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HomeMy WebLinkAboutAGMT - California Surfacing Companyd RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO CITY OF SEAL BEACH Attn: City Clerk 211 - 8th Street Seal Beach, CA 90740 Recorded in Official Records, Orange County Tom Daly, Clerk- Recorder IIIIIIIIIIIIIIINIIINIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIII NO FEE 2010000142239 9:05 am 03/26/10 62 417 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 b Space of above this line for Recorder's use. I , * ** No Recording Fee Pursuant to Government Code Section 6103, 27383 l" NOTICE OF COMPLETION 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 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. A-work - -of improvement on the property hereinafter is described as substantially completed on February 16, 2010 The work was Tennis Courts Resurfacing Project CIP No. BG1004. 6. The name of the contractor, if any, for such improvement was: California Surfacing. The date of the Contract Award was December 14, 2009 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: Seal Beach Tennis Center APN 217- 361 -03. Date: 3123 t 0 atur 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. Executed on *CA, L 3 , 2010, at Seal Beach, California. (Date of Signature) Director of Public Works AN AGREEMENT FOR TENNIS COURTS RESURFACING between -'� SEALB `� `CARPOf�gT !if * Bpi • -; y . - ?3.(1--\\ ` � s y City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 California Surfacing Co. 4557 Oak Lane Claremont, CA 91711 (909) 621 -2195 THIS AGREEMENT is made and entered into this December day of 14, 2009, by and between the City of Seal Beach, a California charter city ( "City "), and The California Surfacing Co. ( "Contractor "). Page D -29 RECITALS WHEREAS, the City Council has approved the plans and specifications for the Tennis Courts Resurfacing ( "Project ") with respect to design criteria; and WHEREAS, Contractor has submitted a bid to City for the Project dated November 3, 2009 in the amount of $45,435. ( "Accepted Proposal" hereinafter). The Accepted Proposal is attached hereto as Exhibit G and contains, among other things, provisions defining the Project scope. NOW, THEREFORE, in consideration of performance by the parties of the mutual promises, covenants, and conditions herein contained, the parties hereto agree as follows: AGREEMENT Contractor's Services. 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. 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), Worker's 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. 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 therefore, except such labor, materials, equipment and services as are specified in the Contract Documents to be furnished by City. 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. Effective Date. This Agreement is effective as of December 14, 2009 (the "Effective Date "), and shall remain in full force and effect until Contractor has rendered the services required by this Agreement. Payment. For performing and completing the work in accordance with the Contract Documents, City shall pay Contractor, in full compensation therefor, the amount of $45,435, 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 Page D -30 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. Contractor's Personnel. 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. 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. Contractor shall indemnify and hold harmless City and its elected officials, officers and 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. 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 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. 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. Indemnification. Contractor's Duty. Contractor shall 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 Page D -31 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. Bid Protests. In addition to its obligations pursuant to Section 5.1, Contractor shall reimburse the City for all attorney fees and costs incurred by City in connection with, arising out of or incident to any bid protest. City's Sole Negligence. Nothing in Section 5.1 shall be construed to require Contractor to indemnify Indemnities for that portion of any Claim to the extent arising from the sole negligence or willful misconduct of the Indemnities. 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 the deposit with City, of any insurance policy or certificate required pursuant to this Agreement. 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. 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 an Contractor shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. Insurance. 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 and professional negligence which may arise from or in connection with the performance of the services hereunder by Contractor, and its agents, representatives, employees and subconsultants. 