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HomeMy WebLinkAboutAGMT - Elite Bobcat Service (Annual Paving Rehab FY01-02) V • PLEASE COMPLETE THIS INFORMATION • RECORDING REQUESTED BY: Recorded in Official Records, County of Orange Darlene Bloom, Interim Clerk-Recorder AND WHEN RECORDED MAIL TO: IIIIIIID IIIIIIIIIIIIIMII'IIIIII!IIIIIIIIIIIIIiI IIIINO FEE Ahrifd 20020646328 08105am 08105102 110 25 R28 4 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR RECORDER'S USE ONLY TITLE OF DOCUMENT: Croluti on / �I ANNUAL PAVEMENT REHABILITATION PROJECT 49673 �t cit IQ 1 2.4t THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (1? (Additional recording tee applies) '0 059-TITLE PAGE(R7/95) • • • WHEN RECORDED RETURN TO: RECORDING REQUESTED PURSUANT TO CITY OF SEAL BEACH GOVERNMENT COD E SECTION 6103 211 8TH STREET SEAL BEACH, CALIFORNIA 90740 RESOLUTION NUMBERS A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEAL — - BEACH DECLARING WORK TO BE COMPLETED AS TO PLANS AND SPECIFICATIONS FOR PROJECT #49673, ANNUAL PAVEMENT REHABILITATION ENTERED INTO BETWEEN ELITE BOBCAT SERVICE,INC.AND THE CITY OF SEAL'BEACH THE CITY COUNCIL OF THE CITY OF SEAL BEACH DOES HEREBY RESOLVE: WHEREAS, on March 25, 2002, the City of Seal Beach entered into a contract with Elite Bobcat Service, Inc. WHEREAS, the City Engineer has determined 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$ 114,447.62. Section 3. That the work is hereby accepted and approved. Section 4. It is further ordered that a "Notice Of Acceptance", Exhibit "A", be filed on behalf of the City is in the Office of the County of Orange within 10 days of the date of this resolution. PASSED, APPROVED AND ADOPT. I ''.y the City Council of the City of Seal Beach at a meeting thereof held on theday' . 2002 by the following vote: AYES: Councilmemb- er„A r,, ,ttc' uiA61-- � , NOES: Councilmembers 411 ABSENT: Councilmembers ! ' .wt) P. 1409 ..- Mayor ATT_ i, , jAy Cityyir erk Y. ? . . • • 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 Numbern f 'n the office of the City Clerk, passed, approved, and adopted by the City Council of t city of Seal Beach, at a re_t. : meet'�igg the eof I on the ° mc( day of �_ 2002.pr. (>d.° L/ try Clerk , : ; • • • • RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO CITY OF SEAL BEACH Attn: City Clerk 211 8th 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 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 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 8ih 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 05/08/02. The work was: Annual Pavement Rehabilitation,Project No.49673 6. The name of the contractor, if any, for such of improvement was: Elite Bobcat Service, Inc. 7. The date of the Contract was: March 25,2002. 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: Pavement rehabilitation of Fern,Goldenrod, Heather and Jasmin,. f Date: k/h6y 320 24,o2- yy__r'r//``��// �� Signamr of owner orp' orate officer of owner named in paragraph 2 or his agent. DEPUTY CITY ENGINEER 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 1) 2% , 2002—. I-..h,�Califop. :. (Dat of Signature) Director of 'isbEtrThics EXHIBIT "A" 03/as76a CONTRACTOR TO PRINT COMPANY NAME: "BOOK4 OF 11 Et-nr A) QE1 Ik)C. CONTRACT DOCUMENTS DOCUMENTS TO SUBMIT UPON AWARD: PUBLIC WORKS CONTRACT ACKNOWLEDGEMENT OF LICENSE LAW PERFORMANCE BOND WORKMEN'S COMPENSATION PAYMENT BOND CERTIFICATE INDEMNIFICATION AND HOLD INSURANCE REQUIREMENTS HARMLESS -Insert other requirements if applicable- LABOR LAW REQUIREMENTS FOR: Annual Paving Rehabilitation FY 2001/2002 CITY PROJECT NUMBER: 4 9 6 73 nealdot ¢ i. > Y�9 3 b`a'h'pi . z? �k�°b f`�rst.� � .