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I 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 Dal , Clerk- Recorder IIIIIIIIIIIIIIIIIIIIIIrIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII No FEE 201100046484512:22 pm 09/20/11 47 412 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Space of above this line for Recorder's use. K No Recording Fee Pursuant to Government Code Section 6103, 27383 r ►� 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. 5. A work of improvement on the property hereinafter is described as substantially completed on August 18, 2011 The work was Fire Station 48 Turnkey Fuel Island Canopy. 6. The name of the contractor(s), if any, for such improvement was: Atom Inc. The date of the Contract Award was December 13, 2010 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: APM 095- 02 -15. Date: G I B 1 1 ( ire of Public Works, City of Seakqach Signature of owner or corporate offi a 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 ?// ? _/1 1 , 2011, at Seal Beach, California. Date of Signature) Director of Public Works, City of Se I each • PUBLIC WORKS AGREEMENT FIRE STATION 48 TURNKEY FUEL ISLAND CANOPY CIP NO.BG0803 between Hci 16 1,5g‘ ciy� s C BFR 21 ' City of Seal Beach 211 - 8th Street Seal Beach, CA 90740 Atom, Inc. 40410 Vista Road Hemet, CA 92544 951 766 -2806 THIS AGREEMENT is made as of December 13, 2010, by and between the City of Seal Beach, a California charter city ( "City "), and Atom, Inc. a ( "Contractor "). 1 of 9 Error! Unknown document property name. • RECITALS A. WHEREAS, the City Council has approved the plans and specifications for the Fire Station 48 Turnkey Fuel Island Canopy CIP No. BG0803 ( "Project ") with respect to design criteria; and B. WHEREAS, Contractor has submitted a bid to City for the Project dated November 16, 2010 in the amount of 65,359.00 ( "Accepted Proposal" hereinafter). The Accepted Proposal is attached hereto as Exhibit G and contains, among other things, provisions defining. the Project scope. NOW, THEREFORE, in consideration of performance by the parties of the mutual promises, covenants, and conditions herein contained, the parties hereto agree as follows: AGREEMENT 1. Contractor's Services. 1.1 Scope and Level of Services. For and in consideration of the mutual promises set forth herein, and subject to the terms and conditions set forth in this Agreement, Contractor shall perform and complete in good and workmanlike manner all work ( "Work ") required by this Agreement and the documents listed in Subsection 1.2 for the Project. 1.2 Contract Documents. The "Contract Documents" that comprise the agreement between the City and the Contractor are the: Notice Inviting Bids, Instructions to Bidders, Accepted Proposal, Non - Collusion Affidavit, Bid Schedule(s), List of Subcontractors, Contractor's Industrial Safety Record, Contractor's Qualification Statement, Bid Security Forms for Check or Bond, Specifications, General and Special Provisions and documents referenced therein, all addenda as prepared prior to the date of bid opening setting forth any modifications or interpretations of any of said documents, this Agreement, Exhibits attached to this Agreement, including but not limited to the Performance Bond (Exhibit A), Payment Bond (Exhibit B), Workers' Compensation Insurance Certificate (Exhibit C), Insurance Endorsements (Exhibit D), Acknowledgment of Penal and Civil Penalties Concerning Contractor Licensing Laws (Exhibit E), Labor Law Requirements (Exhibit F), Accepted Proposal (Exhibit G) and any and all supplemental agreements executed amending or extending the Work contemplated and that may be required to complete the Work in a substantial and acceptable manner. These Contract Documents are hereby incorporated into this Agreement. 1.3 The Work shall be performed in accordance with the Plans, Specifications and other Contract Documents. Contractor shall furnish at its own expense all labor, materials, equipment and services necessary therefor, except such labor, materials, equipment and services as are specified in the Contract Documents to be furnished by City. 2of9 Error! Unknown document property name. • • 1.4 In the event of any material discrepancy between the express provisions of this Agreement and the provisions of the other Contract Documents, the provisions of this Agreement shall prevail. 2. Effective Date. This Agreement is effective as of December 13, 2010 (the "Effective Date "), and shall remain in full force and effect until Contractor has rendered the services required by this Agreement. 3. Payment. For performing and completing the Work in accordance with the Contract Documents, City shall pay Contractor, in full compensation therefor, the amount of $65,359.00, subject to any additions and deletions pursuant to the terms of the Contract Documents. Said sum shall constitute payment in full for all work performed hereunder, including, without limitation, all labor, materials, equipment, tools and services used or incorporated in the Work, supervision, administration, overhead, expenses and any and all other things required, furnished or incurred for completion of the Work as specified in the Contract Documents. City shall make payments to Contractor on account of the contract sum at the time, in the manner, and upon the conditions specified in the Contract Documents. 4. Contractor's Personnel. 4.1 All Work shall be performed by Contractor or under Contractor's direct supervision, and all personnel shall possess the qualifications, permits, and licenses required by state and local law and by the Notice Inviting Bids /Instructions to Bidders to perform such Services, including, without limitation, a City of Seal Beach business license as required by the Seal Beach Municipal Code. 4.2 Contractor shall be responsible for payment of all employees' wages and benefits, and shall comply with all requirements pertaining to employer's liability, workers' compensation, unemployment insurance, and Social Security. Contractor shall fully comply with the workers' compensation law regarding Contractor and Contractor's employees. 4.3 Contractor shall indemnify and hold harmless City and its elected officials, officers, employees, servants, designated volunteers, and agents serving as independent contractors in the role of city officials, from any and all liabilities, damages, claims, costs and expenses of any nature to the extent arising from Contractor's alleged violations of personnel practices. 