ Attorney -in- Fact >>
4 ❑ Trustee
4 ❑ Guardian or Conservator ; >>
4
0 Other: A
4 4 ALL AMER ICANA '
Signer Is R epres e n ti ng: St'HALT • J
01999 National Notary Association • 9350 De Soto Ave , PO Box 2402 • Chatsworth, CA 91313-2402 • www nabonalnotary org Prod No 5907 Reorder Call Toll -Free 1- 800 - 876.6827
/ •
•
INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF
SUBROGATION AND CONTRIBUTION
TITLE OF PROJECT OR WORK:
Indemnitor(s) (list all names):
//AAA ps O Al AV 6 E
S EG e J-rs 1 4 1 ),--
To the fullest extent permitted by law, Indemnitor hereby agrees, at its sole cost and expense, to defend,
protect, indemnify, and hold harmless the City of Seal Beach and its elected officials, officers, attorneys,
agents, employees, volunteers, successors, and assigns (collectively "Indemnitees ") from and against any
and all damages, costs, expenses, liabilities, claims, demands, causes of action, proceedings, expenses,
judgments, penalties, liens, and losses of any nature whatsoever, includmg fees of accountants, attorneys,
or other professionals and all costs associated therewith (collectively "Liabilities "), arising or claimed to
anse, directly or indirectly, out of, in connection with, resulting from, or related to any act, failure to act,
error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors,
materiahmen, suppliers or their officers, agents, servants or employees, arising or claimed to arise, directly
or indirectly, out of, in connection with, resulting from, or related to the above - referenced contract,
agreement, license, or permit (the "Agreement ") or the performance or failure to perform any term,
provision, covenant, or condition of the Agreement, including this indemnity provision. This indemnity
provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by
Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. This indemnity
provision shall survive the termination of the Agreement and is in addition to any other rights or remedies
which Indemnitees may have under the law. Payment is not required as a condition precedent to an
Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an
Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision.
Indemnitor shall pay Indennitees for any attorneys fees and costs incurred in enforcing this
indemnification provision. Notwithstanding the foregoing, nothing in this instrument shall be construed to
encompass (a) Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying
Agreement is subject to Civil Code § 2782(a) or (b) the contracting public agency's active negligence to the
limited extent that the underlying Agreement is subject to Civil Code § 2782(b). This indemnity is
effective without reference to the existence or applicability of any insurance coverage which may have
been required under the Agreement or any additional insured endorsements which may extend to
Indemnitees. Indemnitor, on behalf of itself and all parties claiming under or through it, hereby waives all
rights of subrogation and contribution against the Indemnitees, while acting within the scope of their duties,
from all claims, losses and liabilities arising out of or incident to activities or operations performed by or on
behalf of the Indemnitor regardless of any prior, concurrent, or subsequent active or passive negligence by
the Indemnitees. In the event there is more than one person or entity named in the Agreement as an
Indemnitor, then all obligations, Liabilities, covenants and conditions under this instrument shall be joint
and several.
" Indennitor"
Name 6L T3 l AD LXY Name:
B y: �� By:
Its v I • Its
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AGREEMENT TO COMPLY WITHCALIFORNIA LABOR LAW REQUIREMENTS
[Labor Code §§ 1720, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861, 3700]
The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the
Following provisions of California law:
1. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7,
Chapter 1 (commencmg 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 Califomia Labor Code.
7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to
secure the payment of compensation to its employees. In accordance with the provisions of California
Labor Code Section 1861, Contractor hereby certifies as follows:
"I am aware of the provisions of Section 3700 of the Labor Code which require every employer to
be insured against liability for worker's compensation or to undertake self - insurance in accordance with the
provisions of that code, and I will comply with such provisions before commencing the performance of the
work of this contract."
Date r /0-5/0 AY Signature - s
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STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE
CONTRACTORS' LICENSING LAWS
[Business & Professions Code § 7028.15] .
[Public Contract Code § 20103.5]
I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the
entity on whose behalf this certification is given, hold a currently valid California contractor's license as set
forth below (required at time of award) :
Business & Professions Code § 7028.15:
(a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage
in the business or act in the capacity of a contractor within this state without having a license therefor,
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 pnce 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 mvandate any contract or bid awarded by a public agency
during which time that subdivision was m effect.
(g) A public employee or officer shall not be subject to a citation pursuant to this section if
the public employee, officer, or employing agency made an inquiry to the board for the purposes of
verifying the license status of any person or contractor and the board failed to respond to the inquiry within
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three busmess days. For purposes of this section, a telephone response by the board shall be deemed
sufficient.