+�r"acv a. K F�y4+' 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. CITY OF SEAL BEACH -211 EIGHTH STREET-SEAL BEACH, CA 90740-6379. :"ate. • • BOOK II OF III 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 2 PUBLIC WORKS CONTRACT Annual Paving Rehabilitation, FY 2001 /2002 For the following project named alt .1 ,� .I [f t VI t (/11 11 )J . /ll ?i ,in the City of Seal Beach. THIS AGREEMENT, made and entered into this ad a day of 23/Aade_frl2002 by and between the City of Seal Beach, California, hereinafter referred to as the "CITY," Party of the First Part, and 7o �air 5 4.VICt AL. 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. 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 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. 3 IN WITNESS WHEREOF: The Parties hereto have caused this contract to be executed the day and year first above written. CITY OF SEAL BE . H, CALIFORNIA Party of the Fir 'a• �e L f BY I Afp ,/ - -- �— City Manager ATTEST; 1 ii 41. Cit i k BY CONTRACTOR - P y of the cond Part C'6'o Title 1% v.st, S4-. .tov Oo7 Address • 4 • • EXECUTED IN THREE COUNTERPARTS Bond No. 3419146 Bond Premium $1,062 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded ELITE BOBCAT SERVICE, INC . 1170 F. STXTH STREET, SUITE 100. CORONA, CA 92879 - 1700 (Name and address of Contractor) ( "Principal "), a contract (the "Contract ") for the work described as follows: ANNUAL PAVING REHABILITATION FY 2001/2002 WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW, THEREFORE, we, the undersigned Principal, and GREAT AMERICAN INSURANCE COMPANY P.0. BOX 5440, ORANGE, CA 92863 - 5440 (Name and address of Surety) ( "Surety ") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of NINETY —EIGHT THOUSAND THREE HUNDRED FORTY —FIVE DOLLARS AND THIRTY CENTS. Dollars ($ 98 , 345.30 ), 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 assipas, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed 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. 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 5 • • 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: MARCH 27, 2002 "Principal'' "Surety" ELITE BOBCAT SERVICE, INC. GREAT AMERICAN INSURANCE COMPANY By: 1 �/ ,E,,,.. By: ts Its DAVID L. CULBERTSON 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. • 6 • Ilk State of Celifor is { RIGHT THUMBPRINT (Optional) County of ��/ V �"1�1 1L qk before On ,.v \ �� u EI T AM T OF OFflCER•i.s.'JANE PUBLIC') o . personally appeared � Y' • i p 'NAME'S OF SIGNER'S)) CAPACITY CLAIMED BY SIONERIS) ❑INDIVIDUAL'S) ❑CORPORATE personally known to me -OR- 0 proved to me on the OFFICER(S) I basis of satisfactory 'TITLES) evidence to be the ❑ PARTNER'S) ❑LIMITED person(s) whose name(s) ❑GENERAL is /are subscribed to the ❑ATTORNEY IN FACT within instrument and ❑ TRUSTEE'S) acknowledged to me that ❑GUARDIAN /CONSERVATOR he /she /they executed the ❑OTHER: • same in his /her /their authorized capacity(ies), and that by his /her /their SIGNER IS REPRESENTING: Kathleen M. Fairweather signature(s) on the (Name of Person(s) or Entitylies) V _� Comm. # 1231934 Q �.. -��±_, instrument the person(s), CALIFORNIA NOTARY PUBLIC - > p < Uri or the entity upon behalf � 200 of which the person(s) 7 acted, executed the instrument. RIGHT THUMBPRINT (Options() Witness my hand and official seal. (SEAL) I/041(1A 'i: 1 . (SIGNATURE OF N ( ) CAPACITY CLAIMED BY SIONERIS) ❑INDIVIDUAL'S) ❑CORPORATE ATTENTION NOTARY OFFICER(S) The information requested below and in the column to the right is OPTIONAL. muss Recording of this document is not required by law and is also optional. It could, however, prevent fraudulent attachment of this certificate to any ❑PARTNER'S) ❑LIMITED unauthorized document. ❑GENERAL ❑ATTORNEY IN FACT THIS CERTIFICATE Tide or Type of Document ❑TRUSTEE'S) MUST BE ATTACHED ❑GUARDIAN /CONSERVATOR TO THE DOCUMENT Number of Pages Date of Document ❑OTHER: DESCRIBED AT RIGHT: Signer(s) Other Than Named Above SIGNER IS REPRESENTING: (Name of Person(s) or Entity(iies) WOLCOTTS FORM 03237 Rev. 3.94 Ivies class 0.2A) © 1994 WOLCOTTS FORMS, INC. ALL PURPOSE ACKNOWLEDGMENT FOR CALIFORNIA WITH SIGNER CAPACITY/REPRESENTATION /TWO FINGERPRINTS 7 1111111 7775 6323 8 • • CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF ORANGE On 3 -27 -02 before me, LEXIE SHERWOOD - NOTARY PUBLIC personally appeared DAVID L . CULBERTSON personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. LEXIE SHERWOOD3 V ' _ �.