HomeMy WebLinkAboutCC Resolution 10738 (Andersen Drive Rahabilitation)RESOLUTION NO. 10738
RESOLUTION AWARDING CONTRACT FOR ANDERSEN DRIVE
REHABILITATION, PROJECT NO. 110-4421-656-8000 TO GHILOTTI
BROTHERS, INC., IN THE AMOUNT OF $457,754.00.
WHEREAS, on the 24`" day of October, 2000, pursuant to due and legal notice
published in the manner provided by law, inviting sealed bids for proposals for the work
hereinafter mentioned, as more fully appears from the Affidavit of Publication thereof on
file in the office of the City Clerk of the City of San Rafael, California, the City Clerk of
said City did publicly open, examine, and declare all sealed bids or proposals for doing
the following work in said City, to wit:
"ANDERSEN DRIVE REHABILITATION"
PROJECT NO. 110-4421-656-8000
in accordance with the plans and specifications therefore on file in the office of said City
Cleric; and
WHEREAS, the bid of Ghilotti Brothers, Inc. at the unit prices stated in its bid
was and is the lowest and best bid for said work and said bidder is the lowest responsible
bidder therefore;
NOW, THEREFORE, IT IS HEREBY ORDERED AND RESOLVED
that the bid of Ghilotti Brothers, Inc. and the same is hereby accepted at said unit prices
and that the contract for said work and improvements be and the same is hereby awarded
to said Ghilotti Brothers, Inc. at the unit prices mentioned in said bid.
IT IS FURTHER ORDERED AND RESOLVED that the Mayor
of said City be authorized and directed to execute a contract with Ghilotti
Brothers, Inc. for said work and to return the bidders bond upon the execution of
said contract.
BE IT FURTHER RESOLVED that the Director of Public Works
is hereby authorized to take any and all such actions and make changes as may be
necessary to accomplish the purpose of this resolution.
I, JEANNE M. LEONCINI, City Clerk of the City of San Rafael, hereby certify
that the foregoing resolution was duly and regularly introduced and adopted at a regular
meeting of the Council of said City held on the 6th day of November, 2000, by the
following vote, to wit:
AYES: COUNCIL MEMBERS: Heller, Miller, Phillips and Mayor Boro
NOES: COUNCIL MEMBERS: None
ABSENT: COUNCIL MEMBERS: Cohen
A.
JEAN l�T. LEONCINI; City Clerk
City of San Rafael - Department of Public Works
Bid Summary
Andersen Drive Rehabilitation
TON
Ghilotti Brothers, Inc.
Ghilotti Construction Co.
Bauman Landscape, Inc.
Maggiora & Ghilotti
Project No. 110-4421-656-8000
Engineer's
525 Jacoby St.
246 Ghilotti Ave.
115 Brookside Drive
555 Dubois St
Bid opening: October 24, 2000
Estimate
San Rafael, CA 94901
Santa Rosa, CA 95407
Richmond, CA
San Rafael, CA 94901
ITEM
14,350.00
UNIT
EST
UNIT
ITEM
UNIT
ITEM UNIT
ITUNIT
ITEM UNIT
ITEM
NO.
