HomeMy WebLinkAboutAGMT - Silvia Construction (Paving 07/08) i
RECORDING REQUESTED BY
Kecorded in Official Records, Orange County
Tom Daly, Clerk-Recorder
AND WHEN RECORDED MAIL TO IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII NO FEE
CITY OF SEAL BEACH 2008000026482 12:37pm 01/17/08
Attn: City Clerk 115 30 N12 1
211 - 8th Street 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Seal Beach, CA 90740 (I
11
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
November 28,2007.The work was: Annual Paving Rehabilitation FY 07/08,Project#50244.
6. The name of the contractor,if any,for such of improvement was: Silvia Construction. The date of the
Contract was:July 23,2007.
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.
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Date: /' 10131'
Signature of own or corporate 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 /Lc- ,2008,at Seal Beach,California.
(Date of Signature)
irector of Public Works
s.
•. •
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CONTRACTOR TO PRINT COMPANY BOOK. II ' OF_. III
NAME: i
CONTRACT DOCUMENTS
DOCUMENTS TO SUBMIT UPON AWARD:
❑ PUBLIC WORKS CONTRACT ❑ ACKNOWLEDGEMENT OF
❑ PERFORMANCE BOND LICENSE LAW
❑ PAYMENT BOND ❑ WORKMEN'S COMPENSATION
CERTIFICATE
❑ INDEMNIFICATION AND HOLD
HARMLESS ❑ INSURANCE REQUIREMENTS(3)
❑ LABOR LAW REQUIREMENTS
•
FOR:
ANNUAL PAVING REHABILITATION FY 07/08
CITY PROJECT NUMBER:
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'AFB' mss�I a}
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These Contract Documents are the exclusive property of the Agency and shall not be used in any manner prior consent of the
Agency.Any reuse of these plans and specifications by Others shall be at Other's sole risk and without liability without to the Agency.
. CITY OF SEAL BEACH-211 EIGHTH STREET-SEAL BEACH, CA 90740-6379.
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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
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2
PUBLIC WORKS CONTRACT
Annual Paving Rehabilitation,FY 2007/2008
For the following project named ANNUAL PAVING REHABILITATION, FY 2007/2008
,in the City of Seal Beach.
THIS AGREEMENT, made and entered into this 23RD day of JULY 200 7 by and
between the City of Seal Beach, California, hereinafter referred to as the "CITY," Party of the First Part,
and SILVIA CONSTRUCTION, 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 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 HI. 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
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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 SEAL BEACH,CALIFORNIA
Party of the First Part
T
BY �� ali
City i
c4F.ST:Yb4, keitil/41."/ - 1/ .w'
lerk B ./YZ //__
•ON;.;:; C OR- ',.( r e Second Part
'RESIDENT, JOSEPH W. SILVIA
Title
9007 CENTER AVENUE
RANCHO CUCAMONGA , CA 91730-5311
•
Address
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•
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CALIFORNIA ALL-POSE ACKNOWLEDGMEN,
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STATE OF CALIFORNIA
1 COUNTY OF SAN BERNARDINO
P
On JULY 27, 2007,before me,PATRICIA BURKE,NOTARY PUBLIC,personally g
0 appeared JOSEPH W. SILVIA,personally known to me to be the person whose name is o
subscribed to the within instrument and acknowledged to me that he executed the same in his a
authorized capacity,and that by his signature on the instrument the person, or the entity upon behalf c
i of which the person acted,executed the instrument. 0
o 1
$ WITNESS my hand and official seal. t-
PATRICIA BURKE
,, Commission#1491758 6
0 g p'� . r Notary Public-California
Gi;� San Bernardino County
S Notary Public MY Comm.Expires May 26,2008 C gnature
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2,
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DESCRIPTION IF ATTACHE DOCUMENT 6
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b City of Seal Beach, Public Works Contract
r TITLE OR TYPE OF DOCUMENT
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o NUMBER OF PAGES: Two (2) DATE OF DOCUMENT: Undated at time of sig.
CAPACITY CLAIMED BY SIGNER
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❑ INDIVIDUAL mum THUMBPRINT O
SIGNER
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rid CORPORATE OFFICER PRESIDENT il
TITLE
Ill ATTORNEY IN FACT
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❑TRUSTEE
3 ❑ GUARDIAN OR CONSERVATOR
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❑ Other
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P Signer is Representing:, SILVIA CONSTRUCTION,INC.