�� � COMM. # 1311304 / 1,1" 0 . `► i :�? g 9 NOTARY PUBLIC - CALIFORNIA w C� � �� t' �' ORANGE COUNTY n 4 ture of Notary Public 1 � COMM. EX JULY 27.2005 OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. DESCRIPTION OF ATTACHED DOCUMENT PERFORMANCE BOND TITLE OR TYPE OF DOCUMENT NUMBER or PAGES 2 DATE OF DOCUMENT 3 -27 -02 CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE(S) ❑ PARTNER(S) ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ OTHER: SIGNER IS REPRESENTING: GREAT AMERICAN INSURANCE COMPANY NAME OF PERSON(S) OR ENTITY(S) EXECUTED IN THREE COUNNRPARTS Bond No. 3419146 Bond Premium INCLUDED IN PERFORMANCE BOND PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS l3Y THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded to ELITE BOBCAT SERVICE, INC. 1320 E. SIXTH STREET STE. 100, CORONA, CA 92879 -1700 (Name and address of Contractor) ( "Principal "), a contract (the "Contract") for the work described as follows: ANNUAL PAVING REHABILITATION FY 2901/2002 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 GREAT AMERICAN INSURANCE COMPANY P.O. BOX 5440, ORANGE, CA 92863 -5440 (Name and address of Surety) ( "Surety ") a duly admitted surety insurer under the laws of the State of California, as Surety, are field and fumly bound unto thc Public Agency in the penal sum of NINETY EIGHT THOUSAND THREE HUNDRED FORTY —FIVE DOLLARS AND THIRTY CENTS. Dollars (S 98,345.30 _ this amount being not less than fifty percent (50 %) of the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to work or labor performed under the Contract, the Surety will pay for the same in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and void. This bond shall insure to the benefit of any of the persons Warned 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 s • • Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below, the 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: MARCH 27 , 2002 "Principal" "Surety" ELITE BOBCAT SERVICE, INC. GREAT AMERICAN INSURANCE COMPANY By: 14. By: 1(11/1)". I Its DAVID L. CULBERTSON By: By: ATTORNEY —IN —FACT 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.. 8 8 • • CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT 1' STATE OF CALIFORNIA COUNTY OF ORANGE On 3 -27 -02 before me, LEXIE SHERWOOD - NOTARY PUBLIC personally appeared DAVID L . CULBERTSON personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. WITNESS m h and official seal. / "� LEXIE SHER MM. # 1311304 WOOD Q ° CO (� : `* s� gi NOTARYPUBLIC- CALIFORNIA Si. a • e o Notary Pub is ` • ORANGE COUNTY ,. �� COMM. EXP. JULY 27, 20U " ' OP TIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. DESCRIPTION OF ATTACHED DOCUMENT PAYMENT BOND TITLE OR TYPE OF DOCUMENT NDIIDER PAGES GES 2 DATE OF DOCUMENT 3-27-02 CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE(S) ❑ PARTNER(S) ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ OTHER: SIGNER IS REPRESENTING: • GREAT AMERICAN INSURANCE COMPANY NAME OF PERSON(S) OR ENTITY(S) • • • 1, NN State of California RIGHT THUMBPRINT (Optional) County of %ClACIP On AI ( lb/ before me, i 1, Ain I \llt m NAME/TITL 0 OFFICER-Lc DOE, NOTARY PUBLIC') p o personally appeared ( N.Cit (NAME'S) OF SIGNER'S)) CAPACITY CLAIMED BY SIGNER'S) OINDIVIDUAL(S) ❑CORPORATE ❑ personally known to me -OR- ❑ proved to me on the OFFICER'S) basis of satisfactory (TITLES) evidence to be the ❑PARTNER($) ❑LIMITED persons) whose name(s) °GENERAL is /are subscribed to the °ATTORNEY IN FACT within instrument and °TRUSTEE'S) acknowledged to me that ❑GUARDIAN /CONSERVATOR he /she /they executed the ❑OTHER: same in his /her /their Kathleen M. Fairweather authorized capacity(ies), i It ' ' ' • , � . "? ' 4, Comm # t2 D and that b �� NOTARY PUEII IC - CALICALIFORNIA y his /her /their SIGNER IS REPRESENTING: Name of Person(*) or Entityges) r ORANGE signature(s) on the ' -� - instrument the person(s), Npiripir — --A or the entity upon behalf of which the person(s) acted, executed the instrument. RIGHT THUMBPRINT 'Optional) Wit - ss my hand and official seal. w I (SEAL) , o (SIGNATURE OF iiir RY) CAPACITY CLAIMED BY SIGNER'S) OINDIVIDUALIS) • ❑CORPORATE ATTENTION NOTARY OFFICERIS) The information requested below and in the column to the right is OPTIONAL. (TITLFS) Recording of this document is not required by law and is also optional. OpARTNERIS) ❑LIMITED It could, however, prevent fraudulent attachment of this certificate to any unauthorized document. ❑GENERAL ❑ATTORNEY IN FACT THIS CERTIFICATE Tide or Type of Document OTRUSTEE(S) MUST BE ATTACHED °GUARDIAN /CONSERVATOR TO THE DOCUMENT Number of Pages Date of Document ❑OTHER: DESCRIBED AT RIGHT: Signer(s) Other Than Named Above SIGNER IS REPRESENTING: (Nome of Person(s) or Entity(ies) • WOLCOTTS FORM 03237 Rev. 3-94 Ipriee dam S•2A1 © 1994 WOLCOTTS FORMS, INC. M.I. PURPOSE ACKNOWLEDGMENT FOR CAUFORNIA WITH SIGNER CAPACITY/REPRESENTATION/TWO FINGERPRINTS di 11hI IIllIII1I I 111111 114 1111 67775 6323 118 ( • • • • • • GtEATANERICAN INSURANCE COMPANY' 580 WALNUT STREET•CINCINNATI, OHIO 45202• 513-369-5000•FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than No. 0 14046 SIX POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below its true and lawful attorney-in-fact,for it and in its name,place and stead to execute in behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature t hereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power DAVID L. CULBERTSON DIANA LASKOWSKI - ALL OF - ALL CHARLES L. FLAKE KAREN CHANDLER ANAHEIM, UNLIMITED RICHARD A. COON LEXIE SHERWOOD CALIFORNIA This Power of Attorney revokes all previous powers issued in behalf of the attorney(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal ereunto affixed this 19th day of June . 2001 Attest GREAT AMERICAN INSURANCE COMPANY • • • STATE OF OHIO,COUNTY OF HAMILTON —ss: On this 19th day of June, 2001 , before me personally appeared DOUGLAS R. BOWEN, to me known, being duly sworn, deposes and says that he resided in Cincinnati, Ohio, that he is the Vice President of the Bond Division of Great American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like-authority. ._ , Hstny' z. _s 08.I 0€ This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated March I, 1993. RESOLVED: That the Division President, the several Division Vice Presidents and Assistant Vice Presidents,or any one of them, be and hereby is authorized,fromitime to time,to appoint one or more Attorneys-In-Fact to execute on behalf of the Company,as surety,any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking,contract orsuretyship,or other written obligation in the nature thereof,such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I, RONALD C. HAYES, Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of March 1, 1993 have not been revoked and are now in full force-and effect. Signed and sealed this 27TH day of MARCH 2002 • - \� ----- S1o29S(11197) LNDENLNIFICATION AND HOLD HARMLESS AGREEMENTASD WAIVER OF SUBROGATION AND CONTRIBUTION TITLE OF PROJECT OR WORK: PROJECT #: 49673 • Indemnitor(s)(list all names): CITY OF SEAL BEACH, ITS ELECTED OR APPOINTED OFFICERS, • OFFICIALS, ATTORNEYS, EMPLOYEES, AND VOLUNTEERS RE: ANNUAL PAVING REHABILITATION FY 2001/2002 211 8TH STREET, SEAL BEACH, CA 90740 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 offrcials,'officers, attorneys, agents, employees, volunteers, successors, and assigns (collectively "Indetnitees") from and against any and all damages,costs, expenses, liabilities, claims, demands, causes of action, proceedings, expenses, judgments,penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys, or other professionals and all costs associated therewith (collectively•Liabtiities"), arising