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HomeMy WebLinkAboutAGMT - Sequel Contractors (05/06 Paving Rehab, Phase II) • • J • ` Recorded in Official Records, Orange County RECORDING REQUESTED BY III11 lll 1 1111 1 1111 11111 11111111 1111 11111 111 11 11111 111IIIIIIIIIIIIIII NO FEE AND WHEN RECORDED MAIL TO 2006000645400 08:17am 09/28/06 213 160 N12 1 CITY OF SEAL BEACH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Attn: City Clerk 211 8th Street Seal Beach, CA 90740 Space of above this line for Recorder's use. ***No Recording Fee Pursuant to Government Code Section 6103,27383 **** NOTICE OF COMPLETION Notice pursuant to Civil Code Section 3093,must be filed within 10 days after completion. Notice is hereby given that: 1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property 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 City of Seal Beach. .• 5. A work of improvement on the property hereinafter is described as substantially completed on August + t 11,2006.The work was: Annual Paving Rehabilitation FY 05/06(Phase Two)Project 50174. 6. The name of the contractor, if any, for such improvement was: Sequel Contractors, Inc.. The date of the Contract was: December 12,2005. 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 FY 05/06 (Phase Two)Project 50174. Date: Cr/g/06, _ AP. igna' re of owner or corporat- i fficer of owner named in paragraph 2 or his ye t. 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 SQjj7QIe/ / Z ,2006,at Seal Beach,California. (bate of Signature) Director of Public Works 'I 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 Phase Two For the following project named A nil K A.( 94 v a :l a-+'ian tcy of% ,in the City of Seal Beach. /PA s Se ") THIS AGREEMENT, made and entered into this 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 CONTRAOTOM o hereinafter designated as the"CONTRACTOR,"Party of the Second Part. WITNESSETH: That the Parties do hereto mutually agree as follows: • ARTICLE I. For and in consideration of the payments and agreements hereinafter mentioned to be made and performed by said CITY,the CONTRACTOR agrees with said CITY to perform and complete in a good and workmanlike manner all the work pertaining thereto shown on the drawings and described in the Specifications and Contract Documents, therefore, to furnish at his own proper cost and expense all tools, equipment, labor and materials necessary therefore (except those materials expressly noted as to be furnished by the CITY), and to do everything required by this Agreement and the said Specifications, Drawings,and Contract Documents. ARTICLE II. For furnishing all said materials and labor, furnishing and removing all plant, temporary works or structures, tools and equipment and doing all the work contemplated and embraced in this Agreement, also for all loss and damage arising out of the nature of the work aforesaid, or from the action of the elements, or from any unforeseen difficulties which may arise or be encountered in the prosecution of the work until its acceptance by said CITY, and for all risks of every description connected with the work; also for all expenses incurred by or in consequence of the suspension or discontinuance of work; except such as in the said Specifications are expressly stipulated to be borne by the said CITY and faithfully completing the work and the whole thereof, in the manner shown and described in the said Drawings, Specifications, and Contract Documents and in accordance with the requirements of the Engineer, said CITY will pay and the CONTRACTOR shall receive in full compensation, therefore, the unit prices and the lump sum prices named in the Schedule of Work Items of the Proposal. ARTICLE III. The CITY hereby promises and agrees with said CONTRACTOR to employ and does hereby employ said CONTRACTOR to provide the materials and to do the work according to the terms and conditions herein contained and referred to for the price aforesaid,and hereby contracts to pay the same, at the time,in the manner and upon the conditions set forth in the Specifications and Contract Documents,and the said parties for themselves, their heirs, executors, administrators, successors and assigns, do hereby agree to the full performance of the covenants herein contained. ARTICLE IV. The advertisement for Bids,the Proposal,the Specifications, and the Drawings mentioned therein, and all addenda issued by the CITY with respect to the foregoing prior to the opening of bids, are hereby incorporated in and made a part of this Agreement. ARTICLE V. The statement of prevailing wages appearing in the General Prevailing Wage Rates is hereby specifically referred to and by this reference is made a part of this contract. It is further expressly agreed by and between the parties hereto that should there be any conflict between the terms of this instrument and the bid of proposal of said CONTRACTOR,then this instrument shall control and nothing herein shall be considered as an acceptance of the said terms of said proposal conflicting herewith. ARTICLE VI. By my signature hereunder,as CONTRACTOR,I certify that I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for 3 0 • 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 f lACH,CAL�'i'• . Party of � art //054 , BY iii City Man j' A ST: / - (, i Clerk 4/,?1A , • •• ' -C O' -Party o i'e Second Part Thomas S. Pack, President Title 13546 IMPERIAL HWVY. SANTA FE SPRINGS. CALIF. 