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AGMT - Sequel Contractors (05/06 Paving Rehab, Phase I)
• . 2A • RECORDING REQUESTED BY Recorded in Official Records, Orange County Tom Daly, Clerk-Recorder 11 1111 11111 1 101 1 1111 11111 1 1111 1 1111 1 1111 11111 11 111 11111 11111 11111 1111 11 11 NO FEE AND WHEN RECORDED MAIL TO 2006000179464 12:30pm 03120106 CITY OF SEAL BEACH 213 148 N12 1 Attn: City Clerk 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 211 8th Street Seal Beach, CA 90740 Space of above this line for Reeoider'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 ,V( property hereinafter 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 8th Street,Seal Beach,CA 90740 4. The nature of the interest or estate of the owner..is;_In fee.The Cil"of Seal Beach. 5. A work of improvement on the property hereinafter is described as substantially completed on February 1,2006.The work was: Annual Paving Rehabilitation(Phase One)Project 50174. 6. The name of the contractor,if any,for such of improvement was:Sequel Contractors,Inc. The date of the Contract was: August 17,2005. 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:Annual Paving Rehabilitation(Phase One) Project 50174. . _22,4 (0131:2_ ■•• ■/ /// Signature of owner or corpor...'officer of owner named in paragraph 2 or his 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 2- /6 ,20vris,at Seal Beach,California. (Date of Signature) Director of Public Works *., • • • . , . ...,. . . , ,: . . :. , :., _ -- CONTRACTOR TO PRINT COMPANY BOOK II: OF III NAME:e" � e,f Cc,•-}-r '(� mac• !� - G rs� CONTRACT DOCUMENTS 653, 297 0 a DOCUMENTS TO SUBMIT UPON AWARD: ❑ PUBLIC WORKS CONTRACT ❑ ACKNOWLEDGEMENT OF ❑ PERFORMANCE BOND LICENSE LAW ❑ PAYMENT BOND ❑ WORKMEN'S COMPENSATION CERTIFICATE • ❑ INDEMNIFICATION AND HOLD ❑ INSURANCE REQUIREMENTS(3) HARMLESS ❑ LABOR LAW REQUIREMENTS FOR: ANNUAL PAVING REHABILITATION FY 05/06 (PHASE ONE) CITY PROJECT NUMBER: 5 _,-,.:„,,,..i..:L.: ,..:i.,,,,,:::._.:_:„..,,,...:::T.::,,,,,,,:.:,...,:::...:7,,,T,.... .,,,:„..t.... .,:.;,:_;„::::,,,„:::„.;:,,4„..„...:.. .:::;:.::?:,;,:„....,,.,,„::„.„..„., r dtf 71 _,..7.„.:,.. ,.:.:C a F ~- 'n Y y T ..--.ter` d k 1 t ...4 a - - 't!_ ._.,.,U if ..mow . � .-2,. _ .Y 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. • 1 •QUEL CONTRACTORS, INC. TABLE OF CONTENTS CONTRACT DOCUMENTS 1 DOCUMENTS TO SUBMIT UPON AWARD: 1 PUBLIC WORKS CONTRACT 3 PERFORMANCE BOND 5 PAYMENT BOND 7 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 2005/2006 For the following project named 4/y/G,4 <,,Po(l 7; / go/'q ,in the City of Seal Beach. / ., THIS AGREEMENT, made and entered into this AUG 1 9 2005 day of 20 , by and between the City of Seal Beach, California, hereinafter referred to as the "CITY," Party of the First Part, and SEQUEL CONTFRALIQRS, INC. 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 H. 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 3 • • workmen's compensation or to undertake self-insurance in accordance with the provisions of that code,and I will comply with such provisions before commencing the performance of the work of this contract. IN WITNESS WHEREOF: The Parties hereto have caused this contract to be executed the day and year first above written. CITY OF SE• c EACH,C ORNIA Party of the F,t :art BY Li City Mana_ %, AT ST: , � lerk4 ��,'A I / CO' 'T i R- ; of the econd Part S.Pack,Presidmg Title 13546 IMPERIAL HWY. SANTA FE SPRINGS, CALIF. 90670 _ Address 4 • S CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT •- - - - �>o A -' o iG . . .rreeaercrerer, rr<.eroe`.crOne'nc(`-crcrcrC(te.< 0nCe%C�%Ce..o: State of California County of LOS ANGELES SS. On AUG 1 9 2005 , before me, MICHAEL.ALLEN AMUNbitad,NOTARY RR= Date Name and Tale of Officer(e.g.."Jane Doe.Notary Public") personally appeared " '� �•Pick Presitiont Name(s)of Signer(s) 'personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that MfCHAELALLENAMUNUSON he/she/they executed the same in his/her/their cf x,15. COMM.#1483459 D authorized capacity(ies), and that by his/her/their !NOTARY PUBLIC-CAUFORNLA signature(s) on the instrument the person(s), or the 4 r LOS ANGELES COUNTY cn My.Comm.Exp.April(3.2008 ^' entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Place Notary Seal Above 'e%�7�", �/6 "k /414,f 1� Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: _ Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): _1 Corporate Officer—Title(s): ❑ Partner—❑ Limited 0 General RIGHT THUMBPRINT 0 Partner—❑ Limited ❑General RIGHT THUMBPRINT ❑ Attorney in Fact OF SIGNER 1 Attorney Fact OF SIGNER y i Top of thumb here orne y in Top of thumb here • Trustee IJ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: 0 Other: Signer Is Representing: Signer Is Representing: �`--w•�-_.,•cc:•c:.cccc.�:�c,�.�c.�,�,�c,�c.�c,�,�,•^•-c,•e:.rc;�x:�.�%;,�-:;=-r,-�ccrocr�;�,cc:c=.c.c:.-�c.cc.�cr-.cc..,c.c.cc.�.o:,�::,�, 0 2004 National Notary Association•9350 De Soto Ave..P.O.Box 2402•Chatsworth.CA 91313-2402 Item No.5907 Reorder.Call Toll-Free 1-800-876-6827 • • Bond No. 8195-8137 Bond Premium $3,9).00 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: - WHEREAS the City of Seal Beach,has awarded Sag-P-1 antractars.