or claimed to arise, directly or indirectly, out of, in connection with, resulting from, or related to any act, failure to act. error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors, materialmen,suppliers or their officers, agents,servants or employees, arising or claimed to arise, directly or indirectly, out of, in connection with, resulting from, or related to the above-referenced contract, agreement, license, or permit (the "Agreement") or the performance or failure to perform any term, provision, covenant, or condition of the Agreement, including this indemnity provision. This indemnity provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. This indemnity provision shall survive the termination of the Agreement and is in addition to any other rights or remedies which Indemnitees may have under the law_ Payment is not required as a condition precedent to an Indemnitees right to recover under this indemnity provision, and an entry of judgment against an Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. Indemnitor shall pay Indemnitees for any attorney's fees and costs incurred in enforcing this indemnification provision. Notwithstanding the foregoing,nothing in this instrument shall be construed to encompass (a)Indernnitees 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 panics claiming under or through it,hereby waives all rights of subrogation and contribution against the Indetnitees,while acting within the scope of their duties, from all claims,losses and Iiabilities 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 Indennitees. In the event there is more than one person or entity named in the Agreement as an Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint and several. "Indemnitor' Name ELITE BOBCAT SERVICE, INC Name: By: ( /`%,ei cn,,*c r , 1 By: Its lu 9 • • • AGREEMENT TO COMPLY WITHCALIFOILNIA 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 I (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency ("Agency")and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (I) 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 (S25) 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, Pan 7, Chapter 1, Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provi ions b fore commencing the performance of the work of this contract." Date - ' 7G Signature ,// 10 • • 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 contractors 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: (I) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars (54,500), whichever is greater, or imprisonment in the county jail for not less than 10 days nor more than six months,or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be performed. (c) This section shall not apply to a joint venture license, as required by Section 7029.1. However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to this section with respect to his or her individual licensure. (d) This section shall not affect the right or ability of a licensed architect, land surveyor, or registered professional engineer to form joint ventures with licensed contractors to render services within the scope of their respective practices. (e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non-responsive and shall be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall be subject to Sections 7028.7 to 7028.13,inclusive. Any contract awarded to, or any purchase order issued to,a contractor who is not licensed pursuant to this chapter is void. (f) Any compliance or noncompliance with subdivision (e) of this section, as added by Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect. (g) A public employee or officer shall not be subject to a citation pursuant to this section if the public employee, officer, or employing agency made an inquiry to the board for the purposes of verifying the license status of any person or contractor and the board failed to respond to the inquiry within 11 • • three business