90670 Address • 4 • • • Bond No. 8203-73-58 Bond per= $5,504.00 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach,has awarded Sequel Contractors, Inc. 13546 Imperia]. Highway Santa Fe Springs, CA 90670 (Name and address of Contractor) ("Principal''),a contract(the"Contract")for the work described as follows: Annual Paving Rehabilitation FY 05/06 (Phase Two) WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW,THEREFORE,we,the undersigned Principal,and Federal Insurance Company 15 Mountain View Rd. Warren, NJ 07059 (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California,as Surety,are held and . firmly bound unto the Public Agency in the penal sum of Nine hundred seventeen thousand three hundred twenty nine and 50/100 Dollars ($ 917,329.50 ), 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 hue intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and others as therein provided,then this obligation shall become mill and void;otherwise,it shall be and remain in full force and effect. In case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount 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 her+eot; 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 representatives)pursuant to authority of its governing body. Dated:March 22, 2006 "Principal" "Surety" • .- Cal n • Inc. Feral Insurance y B B . % lir!r ^ By: . ‘N\ck,o..� "'T ack, President Its Linda D. Coats Attorney in Fact By: •ItS '� � 'rr 111.5)1 ;`,� f_Y i"fi r" 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.�.�c.�re�.�r..cci�r-. .cr.�.cccr.�.crcr.�r.�c.�•cc..�.cr..crcc.�ccccc cep.�.cccr..�.�ccr.�.ic-.�r�rc�:.cccccrccc�.o; State of California County of LOS ANGELES ss. On MAR 2 ? 2006 , before me, Daniel Bustamante,Notary Public Date Name and Title of Officer(e.g.,"Jane Doe,Notary Public") personally appeared Thomas S. Pack. President Name(s)of Signer(s) MIpHAEL A.FOWLER.ASS T SECRETARY EIpersonally 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 Z • DANIEL BUSTAMANTE he/she/they executed the same in his/her/their N - COMM.#1537133 !... NOTARY n PUBLIC-CALIFORNIA C y authorized capacity(ies), and that by his/her/their c'' M N signature(s) on the instrument the person(s), or the Exp Dec,20.2008 entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and fficial seal. Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General RIGHT THUMBPRINT ❑ Partner—❑ Limited ❑General RIGHT THUMBPRINT ❑ Attorney in Fact OF SIGNER ❑ Attorney in Fact OF SIGNER orne Top of thumb here y Top of thumb here ❑ Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: ' cee;�e�e^ee:��ee^�GGeici; `Le�eTee ^�v^ce: rG^cG�e:�e�Ge.^t"e.e�Cr_G^c_e o ®2004 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402 Item No.5907 Reorder.Call Toll-Free 1-800876-6827 • CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Orange On MAR 2 2 106 before me, Christine M. Rapp, Notary Public NAME,TITLE OF OFFICER personally appeared Linda D. Coats 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), and that by his/her/their signature(s) on the instrument the µoR► CHRISTINE M.RAPP N e ,Ali ti COMM.#1494518 70 person(s), or the entity upon behalf of which the person(s) . A NOTARY PUBLIC.CALIFORNIA acted, executed the instrument. ORANGE COUNTY My Comm.Expires JULY 9, 2009 1-- — T- �- WI SS my hand and official seal. . R (SIGNATURE OF NOTARY) OPTIONAL U 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 El CORPORATE OFFICER TITLE(S) TITLE OR TYPE OF DOCUMENT ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL NUMBER OF PAGES ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) ' C Chubb 1 ER Federal Insurance Co :ny Attn: Surety Department Sure OF Vigilant Insurance Company 15 Mountain View Road tY ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana 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 afteration 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 2 2nd day of January, 2004 /Z.v,f_y 441'X.Lx,z_Ze(e A.1.44P 2 ^-'154-e't jlr7,---a----') Kenneth C.Wendel,Assistant Secretary ran E.Robertson, STATE OF NEW JERSEY ss. • County of Somerset On finis 2 2 nab),of January, 2 0 0 4 ,before me,a Notary Public of New Jersey,personally came Kenneth C.Wendel,to me known to be Assistant 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 sworn,did depose and say that he is Assistant 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 are such corporate seals and were thereto affixed by authority of the By-Laws of said Companies;and that he signed said Power of Attorney as Assistant Secretary of said Companies • by like 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 Frank E.Robertson, subscribed to said Power of Attorney is in the genuine handwriting of Frank E.Robertson,and was thereto subscribed by authority of said By-Laws and In deponent's presence. Notarial Seal Karen A.Price - p. PR;,F Notary Public State of New Jersey • a RY No. 2231647 pJ A �� Lve_e_.t 0-cr.o •›- Notary Public )0‘ (•1.......r,:).1.:. 