•Irr:: - 13546 Il+ rial HLY Santa Ft Springs, CA 90670 (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows: Arritai awing Rstatilliziticn WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW,THEREFORE,we,the undersigned Principal,and Feral Irmsarne CtrriznY 801 S . FigL xna Ias Argeles, CA 90017 (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of Six lnar:ed fifty three thousand trap hundred n rdy sewn acrd m/100 Dollars ($ 653,297.00 ), this amount being not less than the total contract price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed,all within the time and in the manner therein specified,and in all respects according to their true intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided,then this obligation shall become null and void;otherwise,it shall be and remain in full force and effect. In case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER,the Surety, for value received,hereby stipulates and agrees that no change,extension of time, alteration, addition or modification to the 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 5 • • 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" A, "Surety" �=• - •; dal Ilsuarr:e Ctn any By: Thmse S.Peck,Prank By: VI t' . , Q. Its I, '• A. •' •••;• - 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 • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT r,M.crcc,�r.�.�.M,c�,�-r.�r.�r..M.c:c�.M.cr.�-�.crcc.M�.�c'�.cc.cr�crcc.crcrcrcc.c�.crcrc�.crcrcr.�ccrcrcrc�.o: State of California County of LOS ANGELES SS. On AUG 1 9 2055 , before me, MOMS.A AMUNDSON,NOTARY P UDC; Date Name and Tile of Officer(e.g.."Jane Doe,Notary Publiic') personally appeared ROM S.P$Ck,Pfesident Name(s)of Signer(s) /personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed �rf+a. MICHAEL ALLENAMUNDSON to the within instrument and acknowledged to me that �\ COMM.01483459 > he/she/they executed the same in his/her/their \r1:::.,1:1 NOTARY PUBLIC-CAUFORNIA authorized capacity(ies), and that by his/her/their LOS ANGELES COUNTY My carrrt.Etq.ApdI 13.2008 `' signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. :;:; Place Notary Seal Above " .14 4.00M7 Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: i❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): =1 Corporate Officer—Title(s): ❑ Partner—❑ Limited 0 General RIGHT THUMBPRINT ❑ Partner—❑ Limited ❑General RIGHT THUMBPRINT - OF SIGNER IJ Attorney in Fact SIGNER Top of thumb here 0 Attorney in Fact Top of thumb here ❑ Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: .-1 Other: Signer Is Representing: Signer Is Representing: C 2004 National Notary Association•9350 De Soto Ave..P.O.Box 2402•Chatsworth.CA 91313-2402 Item No.5907 Reorder.Call Toll-Free 1-800-876-6827 • CALIFORNIA ALL - PPOSE ACKNOWLEDGMEN State of California County of Orange On AUG 19 2005 before me, A.P. Coats, Notary Public NAME,TITLE OF OFFICER personally appeared Douglas A. Rapp NAME OF SIGNER(S) ® Personally known to me -or- Proved to me on the basis of satisfactory evidence to be the ❑ person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), f^�—, < AP COATS and that by his/her/their signature(s) on the instrument the �� COMM..•149&i4 or the entity upon behalf of which the person(s) u y NOTARraUBLICO.� MAA person(s), Y Po Pe ( ) n F�� / acted, executed the instrument. CO � � causer � `? My Term 6x0..hdy 2 F � WITNESS my ! . id id official -al. / (SIGNATURE OFNOTARY) 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. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL/OWNER ❑ CORPORATE OFFICER TITLE(S) TITLE OR TYPE OF DOCUMENT ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL NUMBER 01?PAGES ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) Chubb PO Federal Insurance Corn• - Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New Yodc corporation, and PACIFIC INDEMNITY COMPANY,a Wisconsin corporation,do each hereby constitute and appoint Douglas A. Rapp or Linda D. Coats of Laguna Hills, California each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory In the nature thereof(other than bail bonds)given or executed in the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 22nd day of January, 200 4 Xii,,Lrd‘hjetz../1 Kenneth C.Wendel,Assistant Secretary E.Robertson, STATE OF NEW JERSEY- ss. County of Somerset On Ids 2 2 ndiay a January, 2 0 04 ,before me,a Notary Public of New Jersey,personally came Kenneth C.Wendel,to me known to beAssistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMPS Y COMPANY,the companies which executed the foregoing Power of Attorney,and the said Kenneth C.Wendel being by me duly sworn,did depose and say that he IsAssistart Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY and knows the mrpante seals thereof,that the seals affixed to the foraging Power of Attorney are such c rporat esealsandweretheretoafibudbyaut ortyoftheBy;t.awsafsaidCommandt hathesigredsakiPowerofAttuneyasAssislartSecretaryofsaidCompanies by Ike aulhadty;and that he Is acquainted with Frank E.Robertson,and knows him to be Vice Prihsident of said Companies;and that the signature of Frank E.Robertson, subscribed to said Power of Attorney is In the genuine hardeeling of Frank E Robertson,and was thereto subscribed by autlrodly of said By-Laeo and in deponent's pre,semce. Nofada l Seal Karen A.rice •Rh, Mary Public State of New Jersey ra!t ' tiLeAtei o� ®� No.2231647 Notary Public 7.Extract r ;�. — of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,(Miter by the Chairman or the or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary,under their