days. For purposes of this section, a telephone response by the board shall be deemed sufficient. Public Contract Code § 20103.5: In all contracts subject to this part where federal funds are involved, no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However,at the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of this state. The first payment for work or material under any contract shall not be made unless and until the Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or contractor not so licensed shall be subject to all legal penalties imposed by law, including, but not limited to, any appropriate disciplinary action by the Contractors' State License Board. The agency shall include a statement to that effect in the standard form of pre-qualification questionnaire and financial statement. Failure of the bidder to obtain proper and adequate licensing for an award of a contract shall constitute a failure to execute the contract and shall result in the forfeiture of the security of the bidder. r� License no.: /?volts Class: A- Expi tion date: ,;j3( l Date /9/n At Signature A 12 . • INSURANCE REQUIREMENTS FOR CITY OF SEAL BEACH PUBLIC WORKS CONTRACT LIABILITY LNSURANCE 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 even'officer, official, agent, attorney, employee or volunteer of the Citv, 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(51,000,000) 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. • 13 • Pan Intentionally Left Blank 14 • .f • - WORKERS COMPENSATION CERTIFICATE OF INSURANCE WHEREAS,the CITY OF SEAL.BEACH has required certain insurance to be provided by ELITE BOBCAT SERVICE, INC. ISSUED THROUGH THE STATE COMPENSATION INS. FUND 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 suchpolicyorpoliciesare: ELITE BOBCAT SERVICE, INC. 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 1594913-01 10/6/01 10/6/02 4. Said policy or policies shall not be canceled,voided or reduced in coverage or limits of liability, unless and until thirty days' advance written notice thereof has been served upon the City Clerk of the CITY OF Sr AL BEACH. if By-` Ai/F^.!/%a�!. Its r oriz:. •1 d r'tat) •e , 15 • ELITE 3OLCI:: SERVICE, INC. 0 POLICY NUMBER: SC0369203700 ZURICH Steadfast Insurance Company Additional Insured-Scheduled(including Completed Operations) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the: • Commercial General Liability Coverage Part Products-Completed Operations Liability Coverage Part Schedule PROJECT 1: 49673 ANNUAL PAVING REHABILITATION Person or Organization: FY 2001/2002 Specific Job or Project: ADDRESS BELOW CITY OF SEAL BEACH ITS ELECTED OR APPOINTED OFFICERS, OFFICIALS, ATTORNEYS, EMPLOYEES AND VOLUNTEERS, 231 8TH STREET, SEAL BEACH, CA 90740 k Who is an Insured(Section II)is amended to include as an insured the person or organization shown in the Schedule above for whom you perform operations when you and such person or organization have agrxd in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or or nizafion is an additional insured only with respect to liability arising out of`your work'performed for that insured at the Specific Job or Project shown in the Schedule above. B. With respect to the insurance afforded these additional insureds,the following additional exclusion applies: This insurance does not apply to: "Bodily injury' "property damage" `peravnal injury"or"advertising injury"arising out of the tendering of,or the failure to render,any professional architectural,engineering or surveying services,including: 1. The preparing, eppiuving,or failing to prepare or approve,maps,shop drawings, opinions,reports,surveys, field orders,change orders or drawin„o s and specifications;and 2. Supervisory,inspection,architectural or engineering activities. • Countersigned Authorized Representative STF-CGL-1621 C CW(7/93) • 0 ZURICH Steadfast Insurance Company POLICY EFF..pDATE EXP.DATE ' EFT.DATE PRODUCER I DATE ' ENDORSEMENT__TYPED