Public Contract Code § 20103.5:
In all contracts subject to this part where federal funds are involved, no bid submitted shall be
invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However, at
the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of
this state. The first payment for work or material under any contract shall not be made unless and until the
Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board
indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or
contractor not so licensed shall be subject to all legal penalties imposed by law, including, but not limited
to, any appropriate disciplinary action by the Contractors' State License Board. The agency shall include a
statement to that effect in the standard form of pre - qualification questionnaire and financial statement.
Failure of the bidder to obtain proper and adequate licensing for an
award of a contract shall constitute a failure to execute the contract and
shall result in the forfeiture of the security of the bidder.
License no.: 04'1 07.3 Class: A / ( -1 d- Expiration date: /130
4 c
Date � �J � �- SignatureG
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III III
INSURANCE REQUIREMENTS
FOR CITY OF SEAL BEACH
PUBLIC WORKS CONTRACT
LIABILITY INSURANCE
The Contractor shall at all times during the terms of the Contract carry, maintain, and keep in full force and
effect a policy or policies of comprehensive general liability insurance in which the City, along with its
City Council and each member thereof, and every officer, official, agent, attorney, employee or volunteer
of the City, is the named insured or is named as an additional insured with the Contractor in accordance
with the General Provisions. The insurance company issuing such policy(ies) must be acceptable to, and
approved by, the City Engineer and City Attorney. Contractor shall maintain limits of no less than One
Million Dollars ($1,000,000) combined single limit coverage per occurrence for personal injury or death or
property loss or damage which may arise from or relate directly or indirectly to the acts, operations or
omissions of the performance of the Contractor and/or its subcontractors and/or the employees, agents,
officers, officials or volunteers of either, in the performance of this Public Works Contract. Such insurance
shall include coverage for all automobiles utilized by Contractor's or any subcontractor's employees or
agents in the performance of the Contract. Contractor shall also provide an endorsement in the forms
included in Book II.
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Page Intentionally Left Blank
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EXECUTED IN THREE (3) PARTS
Bond No. 615 19 71 Bond Premium $4, 202.00
PERFORMANCE BOND
KNOW ALL PERSONS BY THESE .PRESENTS that:
WHEREAS the City of Seal Beach, has awarded
ALL AMERICAN ASPHALT
PO BOX _2229
CORONA. CA,__92878 -2229
(Name and address of Contractor)
( "Print_ _ i � a1 S ' ON AVENUE( (the "Contract") wo REHABILITATION Dt. �d If f i.
FROM SE BEACH BL s i S , : S
CITY PROJECT NOS. 50010 & 50013
WHEREAS, Principal is required under the term of the Contract to ltunisbi a bond for the faithful
performance of the Contract.
NOW, THEREFORE we, the unders! ed Print a1, d
SAFE�CO INSURANCE COMP OF Al
. MAI ,
SANTA ANA, CA. 9 $5
(Name and address of Surety)
("Surety") a duly admitted surety insurer under the laws of the State of California, u Surety, are held and
firmly bound +Into the Public Agency in the penal stun of
EIGHT HUNDRED FORTY THOUSAND, FOUR 1 1 ' ' •• ss S
Dollars (S 840, 4 . .15 _ ), 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 nude as therein provided, on the Principal's part to be kept and
performed, all with n the time and in the manner therein specified, and in all respects according to their nue
intent and meaning, and shall indemnity 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 N11 force and effect.
In case suit is brought upon this bond, Surery further agrees to pay all court costs and reasonable attorneys'
fees in an amount fixed by the court,
FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder,
or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby
waive notice of any such change. extension of time, alteration, Addition, or modification to the terms of the
Contract or to the work or to the specifications thereunder, Surety hereby waives the provisions of
California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all
rights of a party hereto. [N 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
I1.5
' I •
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: APRIL 23, 2002
"Principal" "Surety"
ALL AMERICAN ASPHALT SAFECO IN • x dt OF = :A 'ICA
By: By:
Its • •
By.�® OWEN M. BROWN
By:
Its Its
(Seal) (Seal)
Note: This bond must be dated, all signatures must be notarized, and
evidence of the authority of any person signing as attorney -in -fact must be
attached.
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• •
■
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
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person(s) whose name(s) are
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- DENNIS JONES the same in }�Jfje�/their authorized >>
<<; `�? C ommission # 1200094 Z capacity(ies), and that by ,faiS%ja�r /their , >>
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Notary Public- California -f signature(s) on the instrument the person(s), or
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, r Riverside County r the entity upon behalf of which the person(s)
S y MyCcmm.bc�'sOct �1Q2 acted, executed the instrument.