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: Exhibit D -1: Additional Insured Endorsement - Commercial General Liability Exhibit D -2: Additional Insured Endorsement - Automobile Liability Exhibit D -3: Additional Insured Endorsement Minimum Scope of Insurance. Unless otherwise approved by City, coverage shall be at least as broad as: Insurance Services Office Commercial General Liability coverage (occurrence form CG 0001). Page D -32 Insurance Services Office form number CA 0001 (Ed. 1/87) covering Automobile Liability, code 1 (any auto). Insurance Services Office form number CG 20 10 11 85 (Ed. 11/85) covering Additional Insured— Owners, Lessees or Contactors (Form B). Worker's Compensation insurance as required by the State of California and Employer's Liability Insurance. Profess nal P0il insurance ' p5iitractor sl all provideptg ty t l a s t a nArcl f rkigied b the `carrier ` -..._ �.. Minimum Limits of Insurance. Contractor shall maintain limits no less than: General Liability: $1,000,000 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. Automobile Liability: $1,000,000 per occurrence for bodily injury and property damage. 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. Deductibles and Self- Insured Retentions. Contractor shall inform City of any deductibles or self - insured retentions except with respect to any professional liability insurance. Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of city or agency 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 or agency officials which are not also limitations applicable to the named insured. 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 or agency officials. Any insurance or self - insurance maintained by City, their officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of city or agency officials shall be excess of Contractor's insurance and shall not contribute with it. 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. Page D -33 Each insurance policy required by this clause 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. Each insurance policy, except for any professional liability policy, required by this clause 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. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VII unless waived in writing by City's Risk Manager. 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. 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 $ 250 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. 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. 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 of Seal Beach - City Clerk 211 8th Street Seal Beach, California 90740 Telephone: (562) 431 -2527 Fax: (562) 493 -9857 With a copy to: Public Works Director Page D -34 City of Seal Beach 211 8th Street Seal Beach, California 90740 If to Contractor: California Surfacing Co. 4557 Oak Lane Claremont, CA 91711 Telephone: (909) 621 -2195 Fax: (909) 626 -4650 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. 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. 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. 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. 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. 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. (Intentionally Left Blank) Page D -35 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 CONTRA • OR: By: By: David N. Canna , City Manager Name: le )C/ % S V , ' Title: 0 pi.) A to, r Attest: r .. By: A lCc I By: a Devine, Ci lerk Name: Title: Approved as to Form: By: C , • uinn M. Barrow, City Attorney Page D -36 **I****DUPLICATE ORIGINAL****•** Executed In Duplicate Premium Based On Final Contract Amount • Bond No. SU 1104849 . Bond premtua$1,363 .00 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that • • WHEREAS the City of Seal Beach,has awarded California Surfacing 4457 Oak Lane Claremont, CA 91711 (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows: Tennis Coutta_Resusfadne-City Prolect Number #BG1004 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 Arch Insurance Company 135 North Los Robles Avenue, Suite 825 Pasadena.. CA 91101 (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 Agencyiri thepenal sumof,Forty five thousand four • hundred thirty five and 00/100 Dollars(5 4 5,4 5 .0 0 ),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, execut ors, 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, tams. covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided,on the Principal's pan 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 mill 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 axed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration,addition or modification to the terms of the Contract,or of the work to be performed there under,or the specifications for the same,shall in any,way affect its obligations under this bond,and it does hereby waive notice of any such change, extension of time,alteration,addit ion, 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 npresentative(s)pursuant to authority of its governing