✓f3 NAME OF PERSON(S)OR ENTITY(S) �$
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•
EXECUTED IN THREE COUNTERPARTS
Bond No 7593474 Bond Premium $4,079
PERFORMANCE BOND
KNOW ALL PERSONS BY T1EESE PRESENTS that:
•
SAS the City of Seal Beach,has awarded SILVIA CONSTRUCTION, INC.
9007 CENTER AVENUE RANCHO CUCAMONGA, CA 91730
(Name and address of Contractor)
("Principal"),a contract(the"Contract")for the work described as follows:
CITY PROJECT NUMBER 50244 PROJECT NAME: ANNUAL PAVING REHABILITATION FY 07/08
WHEREAS, Principal is required under the terms of the Contract to famish a baud for the faithful
performance of the Contract.
NOW,THEREFORE,we,the undersigned Principal,and FIDELITY AND DEPOSIT COMPANY OF MARYLAND
801 NORTH BRAND BLVD. , STE. PENTHOUSE, GLENDALE, CA 91203
(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 FIVE HUNDRED SIXTY—TWO THOUSAND
TWO HUNDRED NINETEEN & 93/100
Dollars (5 562.219.93 ), 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
III
rights of a party hereto.)N WITNESS WHEREOF,two(2)identical counterparts of this inst?u rent, each .
of which shall for all purposes be deemed an original hereo4 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 sign its undersigned representatives)pursuant to authority of its governing body.
Dated: JULY- 26, 2 07
"Principal"
CO STRUC ION o LITY AND DEPOSIT COMPANY OF MARYLAND
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BY r:"--'AW'FAllr_-■—_dlilli
!y.. p
/ JOSEP ^. SILVIA, PRESIDENT CHA'aa L. FLAK
//�� ATTI • EY-IN-FACT
By .C,�e e, � ),L.t� O44-AA.3.1,e_$y.
7 Its CLAIRE R. MANCHESTER—WAMEL, Its
SECRETARY
(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. •
•
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CALIFORNIA AL
L-POSE ACKNOWLEDGMENP
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STATE OF CALIFORNIA
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0, COUNTY OF SAN BERNARDINO
1 On JULY 27, 2007,before me,PATRICIA BURKE,NOTARY PUBLIC personally
0 appeared JOSEPH W. SILVIA,personally known to me to be the person whose name is
05 subscribed to the within instrument and acknowledged to me that he executed the same in his
authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf 4
i of which the person acted,executed the instrument.
5 WITNESS my . • and official seal. 0.
p r
P ��� PATRICIA BURKE
Commission#1491758
,Ai � ' Notary Public-California
R i / L ! r°'rgnature of Notary Public 26,2008 y
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OPTIONAL t.
oThough 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.
c DESCRIPTION OF ATTACHED DOCUMENT f
f.
City of Seal Beach, Performance Bond
• TITLE OR TYPE OF DOCUMENT
c NUMBER OF PAGES: Two (2) DATE OF DOCUMENT: July 26, 2007
1 CAPACITY CLAIMED !:;Y SIGNER
:.1 111 INDIVIDUAL a
C 0 RIGHT
zPARTNER S
❑
P CORPORATE OFFICER PRESIDENT >
TITLE
❑ ATTORNEY IN FACT
t. ❑ TRUSTEE
• ❑ GUARDIAN OR CONSERVATOR ,
a ❑ Other
a Signer is Representing:, SILVIA CONSTRUCTION,INC.
0 NAME OF PERSON(S)OR ENTITY(S)
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CALIFOP:NFA
ALL-PURPOSE ACKNOWLEDGMENT
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0 STATE OF CALIFORNIA '0
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o On JULY 27,2007,before me, PATRICIA BURKE,NOTARY PUBLIC,personally
0 appeared CLAIRE R.MANCHESTER-WAMEL,personally know to me to be the person whose
name is subscribed to the within instrument and acknowledged to me that she executed the same in
0 her authorized capacity,and that by her signature on the instrument the person, or the entity upon
obehalf of which the person acted,executed the instrument.
0 WITNESS my : -• and official seal.
PATRICIA BURKE
Commission#1491758 0
Q i t"r41‘6111;:—:4,-;-"---: Notary Public-California 0 San Bernardino County
lnature of Notary Public nM Comm.Expires May ze,2008
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a OPTIONAL
o Though the data below is not required by law, it may prove valuable to persons relying on the 0
document and could prevent fraudulent reattachment of this form..
0 DESCRIPTION OF ATTACHED ; OCUMENT
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City of Seal Beach, Performance Bond
TITLE OR TYPE OF DOCUMENT
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o, t.
0 NUMBER OF PAGES Two(2) DATE OF DOCUMENT JULY 26, 2007 0
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o CAPACITY CLAIMED BY SIGNER 4.