1,,.CERTIFICATION Extract', •'' .,, s, y. of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: 'All po = • 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 President or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective designations. The 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 writings 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 () the foregoing extract of the By-Laws of the Companies is true and correct, (ii) 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 are 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 22nd clay of March 2006 • 4`tIRAN. �o41LM11I o ,s6,1 e O , #!: •j , � �•�otAtaP t ** ....0 + 'yak-. .��1 FwYD 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 LISTED ABOVE, OR BY Telephone(908)903-3485 Fax (908) 903-3656 e-mail: surety @chubb.com Form 15-10.0225(Ed.4-99)CONSENT • • Bond No. 8203-73-58 Bond Premium Included PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Seal Beach,has awarded to Sequel Contractors, Inc. 13546 Imperial Highway Santa Fe Springs, CA 90670 (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows:Annual Paving Rehabilitation FY 05/06 (Phase Two) 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 Federal Insurance Company 15 Mountain View Rd. Warren, NJ 07059 (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 Four hundred fifty eight thousand six hundred sixty_four and 75/100 Dollars($_ 458,664.75 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 proposes be deemed an original hereof;have been duly executed by Principal and Suety,on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: March 22, 2006 "Principal" "Surety" Sequel Con ran. ., , Inc. Federal Insurance Company //BY:—C24 -21:9-sip,, Its Linda D. Coats By: y: Attorney in Fact t1f,CHAELA.MAHLER,ASST.SECRETARY 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. • s • • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT f'd,rlcY`•c^r.�:r.�.s-�r.�-c�.ctcrcrorcr.�:r<-rc�i^.�`.cr•.cccC•,c-�C�.cCcc`-.cc•ceivc�cC�,c-s..cccc'.crcC.c�.c-'reccFcccccccec�.i~C-.crc�: State of California ss. County of LOS ANGELES On MAR 2 2 1006 , before me, Daniel Bustamante,Notary Public Date Name and Title of Officer(e.g.,"Jane Doe.Notary Public') personally appeared Thomas S. Pack, President Name(s)of Signer(s) MICHAEL A.MAKER o A�pP1 L p rsonally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed DANIEL BUSTAMANTE to the within instrument and acknowledged to me that COMM.#1537133 he/she/they executed the same in his/her/their i.. ...451 NOTARY PUBLIC-CALIFORNIA Al authorized ca ty(' ) by Q . >r LOS ANGELES COUNTY N paci ies , and that b his/her/their My Comm Exp Dec to 2tKlP 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 11236' Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General RIGHT THUMBPRINT ❑ Partner—❑ Limited ❑ General RIGHT THUMBPRINT ❑ Attorney in Fact DESIGNER ❑ Attorne in Fact OF `: Top of thumb here y Top of thumb here ❑ Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: cc4c cr 0000c004• : :�c^ . c_c�C 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 • • CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Orange On VAR 22 2111 before me, Christine M. Rapp, Notary Public NAME,TITLE OF OFFICER personally appeared Linda D. Coats 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), and that by his/her/their signature(s) on the instrument the •►,, CHRISTINE M.RAPP person(s), or the entity upon behalf of which the person(s) "�, �r Comm.#1494518 �o acted, executed the instrument. r : :i NOTARY PUBLIC•CALIFORNIA ORANGE COUNTY c,�6�.