WITNESS my hand and official seal. Jv
Signature of Note v Mc '
(3 OPTIONAL . >>
�� Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent 'A/
fraudulent removal and reattachment of this form to another document ;��
fie
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D of Attached Document K.
Title or Type of Document: Ti/2 ! O RAAAA/c� J 0 /V.D 6 .P6A 4/ >>
re t
� � Document Date: 11.3/0 � Number of Pages: ' 0 pm k
4 Si nerS'Other Than Named Above: l J G E \J O INIJ >>
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4 Capacity(ies) Claimed by Signer Y > >
Signer's Name: To B r ,fl It AKA 1 CMA-S l V AS %�
, RIG THUMBPRINT
OF SIGN
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4 ❑ Individual Top 0f thumb here >>
<< It . Corporate Officer — Title(s): V `/ • F. k "n sec• / 7' EA S. : >>
<<; ❑ Partner — ❑ Limited ❑ General A
<<; ❑ Attorney -in -Fact :;�
❑ Trustee :A
❑ Guardian or Conservator A (�; ❑ Other:
q Signer Is Representing: ALL AMERICAN ASPHALT ;jj
0 1999 National Notary Association • 9350 De Soto Ave , PO Box 2402 • Chatsworth, CA 91313-2402 • www naaonalnotary org Prod No 5907 Reorder Call Toll -Free 1- 800 -876 -6827
. • •
. CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
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• State of California :
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• County of ORANGE
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r 4 -23 -02 b e f ore BARBA J . BENDER, NOTARY PUBLIC
On afore me :
D ft Name and Me or Met (e.g.. ' Jane Doe. Notary Pu 0c') s
personally appeared OWEN M. BROWN ,
t Name(e) ol SIgner(e) s
t
S 7 0011 persona known to me s
T 10CPQMOOZOMONOCIROMMSCOSGIEWNY f
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to be the person(S whose name%) Is1OOt :
BARBARA J. BENDER subscribed to the within Instrument and f
'obl?i'.` COmmtslon * 1267491 acknowledged to me that het K executed s
t : .- a Notary f Oc • � fOmO
I V: rt% Orange County the same in his/IGENIMIX authorized :
: MyCornm.8ctee: Jul 13.234 capacIty(Mlef, and that by hIslbodtketc :
t signaturek*on the Instrument the person%), or :
the entity upon behalf of which the persona) t
acte1 , xecuted the instrument. f
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s Place Notary Seel Above Sign rot Notary • " s
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OPTIONAL
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: and could p revent fraudulent removal and reattachment of this form to another document. s
s
r Description of Attached Document
: Title or Type of Document: PERFORMANCE BOND N0. 615 19 71 s
4 -23 -02 TWO (2) s
Document Date: Number of Pages:
s
, • Signer R ICAN ASPHALT s) Other Than Named Above: AIL AME s
: s
Capacity(les) Claimed by Signer :
5. Signer's Name: , OWEN M. BROWN MGM itlu%113PRINr f
❑ individual fop of rhumb here ,
4 ❑ Corporate Officer — Title(s): :
i ❑ Partner — ❑ Limited ❑ General s
z ;OCIXAttomey In Fact
❑ Trustee
s ❑ Guardian or Conservator f
i ❑ Other. s
:
✓ Signer Is Representing: SAFECO INSURANCE COMPANY OF AMERICA
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0 I5011 Ni Oend Warr Meedesea • IMO 0. Sae Ave.. P0. On 2402 . Chatsworth. CA at 313.2402 • NwareaonMouy.er0 Plea No. 61/07 Reader. Cd Tcefree 14C04764177
• •
Bond No. 615 19 71 Bond Premium included in charge for
Performance Bond.