4.4 Contractor is, and shall at all times remain as to City, a wholly independent contractor. Contractor shall have no power to incur any debt, obligation, or liability on behalf of City or otherwise act as an agent of City. Neither City nor any of its agents shall have control over the conduct of Contractor or any of Contractor's employees, except as set forth in this Agreement. Contractor shall not, at any time, or 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 3 of 9 Error! Unknown document property name. • • all taxes, assessments, penalties, and interest asserted against City by reason of the work performed pursuant to this Agreement. 4.5 City shall have the right to offset against the amount of any fees due to Contractor under this Agreement any amount due to City from Contractor as a result of Contractor's failure to promptly pay to City any reimbursement or indemnification arising under this Section 4. 5. Indemnification. 5.1 Contractor's Duty. Contractor shall defend, indemnify, and hold the City, its elected officials, officers, employees, volunteers, agents, and those City agents serving as independent contractors in the role of City officials (collectively "Indemnitees ") free and harmless from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, bid protests, stop notices, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's fees, disbursements and court costs) of every kind and nature whatsoever (individually, a "Claim," collectively, "Claims "), in any manner arising out of or incident to the performance of the Agreement, including without limitation, the payment of all consequential damages and attorneys' fees and other related costs and expenses. Further, Contractor shall appoint competent defense counsel, at Contractor's own cost, expense and risk, to defend any and all such suits, actions or other legal proceedings of every kind arising out of or incident to the performance of the Agreement that may be brought or instituted against Indemnitees. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against City or the other Indemnitees in any such suit, action, or other legal proceeding arising out of or incident to the performance of the Agreement. Contractor shall reimburse the City and the other Indemnitees, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by Contractor or Indemnitees. This indemnity shall apply to all Claims and liability regardless of whether any insurance policies are applicable. 5.2 Bid Protests. In addition to its obligations pursuant to Section 5.1, Contractor shall reimburse the City for all attorneys' fees and costs incurred by City in connection with, arising out of or incident to any bid protest. 5.3 City's Sole Negligence. Nothing in Section 5.1 shall be construed to require Contractor to indemnify Indemnitiees for that portion of any Claim to the extent arising from the sole negligence or willful misconduct of the Indemnities. 5.4 Nonwaiver of Rights. Indemnitees do not, and shall not, waive any rights that they may possess against Contractor because of the acceptance by City, or the deposit with City, of any insurance policy or certificate required pursuant to this Agreement. 4 of 9 Error! Unknown document property name. • • • 5.5 Waiver of Right of Subrogation. Contractor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation against the Indemnitees, while acting within the scope of their duties, from all claims, losses, and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor. 5.6 Survival. The provisions of this Section 5 shall survive the termination of the Agreement and are in addition to any other rights or remedies that Indemnitees may have under the law. Payment is not required as a condition precedent to an lndemnitee's right to recover under this indemnity provision, and an entry of judgment against a Contractor shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. 6. Insurance. 6.1 Liability Insurance. Contractor shall procure and maintain in full force and effect for the duration of this Agreement insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the services hereunder by Contractor, and its agents, representatives, employees and subcontractors. The policy limits set forth below do not act as a limitation upon the amount of indemnification to be provided by Contractor. Contractor shall complete and execute the following documents attached as Exhibits hereto and incorporated herein by this reference: 6.1.1 Exhibit D -1: Additional Insured Endorsement - Commercial General Liability. 6.1.2 Exhibit D -2: Additional Insured Endorsement - Automobile Liability. 6.1.3 Exhibit D -3: Additional Insured Endorsement. 6.2 Minimum Scope of Insurance. Unless otherwise approved by City, coverage shall be at least as broad as: 6.2.1 Insurance Services Office Commercial General Liability coverage (occurrence form CG 0001). 6.2.2 Insurance Services Office form number CA 0001 (Ed. 1/87) covering Automobile Liability, code 1 (any auto). 6.2.3 Insurance Services Office form number CG 20 10 11 85 (Ed. 11/85) covering Additional Insured— Owners, Lessees or Contactors (Form B). 6.2.4 Workers' Compensation insurance as required by the State of. California and Employer's Liability Insurance. 5 of 9 Error! Unknown document property name. • • 6.3 Minimum Limits of Insurance. Contractor shall maintain limits no less than: 6.4 General Liability: $2,000,000 per occurrence and in the aggregate for bodily injury, personal injury and property damage. Commercial General Liability Insurance or other form with a general aggregate limit shall apply separately to this Agreement or the general limit shall be twice the required occurrence limit. 6.4.1 Automobile Liability: $2,000,000 per occurrence for bodily injury and property damage. 6.4.2 Employer's Liability: $1,000,000 per occurrence and in the aggregate for bodily injury or disease and Workers' Compensation Insurance in the amount required by law. 6.5 Deductibles and Self- Insured Retentions. Contractor shall inform City of any deductibles or self- insured retentions except with respect to any professional liability insurance. 6.6 Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: 6.6.1 City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor; products and completed operations of Contractor; premises owned, occupied or used by Contractor; or automobiles owned, leased, hired or borrowed by Contractor. The coverage shall contain no limitations on the scope of protection afforded to City, its officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials which are not also limitations applicable to the named insured. 6.6.2 For any claims related to this Agreement, Contractor's insurance coverage shall be primary insurance as respects City, its officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials. Any insurance or self- insurance maintained by City, their officers, officials, employees, designated volunteers or agents serving as independent contractors in the role of City officials shall be excess of Contractor's insurance and shall not contribute with it. 6.6.3 Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. 