body. Page D-38 • • • • Datcd:December 15, 2009 N��p-ICI "Surety„ 14 California Surfacing '---! Arch Insurance Company By;, 1— By:Raymond E. Gail Its Its mow! Its ,Attorney in Fact By: By: Its Its (Seal) (Seal) Note:This bond must be dated,all signatures must be notarized,and evidence of the authority of any person signing as attorney-in-fact must be attached. • • Page D-39 • • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California • County of San Bernardino On DEC 1 5 2009 before me, Stacia C. Baker, Notary Public Date Here Insert Name and Title of the Officer personally appeared Raymond E. Gail Name(s)of Signer(s) N/A who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ace subscribed to the within instrument and acknowledged to me that he/slhe/they executed the same in his/1464:4r authorized capacity(.ies), and that by his/hor/their signature(s) on the �..� STACIA C. BAKER instrument the person(s), or the entity upon behalf of w Commission # 1776731 which the person(s) acted, executed the instrument. ' Notary Public -California San Bernardino County hNyComm. oct2v,2o11 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 1X �K , . 6P-AX Place Notary Seal Above Signature of Notary Public 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. 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 RIGHTTHUMBPRINT ❑ Partner—❑ Limited ❑General RIGHTTHUMBPRINT ❑ Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER ❑ Trustee Top of thumb here ❑Trustee Top of thumb here ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: ❑Other: Signer Is Representing: Signer Is Representing: • • • • POWER OF ATTORNEY • • Know All Men By These Presents: That the Arch Insurance Company,a corporation organized and existing under the laws of the State of Missouri,having its principal office in Kansas City, Missouri(hereinafter referred to as the"Company")does hereby appoint Raymond E. Gail and William J. Shupper of Rancho Cucamonga, CA(EACH) its true and lawful Attomey(s)-in-Fact,to make, execute, seal, and deliver from the date of issuance of this power for and on its behalf as surety,and as its act and deed: Any and all bonds and undertakings EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or collection of any promissory note,check,draft or letter of credit. This authority does not permit the same obligation to be split into two or more bonds in order to bring each such bond Within the dollar limit of authority as set forth herein. The Company may revoke this appointment at any time. The execution of such bonds and undertakings in pursuance of these presents shall be as binding upon the said Company as fully and amply to all intents and purposes,as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office in Kansas City, Missouri. ® This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on March 3,2003,true and accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect: 'VOTED,That the Chairman of the Board, the President,or any Vice President, or their appointees designated in writing and filed with the Secretary, or the Secretary shall have-the power and authority to appoint agents and attorneys-in-fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings, obligatory in the nature thereof, and any such officers of the Company may appoint agents for acceptance of process This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of Directors of the Company on March 3,2003: VOTED, That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on March 3, 2003, and any such power so executed, sealed and certified with respect to any bond or undertaking to which it is attached,shall continue to be valid and binding upon the Company. S 00ML0013 00 03 03 Page 1 of 2 Printed in U.S.A. • In Testimony Whereof, the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized officers,this 1st day of May ,20 08 . Arch Insurance Company Attested and Certified III OP 0 canic, RPORATE 3•TP 2. SEAL 1971 .C.-- k ISS00(� ifirLICI / fr rill , Martin J.Nil`',Secretary J. Michael 'ete, Tice • t-siden STATE OF PENNSYLVANIA SS COUNTY OF PHILADELPHIA SS I, Brian C.Kuhn, a Notary Public, do hereby certify that Martin J. Nilsen and J. Michael Pete personally known to me to be the same persons whose names are respectively as Secretary and Vice President of the Arch Insurance Company, a Corporation organized and existing under the laws of the State of Missouri, subscribed to the foregoing instrument, appeared before me this day in person and severally acknowledged that they being thereunto duly authorized signed, sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said corporation and as their own free and voluntary acts for the uses and purposes therein set�# COMMONWEALTH OP PENNSYLVANIA N • OTARIAL SEAL Brian C.Kuhn,Notary Public Brian C.Kuhn;Notary Public City of Philadelphia,Philadelphia County My commission expires 12-06-2011 CERTIFICATION My commission expires December 06,2011 • I, Martin J. Nilsen,Secretary of the Arch Insurance Company, do hereby certify that the attached