- My Comm Expires JULY 9, 2008 WITNESS my hand and official seal. . ill (SIGNATU FNOTARY) OPTIONAL U 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 OF PAGES ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) . licChubb IOIVER Federal Insurance Corny Attn: Surety Department Sure OF Vigilant Insurance Company 15 Mountain View Road tY ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana 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-Fad 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 ban 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 . ifr Kenneth C.Wendel,Assistant Secretary ��� E.Robertson, p STATE OF NEW JERSEY-} ss • County of Somerset On this 22 nd lay of January, 2 0 0 4 ,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 sworn,did depose and say that he Is Assistant 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 are such corporate seals and were thereto affixed by authority of the Br-Laws of said Companies;and that he signed said Power of Attorney as Assistant Secretary of said Companies by like 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 Frank E.Robertson, subscribed to said Power of Attorney Is In the genuine handwriting of Frank E.Robertson,and was thereto subscribed by authority of said By-Laws and In deponent's presence. Notarial Seal Karen A.Price • F. •Ric Notary Public State of New Jersey rCU Lat .� CAte � CRY loo. 2231647 O o Notary Public . or . .--'-e;-., "' •a .3k- c 41 ;,,...I:..•, :; .CERTFICATION Fxirace 1 .f;;,r= .'-- of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: "Ali power Df 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 President or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective designations. The 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 writings 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 n the foregoing extract of the By-Laws of the Companies is true and correct, (ii) 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 are 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 22nd day of March 2006 • U O —C� F� q IAo O 4, 6 sV 4. W ,, .I.'., k ;O j l i 9 lb _ * -__,._—,-#•• e/ .�� �*vAN ',MOO * � 4'oa 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 LISTED ABOVE, OR BY Telephone(908)903-3485 Fax (908)903-3656 e-mail: surety @chubb.com Form 1510-0225(Ed 4-99)CONSENT . • INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTION TITLE OF PROJECT OR WORK: A n n u a l Pay i n 2c l a j;-�a nn Y o Shod Indemnitor(s)(list all names): SEQUEL CONTRACTORS, INC 13546 3urrtu Fe S -in ngaCA90670 To the fullest extent permitted by law, Indemnitor hereby agrees, at its sole cost and expense, to defend, protect, indemnify, and hold harmless the City of Seal Beach and its elected officials, officers, attorneys, agents, employees, volunteers, successors, and assigns (collectively"Indemnitees") from and against any and all damages, costs, expenses, liabilities, claims, demands, causes of action, proceedings, expenses, judgments,penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys, or other professionals and all costs associated therewith (collectively "Liabilities"), arising or claimed to arise, directly or indirectly, out of, in connection with, resulting from, or related to any act, failure to act, error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors, materialmen, suppliers or their officers,agents, servants or employees,arising or claimed to arise, directly or indirectly, out of, in connection with, resulting from, or related to the above-referenced contract, agreement, license, or permit (the "Agreement") or the performance or failure to perform any term, provision, covenant, or condition of the Agreement, including this indemnity provision. This indemnity provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. This indemnity provision shall survive the termination of the Agreement and is in addition to any other rights or remedies which Indemnitees may have under the law. Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. Indemnitor shall pay Indemnitees for any attorneys fees and costs incurred in enforcing this indemnification provision. Notwithstanding the foregoing,nothing in this instrument shall be construed to encompass(a)Indemnitees'sole negligence or willful misconduct to the limited extent that the underlying Agreement is subject to Civil Code§2782(a)or(b)the contracting public agency's active negligence to the limited extent that the underlying Agreement is subject to Civil Code § 2782(b). This indemnity is effective without reference to the existence or applicability of any insurance coverage which may have been required under the Agreement or any additional insured endorsements which may extend to Indemnitees. Indemnitor,on behalf of itself and all parties claiming under or through it,hereby waives all rights of subrogation and contribution against the Indemnitees,while acting within the scope of their duties, from all claims,losses and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor regardless of any prior,concurrent, or subsequent active or passive negligence by the Indemnitees. In the event there is more than one person or entity named in the Agreement as an Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint and several. "Indemnitor" N. SE CONY= RS, IN_ . Name: SEQ _ CO . ORS, I .C. BY: /Mi./fr./71% B • %I: ��i�� I t s '. ' '�' 'ack, Pres .en4 ;(y ;;%i`_tr l: ' T.REGREW 9 0 • 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 r h require every