PAYMENT BOND
(LABOR AND MATERIALS)
KNOW ALL PERSONS BY THESE PRESENTS that:
WHEREAS the City of Seal Beach, has awarded to
ALL AMERICAN ASPHALT
PO X "�`
C0RON C A. 92878-2229
(Name and address of Contractor)
( "Principal "), a contract (the "Contract ") for the work described as follows:
LAMPSON AVENUE REHABILITATION — SEGMENTS" T" ik z,
FROM SEAL BEACH BLVD TO SEAL BEACH CPI'Y LIMITS,
CITY PROTECT NOS. 50010 & 50013
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
SAFECO INSURANCE COMPANY OF AMERICA
___ 2677 NO. MA0 _
SANTA ANA. CA. 92705
(Name and address of Surety)
( "Surety ") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and
firm y bound unto the Public Agency in the penal sum of
FOUR HUNDRED TWEN'T'Y THOUSAND, TWO 11 a - - • el 'III ; 11 s
Dollar; (S a2t1 7q1 - ,R _ _ this amount being not less than fifty percent
(50%) of the total contract price, in lawfttl money of oo 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, Srtzily by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her
or its heirs, executors, administrators, successora or assigns, or subcontractors shall fail to pay any of the
persons named in Section 3181 of the California Civil Code, or any amounts due under the Unemployment
Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to
be deducted, withheld, and paid over to the Employment Development Department from the wages of
employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance
Code, with respect to work or tabor performed under the Contract, the Surety will pay for the same in an
amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and
void.
This bond shall insure to the benefit of any of the persons named in Section 3181 of the California Civil
Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In
case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys'
fees in an amount fixed by the court.
FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder,
or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby
waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the
11 -7
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•
q Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of
California Civil Code f 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 net
forth below, the name of each corporate party being hereto affixed and these presents duly signed by its
undersigned representative(s) puma to authority of its governing body.
Dated:
"Principal" "Surety"
ALL AMERICAN ASPHALT SAFECO INSURANCE COMPANY OF AMERICA
By; By:
Its Its ATTORNEY —IN —FACT
By �% L�i�... By: OWFTT M. BROWN
Its Its
(Seal) (Seal)
Note: This bond must be dated, all signatures must be notarized, and
evidence of the authority of any person signing as attorne•in -fact must be
attached..
•
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CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
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On //a9 0 I- before me, l k� 1 �N � Ajo z y Aso Cs j
£ Date Name and Title of Officer (e g Jane Doe, Notary bad
personally appeared ■ c, • ' ' ► I. P ..40./ 0 S A
Names) of Signer(s)
IX personally known to me > >
, ❑ v
' - evidence >>
4Y to be the person(s) whose name(s) Aare
� subscribed to the within instrument and >>
[£ acknowledged to me that.M1 h /they executed >>
_ _ _� `� the same in Ait70,ef /their authorized >>
[` - D ENNNIS JONES l' capacity(ies), and that by )/J r /their y�
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'k. Commission # 1200094 Z signature(s) on the instrument the person(s), or
Z ,: ",,g Notary Public- California ; the entity upon behalf of which the person(s)
( Z +'' Riverside County acted, executed the instrument. ;�j
'C' �' M yCcmm•Exote3Oct30 2 ,'A
'C WITNESS my hand and official seal. „
r Signature of Notary Pu 7
A
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 this form to another document j�
Description of Attached Document A'
The or Type of Document: pA yM ANT B 0 N D 1 SEirC. . C-/i > j
Document Date: - I 1 a3 / . Number of Pages:1Wd PA'eS
Signer( Other Than Named Above: Ak/F A) M • g 0 Wlv' >>
Capacity(ies) Claimed by Signer .� > >
l\
Signer's Name: 0 B E f 2 AD C - >k�/VlflS ,as >
RIGHT THUMBPRINT ; ��
•
OF SIGNER
0 Individual 1 / Top of thumb here
N Corporate Officer — Title(s): V I r p • AND �fC irkzAc. : 8
❑ Partner — ❑ Limited ❑ General
it ❑ Attorney -in -Fact >:>>
❑ Trustee >>
❑ Guardian or Conservator :>>
(' ❑ Other: j
Signer Is Representing: ALL AMERICAN ASPHALT T ,.
G%✓: ✓✓ %-:✓: ✓:�✓::✓:‹✓✓:' ✓cam✓ ✓: ✓: ✓it %� ✓�✓ ✓:
0 1999 National Notary Assoaatron • 9350 De Soto Ave , PO. Box 2402 • Chatsworth. CA 91313-2402 • www naaonalnotary org Prod No 5907 Reorder Call Toll -Free 1-800-876-6827
• .