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Q ❑ INDIVIDUAL RIGHT S PRIM OF
0 ❑ PARTNER 0.
0 CORPORATE OFFICER CORPORATE SECRETARY
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•
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of Orange SS.
On 7-26-07 before me, Lexie Sherwood - Notary Public
(DATE) (NOTARY)
personally appeared Charles L. Flake
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
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
•
L LEXIE SHERWOOD
>�� •'- COMM.#1593951 12
Vair; NOTARY PUBLIC o CALIFORNW ORANGE COUNTY WITNESS my hand and official seal. Exp.JULY 27,2009
(seal)
nature / GV°t'K seal)
Signature
Lexie Sherwood
OPTIONAL
The following information is not required by law, however it may be helpful in preventing fraudulent use
of this acknowledgement.
Performance Bond
W
DOCUMENT TITLE OR DESCRIPTION
0
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DOCUMENT DATE: 7-26-07 NUMBER OF PAGES.Two (2)
COMMENTS:
O
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S 959E(2004)
• •
Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland,by WILLIAM J. MILLS,Vice President,and ERIC D. BARNES,Assistant Secretary,
in pursuance of authority granted by Article VI.Section 2,of the By-Laws of said Company, rare set forth on the
reverse side hereof and are hereby certified to he in full force and effect on the date h•,e. ,dp • by nominate,constitute
and appoint Richard A.COON,Charles L.FLAKE,David L.CULB '" ,1ttn,rl!. Ee S• ' ' OOD,all of
Anaheim,California, EACH its true and lawful agent and . ma lE d deliver, for,and on
its behalf as surety,and as its act and deed: any an. 0 4'I . n. ' : 1 yap " 1 'xecution of such bonds or
undertakings in pursuance of these presen l W .ink .,� ilk• 1. ,as fully and amply,to all intents and
purposes,as if they had been d , ��� t hbt�Packn�y �.� h k -plarly elected officers of the Company at its office
in Baltimore,Md., i. sr . p s. per's s I. . attorney revokes that issued on behalf of Richard A.COON,
Charles L.FLAKE, y e . `.6 a ew P.FLAKE. Lexie SHERWOOD,dated November 7,2005.
The said Assistant ,g_4.aL..es' e ehy certify that the extract set forth on the reverse side hereof is a true copy of Article VI,
Section 2,of the By- s . said Company,and is now in force.
IN WITNESS WHEREOF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of
November,A.D.2006.
ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND
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By:
Eric D. Barnes Assistant Secretary William J. Mills Vice President
State of Maryland ss:
City of Baltimore
On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland, duly
commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERiC D. BARNES, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to he the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being
by me duly sworn,severally and each for himself deposeth and saith•that they are the said officers of the Company aforesaid,
and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of
the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
Constance A. Dunn Notary Public
My Commission Expires: July 14.2007
POA-F 012-4150H
•
EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND
"Article VI, Section 2.The Chairman of the Board, or the President, or any Executive Vice-President, or any of the Senior
Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee,
shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident
Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to
authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations.
policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in
the nature of mortgages,...and to affix the seal of the Company thereto."
CERTIFICATE
I,the undersigned,Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify
that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that
the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized
by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND.
This Power of Attorney and Certificate may he signed by facsimile under and by authority of the following resolution of the
Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on
the 10th day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically
reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or
hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall he valid and
binding upon the Company with the same force and effect as though manually affixed."
IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seal of the said Company,
this 26TH day of JULY , 2007 .
Assistant Secretary
EXECUTED IN THREE C( ERPARTS •
Bond No. 7593474 Bond Premium INCLUDED IN PERFORMANCE BOND
PAYMENT BOND
(LABOR AND MATERIALS)
KNOW ALL PERSONS BY THESE PRESENTS that
WHEREAS the City of Seal Beach,has awarded to SILVIA CONSTRUCTION, INC.
•
9007 CENTER AVENUE, RANCHO CUCAMONGA, CA 91730
(Name and address of Contractor)
("Principal"),a contract(the"Contract")for the work described as follows:
CITY PROJECT NUMBER 50244 PROJECT NAME: ANNUAL PAVING REHABILITATION FY 07/08
WHEREAS,Principal is required under the terms of the Contract and the California Civil Code to secure
the payment of claims of laborers,mechanics,materialmon,and other persons as provided by law.
NOW,TREREFORE,we,the undersigned Principal,and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
801 NORT BRAND BLVD. . STE. PENTHOUSE. GLENDALE, CA 91203
(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 FIVE HUNDRED SIXTY—TWO THOUSAND
TWO HUNDRED NINETEEN & 93/100
Dollars(S 562.219.93 this amount being not loss 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
S •
•
Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of
California Civil Code§§2845 and 2849.