ITEM
0.88
I QTY
PRICE, $
TOTAL, $
PRICE, $
TOTAL, $ PRICE, $
I
TOTAL, $ PRICE, $
TOTAL, $ PRICE, $
TOTAL, $
1 Asphalt Overlay
TON
7,200
48.00
345,600.00
44.50
320,400.00
48.50
349,200.00
42.50
306,000.00
46.00
331,200.00
2 Cold Planing
SY
7,000
2.00
14,000.00
2.05
14,350.00
2.10
14,700.00
1.20
8,400.00
2.15
15,050.00
3 Fabric Reinforcement
SY
31,000
1.00
31,000.00
0.88
27,280.00
0.85
26,350.00
1.20
37,200.00
0.90
27,900.00
4 Thermoplastic Traffic Stripping
LS
1
10,000.00
10,000.00
17,953.00
17,953.00
18,000.00
18,000.00
18,000.00
18,000.00
18,000.00
18,000.00
5 Miscellaneous Pavement Patching
SF
20,000
1.67
33,400.00
2.32
46,400.00
2.10
42,000.00
2.00
40,000.00
3.20
64,000.00
6 Adjust Manhole Castings to Grade
EA
30
270.00
8,100.00
260.00
7,800.00
330.00
9,900.00
300.00
9,000.00
350.00
10,500.00
7 Adjust Rodholes and Monuments
EA
30
270.00
8,100.00
240.00
7,200.00
260.00
7,800.00
250.00
7,500.00
250.00
7,500.00
Castings to Grade
8 Traffic Control
LS
1
10,000.00
10,000.00
1,251.00
1,251.00
8,680.00
8,680.00
18,180.00
18,180.00
25,145.00
25,145.00
9 Mobilization
LS
1
10,000.00
10,000.00
10,000.00
10,000.00
5,000.00
5,000.00
50,000.00
50,000.00
10,000.00
10,000.00
10 Street Signs
EA
32
100.00
3,200.00
160.00
5,120.00
160.00
5,120.00
160.00
5,120.00
160.00
5,120.00
Grand T,)tal
473,400.00
457,754.00
486,750.00
499,400.00
514,415.00
Andersen Drive Rehabilitation North Bay Construction, Inc
Project No. 110-4421-656-8000 431 Payron Street
Bid opening: October 24, 2000 Petaluma, CA 94955-6004
NO. I ITEM
1 Asphalt Overlay
2 Cold Planing
3 Fabric Reinforcement
4 Thermoplastic Traffic Stripping
5 Miscellaneous Pavement Patching
6 Adjust Manhole Castings to Grade
7 Adjust Rodholes and Monuments
Castings to Grade
8 Traffic Control
9 Mobilization
10 Street Signs
QTY I PRICE, $ I TOTAL, $
TON
7,200
49.00
352,800.00
SY
7,000
3.00
21,000.00
SY
31,000
0.90
27,900.00
LS
1
19,000.00
19,000.00
SF
20,000
2.50
50,000.00
EA
30
420.00
12,600.00
EA
30
325.00
9,750.00
LS
1
38,000.00
38,000.00
LS
1
14,190.00
14,190.00
EA
32
160.00
5,120.00
550,360.00
City of San Rafael ♦ California
Form of Contract Agreement
For
Andersen, Drive Rehabilitation
This Agreement is made and entered into this 6th day of November, 2000 by and
between the City of San Rafael (hereinafter called City) and Ghilotti Brothers, Inc.
(hereinafter called Contractor). Witnesseth, that the City and the Contractor, for the
considerations hereinafter named, agree as follows:
II - Scope of the Work
The Contractor hereby agrees to furnish all of the materials and all of the equipment
and labor necessary, and to perform all of the work shown on the plans and described
in the specifications for the project entitled: Andersen Drive Rehabilitation , all in
accordance with the requirements and provisions of the Contract Documents as defined
in the General Conditions which are hereby made a part of this Agreement.
III- Time of Completion
(a) The work to be performed under this Contract shall be commenced within (5) five
calendar days after the date of written notice by the City to the Contractor to
proceed.
(b) The work shall be completed within (22) twenty-two working days after the date of
such notice and with such extensions of time as are provided for in the General
Conditions.
IIII - Liquidated Damages
It is agreed that, if all the work required by the contract is not finished or completed
within the number of working days as set forth in the contract, damage will be
sustained by the City, and that it is and will be impracticable and extremely difficult to
ascertain and determine the actual damage which the City will sustain in the event of
and by reason of such delay; and it is therefore agreed that the Contractor will pay to
the City, the sum of $500 for each and every calendar day's delay in finishing the work
in excess of the number of working days prescribed above; and the Contractor agrees to
pay said liquidated damages herein provided for, and further agrees that the City may
deduct the amount thereof from any moneys due or that may become due the
Contractor under the contract.