NUMBER SC 30 69203706- 9/28/ ICY 9/28/02(T 9/zo/Oi 75-409056 1 1 9/01 NAMED INSURED: ELITE BOBCAT SERVICE, INC. PrimarylNon-Contributory Endorsement THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY me insurance provided by this'policy will be primary and noncontributory insurance,but only as respects a claim, loss or liability arising out of insured operations or work on behalf of a person or organization shown as an Additional Insured under this policy and performed under an "insured contract"between you and such person or organization,that requires you to maintain such primary and noncontributory insurance and to include them as an additional insured. 46141A--- Countersigned Authorized iesenta. e ' 04/05/2002 16:40 FAX 8187103635 HEATH INSURANCE 121003 03/2§/20qg 15:39 FAX 8187103635 REATH INSURANCE 1®002 • . :MU U. 2002 10:34AM SHE N PARENT • -NO. 8290 P. 3 .. r 1 ADDITIONAL IIDSG7asD IiNDDYcni rr CCAE 61VE CEPHERAL acme • ELITE BOBCAT SERVICE, INC. 1320 g_ SIXTH STREET,d SUITE 100, CORONA, CA 92879 STEAD ASSTT jIINSUUR NCB CcMwtw r �- ' C/O BEATE INSOHANCE BROKERS. 21550 OXNARD STREET, SUITE 950, WOODLAND BILLS Name gad addteai of laamsmce Ce eepasv(`Comontr); CA. 9136 7 OF! asLTr:la: inOJSGT: ANNUAL PAYING RBHASI ITATION FY 2001/2002 C- . -. r ; r • e - -673 Nenvidaltmadlng any inconsistent ctausa a in the policy to which ;.,- sadcstat is amchad (the"Fobf)or in sway aadarsemeasnaw err banter atae6ai dames,h is - stn Beans 3. The City of intik-era in eel Ted officials,ohs,aaoaaryx . employees and volumes ate additional Sin-Ss(the above named additional insureds stn h - neared to as the"Additional t a-ai 7 at)der the Polity in rattan to ditac acdvlda described - - aheve with regard Its operations.��n,.• e4 by a on basil of the Nam nand. The Ad- •-gal Dinned"have no liability far the pat ytame of say seeniutaa ar anamns under the Palley. 2. no Iaaaroo-4 caverage a afforded the Addititma7 Unwed'ender the Palley shall be peietary i tersax, end no edict`sansei:rsiamiaed by the Additional Iasaeds shall b4 called epos to tnaulbus with the ismimnm■mtevagds pm:widedby the Policy. 3. Each h aun> caveman Trader the Policy than apply squarely m Additional Waned salon wham chi 6 made a salt Is brought except with respect to the lima tbs Cmepanfa IiabiWsp. 4. Mang is this rang=of Woman Gbali be walsonod a preclude cow of a alaim by age>aaosd wain-the pcb.�ey agdast mono hinted tadat the policy. All such shall eaten*as doll-petty diem; i.e., it the®e manna as if separate policies bad bas • 'ad to each faWored 17onmg amtaiaed in this ptovaitm WWI spears m in....ee or xpiate the ,•.....•, s Hmfi of liability as previami tm*the adfey- ' 5. The hennaed i$caded by the Policy for contra 1 l 17aba1iry •-- (eubjaet io the tilt; roodhiensa add etelosioas epplicabie to each inat n) includes - . moemed by she lead Inured and,} the indmniGcaeaa andta laid harmless previsions mondani la es saastati hr ecnu eetiaa With the wsaen agtts®tat(s)or permits) designated a•• between the bl'matd Insured sad the Addaitata1 Insureds- 6. Tbc peaty m which this mdon®eat is snarled shall not be •-d - to easieel0»mt, chaise in enamage,radtetlwt d lbeba(amps u the result of the payment of lei),or acunaiegont mean nice written Sara to Public Agency,by aeeirad mail, moan - -.. tapnoed,not len dm thirty (30)days ptibr m the active data aunt In the nun of Co -,-...• fades to camply faith this eaicc p the poesy as kindly drafted will coatmua in full --and tdfset until compliance > this seguitammc 7. Company Safe?*waives all rights of sulaegetioo and eeczibmiog , the Addition' IaWgada, while actingint¢m the serape of tbar dales.Gem all claims,losses ••• liabilities arising all of or incident is perils Insured aguth_st is odium to those acdvldeo 1 - '•-- gmeally abuse with mood to ap&radcDs peettned by Cr a heal!of the Wooed .