Power of Attorney dated May 1,2008 on behalf of the person(s)as listed above is a true and correct copy and that the same has been-in full force and effect since the date thereof and is in full force and effect on the date of this certificate; and I do further certify that the said J.Michael Pete,who executed the Power of Attorney as Vice President,was on the date of execution of the attached Power of Attorney the duly elected Vice President of the Arch Insurance Company. • IN TESTIMONY WHEREOF, I have hereunto subscribed my name and aff ed the corpo .i--I of the Arch Insurance Company on this day of DEC 1 5 2009,20 Martin J.Nil. - ,Secretary This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein and they have no authority to bind the Company except in the manner and to the extent herein stated. • PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND TO THE FOLLOWING ADDRESS: Arch Contractors&Developers Group 135 N. Robles Ave.,Ste.825 Pasadena,CA 91101 • a4 n�X39 1971 00ML0013 00 03 03 Ibsssd Page 2 of 2 Printed in U.S.A. • • *********DUPLICATE ORIGINI• ****** Executed In Duplicate Bond No. t9U 1104849 BINUMCBliu Premium included In Performance Bond PAYMENT BOND (LABOR AND MATERIALS) KNOW ALLPERSONS BY TRESS PRESENTS that: WHEREAS the City of Seal Beach,has awarded to California Surfacing 4, 57 Oqk Lane Claremont, CA 91711 • (Name and address of Contractor) ("Principal.a contract(the"Contract')for the work described as follows: Teak Cents Resurfacing-C Proi cct Number #BG1004 WEEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of Mamas.mechanics,me edalma4 and other persons as provided by law. NOW,THEREFORE.we,the andenigned Principal,and Arch (Insurance Com an 135 North Los Robles venue, uite 825 Pasadena. CA 91101 . (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 Away in the Sul sem of T ;ty li i thousan l�,s even hundred seventeen and 501100 D4068622, 717 .50 this amount being not lets than fifty percent(50B)of the tool contract price,in lawful money of the United States of Amedca,for the payment of which turn well and truly to be made.we bind ourselves,our heirs,executors,administrate,successors,and assigns,jointly and severally,firmly by these presents. THE CONDrIION OF WWI OBLIGATION IS SUCH MGT.if tbs hereby bounded Principal,Iris,her or its heirs,executors,administrators,successors or assigns,or subcontractors shall fail to pay any of the persons named in Section 3381 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 subcontract=pursuant in 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,dust 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 no as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case wit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys'fees In an amount fixed by the COWL FURTHER, the Surety, for value received, hereby stipulates and awes that no change. extension of time, abandon.addition or modification to the arms 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.eatendon of time alteration.addidon,or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the previsions of California Civil Code ft 2845 and 2849. • Page D-43 • • i IN WITNESS WHEREOF,two(2)identical counterparts of this instrument,each of which shall for all purposes be dewed 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:December 15, 2009 "Principal, "Surety" • California Surfacing Arch Insurance Company By By: Raymbnd E. Gail its 6 LA/14,1e' Its Attorney in Fact By: By: Its Its (Seal) (Seal) Note:This bond must be dated,all signatures must be notarized,and evidence of the authority of any person signing as attorney-in-fact must be attached • Page D-42 • • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of San Bernardino On AFC 1 5 2009 before me, Stacie C. Baker, Notary Public Date Here Insert Name and Title of the Officer personally appeared Raymond E. Gail Name(s)of Signer(s) N/A who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ace subscribed to the within instrument and acknowledged to me that he/sl:e/they executed the same in his/ of/their authorized capacity(.ies), and that by his/her/ ieir signature(s) on the • STACIA C. BAKER instrument the person(e), or the entity upon behalf of 4' t,ti Commission # 1776731 which the person(s) acted, executed the instrument. C ". Notary Public -California z� ' San Bernardino County I certify under PENALTY OF PERJURY under the laws Comm. oct29,2011 of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature deth Place Notary Seal Above Signature of Notary Public 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. 