respective designatiorKor signature of such officers may be engraved,printed or lithographed. The signature of each of the following officers: Chairman.President,any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other wry obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY (the"Companies)do hereby certify that (I) the foregoing extract of the lay-Laws of the Companies is hue and correct, (n) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and am authorized by the U.S.Treasury Department further,Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands,and Federal is licensed In American Samoa,Guam,and each of the Provinces of Canada except Prince Edward Island and (it') the foregoing Power of Attorney is true,correct and In full force and effect. Given under my hand and seals of said Companies at Warren,NJ this 19th day of 2:)05 ,erni o 4-4.0"mv. \- �, x • .Z01,41.21:561,410 , /*out+►' *scot0 % aEty Yoaf- Kenneth C.Wendel,Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM,VERIFY THE AUTHENTICITY,OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS USTED ABOVE,OR BY Telephone(908)903-3485 Fax (908)903-3656 e-mail: surety @chubb.com Form 15-10.0225(Ed.4439)CONSENT • Bond No. 8195-81-37 Bond DE-bilEd 1' PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that WHEREAS the City of Seal Beach,has awarded to 1 ( a s, DE- 13546 Idal Highay Santa Fl? Springs, CA 90670 (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows:.Anima Pavement 1 ti.1i WHEREAS,Principal is required under the teams 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 RE112211 ]1 mn:e airPzeiY 801 Si. Figuatna Lcs Arrrg'les, @ 90017 (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 Six hunted fifty three thasar$two hunted rxinaty mmEn rn/100 Dollars($ 653,297.00 this amount being not less than fifty percent (50%)of the total contract price,in lawful money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,our heirs,executors,administrators,successors, and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,her or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 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 named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER,the Surety, for value received,hereby stipulates and agrees that no change,extension of time, alteration, addition or modification to the terms of the Contract,or of the work to be performed thereunder, or the specifications for the same,shall in any way affect its obligations under this bond,and it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to the terms of the 7 • 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: "Principal" "Surety" Seq�1 a••; ..,� Fba1 Insurarre arcreav � . �::a� n By: Y it S.Puts,P & By: •�'' . atep Its Its r • - A. Rapp aey 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. • 8 • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 3e",rcr..0c',oac<.E MMe<er..ercrr rat erc-rencC:cue'.c-'.Mee",crc rcrcr,GrceZe ecrcc c!here erc< .eer,xrtro: State of California County of LOS ANGELES SS. On AUG 19 2018 , before me, MICHAEL ALLEN AMUNDSON,NOT Date Name and Title of Officer(e.g..'Jane Doe,Notary Public") personally appeared TIMM S.Pack President Name(s)of Signer(s) /personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that MCHAELAI.LENAMUNDSON he/she/they executed the same in his/her/their eye �sT- COMM.#1483459 authorized capacity(ies), and that by his/her/their . ., I NOTARY PUBLIC-CALIFORNIA�p gic! , y$1r LOS ANGELS COUNTY N signature(s) on the instrument the person(s), or the 'cc)nm P. 2008"P"'13. entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Place Notary Seal Above i1°� m/ LV��'�---`• Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: 0 Individual Individual ❑ Corporate Officer—Title(s): 71 Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑Generai RIGHT THJMBPRINT _ Partner—❑ Limited n General RIGHT THUMBPRINT ❑ Attorney in Fact OF SIGNER Attorney Fact OF SIGNER - Top of thumb here y in Top of thumb here Trustee 0 Trustee O Guardian or Conservator ❑ Guardian or Conservator ❑ Other: 0 Other: Signer Is Representing: Signer Is Representing: o 2004 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth.CA 91313-2402 Item No.5907 Reorder.Call Toll-Free 1-800-876-6827 • • • CALIFORNIA ALL - PAPOSE ACKNOWLEDGMEN State of California, County of Orange On AUG 19 2005 before me, A.P. Coats, Notary Public NAME,TITLE OF OFFICER personally appeared Douglas A. Rapp NAME OF SIGNER(S) ® Personally known to me - or- Proved to me on the basis of satisfactory evidence to be the ❑ person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), A.P.COATS and that by his/her/their signature(s) on the instrument the m t COMM...1498145 m s • ,�-t=j4:�:�-, n pe rson O, or the entity upon behalf of which the person(s) U ,, 1'y,? NOTARYPiI (M-1 in .r./ ca= acted, executed the instrument MYT U.rL �} SS my • ' I and official seal. AggiLige (SIGNATURE OF NOTARY) 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. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL/OWNER ❑ CORPORATE OFFICER TITLES) TITLE OR TYPE OF DOCUMENT ❑ PARTNER(S) ❑ LnmrrED ❑ GENERAL NUMBER OF PAGES ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTTIY(IES) PO - Federal Insurance Camps Attn: Surety Department • , Chubb OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren,NJ 07059 Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Mane corporation,VIGILANT INSURANCE COMPANY,a New York corporation, and PACIFIC INDEMNITY COMPANY,a Wisconsin corporation,do each hereby constitute and appoint Douglas A. Rapp or Linda D. Coats of Laguna Hills, California each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and delver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory in the nature thereof(other than bail bonds)given or executed in the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. . In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 22nd day of January, 2004 - 41r79--a■ Kenneth C.Wendel,Assistant Se ryZ( E Robertson, - STATE OF NEW JERSEY 1 ss. County of Somerset On this 22 nd way of January, 2004 ,before me,a Notary Public of New Jersey,personally came Kenneth C.Wendel,to me known to beAssistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney,and the said Kenneth C.Wendel being by me duly swam,dd depose and say that he isAssistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney am such corporate seals and were thereto allbced by authority cithe Ely,-Laws d said Compardesx and that he signed said Power of Attorney asAssistant Secretary of said Companies by Ike authority;and that he is acquainted with Frank E.Robertson,and knows him to be Vice President of said Companies:and that the signature of Franic E Robertson, subsabed to said Power of Atomey Is In the genuine thandwrt(ng of Frank E.Robertson,and was thereto subscribed by authority of said By-Laws and in deponents presence. Notarial Seal Karen A.Price &Lei_•A.,C Notary Public State of New Jersey raft e_i. a cr Di�®� Iwo.2V$i647 Notary Public . �,�e .:w,_�•.�.;... 1 CATION Extract' !;''; -`,,;- of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: "Al .. _ • attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,either by the Chairman or the or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective�� signature of such officers may be engraved,printed or liitlographed. The signature of each of the folbwing officers: Chairman,President,any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certlicate relating thereto appointing Assistant Secretaries or Attorneys in-Fad for purposes only of executing and attesting bonds and undertakings and other writings obigatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be veld and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attaded." I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and.PACIFIC INDEMNITY COMPANY (the"Companies")do hereby certify that . (I) the foregoing extract of the By-Laws of the Companies is true and correct, ' (l) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and ate authorized by the U.S.Treasury Department;further,Federal and Vigilant are licensed In Puerto Rico and the U.S. Virgin Islands,and Federal is licensed in American Samoa,Guam,and each of the Provinces of Canada except Prince Edward Island;and (iii) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my hand and seals of said Companies at Warren,NJ this 19th day of kriust 23C6 w+� (e!i! �r \ .4.to • '^* ' 'A9c es -- !�' , �DIANt' �S ,soy a VCa�I Kenneth C.Wendel,Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM,VERIFY THE AUTHENTICITY,OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS USTED ABOVE,OR BY Telephone(908)903-3485 Fax (908)903-3656 e-mail: surety®chubb.com .Form 15.104225(Ed.449)CONSENT This*Woe pentad=to the diSowing Sandy Bond issued by a member lamer ofthe and*Group of Insurance Conquudes,Including Federal Insurance ma%Vigilant Insurance Coapanyand P Baud Mob= 8195-81-37 POLICYHOLDER DISCLOSURE NOTICE 1ERRORLSM RISK INSURANCE ACT OF 2002 You are hey notified that pursuant to the Terrorism Risk Insurance Act of 2002(tine "Act") effective November 26,2002,we are making available to you coverage kr losses arising out of ceitain acts of tonal tenvrism. Tenons' m is defined as any act certified by the Secretary of the Treasury, in concurrence with the Se<xelary of State and the Attorney General ofthe United States,to be an act often oris n to be a violent act or an act that is dangerous to human life, property or igfustructurg to have resulted in damage within the United States,or outside the United States in the case afan air artier or vessel or the premises ofa United States on;and to have been commixed by an individual or iadnnduals acting on behalf ofany£oreignpersonor£reign interest;as part of an effort to coerce the civfflan population of the United States or to influence the policy or affect the conduct of the United States Govt by coenaon. Coverage foc ads atomism is already included in the captioned Surety Bond. You should know that, effective November 26, 2002, any lasses caused by acts of terrorism covered by your Surety Bond will be partially reimbursed by the United States under the formula set forth in the Act Under this formula,the United States of America pays 90%of covered terrorism losses that exceed the statutorily estab hed de Leto be paid by the insurance company providing the owerage.The portion of your premimn that is ale to coverage for such acts of terrorism is zem, because we could not h(and separately charge for)acts of terrorism from other causes of loss when we calarlated your premium. Ifyou have any questions about this notice,please mold your agent or broker. i r ACbR CERTIFICA OF LIABILITY INSURA DATE(MMIDD/YYYY)E 08/25/2005 PRODUCER (949)559-6700 FAX (949)559-6703 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Garrett/Mosier Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 12 Truman Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Irvine, CA 92620 Sandi Ricard INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: St. Paul Fire & Marine Ins. INSURER B: Commerce & Industry Sequel Contractors, Inc. INSURER C: 13546 Imperial Highway INSURER D: Santa Fe Springs, CA 90670 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN( ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSRD DATE IMMIDD/YYI DATE(MMIDDIYYI GENERAL LIABILITY KC06100202 10/01/2004 10/01/2005 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100 000 PRFMISFS(Fa ecrurenna) CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5,000 A X $10,000 Dedt BI/PD PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 —I POLICY Fr jECOT- n LOC AUTOMOBILE UABILITY KC06100202 10/01/2004 10/01/2005 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) A X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) X $2,500 BI/PD Dedt. PROPERTY DAMAGE (Per accident) GARAGE UABIUTY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 7 OCCUR n CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ _ $ WORKERS COMPENSATION AND WC3284095 10/01/2004 10/01/2005 WC STATU- I 10TH- TORY LIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If SPECIAL yes,C AL descnbe ROM IOr E.L.DISEASE-POLICY LIMIT $ 1,000,000 SPECIAL PROlISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Job 356; FY05/06 Annual Paving Project (Phase I) City Job 50714. This certificate may be relied upon only if the description of operations attachment referred to herein is attached hereto. * 10 Day Notice of Cancellation in Event of Non-Payment of Premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL KAXIYMIEWO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Seal Beach City Hall KINX-X XXOPODWfaGXXOX IXKI XIXXe16XX U(d(ifi Xd XXXXXXIXKIXIX9(XX 211 Eighth Street i XiMAXI X*XXX#i4XXXX KKlfkD( K XA(KXXXXXXXXX Seal Beach, CA 90740-6379 AUTHORIZED REPRESENTATIVE John Garrett/DAR ✓,�G+ tY ACORD 25(2001/08) ©ACORD CORPORATION 1988 • s " IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s),authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) • • City of Seal Beach Certificate issued to City of Seal Beach 08/25/2005 Garrett/Mosier Insurance Services, Inc. 08/25/2005 RE: Job 356; FY05/06 Annual Paving Project (Phase I) City Job 50714. City of Seal Beach, along with its City Council and each member thereof, and every officer, official, agent, attorney, employee, or volunteer of the City are added as Additional Insured and this insurance is primary, per G0322 12/97 attached, with respect to work performed for them by Sequel Contractors, Inc. under General Liability coverage. As respects General Liability coverage, Severability of Interest clause is included per 47175 7/01. As respect to General Liability coverage, a Waiver of Subrogation is hereby included, per G0326 7/01 attached. As respect to Automobile Liability coverage, City of Seal Beach, along with its City Council and each member thereof, and every officer, official , agent, attorney, employee, or volunteer of the City are added as Additional Insured, per CA019 6/02 attached. As respect to Automobile Liability coverage, this insurance is primary, per coverage form 44449 12-93. • • COPY ADDITIONAL PROTECTED PERSONS ENDORSEMENT - CONTRACTORS �Stl'l�ul GENERAL LIABILITY - INCLUDING COMPLETED WORK This endorsement changes your Contractors Commercial General Liability Protection. How Coverage Is Changed architect, engineer, or surveyor professional services. There are two changes which are described Architect, engineer, or surveyor below. professional services includes: 1. The following is added to the Who Is • the preparation or approval of maps, Protected Under This Agreement section. drawings, opinions, reports, surveys, This change adds certain protected change orders, designs, or persons and limits their protection. specification; and • supervisory, inspection, or engineering Additional protected person. The person or services. organization named below is an additional protected person as required 2. The following is added to the Other by a contract or agreement entered into primary insurance section. This change by you. But only for covered injury or broadens coverage. damage arising out of: • your work for that person or We'll consider this insurance to be organization; primary to and non-contributory with the • your completed work for that person insurance issued directly to additional or organization if your contract or protected persons listed below if: agreement requires such coverage;, • your contract specifically requires that • premises you own, rent, or lease from we consider this insurance to be that person or organization; or primary or primary and non- contributory; or • your maintenance, operation, or use of • you request before a loss that we equipment leased from that person or consider this insurance to be primary organization. or primary and non-contributory insurance. We explain what we mean by your work and your completed work in the Products and completed work total limit section. Other Terms If the additional protected person is an All other terms of your policy remain the architect, engineer, or surveyor, we won't same. cover injury or damage arising out of the performance or failure to perform Person Or Organization: Any person or organization you are required in a written contract to show as an additional protected person. Name of Insured Policy Number KC06100202 Effective Date 10/01/04 SEQUEL CONTRACTORS, INC. Processing Date 10/20/04 16:24 001 G0322 Rev. 12-97 Printed in U.S.A. Endorsement ®St.Paul Fire and Marine Insurance Co.1997 All Rights Reserved Page 1 of 2 • The StpduI Page 2 of 2 ©St.Paul Fire and Marine Insurance Co.1997 All Rights Reserved CONTRACTORS RECOVERING O....