IV - The Contract Sum
The City shall pay to the Contractor for the performance of the Contract the
amounts determined for the total number of each of the units of work in the
following schedule completed at the unit price stated. The number of units
contained in this schedule is approximate only, and the final payment shall be
made for the actual number of units that are incorporated in or made necessary by
the work covered by the Contract.
AGREEMENT • 1
ITEM
UNIT
EST
UNIT
ITEM
NO. ITEM
QTY
PRICE, $
TOTAL, $
1 Asphalt Overlay
TON
7,200
44.50
320,400.00
2 Cold Planing
SY
7,000
2.05
14,350.00
3 Fabric Reinforcement
SY
31,000
0.88
27,280.00
4 Thermoplastic Traffic Stripping
LS
1
17,953.00
17,953.00
5 Miscellaneous Pavement
SF
20,000
2.32
46,400.00
Patching
6 Adjust Manhole Castings to
EA
30
260.00
7,800.00
Grade
7 Adjust Rodholes and
EA
30
240.00
7,200.00
Monuments
Castings to Grade
8 Traffic Control
LS
1
1,251.00
1,251.00
9 Mobilization
LS
1
10,000.00
10,000.00
10 Street Signs
EA
32
160.00
5,120.00
Grand Total
457,754.00
V - Progress Payments
(a). On not later than the 6th day of every month the Public Works Department shall
prepare and submit an estimate covering the total quantities under each item of
work that have been completed from the start of the job up to and including the
25th day of the preceding month, and the value of the work so completed
determined in accordance with the schedule of unit prices for such items together
with such supporting evidence as may be required by the City and/or Contractor.
(b). On not later than the 15th day of the month, the City shall, after deducting previous
payments made, pay to the Contractor 90% of the amount of the estimate as
approved by the Public Works Department.
(c). Final payment of all moneys due shall be made within 15 days after the expiration of
35 days following the filing of the notice of completion and acceptance of the work by
the Public Works Department.
(d). The Contractor may elect to receive 100% of payments due under the contract from
time to time, without retention of any portion of the payment by the public agency,
by depositing securities of equivalent value with the public agency in accordance
with the provisions of Section 4590 of the Government Code. Such securities, if
deposited by the Contractr, shall be valued by the City's Finance Director, whose
decision on valuation of the securities shall be final.
VI - Acceptance and Final Payment
(a) Upon receipt of written notice that the work is ready for final inspection and
acceptance, the Engineer shall within 5 days make such inspection, and when he
finds the work acceptable under the Contract and the Contract fully performed, he
will promptly issue a Notice of Completion, over his own signature, stating that the
work required by this Contract has been completed and is accepted by him under
the terms and conditions thereof, and the entire balance found to be due the
Contractor, including the retained percentage, shall be paid to the Contractor by
the City within 15 days after the expiration of 35 days following the date of
recordation of said Notice of Completion.
(b) Before final payment is due the Contractor shall submit evidence satisfactory to the
Engineer that all payrolls, material bills, and other indebtedness connected with
work have been paid, except that in case of disputed indebtedness or liens the
Contractor may submit in lieu of evidence of payment a surety bond satisfactory to
the City guaranteeing payment of all such disputed amounts when adjudicated in
cases where such payment has not already been guaranteed by surety bond.
AGREEMENT • 2
(c) 'The making and acceptance of the final payment shall constitute a waiver of all
claims by the City, other than those arising from any of the following: (1) unsettled
liens; (2) faulty work appearing within 12 months after final payment; (3)
requirements of the specifications; or (4) manufacturers' guarantees. It shall also
constitute a waiver of all claims by the Contractor, except those previously made
and still unsettled.
(d) If after the work has been substantially completed, full completion thereof is
materially delayed through no fault of the Contractor, and the Engineer so certifies,
the City shall, upon certificate of the Engineer, and without terminating the
Contract, make payment of the balance due for that portion of the work fully
completed and accepted.