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT M
t .vet...“ ont.Ht.y4.v.t v,t.v.t.v.t..T C.v t.v.< v. <.ht v.t.v.t.v.4_v.t..•.t..•ft..•. �y4.v.4.yt y4. Nt.v lt. v, 4_ v, Q .v,f..•.Q.yQ_.ft.v _••s• .H .v, .vs .v, •.M —%% f
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• State of Callfomla
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ss. 5
• County of ORANGE f
j s
9 On 4 23 -02 , before me, BARBARA J. BENDER, NOTARY PUBLIC s
` Name and TPoe or off (e.g., vane Oa, Notary Public') s
Dee s
• t personally appeared OWEN M. BROWN
1 Names) d Signer(e) s
)00 personally known to me
to be the person( whose names) IslecK f
BARBARA J. BENDER subscribed to the within Instrument and '
T - t Z0^ • 1247491 acknowledged to me that helACexecuted f
1 � NOS California the same In his/121 OCK authorized f
1 ` • �� MyConn. EgokesJul 3, X04 capacIty(}9 , and that by hisibedtkeix s
signatureon the Instrument the person(l, or s
t the entity upon behalf of which the person(:6) '
act =d, executed the Instrument. s
.
WI ; SS , c 5 hand and A ti seal. s
Ptaa Notary Seal Above - - Slone T Notary Public t
OPTIONAL
i Though the information below Is not required by law, 11 may prove valuable to persona relying on the document s
i and could p revent fraudulent removal and reattachment of Shia form to another document. s
s
Description of Attached Document
I Title or Type of Document: PAYMENT BOND NO. 615 19 71 s
s
4 -23 -02 Number of Pages: T (2) '
Document Date:. s
i s
Y S Other Than Named Above: ALL AMERICAN ASPHALT s
s
✓ Capaclty(les) Claimed by Signer s
Signer's Name: OWEN M. BROWN HIGHT THUMUPIliNT f
: ❑ indlviduel Top a hthumb s • 4 ❑ Corporate Officer — Tltle(s): s
i ❑ Partner — ❑ Limited ❑ General s
MOIXAttomey In Fact
2 ❑ Trustee f
s ❑ Guardlan or Conservator
• ❑ Other. s
< f
. Signer Is Representing: SAFECO INSURANCE COMPANY OF AMERICA
2 f
r
2 s
0W0a7 � c:n o ?,o n✓J; 'C.'7 '.v0.'O - "o "0 P'O:<'O:n0" ".VGNC'•r *•O.v '.v - .'0 "7 '.vO:w.O•v &a'4CN 'n t 'N4 t7O.nl N4 N.'N. '7'."N. 'N.'/,�
o Me National Notary MeeeMbn • MO 0e Sete Ave., A.O. See 4102 • ClataweM CA 1113134402 • ww,v.rauenbatay eq Plod No 6007 Mader. CAI Wpm 14004764877
AF E C O" • P OWER ECO INSURANCE COMPANY OF AMERICA
S
NERAL INSURANCE COMPANY OF AMERICA
OF ATTORNEY HOME OFFICE SAFECO PLAZA
SEATTLE, WASHINGTON 98185
No. 9164
KNOW ALL BY THESE PRESENTS:
That SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA, each a Washington corporation, does each hereby
appoint
****************************** * * ** * * * * * * * * * * * * * * * * * * * * * * *OWEN M BROWN; Anaheim, Callfemia** * * * * * * * * * * * * * * * * * * * * * ** * * ** * * ** ssss ** * ** * * * * * * * * * * * * ** * * * * * * **
Its true and lawful attorney(s) -in -fact, with full authonty to execute on its behalf fidelity and surety bonds or undertakings and other documents of a similar character
issued in the course of its business, and to bend the respective company thereby.
IN WITNESS WHEREOF, SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA have each executed and
attested these presents
this 28th day of Apnl , 1999
... voisisit
R.A. PIERSON, SECRETARY W. RANDALL STODDARD, PRESIDENT
CERTIFICATE
Extract from the By -Laws of SAFECO INSURANCE COMPANY OF AMERICA
and of GENERAL INSURANCE COMPANY OF AMERICA:
"Article V, Section 13 - FIDELITY AND SURETY BONDS the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that
purpose by the officer in charge of surety operations, shall each have authonty to appoint individuals as attomeys -in -fact or under other appropriate titles with authority to
execute on behalf of the company fidelity and surety bonds and other documents of similar character Issued by the company in the course of its business . On any
Instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authonty or on any bond or
undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not
be necessary to the validity of any such instrument or undertaking "
Extract from a Resolution of the Board of Directors of SAFECO INSURANCE COMPANY OF AMERICA
and of GENERAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970
"On any certificate executed by the Secretary or an assistant secretary of the Company setting out,
(i) The provisions of Article V, Section 13 of the By -Laws, and
(n) A copy of the power -of - attomey appointment, executed pursuant thereto, and
(iii) Certifying that said power -of- attomey appointment Is in full force and effect,
the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof."