+AGES FROM A lonnOtri THIRD PARTY ENDORSEMENT This endorsement changes your General Rules: s. Now Coverage Is Changed recovery and fail to do so, we'll pay all of the expenses we incur in bringing such The following replaces the Recovering action. Damages From A Third Party section. Waiver of.rights of recovery. We waive any Recovering Damages From A Third Party right of recovery we may have against any person or organization that you agree in a Any protected person under this policy may written contract to waive. be able to recover all or part of a loss •But we'll waive such a right of recovery from someone other than us. Because of only for the payments we make under your this, each protected person must do all Contractors Commercial General Liability that's possible after a loss to preserve any Protection for covered bodily injury or • right of recovery available. property damage or medical expenses that If we make a payment under this policy that result from: right of recovery will belong to us. But we • Your ownership. maintenance, Or use of a will not have this right of recovery against premises that you rent, lease, or borrow any: from others, or own; or • parent company, or owned or controlled • your products, your work, or•your subsidiary of yours; or completed work. • affiliated company over which you have management control. We also waive any right of recovery we may have against any person or organization We will work with you or any protected that you agree in a written contract to • person in the exercise of our right of waive for any payment we Make under your Contractors Commercial General Liability recovery. If we recover any amount as a Pont result of exercising such right, the amount Protection for. will be divided as follows: • covered personal injury; or • covered advertising injury. 1. Any protected person or other insurer who paid amounts in excess of the. limits The written contract that requires this waiver of coverage that apply under this policy of right of recovery must be made before will be reimbursed for the actual amount and be in effect when: paid. • the bodily injury or property damage 2. Next, we'll be reimbursed for any happens; or payments we've actually made. • the event that causes the bodily injury resulting in the medical expenses happens; 3. Then, if any amount remains, any or protected person or other insurer who • the personal injury offense or- advertising paid amounts before the limits of injury offense is committed. • coverage for this policy applied will be reimbursed for the actual amount paid. We explain the terms your products, your work, and your completed work in the Recovery expenses. The expenses incurred in Products and completed work total limit obtaining a recovery of any payment we section. make under this policy from someone other than us wilt be divided in the same ratio as Terms that recovery is shared. However, if we bring legal action against someone else to • recover losses on our own or try to obtain All other terms of your policy remain the same. G0326 Rev. 7-01 Printed in U.S.A. Endorsement eSt.Paul Fire and Marine Insurance 2001 A I eserved • Sequel Contractors, inc. Policy #: KCl6100104 iWurius- • • • ADDITIONAL INSURED ENDORSEMENT — COMMERCIAL AUTO 'n1eStFAul This endorsement changes your Auto Liability Protection. How Coverage is Changed • Anyone who drives a covered auto with your permission or with the permission The following is added to the Who is of one of your employees or agents. Protected Under This Agreement section of your Auto Liability Protection. This But, the person or organization named change broadens coverage. below is not a protected person if they are the owner of or anyone else from The person or organization named whom you rented, leased, hired or below, for whom you are doing work, borrowed that covered auto. is protected. But only for bodily injury or property damage that results from the ownership, maintenance, use, loading Other Terms or unloading of a covered auto by: • You All other terms of your policy remain the same. • An employee of yours; or Person or Organization: • Any person or organization you are required in a written contract to show as an additional protected person. • Name of Insured Policy Number KC06100202 Effective Date 10/01/2004 Sequel Contractors,Inc. Processing Date 10/01/2004 CA019 Rev. 6-02 Printed in U.S.A. Endorsement ©St.Paul Fire and Marine Insurance Co. 2002 All Rights Reserved Page 1 of 1 DATE'ACORD CERTIFICATE OF LIABILITY INSURAISE 09/30/2005) PRODUCER (949)559-6700 FAX (9, 559-6703 THIS CERTIFICATE ISTSUED AS A MATTER OF INFORMATION Garrett/Mosier Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 12 Truman HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Irvine, CA 92620 Sandi Ri card INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Property