6.6.4 Each insurance policy required by this Section 6 shall be endorsed to state that coverage shall not be canceled or materially modified except after 30 days prior written notice by first class mail has been given to City. 6 of 9 Error! Unknown document property name. • • 6.6.5 Each insurance policy, except for any professional liability policy, required by this Section 6 shall expressly waive the insurer's right of subrogation against City and its elected officials, officers, employees, servants, attorneys, designated volunteers, and agents serving as independent contractors in the role of city or agency officials. 6.7 Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VIII unless waived in writing by City's Risk Manager. 6.8 Verification of Coverage. All insurance coverages shall be confirmed by execution of endorsements on forms approved by the City. The endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All endorsements are to be received and approved by City before services commence. As an alternative to City forms, Contractor's insurer may provide complete, certified copies of all required insurance policies, including endorsements effecting the coverage required by these specifications. 7. Liquidated Damages. Should the Contractor fail to complete the project, or any part thereof, in the time agreed upon in the Contract, the Contractor shall reimburse the City for the additional expense and damage for each calendar day that the Contract remains uncompleted after the Contract completion date. It is agreed that the amount of such additional expense and damage incurred by reason of failure to complete the Contract is the per diem rate of $ 750 per calendar day. Such amount is hereby agreed upon as liquidated damages for the loss to the City resulting from the failure of the Contractor to complete the project within the allotted time and to the value of the operation of the works dependent thereon. It is expressly understood and agreed that this amount is a reasonable amount and is established in lieu of damages that are incapable of calculation at the inception hereof; and this amount is not to be considered in the nature of a penalty. The City shall have the right to deduct such damages from any amount due, or that may become due to the Contractor, or the amount of such damages shall be due and collectible from the Contractor or the Contractor's Surety. Progress payments made after the scheduled completion date shall not constitute a waiver of liquidated damages. 8. Suspension. City may, in writing, order Contractor to suspend all or any part of the Contractor's Services for the convenience of City or for work stoppages beyond the control of City or Contractor. A suspension of the Services does not void this Agreement. 9. Notices. Any notices, bills, invoices, or reports authorized or required by this Agreement shall be in writing and shall be deemed received on (a) the day of delivery if delivered by hand or overnight courier service during Contractor's and City's 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 7 of 9 Error! Unknown document property name. • • other addresses as the parties may, from time to time, designate in writing pursuant to the provisions of this Section. All notices shall be addressed as follows: If to City: City Clerk City of Seal Beach 211 -8th Street Seal Beach, California 90740 Telephone: (562) 431 -2527 Fax: (562) 493 -9857 With a copy to: Public Works Director City of Seal Beach 211 -8th Street Seal Beach, California 90740 If to Contractor: Atom, Inc. 40410 Vista Road Hemet, CA 92544 Telephone: (951) 766 -2806 Fax: (951) 658 -4937 Attn: Larry Boyer 10. Non - Assignability; Subcontracting. Contractor shall not assign, transfer, or subcontract any interest in this Agreement or the performance of any of Contractor's obligations hereunder. Any attempt by Contractor to so assign, transfer, or subcontract any rights, duties, or obligations arising hereunder shall be null, void and of no effect. 11. Compliance with Laws. Contractor shall comply with all applicable federal, state and local laws, ordinances, codes and regulations in force at the time Contractor performs the Services. 12. Non - Waiver of Terms, Rights and Remedies. Waiver by either party of any one or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement. In no event shall the making by City of any payment to Contractor constitute or be construed as a waiver by City of any breach of covenant, or any default which may then exist on the part of Contractor, and the making of any such payment by City shall in no way impair or prejudice any right or remedy available to City with regard to such breach or default. 13. Attorneys' Fees. In the event that either party to this Agreement shall commence any legal action or proceeding to enforce or interpret the provisions of this Agreement, the prevailing party in such action or proceeding shall be entitled to recover its costs of suit, including all attorneys' fees incurred in connection therewith. 14. Construction. The validity, interpretation, and performance of this Agreement shall be controlled by and construed under the laws of the State of 8 of 9 Error! Unknown document property name. California. In the event of any asserted ambiguity in, or dispute regarding the interpretation of any matter herein, the interpretation of this Agreement shall not be resolved by any rules of interpretation providing for interpretation against the party who causes the uncertainty to exist or against the party who drafted the Agreement or who drafted that portion of the Agreement. 15. Entire { Agreement. This Agreement, including any other documents incorporated herein by specific reference, represents the entire and integrated agreement between Contractor and City. This Agreement supersedes all prior oral or written negotiations, representations, or agreements. This Agreement may not be amended, nor any provision or breach hereof waived, except in a writing signed by the parties which expressly refers to this Agreement. 16. Severability. The invalidity in whole or in part of any provisions of this Agreement shall not void or affect the validity of the other provisions of this Agreement. IN WITNESS WHEREOF, the parties, through their respective authorized representatives, have executed this Agreement as of the date first written above. CITY OF SEAL BEACH CONTRACTOR By: By: David Ca many, City Manager Name: Larry Boyer Title: President Attest: r\ By: 40(L/(i.. . .c. /L... By: Linda Devine, City Clerk Name: Title: Approved as to Form: By: uinn M. Barrow, City Attorney 9 of 9 Error! Unknown document property name. 