employer to be insured against liability for worker's compensation or to undertake se • urance in accordance with the provisions of that code,and I will comply with such provisions befor- . mencing the per •• :.nce of the work of this contract." Date MAR 2 2 Signature 4 J AA1 ho -, rest•enf 10 • • STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business&Professions Code§ 7028.15] [Public Contract Code§20103.5] I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the entity on whose behalf this certification is given,hold a currently valid California contractor's license as set forth below(required at time of award) : Business&Professions Code§ 7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefor, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section, the court shall impose a fine of 20 percent of the 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 contractor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision of law,unless one of the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal,and fmality of such citations shall be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any purchase order issued to,a contractor who is not licensed pursuant to this chapter is void. (f) Any compliance or noncompliance with subdivision (e) of this section, as added by Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect. (g) A public employee or officer shall not be subject to a citation pursuant to this section if the public employee, officer, or employing agency made an inquiry to the board for the purposes of 11 0 • 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 not limited to,any appropriate disciplinary action by the Contractors'State License Board. The agency shall include a statement to that effect in the standard form of pre-qualification questionnaire and fmancial 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 t e bidder. License no.: 610600A Class: ; Exp'y• •ate: Ja uary 31, 2007 Date MAR 2 2 !006 Sign _d7Ai: '� • 12 • • INSURANCE REQUIREMENTS The Contractor shall at all times during the terms of the Contract carry,maintain,and keep in full force and effect a policy or policies of comprehensive general liability insurance in which the City, along with its City Council and each member thereof, and every officer, official, agent, attorney, employee or volunteer of the City, is the named insured or is named as an additional insured with the Contractor in accordance with the General Provisions. The insurance company issuing such policy(ies) must be acceptable to, and approved by, the City Engineer and City Attorney. Contractor shall maintain limits of no less than One Million Dollars($1,000,000)combined single limit coverage per occurrence for personal injury or death or property loss or damage which may arise from or relate directly or indirectly to the acts, operations or omissions of the performance of the Contractor and/or its subcontractors and/or the employees, agents, officers,officials or volunteers of either,in the performance of this Public Works Contract. Such insurance shall include coverage for all automobiles utilized by Contractor's or any subcontractor's employees or agents in the performance of the Contract. Contractor shall also provide an endorsement in the forms included in Book II. • 13 0 • Page Intentionally Left Blank 14 • • WORKER'S COMPENSATION CERTIFICATE OF INSURANCE WHEREAS,the CITY OF SEAL BEACH has required certain insurance to be provided by NOW THEREFORE,the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insureds and that the same are in force at this time. 1. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL BEACH, CA 90740-6379. 2. The insureds under such policy or policies are: 3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of California covering all operations of the named insureds,as follows: POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability, unless and until thirty days' advance written notice thereof has been served upon the City Clerk of the CITY OF SEAL BEACH. By: Its Authorized Representative 15 0 • ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY Name and address of named insured("Named Insured"): Name and address of Insurance Company("Company"): OFFICIAL TITLE OF PROJECT: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the"Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows: 1. The City of.Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third-party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s) or permit(s) designated above,between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereof. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against'in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent,or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction,interpretation,and enforcement of this contract of insurance. 