-- -• remedies of say Oar. cemcimttst svbsqaeot active or paodve aeglivnarn by the Additi-•- lnpaums it h is hereby 4gretd that the lies of dm Slaw of Cabral shell NPpb' to and govern the validity, oonnntctian.jateptemsloy,ad eattatament of this comma of insamose 5. This adolsaspcat and all notices Sven herelmda shall be salt m PabUcl Agency et Meer otPublis Woes • CJbof Sod Earl 21132 Hirsh i Seal Beach t:a 90740 16 • 04/0572002 16:41 FAX 8187103635 HEATH INSURANCE Id)004 03/28/20o2�1LN, "LUUC�lU8i4A�0383J}ih�fl YAH�N'1HEATH INSURANCE :.• NO. 8280 P. 4 X004 661fAA I • 14 Ester a and alarm eed zest in am.; m6 aidonem swift mulled Lea\shall be Lola m Ia alvr''e amd.qy a`Lte r�Ils amen,ter=win as of dm ped y m width Lug IYPE TO'MUCH POIJCY Memo i mats aai - . TADS slaxasiaapar atmczam memo Limping, 11. &be is hind ar m®doas we in to identified en an eked dae.e The!Maize iaer nuns as the dipole eaventd s, IaeLider a Gmaaaall.iability 0 Wald=Raami • • OwronsdendbrdiftteamS n Un L•gound POW"Damage •a Aod .�>eaed Opermlams ❑ polhAum m dby CIL Boned firm Ptepetij Demme Q Ligon T. I d�IS&dad P lC peosiva IS General ;shay p Mismural 0 . L2 A*dhdaaible or 0 ealfdasmed ?nadm Cebee an) at 1 Sr 000 sperm:to alllaovessee(s)aape (Shwa ea me). The dedo.aa.is eppiked de 0 Per dine er 0 Fr rte"Asa 13. 'Leis anSacee cmae et U elides made potty(cheek me). 14. TlugwiReenmeiseAae&..een 3/28/02 . at 124D1A,1dadfirmaopen of Fahey • ., Tam ; tee n,bend dean me i penny ofpede y the two gene Sate et Cet tbstis,Cal a bat ay azedneley m bond the Cotepenyl m deie m doeeamrmt sad thinly ley e:rnnlao latent 1 da so bind the Camp.nr. Peneuted 1 • S a/0)— S4 (Original signature only; no faestm.ie signature or initialed signature aeeeptedl • PhantMa_: (05) Wi aide • • • • t7 • • -- ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY ELITE BOBCAT SERVICE, INC. 1320 EAST 6TH STREET, Sr1TTE 100 , CORONA . CA 92879 ' Name and address of named insured('Named Insured"): • NATIONAL UNION FIRE INS. CO. OF PITTSBURG, PA C/O AMERICAN INTERNATIONAL COMPANIES, ONE MACARTHUR PLACE SUITE 600, SOUTH Name and address of Insurance Company("Company"): COAST METRO, CA 92707 • OFFICIAL TITLE OFPROJECT: ANNUAL PAVING REHABILITATION FY 2001-2002 CITY PROJECT NUMBER: 49673 FOR THE CITY OF SEAL BEACH 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 tuned additional insureds are hereafter referred to as the "Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third-party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnifica-tion 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 thereto. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement 7. Company bereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, froth 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 8Fh Street 20 • • Seal Beach CA 90740 • 10. Except as stated above and not in conflict with this endorsement,nothing contained herein shall be - held to waive,alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. • TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO 10/18/01 — 9/28/02 LIABILITY • • Following Form 0.Umbrella Liability. 0 • 10. Applicable underlying coverages: INSURANCE COMPANY STEADFAST INS . CO. POLICY NO. SC0369203700 AMOUNT $1 , 000 ,000 / $2 ,000, 000 11. The following inclusions, exclusions, extensions or specific provisions relate to the above coverages" PER POLICY FORMS • 12. A ❑ deductible or 0 self-insured retention (check one) of S NO DEDUCTIBLE applies to all coverage(s) except (if none, so state). The deductible is applicable 0 per claim or 0 per occurrence(check one). 13.' 'This is an 2Q)6ccurrence or 0 claims made policy(check one). 14. This endorsement is effective on 3/28/02 at 12:0i A.M. and forms a part of PolicyNumbcr 3467898 NATIONAL UNION FIRE INS . CO OF PITTSBURGH , PA LIMI;,T $1 ,000, 000 I rt L. 14 1.17-- (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. Execu- d q % ,2003 LaSilr . e riip'. R esentative (Orig"a at signature only; no facsimile signature or initialed signature accepted) Phone No.: 049 ) Gr /& O - 37p0 • is 21