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 Califomia contractor's license as set forth below (required at time of award): Business & Professions Code § 7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to-engage in the business or act in the capacity of a contractor within this state without having a license therefore, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or • imprisonment in the county jail for not less than 10 days nor more than six months, or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be performed. (c) This section shall not apply to a joint venture license, as required by Section 7029.1. However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to this section with respect to his or her individual licensure. (d) This section shall not affect the right or ability of a licensed architect, land surveyor, or registered professional engineer to form joint ventures with licensed contractors to render services within the scope of their respective practices. (e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non - responsive and shall be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency shall, before awarding a contract or issuing a purchase order, verify that the cont . ctor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision •f law, unless one of the foregoing exceptions applies, the registrar may issue a citation to any public offic - r or employee of a public entity who knowingly awards a contract or issues a purchase order to a co tractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal, ,and finality o such citation; shall be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any p rchase order, issued • to, a contractor who is not licensed pursuant to this chapter is void. ` • I 4 (f) A compliance or noncompliance with s'ubdivisiori• (e) of :this s ction,! 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 t6 a citation pursu: t to this section if the public employee, officer, or employing agency made an inquiry to the board or the purposes of Page D -49 I I ' �,,`` + - - - - 81f I i • IIr;'S iJ �i�LI'! � '! � ' IJG 11 t • i ! "` .� i '�t w �I � ! i :� r�ii - ,i b i r Y! - -- • • verifying the license status of any person or contractor and the board failed to respond to the inquiry within three business days. For purposes of this section, a telephone response by the board shall be deemed sufficient. Public Contract Code§20103.5: In all contracts subject to this part where federal funds are involved, no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However,at the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of this state. The first payment for work or material under any contract shall not be made unless and until the Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or contractor not so licensed shall be subject to all legal penalties imposed by law, including, but notiiiiiited • to,any appropriate disciplinary action by the Contractors' State License Board. The agency shall include a statement to that effect in the standard form of pre-qualification questionnaire and financial statement. Failure of the bidder to obtain proper and adequate licensing for an award of a contract shall constitute a failure to execute the contract and shall result in the forfeiture of the security of the bidder. License No.: CIS W- Class: ' 1 pj Expiration Date: f 'A j° Date: • • •F ! Page D-50 ! ;; it 1 ! jail i �: f Ir ti1�6I 1.t;; k yy�. I ;y II,val.. � I i , .wi.`IL91tll�lnIy _4�''`L it i` ''.1 �'i fri 1` '. b iBi ill • • EXHIBIT F LABOR LAW REQUIREMENTS Page D -51 • • AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code §§ 1720, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861, 3700] The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the Following provisions of California law: 1. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency ( "Agency ") and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency, forfeit twenty -five dollars ($25) for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2, Part 7, Chapter 1, Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self - insurance in accordance with the provisions of that code, and I will comply with such prow' 'ons before commencing the performance of the work of this contract." • Date 0.-- ce Signature L—Ct eiesd ein f Page D -52 • • EXECUTED IN DUPLICATE Bond No. 6708063 Bond Premium $1, 634.00 PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach, has awarded to ATOM, INC . 40410 VISTA RD. HEMET CA 92544 (Name and address of Contractor) ( "Principal"), a contract (the "Contract") for the work described as follows: Fire Station 48 Turnkey Fuel Island Canopv Project. CIP# BG0803. WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW, THEREFORE, we, the undersigned Principal, and FIRST NATIONAL INSURANCE COMPANY OF AMERICA 333 CIJY BL WEST STE 300 ORANGE CA 92868 (Name and address of Surety) ( "Surety ") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of SIXTY —FIVE THOUSAND THREE HUNDRED FIFTY —NINE AND NO /100 Dollars ($ 65 , 359.00 this laount 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 raja, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, or subcon ractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code, or any amounts die 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 for+i 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 iii an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and void. This bond shall insure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns in any 4uit 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. i FURTHER, the Surety, for value received, hereby stipulate# 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 obligadons under this bond, and it does hereby waive notice of any such change, extension of time. alteration, addition. or tliodification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below, the Page D -37 ' • • • name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: "Principal" "Surety" ATOM, INC. FIRST NATIONAL INSURANCE COMPANY OF AMERICA 1 By: �� Its re R^ ItsJ ' RGAST, ATTORNEY —IN —FACT By: By: Its Inv (Sell) (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 -38 THREE EXECUTED COPIES of the Contract Documents are due by January 3.2011, All documents must be on City forms and additional copies can be requested from the City. No documents will be accepted that are In any way modified by the Contractor. Time and Date of Pre -Construction Meeting to be determined. -Err.." viI i I r j1 .i +i ill 'j•,�i' +rq'iI ='t flit Ia I t''l f 1 1 111I� 1 s P j 't s ,l i ` • 1 , I r k. . . i ,: ; I j P I i k e CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT - ._,._�_n _ � <. ', _� non., .>: _- _ .av S<!�« ..�•> 1 I . :_i; State of ;California County of R iverside r. O 01.