16 • • 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: Director of Public Works City of Seal Beach 211 8th Street,2nd Floor Seal Beach CA 90740 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: ❑ Contractual Liability ❑ Explosion Hazard ❑ Owners/Landlords/Tenants ❑ Collapse Hazard ❑ Manufacturers/Contractors ❑ Underground Property Damage ❑ Products/Completed Operations ❑ Pollution Liability ❑ Broad Form Property Damage ❑ Liquor Liability ❑ Extended Bodily Injury ❑ ❑ Broad Form Comprehensive ❑ ❑ General Liability Endorsement 12. A ❑ deductible or ❑ self-insured retention (check one) of $ applies to all coverage(s)except: (if none, so state). The deductible is applicable ❑ per claim or ❑ per occurrence (check one). 13. This is an ❑ occurrence or❑ claims made policy(check one). 14. This endorsement is effective on at 12:01 A.M.and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20 Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( ) 17 a a ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Name and address of named insured("Named Insured"): Name and address of Insurance Company("Company"): OFFFICAL TITLE OF PROJECT: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows: The City of Seal Beach,its elected officials,officers,attorneys,agents,employees,and volunteers are additional insureds(the above named additional insureds are hereafter referred to as the"Additional Insureds")under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 1. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 2. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 3. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third-party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 4. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained or executed in conjunction with the written agreement(s)or permits)designated above,between the Named Insured and the Additional Insureds. 5. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits(except as the result of the payment of claims), or non-renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 6. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation,and enforcement of this contract of insurance. This endorsement and all notices given hereunder shall be sent to Public Agency at: Director of Public Works City of Seal Beach 211 8th Street,2"d Floor Seal Beach CA 90740 7. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. 18 • I TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: ❑ Any Automobiles ❑ Truckers Coverage ❑ All Owned Automobiles ❑ Motor Carrier Act ❑ Non-owned Automobiles ❑ Bus Regulatory Reform Act ❑ Hired Automobiles ❑ Public Livery Coverage ❑ Scheduled Automobiles ❑ ❑ Garage Coverage ❑ 11. A ❑ deductible or ❑ self-insured retention (check one) of $ applies to all coverage(s)except: (if none,so state). The deductible is applicable ❑ per claim or❑per occurrence(check one). 12. This is an ❑ occurrence or❑ claims made policy(check one). 13. This endorsement is effective on at 12:01 A.M. and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20 Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( ) 19 0 • ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY Name and address of named insured("Named Insured"): Name and address of Insurance Company("Company"): OFFICIAL TITLE OF PROJECT: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows: 1. The City of Seal Beach,its elected officials, officers, attorneys,agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the"Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall covered as third-party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnifica-tion and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their.duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction,interpretation,and enforcement of this contract of insurance. 20 • • 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: Director of Public Works City of Seal Beach 211 8th Street,2nd Floor Seal Beach CA 90740 10. Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY ❑ Following Form ❑ Umbrella Liability 0 10. Applicable underlying coverages: INSURANCE COMPANY POLICY NO. AMOUNT 11. The following inclusions, exclusions, extensions or specific provisions relate to the above coverages: 12. A ❑ deductible or ❑ self-insured retention (check one) of $ applies to all coverage(s)except: (if none, so state). The deductible is applicable ❑ per claim or ❑ per occurrence(check one). 13. This is an ❑ occurrence or❑ claims made policy(check one). 14. This endorsement is effective on at 12:01 A.M. and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20 Signature of Authorized Representative (Original signature only; no facsimile signature or initialed signature accepted) Phone No.: ( ) 21 ACORDM C E RT I F I CA� OF LIABILITY INSURA DATE(MAIDDYYYY) 03/21/2006 PRODUCER (949)559-6700 FAX (949)559-6703 THIS CERTIFICATE IS I SUED 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 iondi Ricard INSURERS AFFORDING COVERAGE NAIC# RED INSURER A: Travelers Property Casualty INSURER B: [-Sequel Contractors, Inc. ' INSURER C: 13546 Imperial Hwy. 