IN WITNESS WHEREOF, two(2)identical counterparts of this instrument, each of which shall for all
purposes be deemed an original hereof,have been duly executed by Principal and Surety, on the date set
forth below, the name of each corporate party being hereto affixed and these presents duly signed by its
undersigned representatives)pursuant to authority of its governing body.
Dated: JULY 26,2107
"Principal" tC ' •
SILVIA CONSTRUCT 01, IN,. FIDELTY AND DEPOSIT COMPANY OF MARYLAND
By: / IL ' BT M
� PRESIDENT is CHARL 4 E
By�±' Lam. -A- tiicQjBy: ATTORN .—IN—FACT
Its CLAIRE R. MANCHESTER—WAMEL Its
SECRETARY
(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 P
OSE ACKNOWLEDGMENN
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$ STATE OF CALIFORNIA
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I On JULY 27, 2007,before me,PATRICIA BURKE,NOTARY PUBLIC personally
0 appeared JOSEPH W. SILVIA,personally known to me to be the person whose name is F
subscribed to the within instrument and acknowledged to me that he executed the same in his Q
00 authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf g
2 of which the person acted, executed the instrument. 5
n WITNESS my h. . , and official seal. 0
,„= PATRICIA BURKE r
/ .7 Commission#1491758 •
3 z ��� Notary Public-California
a — San Bernardino County -
/gnature of Notary Public " NN Comm.Expires May 26,2008
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OPTIONAL
9
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a Though the data below is not required by law,it may prove valuable to persons relying on the
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DESCRIPTION OF ATTACHED D I CUMENT
ii City of Seal Beach, Payment Bond
a TITLE OR TYPE OF DOCUMENT
P
1 NUMBER OF PAGES: Two(2) DATE OF DOCUMENT: July 26,2007 z
o CAPACITY CLAIME It BY SIGNER 5
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. Signer is Representing: SILVIA CONSTRUCTION,INC.
NAME OF PERSON(S)OR ENTITY(S) i.
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IFO ALL-PURPOSE ACKNOW LDGMENT
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$ On JULY 27,2007,before me, PATRICIA BURKE,NOTARY PUBLIC personally oo/
0 appeared CLAIRE R.MANCI�ESTER-WAMEL,personally know to me to be the person whose 0
/ name is subscribed to the within instrument and acknowledged to me that she executed the same in
0 her authorized capacity, and that by her signature on the instrument the person,or the entity upon o
behalf of which the person acted, executed the instrument. 0
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PATRICIA BURKE °
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Notary Public-California
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o DESCRIPTION OF ATTACHED DOCUMENT 0
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$ City of Seal Beach, Payment Bond o
° TITLE OR TYPE OF DOCUMENT 0
oo;
o NUMBER OF PAGES Two (2) DATE OF DOCUMENT JULY 26, 2007 0
CAPACITY CLAIMED BY SIGNER 0
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•
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of Orange SS.
On 7-26-07 before me, Lexie Sherwood - Notary Public
(DATE) (NOTARY)
personally appeared Charles L.. Flake
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
person(s), or the entity upon behalf of which the person(s)acted, executed the instrument.
LEXIE SHERWOC D
COMM.#1593951 33
' 4- NOTARY PUBLIC 0 CAUFORNIA
ORANGE COUNTY
WITNESS my hand and official seal. tle.::,4170tCy,
Comm.Exp.JUL"27,Zoos
Si nature �� (seal)
( )
Lexie Sherwood
OPTIONAL
The following information is not required by law, however it may be helpful in preventing fraudulent use
of this acknowledgement.
Payment Bond
DOCUMENT TITLE OR DESCRIPTION
DOCUMENT DATE. 7-26-07 NUMBER OF PAGES:Two (2)
s
s
COMMENTS: a
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S 959E(2004)
• •
Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS:That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,a
corporation of the State of Maryland,by WILLIAM J.MILLS,Vice President,and ERIC D. BARNES,Assistant Secretary,
in pursuance of authority granted by Article VI,Section 2,of the By-Laws of said Company, ,* 1are set forth on the
reverse side hereof and are hereby certified to he in full force and effect on the date h re' ..en„by nominate,constitute
and appoint Richard A.COON,Charles L. FLAKE,David L.CULB ' f��' n1eadie S• + ' OOD all of
Anaheim,California, EACH its true and lawful agent and ma + y °1�, d deliver, for,and on
its behalf as surety.and as its act and deed: any an• o �n d'. . ,n. • ®1,J�' 'xecution of such bonds or
undertakings in pursuance of these presen : 1 . • .mQ .+ >ty,>xl.. y,as fully and amply,to all intents and
purposes,as if they had been d �•�i tUltl ackn•o s .`�thk_ gularly elected officers of the Company at its office
in Baltimore,Md., i �i • p'.."per• .4 f lje _ • attorney revokes that issued on behalf of Richard A.COON,
Charles L. FLAKE, : ` '' U 'a thew P.FLAKE,Lexie SHERWOOD,dated November 7,2005.