I, R A. Pierson, Secretary of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA, do hereby certify that the
foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of these corporations, and of a Power of Attomey issued pursuant thereto, are true and
correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation
this 23rd day of APRIL , 2002 .
�rCNy _co Mp,4
CORPORATE
3 SEAL s SEAL
j95'� ° 1 Z�
' 'OP w � ` 011% ' R.A. PIERSON, SECRETARY
S- 0974 /SAEF 7/98 ® Registered trademark of SAFECO Corporation
4/28/99 PDF
-- •• • • • • ,.. �... ,_ .......
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WORKER'S COMPENSATION CERTIFICATE OF INSURANCE
WHEREAS, the CITY OF SEAL BEACH has required certain insurance to be provided by
x Eagle Pacific Insurance Company
NOW THEREFORE, the undersigned insurance company -does hereby certify that it has issued the policy
or policies described below to the following named insureds and that the same are in force at this time.
1. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL
BEACH, CA 90740 -6379.
2. The insureds under such policy or policies are: A 11 American Asphalt, etal
3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of
California covering all operations of the named Insureds, as follows:
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
4S0100304 6/8/01 6/8/02
4S0100305 6 8 01 6/8/02
4. Said policy or policies shall not be canceled, voided or reduced in coverage or lints of 'lability,
unless and until thirty days' advance written notice thereof has been served upon the City Clerk of the
CITY OF SEAL B CH.
Byo
Its Authorized Represe e
. 11 -15
r
ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY
All American Asphalt — P.O. Box 2229, Corona, CA 92878
Name and address of named insured ("Named insured"):
Royal Surplus Lines Ins. Co. c/o 701 N. Brand Blvd, Glendale, CA
Name and address of Insurance Company ("Company'): 91203
OFFICIAL TI7'LEO1gPROJECT: Lampson Avenue Rehabilitation
Project #50010 & 50013
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached
(the "Policy') or in any endorsement now or hereafter attached thereto, it is agreed as follows:
1. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are
additional insureds (the above maned additional insureds are hereafter referred to as the "Additional
Insureds") under the Policy in relation to those activities deserted generally above with regard to
operations perforated by or on behalf of the Named Insured, The Additional Insureds have no liability
for the payment of any premiums or assessments under the Policy.
2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance,
and no other insurance maintained by the Additional Insureds shall be called upon to coutdbute with
the insurance coverages provided by the Policy.
3. Each msutaate coverage under the Policy shall apply separately to each Additional Insured against
whom claim is made or suit is brought except with respect to the limits of the Company's liability.
4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured
under the policy against another insured under the policy. AU such chains shall covered u third -party
claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing
contained in this provision shall operate to increase or replicate the Company's limits of liability as
provided'umder the policy.
5. The insurance afforded by the Policy for contractual liability insurance (subject to the terns,
conditions and exclusions applicable to such insurance) includes liability assurned by the Named
Insured under the indemnification and/or hold harmless provision(s) contained in or executed in
conjunction with the written agreemen(s) or permits) designated above, between the Named Insured
and the Additional Insureds.
6. The policy to which this endorsement is attached shall not be subject to cancellation change in
coverage, reduction of limits (except as the result of the payment of claims), or non- renewal except
after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty
(30) days prior to the effective date thereof In the event of Company's failure to comply with this •
notice provision, the policy as initially drafted will continue in full force and effect until compliance
with this notice requirement.
7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,
while acting within the scope of their duties, from all claims, losses and liabilities arising out of or
incident to the perils insured against in relation to those activities described generally above with
regard to operations performed by or on behalf of the Named Insured regardless of any prior,
concurrent, or subsequent active or passive negligence by the Additional Insureds.
8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity,
construction, interpretation, and enforcement of this contract of insurance.
9. This endorsement and all notices given hereunder shall be sent to Public Agency at:
Director of Public Works
•
City of Seal Beach
211 8th Street
Seal Beach CA 90740
11 -16
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10. Except as stated above and not in conflict with this endorsement, nothing contained bnein shall be
held to waive, slier or extend any of the limits, agreements, or exclusions of the policy to which this
endorsement is attached.
TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF
THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY
Commercial General Liability 8/1/01 to 8/1/02 $1,000,000/$2,000,000
11. Scheduled items or Locations are to be identified on an attached sheet. The following inclusions
relate to the above coverages. Includes:
Contractual Liability Explosion Hazard
Owners/Landlords/Tenants Collapse Hazard
Manufacturers/Contractors underground Property Damage
Products/Completed Operations PoThition Liability as per insuring agree.