Such payment shall be made under the terms and conditions governing final payment,
except that it shall not constitute a waiver of claims.
IN WITNESS WHEREOF, City and Contractor have caused their authorized
representatives to execute this Agreement the day and year first written above.
ATTEST: CITY OF SAN RAFAEL:
*AV4t-V-
Yea'hne M. Leoncint Albe?Ooro
City Clerk Mayor
APP M: GHILOTTI BROTHERS, INC.:
T.
Ga R ianti
Ci0 e
%Fhael M. Ghilotti, Executive VP,&
1,
File No: 16.01.202 Corp Sec
Dante W. Ghilotti
Executive VP, Administration & Finance
AGREEMENT 9 3
Bond Executed in Duplicate
CONTRACTOR'S BOND
FOR FAITHFUL PERFORMANCE.
Bond No: 005SB103370453BCM
Premium: $2,701.00
.TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
Hartford, Connecticut 06183
KNOW ALL MEN BY THESE PRESENTS:
That we, Ghilotti Bros., Inc.
as Principal, and TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, a corporation organized under the laws of the State of Connecticut and
duly authorized under the laws of the State of California to become sole surety on
bonds and undertakings, as Surety, are held and firmly bound unto
City of San Rafael
as Obligee,
in the full and just sum of Four Hundred Fifty Seven Thousand Seven Hundred
Fifty Four & 00/100 ---
Dollars, ($457,754.00 ), lawful money of the United States of America, to be paid to
the said Obligee, successors or assigns; for which payment, well and truly to be
made, we bind ourselves, our heirs, executors, successors, administrators and
assigns, jointly and severally, firmly by these presents.
Sealed with our seals and dated this 9th day of November, 2000.
THE CONDITION OF THE ABOVE OBLIGATION is such that whereas the said
Principal has entered into a contract or is about to enter into a contract with the
said Obligee
Andersen Drive Rehabilitation
as is more specifically set forth in said contract, to which contract reference is
hereby made.
NOW, THEREFORE, if the said Principal shall well and truly do the said work, and
fulfill each and every of the covenants, conditions and requirements of the said
contract in accordance with the plans and specifications, then the above obligation
to be void, otherwise to remain in full force and virtue.
Ghilotti Bros. Inc
BY: `
Michael M. Ghilotti, Executive Vice President
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
�brney-ln-Fact ByLawrence J. Co iie A
Y �
S-2359-1 (07-97)
CALIFORNIA ALL-PURPOSE AC-MV0VBG-NA=
State of CALIFORNIA
County of SONOMA
On 11/9/00 before me, KELLY HERMAN .
DATE NAI.IE, TITLE OF OFFICER - E.G., JANE DOE. NOTARY PUSUC
personally appeared. LAWRENCE J. COYNE
"WE($) OF SIMER(5)
® personally known to me - OR - ❑ proved to me on the basis of satisfactory evidence
to be the person6sk whose name{* ism
subscribed to the within instrument and
acknowledged to me that he/zhm*AaEq,,
executed the same in hislmx/tkzir authorized
capacitaazs y, and that by hi.slY r
signature(g) on the instrument the person(po
ror the' entity upon behalf of which the
KE1 LY HERMAN z personA acted, executed the in —L =ent
O . � NOTARY PUBLIC - CAL IF. �
z ; 'm COUNTY OF SONOMA �
My cor;r.,. Exp. Sept. s. 2001 WI=, SS my hand and official_ seal
SIGNATURE OF NOTARY
OPTI ONA1
Though the data below is not required by law, it may prove valuable to persons relying on the
document and prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTIT(IES)Y
TRAVELERS CASUALTY AND SiTRETY COMPANY OF AMERICA
DESCRIPTION. 01= ATTACHED DOCUMENT
PERFORMANCE BOND
TITLE OR TYPE OF DOCUMENT
TWO
NUMBER OF PAGES
11/9/00
DATE OF DOCUMENT
n/a
SIGNER(S) OTHERTHAN NAMED ABOVE
Bond Executed in Duplicate
PAYMENT BOND - PUBLIC WORK.