The said Assistant •°3es4erehy certify that the extract set forth on the reverse side hereof is a true copy of Article VI,
Section 2,of'the By s said Company,and is now in force.
IN WiTNESS WHEREOF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of
November,A.D.2006.
ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND
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By:
Eric D. Barnes Assistant Secretmn' William J. Mills Vice President
State of Maryland ss:
City of Baltimore f
On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland, duly
commissioned and qualified, came WILLIAM J. MILLS. Vice President, and ERIC D. BARNES, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to he the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being
by me duly sworn,severally and each for himself deposeth and saith,that they are the said officers of the Company aforesaid,
and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of
the said Corporation.
IN TESTIMONY WHEREOF, i have hereunto set my hand and affixed my Official Seal the day and year first above
written.
'
s. �
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L./ _)-^"-r",- -
.11
Constance A. Dunn Notary Public
My Commission Expires: July 14,2007
POA-F 012-4150H
•
EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND
"Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice-President, or any of the Senior
Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee,
shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident
Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to
authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations,
policies, contracts, agreements, deeds, and releases and assignments of_judgements, decrees, mortgages and instruments in
the nature of mortgages,...and to affix the seal of the Company thereto."
CERTIFICATE
I,the undersigned,Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify
that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that
the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized
by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the
Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on
the 10th day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically
reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or
hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall he valid and
binding upon the Company with the same force and effect as though manually affixed."
IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seal of the said Company,
this 26TH day of JULY , 2007 .
Assistant Secretary
•
• •
INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND
WAIVER OF SUBROGATION AND CONTRIBUTION
TITLE OF PROJECT OR WORK: ANNUAL PAVING REHABILITATION, FY 2007/2008
Indemnitor(s)(list all names):
SILVIA CONSTRUCTION , INC .
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.- event there is more than one person or entity named in the Agreement as an
Indemnitor, then-all oblig.tions, liabilities, covenants and conditions under this instrument shall be joint
and several.
"Indemnitor"
Na i e JJOO S E P - W. S I L , I P! SID ' Name:CLAIRE R R. MANCH_ESTE R—WAMEL, SECRETARY
By: I .sir ,i a . _ By:eQ4.4..i._,-g.
MEP Its
9
• ACKNOWLEDGMENT
CALIFORNIA ALL-PURPOSE
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6 STATE OF CALIFORNIA
o
1 COUNTY OF SAN BERNARDINO
0
o On JULY 27, 2007,before me,PATRICIA BURICE,NOTARY PUBLIC,personally
Qappeared JOSEPH W. SILVIA,personally known to me to be the person whose name is y
0 subscribed to the within instrument and acknowledged to me that he executed the same in his 1
0 authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf 0
1 of which the person acted,executed the instrument. 0
o
1
WITNESS my hand and official seal.
E / ��,�. PATRICIA BURKE
Commission#1491758
i ; - Notary Public-California
9
'��'d► San Bernardino County
6 /a 1 attire of Notary ublic My Comm.Expires May 26,2008
v
OPTIONAL 2
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l ESCRIPTION OF ATTACHED DOCUMENT
$ '6
0 City of Seal Beach,Indemnification& it armless Agreement/Waiver of Subrogation&Contribution
f TITLE OR TYPE OF DOCUMENT o.
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a NUMBER OF PAGES: One(1) DATE OF DOCUMENT: July 27,2007 4
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0 NAME OF PERSON(S)OR ENTITY(S)
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IA ALL—PURPOSE ACKNOWL DGMENT
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$ On JULY 27,2007,before me, PATRICIA BURKE,
NOTARY PUBLIC personally 3
b appeared CLAIRE R.MANCHESTER-WAMEL,personally know to me to be the person whose
name is subscribed to the within instrument and acknowledged to me that she executed the same in 0
S her authorized capacity,and that by her signature on the instrument the person,or the entity upon
g behalf of which the person acted,executed the instrument. 8
o'a
oWITNESS my h. ►-'and official seal. u � PATRICIA BURKE o
a , Commission#1491758 g
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My Comm.Expires May 26,2008
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0. city of Seal Beach,Indemnification&Harmless Agreement/Waiver of Subros?ation�i Contribution o
o TITLE OR TYPE OF DOCUMENT
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S •
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 L . Code which require every em. . -r to
be insured against liability for worker's compensation or to underta - self-ins . e •• = ordance with the'
provisions of that code, and I will comply with such provisions b: ore comm= c'..: the performance ofofj
work of this contract."•
Date JULY 27, 2007 Si e
gnature �_ar
•
SILVIA CONSTRUCTION, INC.