Casualty INSURER B• Sequel Contractors, Inc. INSURER C" 13546 Imperial Hwy. INSURER D: Santa Fe Springs, CA 90670 INSURERE COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDINI ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRD DATE IMM/DD/YYI DATE(MM/DDIYYI GENERAL LIABILITY DTECOO819C794TILO5 10/01/2005 10/01/2006 EACH OCCURRENCE _ $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 PRFMISFS(FA orrurpnra) CLAIMS MADE X OCCUR MED EXP(Arty one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 —I POLICY n ECT n LOC AUTOMOBILE LIABILITY DT8100819C794TIL05 10/01/2005 10/01/2006 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) A X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ —I OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ _ $ WORKERS COMPENSATION AND TORY Y LIMITS R EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E L DISEASE-EA EMPLOYEE $ If yes,describe under _SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: 356; FY05/06 Annual Paving Project (Phase I) City Job 50714. This certificate may be relied upon only if the description of operations attachment referred to herein is attached hereto. r° 10 Day Notice of Cancellation in Event of Non-Payment of Premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL IX MAIL City of Seal Beach 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: Andy Dasilva XkXdfdfd 6XIXX (#XXIXOS )614Xal XKXIXfIXXX 211 Eighth Street KKAH i (AMX XXX'XXXI DEXXXXI0W31XXXDX1LXXXXXXXXX Seal Beach, CA 90740-6379 AUTHORIZED REPRESENTATIVE 1 John Garrett/DAR ACORD 25(2001/08) ©ACORD CORPORATION 1988 • • IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) City of Seal Beach • Certificate issued to City of Seal Beach 09/30/2005 Garrett/Mosier Insurance Services, Inc. 09/30/2005 RE: 356; FY05/06 Annual Paving Project (Phase I) City Job 50714. City of Seal Beach, along with its City Council and each member thereof, and every officer, official , agent, attorney, employee, or volunteer of the City are added as Additional Insured and this insurance is primary, per CGD2481002 attached, with respect to work performed for them by Sequel Contractors, Inc. under General Liability coverage. As respect to General Liability coverage, a Waiver of Subrogation is hereby included, per CGD3160704 attached. As respects General Liability coverage, Severability of Interest clause is included per CG00011001. As respect to Automobile Liability coverage, City of Seal Beach along with its City Council and each member thereof, and every officer, official , agent, attorney, employee, or volunteer of the City are added as Additional Insured, per CA20480299 attached. As respect to Automobile Liability coverage, this insurance is primary, per coverage form CA0010104 . • • Page 1 of 2 Insured: Sequel Contractors,Inc. CG D2 48 10 02 Policy No.: DTEC00819C794TIL05 Effective: 10/01/05-06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS OPERATIONS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY—CONTRACTORS COVERAGE PART 1. WHO IS AN INSURED—(Section II) is amended to include any person or organization you are required to include as an additional insured on this policy by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The person or organization is only an additional insured with ' respect to liability caused by"your work"for that additional insured. 2.The insurance provided to the additional insured is limited as follows: a) In the event that the limits of liability stated in the policy exceed the limits of liability required by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought, this endorsement shall be limited to the limits of liability required by such contract or agreement. This endorsement shall not increase the limits stated in Section III—LIMITS OF INSURANCE. b) The insurance provided to the additional insured does not apply to "bodily injury", "property damage", "personal injury" or "advertising injury" arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: I. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,field orders, change orders, or drawings and specifications; and II. Supervisory or inspection activities performed as part of any related architectural or engineering activities. c) This insurance does not apply to "bodily injury" or "property damage" caused by "your work" included in the"products-completed operations hazard". 3. Subpart (1)(a) of the Pollution exclusion under Paragraph 2., Exclusions of Bodily Injury and Property Damage Liability Coverage (Section I —Coverages) does not apply to you if the "bodily injury"or"property damage" arises out of "your work" performed on premises which are owned or rented by the additional insured at the time"your work" is performed. 4.Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought specifically requires that this insurance apply on a primary or non-contributory basis. When this insurance is primary and there is other insurance available to the additional insured from any source, we will share with that other insurance by the method described in the policy. 