-87 ;be fore rrte Terra C ox, Notary Public , t! I Here Insert eleme and Tina of the Otker perso appe . Larry Byer C 9 l who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the t. within instrument and acknowledged to me that TERRA J. COIL bo/ohathey executed the same in hiel9aer/their authorized i Ier ■ Commission • 1892519 capacity(ies), and that by hiellaer/their signature(s) on the .;1'. Notary Public • California instrument the person(s), or the entity upon behalf of ) i -1J Rh orakto County which the person(s) acted, executed the instrument. - F Comm. roe Jul 10 2014 I certify under PENALTY OF PERJURY under the laws a of the State of California that the foregoing paragraph is true and correct. i< WITNESS my hand and official seal. R; t. Place Notary seal Above Signature s" • Spnature of Nota Public OPTIONAL P. Though the information below is not required by law, it may prove valuable to persons relying on the document F. and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: eck Yl P114 iSlYl A i Document Date: 1,9 - n--I0 Number of Pages: o2 g () jerern U and Pry, 5-1 SI ner s Other Than Named Above: Capaclity(ies) Claimed by Signer(s) Signer's Name: Larry Boyer Signer's Name: Lc) (.k L.Q (IA L ❑ Individual ❑ Individual ® Cor orate Officer — Title (s): President � • �" • p (s ) rporete Officer —Title(s): c— ' ❑ Partner — ❑ Limited ❑ General • Partner — ❑Limited ❑General it RICH I HUf 1GPRIi:T 1- ,...q FS FFIT.1 is ❑ Attorney in Fact ,, - •, .- ❑ Attomey in Fact - ❑ Trustee To of thumb here ❑ Trustee Top of thumb her { ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: ti= . z' Signer Is Representing: Signer Is Representing: • 02007 Nada & Notary Aseodadm• 9960 De Sato Ave., PO. Box 2102 •Chatsaodh. CA 91919.2102• veneNafbntlNOOaryorp Item 46907 Reorder :O Toll -Rae 7.80687&6827 c F- f. �i C. i; c. =• I i • • CALIFORNIA ALL - PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of RIVERSIDE On / a Jig /lam before me, R. NAPPI "NOTARY PUBLIC" (Here insert name and title of the officer) personally appeared JEREMY PENDERGAST who proved to me on the basis of satisfactory evidence to be the person f s) whose name($1s /are-subscribed to the within instrument and acknowledged to me that he /she/they executed the same in his/healtheir authorized capacity(i s ), and that by his/her/their signatures) -on the instrument the person(.ej; or the entity upon behalf of which the person(s) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my nd and official seal. ; R. NAPPI COMM- #1796916 si NOTARY PUBLIC - CALIFORNIA RIVERSIDE COUNTY Signature of Notary Public (Notary Seal) ',- MyComm.ExplrasJuns 7, 2012 ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exceprion is if a document is to be recorded outside of California. In such instances, any ahenrathve (Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. cer(f}'ing the authorized capacity of the signer). Please check the (Title or description of attached document continued) document carefullyfor proper notarial wording and attach this form if required. Number of Pages Document Date • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the some date the acknowledgment is completed. (Additional information) • Tire notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i e. ❑ Individual (S) he/she/they is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a (Title) sufficient area permits, otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney - - Fact 4 Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment rs not misused or attached to a different document. ❑ Other 3 Indicate title or type of attached document, number of pages and date. sti Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.c. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA v12.10.07 800- 873 -9865 www.NotaryClasses.com • • EXECUTED IN DUPLICATE • Bond No. 6708063 Bond Premium INCLUDED IN PERFORMANCE BOND PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that WHEREAS the City of Seal Beach, ha awarded ATOM, INC. 40410 VISTA RD. HEMET CA 92544 (Name and address of Contractor) ("Principal"), a contract (the "Contract") for the work described as follows: Fire Station 48 Turnkey duel island Canony„Proiec CIPit BGORO 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 FIRST NATIONAL INSURANCE COMPANY OF AMERICA 333 CITY BL WEST STE 300 s ' .` GE CA 9 (Name and address of Surety) ("Surety ") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of SIXTY —FIVE THOUSAND THREE HUNDRED FIFTY —NINE AND NO /100 Dollars (S 65 , 359 ), this amount being not less than the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his. her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed there under, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications there larder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: "Principal" "Surety" ATOM, INC. FIRST NATIONAL INSURANCE COMPANY OF AMERICA Page D-34 - - • • B. By: y � ���t Its cni' its P D'RGAST, ATTORNEY —IN —FACT By: By: / SCc.re i'641 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-35 ” Pk 'rill ; 1 , 'f �'+,,I � , it i ;]II� " i I I 1 i I c 111 s ' , { ± 01.1' I 1 • f E F. CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of :California 1 K - / County -of Riverside h a. On L2 !� ! before.me, Terra Cox, Notary Public a. Date 1 Here Insert Name and 11tle of the Mar personally appeared . Larry Boyer 4A- F,i' _k. stn f- I I Name of Signer%) f; ?. who proved to me on the basis of satisfactory evidence to r. r. be the person(s) whose name(s).is/are subscribed to the r.. within instrument and acknowledged to me that g 1ERRA J. COX hsid17 y executed the same in hisMerAheir authorized °' «,r /cfl ' Commission • 1892519 capacity(ies), and that by bisAtersitheir signature(s) on the F .:, _S . Notary Public - California instrument the person(s), or the entity upon behalf of \ = - 1 ,, % Riverside County which the person(s) acted, executed the instrument. g be Conan. res Jul 10, 2014 - 1 certify under PENALTY OF PERJURY under the laws A of the State of California that the foregoing paragraph is . true and correct. i i: WITNESS my hand and official seal. r: f Signature e • Place Notary Seal Above Signature of Notary lc z° OPTIONAL k' 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 Per an r-,° I S iv k Document Date: Id— I q -h) Number of Pages: 02 1: 0 • Signer(s) Other Than Named Above: J e r pr P 4 >n.' M1 Capacity(les) Claimed by Signer(s) .1 r; Larry Boyer Cr; .k L Uit L Signer's Name: Ry Y Si Name t ❑ Individual ❑ Individual 9 President ® Corporate Officer — Title(s): °rpomte Officer — Title(s): — ❑ Partner ❑ Limited ❑ General °❑Partner — ❑ Limited ❑ General fi RIGHTIHU'i6PRlFJT 1 I T iIU 1- r7F:F;T ❑ Attorney in Fact h - NFT, ❑ Attorney in Fact T thumb here ❑ Trustee op of thumb here To of t p Trustee p hu r ❑ Guardian or Conservator ❑ Guardian or Conservator L. ❑ Other: ❑ Other: .i.