SECTIONS 3247 - 3252, CIVIL CODE
(CALIFORNIA)
KNOW ALL MEN BY THESE PRESENTS:
Bond No: 005SBI03370453BCM
Premium: Included
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
Hartford, Connecticut 06183
THAT WHEREAS, The State of California, acting by and through the
City of San Rafael
has awarded to Ghilotti Bros., Inc.
as Contractor, a contract for the work described as follows:
Andersen Drive Rehabilitation
AND WHEREAS, Said Contractor is required to furnish a bond in connection with
said contract, to secure the payment of claims of laborers, mechanics, materialmen,
and other persons as provided by law.
NOW, THEREFORE, We the undersigned Contractor and Surety are held and
firmly bound unto the State of California in the amount required by law, the sum of
Four Hundred Fifty Seven Thousand Seven Hundred Fifty Four& 001100---
($457,754.00) Dollars, for which payment well and truly to be made we bind
ourselves, our heirs, executors and administrators, successors and assigns, jointly
and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH,
That if said Contractors shall fail to pay (1) Any of the persons named in Civil Code
Section 3181, (2) amounts due under the Unemployment Insurance Code for work
or labor performed in connection with said contract by any such claimant, or (3) any
amounts required to be deducted, withheld and paid over to the Employment
Development Department from wages of the employees of Contractor and his sub-
contractors with respect to such work and labor, pursuant to Section 13020 of the
Unemployment Insurance Code, then the Surety or Sureties herein will pay for the
same in an aggregate amount not exceeding the sum specified in this bond, and
also in case suit is brought upon the bond, a reasonable attorney's fee, to be fixed
by the court, otherwise the above obligation shall be void.
This bond shall inure to the benefit of any of the persons named in Civil Code
Section 3181 so as to give a right of action to such persons or their assigns in any
suit brought upon this bond.
This bond is executed and filed to comply with the provisions of the act of
Legislature of the State of California as designated in Civil Code, Sections 3247 -
3252 inclusive, and all amendments thereto.
IN WITNESS WHEREOF, We have hereunto set our hands and seals on this
9th day of November, 2000
Ghilotti Bros.. Inc.
Bv: j4uk"�J
Michael M. Ghilot4i, Executive Vice President, Contractor
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
By
Lawrence J. Coyifie, At =rney-In-Fact
S -2061-B (07-97)
CALEFORN74 ALL-PURPOSE. AC1fjV0TT=GE 1EA1T
State of CALIFORNIA
County of SONOMA
On 11/9/00 before me, KELLY HERMAN
DATE NAME. TITLE OF OFFICER - E.G., JANE DOE. NOTARY PUSUC
personally appeared LAWRENCE J. COYNE
NAUE(S) OF SIGNER(S)
® personally known to me - OR - ❑ proved to me on the basis of satisfactory evidence
to be the person6sk whose name( ism
subscribed to the within instrument and
acknowledged to me that he/sl�,7
executed the same in ds/=xf tkiZr authorized
capacity, and that by hi.s/bm- r
signature(g) on the is dn=ent the person(g)
.�
y T:m F OFriMAL SEAL- `154
X14 i or the ' entity upon behalf of which the
I�Ei.L�r HERMAN �
NOTARY PUBLIC -CALIFl.7 erson(4 acted, executed the instrument.
o:-sora,-,,�A . —X.
PAY Comm, EXP.etrE. .8 ,2001
�•Y`Sys .n ...... .. 9 •'
WITNESS my Band and official seal.