Broad Form Property Damage Liquor Liability
Extended Bodily Injury
Broad Form Comprehensive
General Liability Endorsement
12. A deductible or self - insured retention (check one) of $ 10,000
applies to all coverage(a) except
(if none, m state). The deductible is applicable per claim or per occurrence (check
one).
13. This is an occurrence or claims made policy (check one).
14. This endoraerraihefft pn 8/1/01 at 12:01 A.M. and forms a part
ofPolicy Number 51 / .
Kathy Lopez (prkt name), hereby
declare under penalty of petjwy under the laws of the State of California, that I have the authority to bind
the Company to this endorsement and that by my execution hereof I do so bind the Company.
Executed April 29 , 2 0 0 2 cxxxxxxxxxx
gd. Le C �
•
Signature of Autlned • resentative
•
(Original signature only; no facsimile signature or initialed signature
accepted) -
Phone No.: ( 714) 937-4270
I1.17
•
ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY
All American Asphalt — P.O. Box 2229, Corona, CA 92878
Natroe and address of named insured ( "Named Insured"): -
•
Hartford Fire Ins. Co. c/o P.O. Box 2333, Brea, CA 92622
Name and address of Insurance Company ("Conway"):
OFFFJ<CAL'I'ITLE OF PROJECT: Lampson Avenue Rehabilitation
Project #50010 & 50013
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the
"Policy") or in any endorsement now or hereafter attached thereto, it is agreed as follows:
The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional
insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the
Policy in relation to those activities described generally above with regard to operations performed by or on behalf
of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments
under the Policy.
1. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no
other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance
coverages provided by the Policy.
2. Each insurance Coverage under the Policy shall apply separately to each Additional Insured against whom claim
is made or suit is brought except with respect to the limits of the Company's liability.
3. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under
the policy against another insured =der the policy. All such claims shall covered as third -party claims. Le., in
the same manner as if separate policies had been issued to each insured. Nothing contained in this provision
shall operate to increase or replicate the Company's limits of liability u provided under the policy.
4. The insurance afforded by the Policy for contactual liability insurance (subject to the terns, conditions and
exclusions applicable to such insurance) includes liability assumed by the Named Insured under the
indemnification and/or hold harmless provision(s) contained or executed in conjuuncdon with the written
agreements) or pennit(s) designated above, between the Named Insured and the Additional Insureds.
5. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage,
reduction of limits (except as the result of the payment of claims), or non - renewal except after written nodce to
Public Agency, by certified rail, return receipt requested, not less than thirty (30) days prior to the of baive
date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially
drafted will continue in bull force and effect until compliance with this notice requirement.
6. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting
within the scope of their duties, tom all claims, losses and liabilities arising out of or incident to the perils
insured against in relation to those activities described generally above with regard to operations performed by
or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive
negligence by the Additional Insureds.
It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction,
interpretation, and enforcement of this contract of insurance.
This endorsement and all notices given hereunder shall be sent to Public Agency at
Director of Public Works
City of Seal Beach
211 8th Street
Seal Beach CA 90740
7. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to
waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is
attached.
I1 -18
•
•
•
• TYPE OF COVERAGES TO WHICH POLICY PERIOD
LIMITS OF
THIS ENDORSEMENT ATTACHES FROM/ TO
LIABILITY
Commercial - Automobile 8/1/01 to 8/1/02
Scheduled items or locariona are to be identified on an attached sheet. The following inclusions rebate to
the above coverages. Includes:
Any Automobiles
All Owned Automobiles Motor Carrier Act
Non -owned Automobiles $
Hired Aut mobiks RIAiRitkinzirkmrPile
Scheduled Automobiles
xamtgoliountnipx
11. A deductible or self- inauced retention (check one) of S 10,000. applies to all
coverage(e) except:
fnom, so state). The deductible is applicable per claim or per occurrence (check one).
12. This is an occurrence or claims suede policy (check one).
•
13. This endorsement le effective on 8/1/01
at 12:01 A.M. and forms a part of Policy
Number 72UENGK5491
I, Kathy Lopez (print name), hereby
declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the
Company to this endorsement and that by my execution hereof, I do so bind the Company.