= i z : Signer Is Representing: Signer Is Representing: r, a ' i. 02007 Natlaml Notary Aasodetlon• 9950 Da Soto Ave., P.Q Scot 2402 •Chalewodh, CA 91919.2402•vAmNhtlonelNoteryorp IUm 415007 Reorder-CallTd4Free 1800.9769827 li E .. E I • • CALIFORNIA ALL - PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of RIVERS IDE On t Q I t 7 /fry before me, R. NAPPI "NOTARY PUBLIC" (Here insert name and title of the officer) personally appeared JEREMY PENDERGAST who proved to me on the basis of satisfactory evidence to be the personjs)'whose name(rrpis /aie-subscribed to the within instrument and acknowledged to me that he/sheithey executed the same in his/her/their authorized capacity(-ies), and that by his/her/their signatures) -on the instrument the person(.ej; or the entity upon behalf of which the persons) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. • ,, R NAPPI WITNESS my hand and official seal. ; COMM. #1796916 4Wi , 9�� NOTARY PUBUC- CALIFORNIA ri am CO SUNTY (Notary Seal) DE rw 7, 2012 Signature of Notary Public " • • ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outride of California. In such instances. any abemative (Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a nmary in California (i.e. certifying the audrariced capacity of the signer). Please check the (Title or description of attached document continued) document careftdlyfor proper notarial wording and attach this form if required. Number of Pages Document Date • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers) personally appeared which must also be the same date the acknowledgment is completed. (Additional information) • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your tide (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. ❑ Individual (s) he/she/they is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a (Title) sufficient area permits, otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney - - Fact } Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other + Indicate title or type of attached document, number of pages and date + Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer. indicate the title (Le. CEO, CFO. Secretary). • Securely attach this document to the signed document I 2008 Version CAPA v12.10.07 800- 873 -9865 www.NotaryClasses.com „ • „ - . lip T HIS PO)IVER OPATT,ORNEY IS NOT VALID U S IT IS PRINTED ON RED BACKGROUND. , • -, - , -; -, - 3014457 . „ „ „ . • „ - , • This Power of Attorney Whits the acts Of thine named heroin, and they have no authority t0 bind the Company except in the manner and to the extent ” „ - herein stated. " "' , - - „ ' ' ' " ; - , " „ . , . . , „ - . , „ , • „ „ . , „ „ ' FIRST NATIONAL INSURANCE COMPANY OF AMERICA , ' , , ' . 1 ' „ ' • - , ' ' • - " , " -- ' - '• : SEATTLE -WASHINGTON '. ' --, , ' • - ' . . . . - „ . - ' - - - :' . ,- . ' : " ' - , ,- :-. ., -- - - ;- : POWER OF, AttORNEY' " , : ; - .- " KNOW ALL PERSONS BVTHESE PRESENTS That First National Insurance Company of America (the "Company"), a Washington stock insurance company , pursuant to and authority of the Bplaw-and Authorization:hereinefter set forth, does hereby Kerne, constitute and appoint • ROSEMARYNAPPI,, : - JEREMY PENDERGAST; MICHAEL b. STONG; ALL OF THE CITY OF RIVERSIDE; STATE OF CALIFORNIA- each individually if there be more than one named its true and lawfulattOrnetin-fact to make, execute, seal acknowledge andcleliver; for and tints behalf as - • : -, , surety and as its act and :deed, any and. all undertakings,'„ boric* - recognizances.' and . other' surety Obligations fn the - penal -suni not exceeding "; FIFTY - MILLION AND'00/1 00 ,-. - .. *.*****# DOLLARS ($1 50,000,000.00 ** ! * * ***** ****************** each, and 'the 'execution of -, such - , - -: -, undertakingt, bonde:reCognizanCes and other surety obligations, pursuance of these presenta,,Shallbe as binding!uPon the Company as if they had been duly signed by the president and attested by the secretary of theCOmpany in their -Own proper persona. - ' . : • - .. ' . . , „ - : „ „ • „ - " " . „ , , . , , , , ' - That this power is made and executed pursuant to and by authority of the following,Bylaw and Authodiation: - ' , s ', ., ' • , ., -,-, ' , , . ; s ,... „ „ , „ „ „ , „ - . . . , . . .„ , co - • ' : : ARTICLE IV Execution of Contracts : Section 12 Surety BOndsandUndertakirigs. -. ' , . ' I " i : ' . ' : ' : -‘ ' -- ' - • ' - ', i 0 Any (Aker or other official of the CorporatiOn authorized for that purpose in writing by the Chairman or the President and subject to duchlirnitetions Q. . , : as the Chairman or the President may prescribe , appoint-such attOmeys-in=fact,;as may be necessary to act in behalf of the Corporation to make, execute- teal, acknowledge and deliver as surety any and all undertakings bonds, recOgnizances and other surety obligationijSuch :- g ,.: . . fact subject to the limitations set forth, in their respective powers of attorney shall have full power to bind the Corporation by their signature and .42 c =,. • "; executed,- such instruments ahall be as - binding astf by the president and attested by the secretary By the following instrument the chairman or the president has authorized the officer mother official named therein to appoint attorneys-th-fact: ; , , 8 Pursuant to Art icle,IV, Section 12 of thes13Y-lawsGarnet W Elliott, Assistant Secretary of First National Insurance Company of Americe, is authorized Td 1r- 0 , e - „ to appoint such attorneys-in fact as may be necessary to act in behalf of the Corporation to thake, execUte, seal, acknowledge and deliver as surety ° a 15 - " any and all undertakings,' bonds, recognizances and other surety „ : - : - ' , ' , - - - - - - - ' -- ' ::- ' -: ' ' - ' ' --, e ' E la That the By-law ,andlhe Authorization set forth above are true copies thereof and are now in full force and effect IN WITNESS; WHEREOF, this ROvier, of Attorney has been subscribed by an authorized officer or official of the Company and the corporate' seal Of ail First National' Insurance Company of America has been affixed -thereto in Plymouth:meeting, Pennsylvania this s6th .- day of ' ; ' ; July - ' 's '• -, ' ,:, ,_ 1 2 " --- 2010 - ' --- ' .; - - - „' ;, 1 „ , , • .- ' - s, ; . , - • , : -, ; : ,; , „- -; - , „ 0 co - -. - : - , . , -. : . , ' , , • - i " , - ' FIRST NATIONAL'INSURANCE COMPANY OF AMERICA i lr.ig , '. - , - ' ' , - : , • ",' - - ' co • -,-- : - : . - ' - Y st4t.- rz ' ' - E i ' - r ) . _:...4_.. . 5,7/-0.----7/ -- , 5, , o pt ,, - , - - -, . -; -, '" •, : - , : -, - : , - : : - -, , •!