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 RIGHTTHUMBPRINT ❑Partner—❑ Limited ❑ General RIGHTTHUMBPRINT ❑ Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER ❑ Trustee Top of thumb here ❑Trustee Top of thumb here ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: ❑Other: Signer Is Representing: Signer Is Representing: • POWER OF ATTORNEY • Know All Men By These Presents: - ...._... . . That the Arch Insurance Company,a corporation organized and existing under the laws of the State of Missouri,having its principal office in Kansas City, Missouri(hereinafter referred to as the"Company")does hereby appoint Raymond E. Gail and William J. Shupper of Rancho Cucamonga, CA(EACH) its true and lawful Attomey(s)-in-Fact, to make, execute, seal, and deliver from the date of issuance of this power for and on its behalf as surety,and as its act and deed: Any and all bonds and undertakings EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or collection of any promissory note,check,draft or letter of credit. This authority does not permit the same obligation to be split into two or more bonds in order to bring each such bond within the dollar limit of authority as set forth herein. The Company may revoke this appointment at any time. The execution of such bonds and undertakings in pursuance of these presents 'shall be as binding upon the said Company as fully and amply to all intents and purposes,as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office in Kansas City, Missouri. This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on March 3,2003,true and accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect: "VOTED,That the Chairman of the Board, the President,or any Vice President, or their appointees designated in writing and filed with the Secretary, or the Secretary shall have the power and authority to appoint agents and attorneys-in-fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings, obligatory in the nature thereof, and any such officers of the Company may appoint agents for acceptance of process." ' This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of Directors of the Company on March 3,2003: VOTED, That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on March 3, 2003, and any such power so executed, sealed and certified with respect to any bond or undertaking to which it is attached,shall continue to be valid and binding upon the Company. 00ML0013 00 03 03 Page 1 of 2 Printed in U.S.A. - In Testimony Whereof,the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized officers,this 1st day of May ,20 08 . Arch Insurance Company Attested and Certified eieance ORPORATE +� SEAL �1 1971 �– I Nis�oud , irf_i„,„// yfrl rAi, - Martin J.Nil`v,Secretary J. Mi'hael 'ete, vice ' 1-siden STATE OF PENNSYLVANIA SS COUNTY OF PHILADELPHIA SS I, Brian C. Kuhn, a Notary Public,do hereby certify that Martin J. Nilsen and J. Michael Pete personally known to me to be the same persons whose names are respectively as Secretary and Vice President of the Arch Insurance Company, a Corporation organized and existing under the laws of the State of Missouri, subscribed to the foregoing instrument, appeared before me this day in person and severally acknowledged that they being thereunto duly authorized signed, sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said corporation and as their own free and voluntary acts for the uses and purposes therein set •••risa•RRR� COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL Brian C.Kuhn,Notary Public Brian C.Kuhn; Notary Public City of Philadelphia,Philadelphia County My commission expires 12-06-2011 CERTIFICATION My commission expires December 06,2011 I, Martin J.Nilsen,Secretary of the Arch Insurance Company, do hereby certify that the attached Power of Attorney dated May 1, 2008 on behalf of the person(s)as listed above is a true and correct copy and that the same has been-in full force and effect since the date thereof and is in full force and effect on the date of this certificate; and I do further certify that the said J.Michael Pete,who executed the Power of Attorney as Vice President,was on the date of execution of the attached Power of Attorney the duly elected Vice President of the Arch Insurance Company. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and afr ed the corpor-i-.1 of the Arch Insurance Company on this day off 1F(: 1 5 ?In ,20 ,, Martin J.Nil-.- ,Secretary This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein and they have no authority to bind the Company except in the manner and to the extent herein stated. • PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND TO THE FOLLOWING ADDRESS: Arch Contractors&Developers Group 135 N. Robles Ave.,Ste.825 Pasadena,CA 91101 CORPORATE 4 1 SEAL 71 19 00ML0013 00 03 03 Mucci Page 2 of 2 Printed in U.S.A. From:CLARKE HOCKWALD To:Rich Hottel Date:12/10/2009 Time:3:16:54 PM Page 2 of 3 • Cert. ID 392 ACORD., CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/10/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DEER CREEK INSURANCE SERVICE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8439 WHITE OAR AVE., SUITE 106 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR RANCHO CUCAMONGA CA 91730 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (909) 980-6180 (909) 900-2965 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERICAN STATES INSURANCE CO. CALIFORNIA SURFACING COMPANY INSURER B: (SAFECO INS. COMP. OF AMERICA) 4457 OAK LANE