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 ADM TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR Jd RD DATE IMM/DD/YY1 DATE IMMIDDLYYI GENERAL LIABILITY DTEC00819C794TI L05 10/01/2005 10/01/2006_,EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100000 VRFMIS S(Fa nccuranrn) r ICLAIMS MADE © OCCUR MED EXP(Any 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 7 POLICY I-I JEOT n LOC AUTOMOBILE LIABILITY DT8100819C794TIL05 10/01/2005 t 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 $ OCCUR n CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- TVRYLIN�TS I FR 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 E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Job #367, Annual Paving, Rehabilitation FY 2005/2006, Phase Two, Project No. 50174. This certificate may be relied upon only if the certificate addendum 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 MUM**MAIL City of Seal Beach 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Director of Public Works 211 Eighth St. DOMMKAIXIXMMKUNIXIMBOXXXXXXXXXXOLYMMXXXXCIONXXXX 2nd Floor X039 306XAl'X/OR XelOii MI(lfl(Xd( DEXXXXI(36L IfGXrXi XXXXXXXXXX Ash Seal Beach, CA 90740-6379 AUTHORIZED REPRESENTATIVE Pktiewhir- John Garrett/DMW 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) II City of Seal Beach • Certificate issued to City of Seal Beach 03/21/2006 Garrett/Mosier Insurance Services, Inc. 03/21/2006 RESb #367, Annual Paving, Rehabilitation FY 2005/2006, Phase Two, Project No. 50174. The City of Seal Beach, along with its City Council and each member thereof, every officer, official , agent, attorney, employee or volunteer of the City is 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 respect to Automobile Liability coverage, The City of Seal Beach, along with its City Council and each member thereof, every officer, official , agent, attorney, employee or volunteer of the City is added as Additional Insured, per CA20480299 attached. • • • Page 1 of 2 CG D2 48 10 02 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. 1111 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: http://eforms.travelers.com/NXT/gateway.d11/fssforms 1/general%2Oliability/cgd2481002.h... 9/30/2005 • • 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 Privacy.I Legal Notices ©2004 The St.Paul Travelers Companies,Inc. • • http://eforms.travelers.com/NXT/gateway.dll/fssforms 1/general%201iability/cgd2481002.h... 9/30/2005 . • • COMMERCIAL GENERAL LIABILITY Al) 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"occurrence", whether such damage age" occurs or the "personal injury" or "advertis- ing injury" offense is committed, to name as an 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 a= ning; or water; or any combination of any of of that part of any premises leased to you, subject –= these causes. to the following provisions: The Damage To Premises Rented To You 1. Limits of Insurance. The limits of insurance rs- 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 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 cluded by endorsement; or premises while rented to you, or tempo- 4— 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 III Page 2 of 6 Copyright, The Travelers Indemnity Company, 2004 CG D3 16 07 04 • • • COMMERCIAL AUTO POLICY NUMBER: DT-810-0819C794-TI L-05 ISSUE DATE: 10-11-05 • 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): ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED TO INCLUDE AS AN ADDITIONAL INSURED ON THIS COVERAGE FORM IN A WRITTEN CONTRACT OR AGREEMENT THAT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS AND THAT IS IN EFFECT DURING 4110 THE POLICY PERIOD. (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 qualities 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 • •THOLDER COPY SG STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142,-0807 COMPENSATION INSURANCE OF Li is A D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 03-21-2006 GROUP: 000046 POLICY NUMBER: 0015752-2005 CERTIFICATE ID: 57 CERTIFICATE EXPIRES: 10-01-2006 10-01-2005/10-01-2006 CITY OF SEAL BEACH SG JOB:N367, ANNUAL PAVING, REHABILITATION DIRECTOR OF PUBLIC WORKS FY 2005 211 8TH ST 2ND FL 2006, PHASE TWO, 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 upon30 days advance written notice to the employer. We will also give you 30days 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. IN THORIZED REPRESENTATI PRESIDENT MPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 11-07-2005 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER SEQUEL CONTRACTORS, INC SG 13546 IMPERIAL HWY ANTA FE SPRINGS CA 90670 [B15,SG] IREV.2 05) PRINTED : 03-21-2006