10
RPOSE ACKNOWLEDGMENT
CALIFORNIA ALL P
an�o,ivmivcoi-.vs�igtrfr,:oo/c%m�n�oinn.���n/r�J:»/��/oJ.�J r�J OioivioJ U.r!i�/J ntJJ fxHaJJ 1�inJ Oi✓ n�vninrninuOiraJ VJ wisin//m.+�J�rrvi�.ainffnr/�J�/�JOinn.J�Jfui�r*
n
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STATE OF CALIFORNIA
COUNTY OF SAN BERNARDINO
J
On JULY 27, 2007,before me,PATRICIA BURKEE,NOTARY PUBLIC,personally '
appeared JOSEPH W. SILVIA,personally known to me to be the person whose name is
0 subscribed to the within instrument and acknowledged to me that he executed the same in his Q
0 authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf c
of which the person acted,executed the instrument. fl
o
WITNESS my h, and official seal.
n / .,.� PATRICIA BURKE
Commission#1491758
D �},4114.6,•
-�•`- Notary Public-California
n1%a V,
�/ , 4 .,; San Bernardino County
7:ignature of Notary Public My Comm.Expires May 26,2008
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OPTRONAL 0
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5
c DESC 1" ; !"TION OF ATTACHE 31 DOCUMENT
a d
9 City of Seal Beach,Agreement to Comply W/California Labor Law Requirements
G TITLE OR TYPE OF DOCUMENT
g NUMBER OF PAGES: One(1) DATE OF DOCUMENT: July 27, 2007 y
CAPACITY CLAD I BY SIGNER
51 0
❑ INDIVIDUAL RIGHT ixuMePRINIOF
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0 111 PARTNER F.
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3 Signer is Representing: SILVIA CONSTRUCTION,INC.
4 NAME OF PERSON(S)OR ENTITY(S) g
!/ii'.L!'.7 4,%7 C/•I.Y7;i7 OJJ I.%,7K/N,27-4,6,7,JJ.^IJJ4NG'FI.Y l75;J mxC:JUfJ/O/!',—,71,i.,:,f/4..W.,A.7,J/t7/G"Glll:.7..1CJJ r//CJ n!7•UJ i4 l.•JJ/.VA TS.T el-W/!7/J)•iJUNM'J.,:r.Y/27Wv%/HC5V:h7OrMi
•
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 finality of such citations shall
be subject to Sections 7028.7 to 7028.13,inclusive. Any contract awarded to,or any purchase order issued
to,a contractor who is not licensed pursuant to this chapter is void.
(1) 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
•
• •
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 financial statement.
Failure of the bidder to obtain proper and a I equate licensing for an
award of a contract shall constitute a failure to e. ecute the contract a
shall result in the forfeiture of the security of th= I id• r.
License no.: 568194 Class: Q/ Ex p.o ation - u. I-%�•
Date JULY 27, 2007 Signature //�/ �� ` ■ —
J4 :• W. S :7,, ; :• lENT
ILVIA CONSTRUCTION, INC.
•
•
12
CALIFORNIA
ALL-POSE ACKNOWLEDGVIENN
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1 STATE OF CALIFORNIA
P
1 COUNTY OF SAN BERNARDINO
4
1 On JULY 27, 2007,before me,PATRICIA BURKE,NOTARY PU':LIC,personally
fappeared JOSEPH W. SILVIA,personally known to me to be the person whose name is g
subscribed to the within instrument and acknowledged to me that he executed the same in his
authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf 0
of which the person acted, executed the instrument.
0 WITNESS my hails and official seal. 0
g ���4 PATRICIA BURKE
,:A Commission#1491758 f
i i _� Notary Public-California t
� _ T4' San Bernardino County
tA
afore of Notary Public '”` My Comm.Expires May 26,2001
4.
0. (OPTIONAL 6
it it g
o Though the data below is not required by law, it may prove valuable to persons relying on the
y.