C SIGMA RE OF NOTARY
OPTIONAT
Though the data below is not required by law, it may prove valuable to. persons relying on the
document and prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE
TITLES)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
DESCRIPTION OF ATTACHED DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENnT(IES)Y
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
PAYMENT BOND
TITLE OR TYPE OF DOCUMENT
T6JO
NUMBER OF PAGES
11/9/00
DATE OF DOCUMENT
n/a
SIGNER(S) OTHER THAN NAMED ABOVE
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
TRAVELERS CASUALTY AND SURETY COMPANY
FA 81INGTON CASUALTY COMPANY
Hartford, Connecticut 06183-9062
TRAVELERS CASUALTY AND SURETY COMPANY OF ILLINOIS
Naperville, Illinois 60563-8458
PUW%t.OFA-TT-ORNEY AND CERTIT+ICATE_O.F.AUTH_ORITY OF ATTORNEY(S)-IlN-FACT
KNOW ALL PERSONS BY THESE - PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FA UVIINGTON CASUALTY COMPANY,
corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford,
County of Hartford, State of Connecticut, and TRAVELERS CASUALTY AND SURETY COMPANY OF ILLINOIS, a
corporation duly organized under the laws of the State of Illinois, and having its principal office in the City of Naperville, County of
DuPage, State of Illinois, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make,
constitute and appoint: Lawrence J. Coyne, Goran G. E. Ryn, Kelly Holtemann, Bonnie K. Frymire or Thomas Hughes
of Petaluma, CA, their true and lawful Attorneys) -in -Fact, with full power and authority hereby conferred to sign, execute and
acknowledge, at any place within the United States, or, if the following line be filled in, within the area there designated
the following instrument(s):
by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the
nature of a bond, recognizance, or conditional. undertaking and any and all consents incident thereto
and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers
of the Companies, and all the acts of said Attorneys) -in -Fact, pursuant to the authority herein given, are hereby ratified and
confirmed.
This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are
now in full force and effect:
VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any
Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in Fact
and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe
to' sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in
the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such
appointee and revoke the power given him or her.
VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President
may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is
in writing and a copy thereof is filed in the office of the Secretary.
VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional
undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chaiiman, any Executive Vice President, any
Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any
Assistant Secretary and duly. attested and sealed with the Company's seal by. a Secretary or Assistant Secretary, or _(b) duly executed (under seal, if
required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their.certificates .of authority or
by one or more Company officers pursuant to a written delegation of authority.
This Power of Attorney and Certificate of Authority is signed and sealed by facsimile under and by authority of the following
Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY, FARMINGTON CASUALTY COMPANY and
TRAVELERS CASUALTY AND SURETY COMPANY OF ILLINOIS, which Resolution is now in full force and effect:
VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice 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 Resident Vice Presidents, Resident 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 in the future with respect to any bond or
undertaking to which it is attached:
IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS
CASUALTY AND SURETY COMPANY, FARMINGTON CASUALTY COMPANY and TRAVELERS CASUALTY AND
SURETY COMPANY OF ILLINOIS have caused this instrument to be signed by their Senior Vice President, and their corporate
seals to be hereto affixed this 3rd day of December, 1999,
STATE OF CONNECTICUT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
TRAVELERS CASUALTY AND SURETY COMPANY
}SS. Hartford FARMINGTON CASUALTY COMPANY
COUNTY OF HARTFORD TRAVELERS CASUALTY AND SURETY COMPANY OF ILLINOIS
�'NO SORFTp g,,,�TY Atib SG GASU 44� D 8UgEn,
MrFORD s HARTFORD, t 1 9 8 2 Q SEAL ' By
CONN. U ON ° Z * ; 1871
° $6Yy�yyE1L�1 George W. Thompson
Senior Vice President
On this 3rd day of December, 1999 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly
sworn, did depose and say: that he/she is Senior. Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY, FARMINGTON CASUALTY COMPANY and
TRAVELERS CASUALTY AND SURETY COMPANY OF ILLINOIS, the corporations described in and which executed the
above instrument; that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate
seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing
Resolutions thereof.
.7
My commission expires June 30, 2001 Notary Public
Marie C. Tetreault
'CERTIFICATE
I, the undersigned, Assistant Secretary of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA,
TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, stock corporations of
the State of Connecticut, and TRAVELERS CASUALTY AND SURETY COMPANY OF ILLINOIS, stock corporation of the
State of Illinois, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in
full force .and has not been: revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the
Certificate of Authority, are now in force.