Executed April 29, 2002 xygtxxxxxxxxxxxxx
Signature of Authorized Representative rQ� %(,
(Original signature only; no facsimile signature or initialed signature
accepted)
PhoneNo.: (714) 937 -4270
•
II.19
•
• -
- •
- •
ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY
All American Asphalt — P.O. Box 2229, Corona, CA 92878
•
Rome and address of named insured ("Named Insured"): •
Great American • • — • .t Fi•u- •. • ;■•• - , CA 90017
Name and address of Insurance Company ("Company").
OFFICIALTITLEOFPROIECT; Lampson Avenue Rehabilitation
Project #50010 & 50013
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the
"Policy") or in any endorsement now or hereafter attached thereto, it is agreed as follows:
1. The City of Seal Beach, its elected officials, officers, anorneys, agents, employees, and vohtnleers
•
are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Itmtreds")
under the Policy in relation to those activities described generally above with regard to operations performed by or
on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or
assessments under the Policy.
•
2. The insurance coverages afforded the Additional Insureds under the Policy shall be printery
insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the
insurance coverages provided by the Policy.
3. Each insurance coverage under the Policy stall apply separately to each Additional Insured
against whom claim is made or suit is brought except with respect to the limits of the Company's liability.
4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one
insured under the policy against another insured under the policy. All such claims shall covered as third -party
claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this
provision gull operate to increase or replicate the Company's limits of liability u provided under the policy.
S. The insurance afforded by the Policy for contractual liability insurance (subject to the terns,
conditions and exclusions applicable to such Insurance) includes liability assumed by the Named Insured under the
indemnification and/or hold harmless provisions) contained in or executed in conjunction with the written
agreement(s) or pennit(s) designated above, between the Named Insured and the Additional Insureds.
6. The policy to which this endorsement is attached shall not be subject to cancellation, change in
coverage, reduction of limits (except as the result of the payment of claims), or non- renewal except after written
notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the
effective date thereto. In the event of Company% failure to comply with this notice provision, the policy as initially
drafted will continue in 1bU force and effect until compliance with this notice requirement
7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,
while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to die
peals insured against in relation to those activities described generally above with regard to operations performed by
or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by
the Additional Insureds.
8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity,
construction, interpretation, and enforcement of this contract of insurance.
9. This endorsement and all notices given hereunder shall be sent to Public Agency at
Director of Public Works
City of Seal Beach
211 8th Street
•
11 -20
•
Seal Beach CA 90740
10. Except as stated above and not in conflict with this endorsement, nothing contained herein .hall be
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which
Ibis endorsement is attached.
TYPE OF COVERAGES TO WHICH POLICY PERIOD
LINDTS OF --
THIS ENDORSEMENT ATTACHES FROM/TO
LIABILITY
Following Form
•
Umbrella Liability x 8 /1/01 to 8/1/02
10. Applicable underlying coverages:
INSURANCE COMPANY POLICY NO.
AMOUNT Royal Surplus $1,000,000 KZB517647
Hartford Fire Ins. $1,000,000
, 1, 000,000 4S0100304 450100305
Eagle Pacific
11. The following inclusions, exclusions, extensions or specific provisions relate to the above
coverages: see. attached
12. A deductible or self insured retention (check one) of $ 10,000
applies to all coverage(s) excepts —
• _ (if none,
so state). The deductible is applicable per claim or per occurrence (check one).
13. • ' This is an occurrence or claims made policy (check one).
pay 1Nu144iber TUU 3 sa 7 � 7 2is effective On 8 /1/01 at 12:01 A.M. and forms a part of
Kathy Lopez
(print name), hereby declare under
penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this
endorsement and that by my execution hereof, I do so bind the Company.
Executed April 29 , 2002
xifxxxxxxxxxxxxxxxx
Signature of • Rep tative
(Original signature only; no facsimile signature or initialed signature
accepted)
PhoneNo.: ( 71 ) 937 -4270
1141
•
All American Asphalt
Certificate for City of Seal Beach
Project: Lampson Avenue Rehabilitation
Project #50010 and 50013
Addendum to Umbrella Liability Section of Certificate
11. The following inclusion, exclusion, extension or specific provisions
relate to the above coverages:
Commercial Umbrella Coverage Form
Advertising Injury / Following Form
Personal Injury / Following Form
Loading — Unloading Exclusion / Following Form
Contractual Liability / Following Form
Employee Benefits Liability / Following Form
Foreign Liability / Following Form
Care, Custody & Control Exclusion
Professional Liability Exclusion
Earth Movement Exclusion
Year 2000 Computer Related & Other Electronic Problem Exclusion
Lead Exclusion
/6, b