2 document and could prevent fraudulent reattachment of this form.
0 DESCRIPTION OF ATTACHED DOCUMENT y
0 5
City of Seal Beach, Penal and Civil Penalties Licensing Laws Acknowledgment s
TITLE OR TYPE OF DOCUMENT fi
o 1.
o
NUMBER OF PAGES: Two(2) DATE OF DOCUMENT: July 27,2007 I
gi CAPACITY CLAIMED 11 Y SIGNER
ti
❑ INDIVIDUAL RIGHT THUMBPRINT OF
5 SIGNER
0 ❑ PARTNER 5
o FAO CORPORATE OFFICER PRESIDENT
I. TITLE
❑ ATTORNEY IN FACT
A
r
TRUSTEE
o ❑ r
o El OR CONSERVATOR
a
o Li 0 El
Other
Y P
1
o Signer is Representing: SILVIA CONSTRUCTION.INC.
o NAME OF PERSON(S)OR ENTITY(S)
d
•z�,is a M
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. •
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
• •
Page Intentionally Left Blank
•
14
ACORD CERTIFICATOF LIABILITY INSURANdi OP ID 08 DATE(MM/DDIYYYY)
-- SILVI-1 07/26/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
*.Raintree Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
License #0557773 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
2039 North D Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Bernardino CA 92405
Phone: 909-881-2654 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Interstate Fire & Cas./CRC
INSURER B. Nationwide Mutual Ins. Co
Silvia Construction, Inc. INSURER C: St. Compensation Ins. Fund
9007 Center Ave. INSURER D
Rancho Cucamonga, CA 91730
INSURER E.
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
1NSR INS y DATE(MM/DDIYY)E POLICY E(MM/DD/YY))�
LTR INSRD TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X X COMMERCIAL GENERAL LIABILITY SGL1000679 07/03/07 07/03/08 PREMISES(Eaoccurence) $ 50,000
CLAIMS MADE X OCCUR MED EXP(My one person) $ Excluded
X CONTRACT PROTECT/ PERSONAL&ADV INJURY $ 1,000,000
BROAD FORM PD/ XCU INCLUDED GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000
—1 POLICY I 11 jEC n LOC
AUTOMOBILE LIABILITY
B X X ANY AUTO ACP7821895282 07/03/07 07/03/08 COMBINED accident) NGLE LIMIT
CO dent) $ 1,000,000
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
7 OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WC SVATU- 0TH-
WORKERS COMPENSATION AND X TORY LIMITS I ER
C EMPLOYERS'LIABILITY 44-24676-06 07/03/07 07/03/08 E.L.EACH ACCIDENT $ 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under
SPECIAL PROVISIONS below E L DISEASE-POLICY LIMIT $ 1,000,000
OTHER
* 10 DAYS NOTICE OF CANCELLATION
FOR NON-PAYMENT OF PREMIUM *
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: Annual Paving Rehabilitation FY 07/08 City Project Number: 50244
The City of Seal Beach, its elected officials, officers, attorneys, agents,
employees and volunteers are named as Additional Insureds with respects to
General Liability & Auto Liability. Coverage is Primary & Non-Contributing.
Waiver of Subrogation applies to General Liability & Auto Liability
CERTIFICATE HOLDER CANCELLATION
SEALBEA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR-T9 MAIL *3 0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, LL
City of Seal Beach
Director of Public Works
211 8th Street, 2nd Floor E4•
Seal Beach CA 90740 AUT ORIZED R TATIVE n
ACORD 25(2001/08) / 0 ACORD CORPORATION 1988
07/26/2007 12:38 90944122 SILVIA CONSTRUCON PAGE 05/11
WORKER'S COMPENSATION CERTIFICATE OF INSURANCE
WEEREAS,the CITY OF SEAL BEACH has required certain.insurance to be provided by
S • TE COMPEN A . s , _NS ; : i Ls
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: SILVIA CONSTRUCTION, INC
3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of
Califonhia covering all operations of the named insureds,as follows:
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
44-24676-06 7 /3[07 7/1/m1
4. Said policy or policies :all not be canceled,voided or reduced in coverage or limits of liability,
unless and until thirty days' ad i cc wri, notice thereof has been served upon the City Clerk of the
CITY OF SEAL BEACH. I
Its A i rized Rti.-sentative
15
07/26/2007 12:38 939.1122 SILVIA CONSTRION PAGE 06/11
Mir
•
ADDITIONI,L INSURED ENDORSEMENT COMPREHENSIVE GENERAL
LIABILITY
SILVIA CONSTRUCTION, INC 90097CENTER AVE . , RANCHO CUCAMONGA 91730
Name and address of named insured("Named Insured"):
INTERSTATE FIRE & CASUALTY 1815 VIA EL PRADOL STE 401 , REDONDO
Name and address of Insurance Company("Company"): BEACH, CA 90277
OFTICIAL TITLE OP PROJECT: ANNUAL PAVING R E.HA B T •I T AT I O N FY 07/08 #5 0 2 4 4
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 poli.y against another insured wider the policy. All such claims shall covered as third--party
claims, i.e., io 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 w tb 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 tine Named Insured regardless of any prior,
concwrent;or subsequent active or passive negligence by the Additional Insureds.