5.As a condition of coverage, each additional insured must: • • Page 2 of 2 a.) Give us prompt written notice of any "occurrence" or offense which may result in a claim and prompt written notice of"suit". b.) Immediately forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with policy conditions. c.) Tender the defense and indemnity of any claim or"suit" to any other insurer which also insures against a loss we cover under this endorsement. This includes, but is not limited to, any insurer which has issued a policy of insurance in which the additional insured qualifies as an insured. For purposes of this requirement, the term "insures against" refers to any self-insurance and to any insurer which issued a policy of insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer provide the additional insured with a defense and/or indemnity under that policy of insurance. d.) Agree to make available any other insurance that the additional insured has for a loss we cover under this endorsement. CG D2 48 10 02 ©2004 The St.Paul Travelers Companies.Inc. http://eforms.travel ers.com/NXT/gateway.dll/fssforms 1/general%20liability/cgd2481002.h... 9/30/2005 • • COMMERCIAL GENERAL LIABILITY Insured: Sequel Contractors,Inc. Policy No.: DTECO0819C794TIL05 Effective: 10101105-06 2. This insurance does not apply to damage to 5. This Provision B. does not apply if coverage premises while rented to you, or temporarily for Damage To Premises Rented To You of occupied by you with permission of the COVERAGE A. BODILY INJURY AND owner, caused by: PROPERTY DAMAGE LIABILITY(Section I– a. Rupture, bursting, or operation of pres- Coverages) is excluded by endorsement. sure relief devices; C. BLANKET WAIVER OF SUBROGATION b. Rupture or bursting due to expansion or We waive any right of recovery we may have swelling of the contents of any building or against any person or organization because of structure, caused by or resulting from wa- payments we make for injury or damage arising ter; out of: premises owned or occupied by or rented c. Explosion of steam boilers, steam pipes, or loaned to you; ongoing operations performed steam engines, or steam turbines. by you or on your behalf, done under a contract with that person or organization; "your work"; or 3. Paragraph 6. of LIMITS OF INSURANCE "your products". We waive this right where you (Section III) is deleted and replaced by the have agreed to do so as part of a written contract, following: executed by you before the "bodily injury" or Subject to 5. above, the Damage To Prem- "property damage" occurs or the "personal injury" ises Rented To You Limit is the most we will or"advertising injury"offense is committed. — pay under COVERAGE A. for the sum of all D. BLANKET ADDITIONAL INSURED – MANAG- damages because of "property damage" to ERS OR LESSORS OF PREMISES any one premises while rented to you, or temporarily occupied by you with permission WHO IS AN INSURED (Section II) is amended to of the owner, caused by: fire; explosion; light- include as an insured any person or organization Wing; smoke resulting from such fire, explo- (referred to below as "additional insured") with . sion, or lightning; or water. The Damage To whom you have agreed in a written contract, exe- Premises Rented To You Limit will apply to all cuted before the "bodily injury" or"property dam- "property damage" proximately caused by the age" occurs or the "personal injury" or "adverbs- -- ing injury" offense is committed, to name as an same "occurrence",, whether such damage results from: fire; explosion; lightning; smoke additional insured, but only with respect to liability resulting from such fire, explosion, or light- arising out of the ownership, maintenance or use .. ning; or water; or any combination of any of of that part of any premises leased to you, subject =MEMO these causes. to the following provisions: The Damage To Premises Rented To You 1. Limits of Insurance. The limits of insurance Limit will be the higher of: afforded to the additional insured shall be the limits which you agreed to provide in the writ- = a. $300,000; or ten contract, or the limits shown on the Decla- b. The amount shown on the Declarations rations, whichever are less. for Damage To Premises Rented To You 2. The insurance afforded to the additional in- Limit. sured does not apply to: 4. Paragraph a. of the definition of"insured con- a. Any "bodily injury" or "property damage" tract" (DEFINITIONS – Section V) is deleted that occurs, or"personal injury"or"adver- and replaced by the following: tising injury" caused by an offense which a°_ a. A contract for a lease of premises. How- is committed, after you cease to be a ten- ever, that portion of the contract for a ant in that premises; lease of premises that indemnifies any b. Any premises for which coverage is ex- person or organization for damage to eluded by endorsement; or premises while rented to you, or tempo- --_ rarily occupied by you with permission of c. Structural alterations, new construction or the owner, caused by: fire; explosion; demolition operations performed by or on lightning; smoke resulting from such fire, behalf of such additional insured. explosion, or lightning; or water, is not an 3. The insurance afforded to the additional in- "insured contract"; sured is excess over any valid and collectible Page 2 of 6 Copyright, The Travelers Indemnity Company, 2004 CG D3 16 07 04 Sequel Contractors,Inc. Effective: 10/01/05-06 COMMERCIAL AUTO POLICY NUMBER:DT8100819C794TIL05 ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name of Person(s)or Organization(s): (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured"for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1