INSURER C: CLAREMONT CA 91711 INSURER D: I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 ADD'LJ POLICY NUMBER YEFFECTIVE IPOLICYEXPIRATION LIMITS LTR NSRDI TYPE OF INSURANCE DATE(MMIDD/YY1 DATE(MMlDDJYY1 GENERAL LIABILITY EACH OCCURRENCE (S 1,000,000 DAMAGE TO RENTED A e COMMERCIAL GENERAL LIABIUTY 01CG637183-60 9/23/2009 9/23/2010 PREMISES(Ea occurence) S 300,000 I CLAIMS MADE e OCCUR MED EXP(Any one person) S 10,000 PERSONAL S ADV INJURY ��S 1,000,000 II GENERAL AGGREGATE FS 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 K POLICY n JP n LOC INCLUDES COMPLETED OPERAT AUTOMOBILE UABILITY COMBINED SINGLE LIMIT S ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) IS HIRED AUTOS BODILY INJURY I S NON-OWNED AUTOS (Per accident) 11 — -- - PROPERTY DAMAGE I s (Per accident) GARAGE UABIUTY AUTO ONLY-EA ACCIDENT S 7 ANY AUTO OTHER THAW EA ACC $ I AUTO ONLY: AGG S I EXCESS/UMBRELLA LIABILITY 'EACH OCCURRENCE IS 1,000,000 A I K 'OCCUR CLAIMSMADE 01SU361981-60 9/23/2009 9/23/2010 AGGREGATE Is 1,000,000 S DEDUCTIBLE S I x _RETENTION S 10,000 S WORKERS COMPENSATION AND I TORY LIMITS I IV-1 EMPLOYERS'LIABILITY E.L.EACH ACCIDENT '$ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L DISEASE-EA EMPLOYE S If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER FORMCG7680 ATTASCED HERETO. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL HER MAIL 30 DAYS WRITTEN City of Seal Beach NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,1t RCLSNitO[Y 211 8th Street IBIZOLKALKIEMENEDDISSILIKX1RIAMICIIMIXXXIXXIICKILE& REIRNMIXBXX Seal Beach CA 90740 AUTHORIZED REPRESENTATIVE ,,. (,, t ACORD 25(2001/08) ©ACORD CORPORATION 1988 Page 1 of 2 From:CLARKE HOCKWALD To:Rich Hottel Date:12/10/2009 Time:3:16:54 PM Page 3 of 3 • INSURED: CALIFORNIA SURFING POLICY#: 01CG637183-50 EFFECTIVE: 09/23/2008 EXPIRES: 09/23/2009 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY CG 76 80 03 96 COVERAGE COMMERCIAL GENERAL LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF SEAL BEACH (If no entry appears above. information required to complete furnished by, the person or organization shown in the this endorsement will be shown in the Declarations as Schedule. applicable to this endorsement). With respect to the insurance afforded the additional WHO IS AN INSURED (Section II) is amended to include as insured, paragraph 4. of COMMERCIAL GENERAL LIABILITY an insured the person or organization shown in the CONDITIONS (Section IV) is deleted and replaced by the Schedule subject to the following provisions. following 1. This insurance applies only with respect to liability: 4. Other Insurance a. Arising out of your ongoing operations for that a. This insurance is primary and noncontributory, insured by or for you; or and our obligations are not affected by any other b. Arising from the general supervision of your insurance carried by such additional insured ongoing operations by the person or organization whether primary, excess, contingent, or on any shown in the Schedule. other basis. 2. This insurance does not apply to 'bodily injury' or b. This additional provision applies only to the "property damage" arising out of the sole negligence person or organization shown in the Schedule. or willful misconduct of; or for defects in design Page 1 of 1 óAIIstate.a You're In good hands. Public Works De CERTIFICATE OF INSU a11")/ °f Seal Beach Partment EFFE, TIVE DATE OF RTIFICATE MAR"0 .2:2010 0./02/10 ALLSTATE INSURANCE COMPANY HOME OFFICE- NORTHBROOK, IL 60062 RECEIVED hereby certifies that the following insurance is in force: POLICYHOLDER POLICY NUMBER POLICY PERIOD RICH HOTTEL 048605358 BAP 05/02/10 TO 05/02/11 DBA CALIFORNIA SURFACING AT 12:01 A.M. STANDARD TIME 4457 OAK LANE CLAREMONT, CA 91711-2130 The---person--or-organization-designated--below--is--described---in the-policy as:-- ------------------------------------------------- ----- --- CITY OF SEAL BEACH - • 211 8TH ST 2ND FLOOR SEAL BEACH, CA 90740-6305 • LIENHOLDER (Loss Payable Clause) — - --- - - --.- ADDITIONAL INTERESTED-PARTY - X ADDITIONAL INSURED • X CERTIFICATE HOLDER • I arages designated are afforded as stated below: Basis of Coverage: LIMITS OF LIABILITY $ 1,000,000 COMBINED SINGLE LIMITS X ANY "AUTO" ' OWNED "AUTOS" ONLY SPECIFICALLY DESCRIBED "AUTOS" HIRED "AUTOS" ONLY _ NONOWNED "AUTOS" ONLY _ OWNED PRIVATE PASSENGER "AUTOS" ONLY OWNED "AUTOS" OTHER THAN PRIVATE PASSENGER OWNED COMMERCIAL "AUTOS" ONLY To the person or organization stated above: This policy, as respects the interest of the loss payee, additional interested party, additional insured or certificate holder named herein, may be cancelled by the Company during the policy period by giving such person or organ- ization 10 days written notice at its last address known to the Company. Proof of such mailing is deemed sufficient proof of such notice. This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy referred to above. 885 10 03 PAGE 1 OF 1 BU114R-3 "'?