- - MI -,, . , ; Garnet W. Elliott - Assistant Secretary," : -: ; s ,, : : ; ; •, c' 0 t — COMMONWEALTH OF PENNSYLVANIA s ' 'es - : " " ' '- = ' ", " ; ' " • ' , • : . = -. = - " ' :' ' • Z"D C OUNTY, OF MONTGOMERY ,- - - ; - - ' ": , , ‘- - - - • - :- . ' ' ' = ' , - . • , -, — . l el, On this 6th -- - d o f : , : :July - -, -- ., 2010 ' ' , before me, a Notary Public, bersonally, carite Garnet W: Elliott, to me -known, and .>,- 2, L .0 „),, acknowledged that he is in Assistant SeCretary' First National Insurance Company of America; that he knows the seal Of said corpOratiOn; and that he executed the above Power of Attorney and affixed the corporate seal of First National Insurance Company of Atherioa thereto With the authority and at 4 " CO , UV= , , > direction ofatild cOrPoiation.i - - — . ' I . - - ; i ;: - - . - . . . ._ - - , - - , , . " „ z; Q IN, TESTIMONY WHEREOF : .9) , ; - . , to subscribed •rny name and affixed my notarial seal at Plymouth Meetin ,"Penneylyanie, on the day and Year )- - first above Written: ' : 1 -44, 0 ' '” ' .- . - s . s • ' s : - ' :lir 0 - V" = -- - - - rettia P'esiells, Notary PA:la ' By ' ' OF - - , - • - 1 - ' - ; = ; s :I.-- 9 . -1- - - - . - %mouth Ticiv; ivoritgopo'ricouriry. : , - , • ' „ „' ;' : : ' , : 2 Tere Pastella, Notary Public C - - - ; -; ' :- ' ' , - ‘, ; • • -, . . .. 4ICAt ,....„ ', • .. t „ ' : , - foty Co•nrrussonzEmire.aitti. : • 1.:‘ -; ., ' ' - " ' : ' ' ' Momber, fcNo itt on ', ; _ , - s = ', , - . • , -; = s „ ss ' , = s 2 s : , I, the UndersigiliA, Ass I -i„'tik , ret - Natibrial:Insuranbe,Convany - of Amerida, do hereby certify that the original power of attorney of which the foregoing is a full; tru:'1' • - •-•'.- . y is'in,full force and effect on the date of this certificate; and I do further certifythetthe officer or official who • , : , executed the said power of a . - , is an Assistant - FSedretaryspeclaily authorized by the chairman or - presideTitle? appoint - attorneys is . f provided in Article IV Section 12 Of the By laws of First National Insurance Company Of America This certffiCate and the above power of' attorney may be Signed by feCsfinfie, or thechaniCally;reproduced:sigriatUree under and by authority 01 the following vote Of the board of directors of First National Insurance Company of America at a meeting duly called and held on the 18thAayof September, 200 9. VOTED that thelaCsiMile or mechanically reproduced signature of any assistant secretary of the company wherever appearing Upon - a Certified'. , • z. : „:s , ,- copy of any power Of attorney iseued, by the Oothpany,irr connection with surety-bonds, shall be Valid and binding upon the cOMPanywithlha : • - .,' ; same force and effect as though manually affixed: -', -,-, :; ,-, , -, ; :, , , z : : , ; -.; : :, - • „ ;:. 1 ': 1 , : -; , -,- .; :-, ,' ,, , s , s' , • , , - „ IN TESTIMONY WHEREOF 1 hereunto subscribed myna - ‘„, : • : ' ed the corporate seal of the said cOmpany, I - , day of Vi.eiriv:44A.: -, ' saoef. : _ „ 2 .-.- •: :, : ' -.' - ': : -'- , - : ,. :: ,- : -.' . :' - -.- ' - -, - : : , •- ' : .-- ' ,": , smi.: : pavi., M. Carey, - Stant Secretary rl, 1•li :Ill ' i. MI .it r ' ,�,'. ' I x ' 0 ,1 1 Ifl 'I l II . i. i i' 1 . �9 is ,;; ,,'�• . S ` ' „. I • ACORD C O LI ABILITY INSURANCE D ili MIDDN 0 m PRODUCER 714 - 541 -6166 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GCIS • ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO BOX 10255 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Ana, CA 92711 i INSURERS AFFORDING COVERAGE NAIC # • INSURED INSURERA C olony Insurance Company 39993 . ATOM, Inc., and A T 0 M Engineering Construction INSURERS: Argonaut - Midewest Insurance Company 19828 40410 VISTA ROAD Hemet, CA 92544 i ' INSURER C: • INSURER D: INSURER E: COVERAGES , !I 4 .` 1 • THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING z. ANY REQUIREMENT, TERM OR CONDmON 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. WSRADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR /NERD TYPE OF INSURANCE POLICY NUMBER DATEIMMIDD/YYI DATEIMMIDDIYYI LIMTTS A Y GENERAL IJABIUTY GL950849 08/25/2010 08/25/2011 EACH OCCURRENCE $ 1,000,000 , X COMMERCIAL GENERAL LUTY PR M S RENTED UIBI Ea occur9 s $ 100,000 CLAIMS MADE © OCCUR MED EXP (Anyone person) $ 5 000 _ PERSONAL $ ADV INJURY $ 1,000,000 X 5,000 Deductible 1 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE UMIT APPUES PER: I PRODUCTS - COMP/OPAGO $ 2,000,000 POLICY I JEG 1-1 LOC B Y AUTOMOBILE LIABILITY SA8024474 08/25/2010 08/25/2011 COMBINED SINGLE LIMIT acacia* $ 1,000,000 ANY AUTO (Eaa X ALL OWNED AUTOS BODILY person) INJURY $ • so L X scsEDAUTOS X HIRED AUTOS BODILY INJURY $ X NON.OWNEDAUTOS (Per accident) X No deductible applies. PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EAACCIDENT 5 ANY AlJTO OTHER THAN $ _ AUTO ONLY: AGG $ EXCESS/UMBRELLALIABILITY EACH OCCURRENCE _ $ OCCUR I CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ • • RETENTION $ $ WORKERS COMPENSATION AND ITO YI111T3I I EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE EJ_ EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? E.L DISEASE- EA EMPLOYEE 5 Ifyes. describe under SPECIAL PROVISIONS below E.L DISEASE -POLICY LIMIT $ OTHER • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Scheduled Autos: 2004 Chevrolet 3500 1 GBJC34U84E225077, 2004 Chevrolet 3500 1 GBJC34424E215967 • The City, it's officers, officials, employees, designated volunteers and agents serving as independent contractors in the role of City officials, are named as additional insured with respect to the general liability provided by this policy per attached forms. CERTIFICATE HOLDER CANCELLATION . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Clerk DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Seal Beach NOTICE TO THE CERTIFI YE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO BO SNAIL ' 211 -8th Street IMPOSE NO OBLIG4 N R LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR . Seal Beach, CA 90740 REPRESENTATIV AUTHORIZED REP ES A E • I ACORD 25 (2001108) 0ACORD CORPORATION 1988 1 , !4 71 , ! '1 171' t 1 ! .i • i 111 it f l� is . THIS ENDORSE ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. .TRAN FER OF RIGHTS OF RECOVERY AGAINST•.OTHERS TO US This endorsement modifi s insurance provided under the following: COMMER0I1L GENERA LIAI3ILITY PART PRODUCTS /COMPL-ET OPERATIONS LIABILITY COVERAGE PART The following is added to aragraph.8 "'Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any rights of re overy we may have against any person or organization because of payments we make for injury or damage, resulting from your ongoing operations or "yourwork° done under a contract with that person or- organization and included in the "products - completed operations hazard° if a. you agreed to such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contractor lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Named Insured: ATOM, Inc. and A T 0 M Engineering Construction Policy Number: GL950849 Eff/Exp Dates: 08/25/2010 to 08/25/2011 U047 -0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. R a i' ii. 11 ',11 �I ,.! � ICI, C , i ��ll' A l i ',' ! Named Insu d: A; OM, Ir ' •• -T O Engin Con lction • Policy Number: GL950849I Eff /Exp Dates: O /25/2010 to 08/25/2011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PER ON OR ORGANIZATION This endo I endorsement insurance provided 1. under the following: • COMMERCI GENERA_ LIABILITY.'COVERAGE PART SCHEDULE Name of Additional Insure] Person(s) or Organization(s) (Additional Insured): I Location(s) of Covered Operations: ALL PERSONS OR ORGANIZATIONS AS REQUIRED BY AS DESIGNATED IN WRITTEN CONTRACT WRITTEN CONTRACT WITH THE NAMED INSURED. WITH THE NAMED INSURED. A. SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule for whom you are performing operations when you and such - person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for 'bodily injury", "property damage' or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. • B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability "Bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations at Work "Bodily injury" or "property damage' occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or U156P -0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 2 • • with its permission. ti 1:1 ' 21 :11: • ,17 tit ' ! I i „ • . : • 2. that portion • your mile lout of which the injury or damage arises has been put to its intended Use • y any person organization. Negligence of Additi • nal Insured uBodily injury" or "pro•erty damage" Arising directly or indirectly out of the negligence of the additional insured(s)-. - - C. SECTION 'IV MERCIAIL GENEF1AL LIABILITY CONDITIONS, 4. Other Insurance is amended And, the foil. wing:added: IL ;1;. The insurance afford .-d by this Coveragel Part for the additional insured shown in the Schedule is primary insurance a d we will not seek contribution from any other insurance available to that additional insured. ALL OTHER TRMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. • • • • U156P-0310 Includes copyrighted material of ISO Properties, Inc., Page 2 of 2 with its permission. • • JJg4 Named Insu • T ti in .a Teo E ` n'eeri g Constr cti. !� ' ;ti Policy Number: GL95.0.849 . i Eff/Exp Dates: 08/25/2011 to 08/25 12011 TATS ENDORSE NT CHANGES THE POLICY. PLEASE READ 11' CAREFULLY. 1. DESIG! ATED CONSTRUCTION PROJECT(S) GENERAL GGREGATE •LIMIT - RESTRICTED FORM This endorsementiriodifies '' . ance provided under following: COMMERCIAL .kENERAL LABILITY COVER4 E PART SCHEDULE • Designated Construction Pro ects: ALL CONSTRUCTION PR o JECTS DURING THE POLICY TERM SUBJECT TO THE LIMIT • BELOW (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I — COVERAGE C MEDICAL PAYMENTS, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: • 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to thc amount of the General Aggregate Limit shown in thc Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all dam- ages under SECTION 1— COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, except damages because of "bodily injury" or "property damage" included in the - products-completed operations hazard ", and for medical expenses under SECTION 1- COVERAGE C MEDICAL PAYMENTS regardless of the number of a. Insureds_ - b. Claims made or "suits" brought or c. Persons or organizations making claims or bringing "suits ". 3. Any payments made under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND • PROPERTY DAMAGE LIABILITY for damages or under SECTION I - COVERAGE C MEDICAL • EXPENSES shall reduce the Designated Construction Project General Aggregate Limit for that designated con- struction-project Such payments chall not reduce the General Aggregate Limit shown in the Declamations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damages to Premises Rented to You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. 5. The most we will pay for the sum of all Designated Construction Project General Aggregate Limits combined • and to which this insurance applies is $5,000,000. • UCG2503 -0310 Contains material Copyright, Insurance Services Office, Inc., 1996 Page 1 of 2 with its permission. pri B. �i l� Iii �lS 1�, g ! �� .elrlf , . v igil 1 1 • I I I • .. • B. For all sums xvhicti the in a b ecomes l obligated to pay as damages caused by "occurrences" under SECTION I — COVERA ES, COVERAGE A' BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and caused t y accidents under SECTION I - COVERAGE C MEDICAL PAYMENTS, which cannot be attributed only ongoing operations at a single designated construction project shown in the Schedule above: i 1. Any payments made der SECTION :I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMA 4 E LIABILITY for damages or under SECTION 1- COVERAGE C MEDICAL PAYMENTS s191 re • ce the amount availab a under the General Aggregate Limit or the Products- Completed OperationsfAggregate invit,lwhicliever is app cable; and • • 2. Such payr{iLnts shall n reduce any±Desig Construction Project General Aggregate Limit. - C. When coverage g for liabili , resulting fin the "products- completed operations hazard" is provided, any payments for damages because of "b • • 1y injury" or "property damage" included in the "products- completed operations haz- ard" will reduce the Produ ts- Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Const ction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of SECTION III — LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated. • ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. • Page 2 of 2 Contains material Copyright, Insurance Services Office, Inc., 1996 L CG2503 -0310 with its permission. {" .1 :11 ,"rd. 1 11 ' 1' q; I I ,I 1 i 1 •: y II 0 j111= ti '1 { 1 II CERTHOLDER COPY 'I 1 SG STATE c o P E N S AT t o - .O. BOX 4208'07, SAN FRANCISCO,CA 94142 -0807 I N S U R A N C E FUND C RTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-20 -2010 GROUP: - ' - i POLICY NUMBER: 1949010 -2010 CERTIFICATE ID: 27 11 { + i 1 = CERTIFICATE EXPIRES: 12 -01 -2011 1' I I' 12 -01- 2010/12 -01 -2011 CITY OF SEAL BEACH t` r SG 211 8TH ST SEAL BEACH CA 90740 -6305 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 indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. 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. 4 A/Miola Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 81,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - LARRY BOYER P,T - EXCLUDED. ENDORSEMENT #1600 - ERICK LUNA SEC - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12 -01 -2010 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER ATOM INC SG 40410 VISTA RD HEMET CA 92544 [JAT,CS] PRINTED : 12 -20 -2010 (RE V.8.2010)