S. It is hereby weed 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
- 07/26/2007 12:38 90948.2 SILVIA CONSTRUC PAGE 07/11
f-
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,2M Floor
Seal Beach CA 90740
10. Except as stated above and not in coact 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 7/3/0 7— LIMITS OF$2 ,0 0 0,0 0 0 A G G
THIS ENDORSLMENT ATTACHES FROMITO 7/3/08 L.LA.BILI'I'Y $1 , 0 0 0, 0 0 0 O C
11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions
relate to the above coverages. Includes:
Contractual Liability ju Explosion Hazard
NiC Owners/Landlords/Tenants j J Collapse Hazard
0 Manuiacturers/Contractors 14 Underground Property Damage
XX Products/Completed Operations • 0 Pollution Liability
ij3t Broad Form Property Damage 0 Liquor Liability
Li Extended Bodily Injury 0
xtx Broad Form Comprehensive ❑
O$ General Liability Endorsement
12. AxII.deductible or ❑ self-insured retention (check one) of$10,0 0 0
applies to all coverage(s)except N n N E
(if none,so state). The deductible is applicable ❑ per claim order occurrence(check
one).
13. This is anXXoccurreztce or 0 claims made policy(check one).
14. This endorsement is effective on 7/2 6/0 7 at 12:01 A.M.and forms a part
of Policy Number S GL 10 0 0 6 7 9
I, GEORGINA FIETSCH (print name), hereby
declare under penalty of perjury under the laws of the State of California,that I have the authority to bind
the Company to this endorsement and that by my execution.hereof,I do so bind the Company.
Executed SAN BERNAR LINO _ A /2 6 .20 07
• .,_B l . .kt . 111 _ ,. ill
Si a . e of A(iiTrized Rep F entative
($riginal signature only; no facsimile signature or initialed signature
accepted)
PhoneNo.: Q09 ) 881-2654
•
17
07/26/2007 12:38 9094822 SILVIA CONSTRUCN PAGE 08/11
•
ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY
SILVIA CONSTRUCTION INC • ss � ; : ; . ► . s _ ONGA, CA 91730
Name and address of named insured("Named Insured"):
NATIONWIDE MUTUAL INS . CO . P .O . BOX 997130, SACRAMENTO , CA 95899-7130
Name and address of Insurance Company("Company"):
OFFFICAL TITLE OF PROJECT: ANNUAL PAVING REHABILITATION FT 07/08 #50244
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 permit(s)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
2118tH Street,2' 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
4.
07/26/2007 12:38 9094122 SILVIA CONSTRUN PAGE 09/11
•
TYPE OF COVERAGES TO WHICH POLICY PERIOD
LINHTSOI$ $1 , 000, 000 CSL •
THIS ENDORSEMENT ATTACHES • PROM/TO 7/3/07-7/3/08
LIABILITY
Scheduled items or locations are to be ident f ed on an attached sheet. The following inclusions relate to
the above coverages. Includes:
MK Any Automobiles ❑ Truckers Coverage
❑ All Owned Automobiles 0 Motor Cartier Act
Non-owned Automobiles 0 Bus Regulatory Reform Act
Oc Hired Automobiles ❑ Public Livery Coverage
❑ Scheduled Automobiles ❑
❑ Garage Coverage ❑
11. A Ac deductible or 0 self-insured retention (check one) of $ NIL applies to all
coverage(s)except NONE
(ff none,so state). The deductible is applicable ❑per claim d[X]per occurrence(check one).
12. This is angkoccurrence or❑claims made policy(check one)_
13. This endorsement is effective on 7/26/07 at 12:01 A.M. and forms a part of Policy
Number A C P 7 8 2 1 8 9 5 2 8 2
I, G E O R G I N A F I E T S C H (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 SAN BERN! RUINS CA JULY 2628 07
si;4 of mind •I .resentative •
(Original signature only; no facsimile signature or initialed signature
accepted)
PhoneNo.: ( 909) 881-2654
19