^K Allstate. I • You're in goad hands. POLICY NUMBER 048605358 BAP COMMERCIAL AUTO t THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Name and Address of Person or Organization: CITY OF SEAL BEACH 211 8TH ST 2ND FLOOR SEAL BEACH, CA 90740-6305 A. The person or organization shown in the Schedule is included as an-insured but only`if liable for•the conduct of an "insured" and only to the extent of that liability. B. CANCELLATION 1. If we cancel the policy, we will mail or deliver notice to such person or organization in accordance with the Common Policy Conditions. 2. If you cancel the policy, we will mail or deliver notice to such person or organization. 3. Cancellation ends this agreement. ( 1114(1-93) BU114R-3 • WORKER'S COMPENSATION CERTIFICATE OF INSURANCE WHEREAS,the CITY OF SEAL BEACH has required certain insurance to be provided by Cqlrfdf/CI NSI c-1iM1°) 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:_ CI I I L°tip/°yevi 611 Ca AA 4 Su 14..zvc 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 El-t±CTNE DATE EXPIRATION DATE 1$c 1%41 `01 1z- i - (`.'3 I -- I - 2.Q i d 4. Said poll,y or policies shall not be canceled,voided or reduced in coverage or limits of liability,unless and until thirty days`:dvance written notice thereof has been served upon the City Clerk of the CITY OF SEAL ' =4 . By: Its Authorized I'epre -u tative Page D-44 • • • Sd STATE PD. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FUND _CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-11-2009 GROUP: POLICY NUMBER: 1891841-2009 CERTIFICATE ID: 61 CERTIFICATE EXPIRES:01-01-2010 '012009/01-01-2010 -CITY OF SEAL BEACH Sd 211 8TH ST SEAL BEACH CA 90740-8305 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period that will expire or did expire as indicated above. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. VE4X-v‘A./ THORIZED REPRESENTATI PRESIDENT UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE -FOLLOWING: THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 02-24-2009 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. • EMPLOYER C HOTTEL, RICH DBA: CALIFORNIA SURFACING Sd 4457 OAK LN CLAREMONT CA 91711 [B16,SJI (REV.2-05) PRINTED : 12-11-2009 • ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY L ii"ronJS. 3urF-ch,c)A` (HS? a16l,1-‘7"9 C(q reifrx C C r g7 'l i Name and address of named insured(`r Named Insured"): Name and address of Insurance Company("Company"): OFFICIAL TITLE OF PROJECT:TENNIS COURTS RESURFACING Notwithstanding any inconsistent statement in the policy to which this endorsement is attached(the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows: 1. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the"Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim _ is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third-party claims,i.e.,in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision Cshall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits(except as the result of the payment of claims),or non-renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereof. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, 1 . interpretation,and enforcement of this contract of insurance. 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: City Engineer City of Seal Beach 211 8th Street,2nd Floor Seal Beach CA 90740 Page D-46 • 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: 4 Contractual Liability 'Explosion Hazard Owners/Landlords/Tenants Collapse Hazard Manufacturers/Contractors 'Underground Property Damage jZf Products/Completed Operations Pollution Liability Broad Form Property Damage \Liquor Liability Extended Bodily Injury ❑ .%Broad Form Comprehensive ❑ Ig General Liability Endorsement 12.. A%deductible or❑ self-insured retention(check one)of$ )OOO. CO applies to all coverage(s)except: (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). _14. - .This endorsement is effective on -- ----- --- at-12:01-A.M. and forms a part of- Policy Number 'J�,q.� I, � 'C r `I`� el (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 W Va./. ,20 1 • Signature o orized Representative (Original signature only; no facsimile signature or initialed signature accepted) �J Phone No.: ( ?e I) CV-1 x1( Page D-47 Commercial Auto policy ca.ellation notice for • tom El sta.to non-payment of premium - You're in good hands. Allstate Insurance Company PO Box 660649 Dallas,TX 75266-0649 Information as of May 13,2010 Hin11111111' "inl1liilull11111110114Idilli'NI114111 Policyholder Page 1 of 1 CITY OF SEAL BEACH Rich Hottel 211 8TH ST FL 2 DBA California Surfacing SEAL BEACH CA 90740-6305 Policy number 1 048 605 358 1 Vehicle 2003 Chevy Truck C4C042 Your Allstate agency is David C Budge 1315 W Covina Pkwy This is to notify you that the policy listed on this notice will be West Covina,CA 91790 cancelled at the date and time shown on this notice. Any coverage (626)856-1999 afforded by this policy will cease as of such date and time. Cancellation Effective Date and Time:June 2,2010,12:01 A.M. Standard Time at the address of the Insured. Allstate Insurance Company Home Office:Northbrook,IL B2064-1