Signed and Sealed at the Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this9TH day of
NOVEMBER, 2000
NO {?SOREIp� �J*LTY Apes pA6U.tJ10 SUf4cj�,
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9 HARTFORD• ` a ftaRTFORd, 19 8 2 0 o seAL , By -
CONN. CONN. ° z *� �!a, ; 1871
° Kori M. Johanson
fid,;yE*L"�`A'�ya�� CINOS
Assistant Secretary, Bond
ACORP. CERTIFICAI _OF
LIABILITY INSUR..NCgsR SD
DATE(MM/DDIYY)
HILO-1
11/09/00
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Don Ramatici Insurance, Inc.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 551
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Petaluma CA 94953
Phone:707-782-9200 Fax:707-782-9300
INSURERS AFFORDING COVERAGE
INSURED
INSURER A: Evanston Insurance Co.
INSURER B: Nationwide Mutual Ins. Co.
Ghilotti Bros., Inc.
INSURER C: National Union Fire Insurance
525 Jacoby Street
INSURER D: CO. of Pittsburgh, PA
San Rafael CA 94901
I
INSURER E: State ComiDensation Ins. Fund
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,
INSR TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY ErFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MMIDD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY OOGLP1004993
10/01/00 10/01/01 IFIRE DAMAGE (Any one fire) $ 50,000
CLAIMS MADE a OCCUR
MED EXP (Any one person) $ 5,000
X GL Ded. $5,000
( PERSONAL & ADV INJURY $1,000,000
X X, C, U Included
GENERAL AGGREGATE $2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
I PRODUCTS - COMP/OP AGG $ 1,000,000
POLICY E� n LOC
I
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $ 1,000000
B X ANY AUTO ACP7800621590
10/01/00 10/01/01 (Ea, accident)r
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
—
BODILY INJURY $
NON -OWNED AUTOS
(Per accident)
X Ded. $1000 APD
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
ANY AUTO
i
EXCESS LIABILITY
C X OCCUR CLAIMSMADE BE7403562 10/01/00 10/01/01
DEDUCTIBLE
X RETENTION $ None
WORKERS COMPENSATION AND
E EMPLOYERS' LIABILITY
OTHER
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $ 10,000,000
(AGGREGATE $ 10,000,000
$
$
$
X I TORY LIMITS I I ER
315129300 10/01/00 10/01/01IE.L.EACH ACCIDENT $1,000,000
E.L. DISEASE - EA EMPLOYEE $1,000,000
E.L. DISEASE - POLICY LIMIT $ 1, O O 0 , 0 0 0
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Operations of the Named Insured for the Certificate Holder
* 10 days notice will be sent on nonpayment
**agents & employees
JOB: Andersen Drive Rehabilitation, San Rafael, Proj #110-4421-656-8000
GBI #00439 30*XCG201OLF 11/85
CERTIFICATE HOLDER I Y I ADDITIONAL INSURED; INSURER LETTER:
SANRAF4
City of San Rafael, its
elective & appointive boards
commissiona, officers**
P.O. Box 151560
San Rafael, CA 94915-1560
I
ACORD 25-S (7/97)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILLMAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,'--__.
' .RL`f ALSG, YYriYYh'E8!
_� QAMPAYSIOTIOERPORATION 1988
Policy Number: OOGLP1004993-
Commercial General Liability
THIS ENDORSEMENT CHANGES THE POLICY - PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
City of San Rafael, its elective & appointive Boards, Commissions, Officers, Agents & Employees
P.O. Box 151560
San Rafael, CA 94915-1560
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the
Schedule, but only with respect to liability arising out of "your work" for that insured by or for you.
The insurance provided herein is primary coverage to the certificate holder with respects to any insurance or self
insurance programs maintained by the certificate holder, and no insurance held or owned by the certificate holder shall
be called upon to contribute to a loss.
The inclusion of more than one insured shall not operate to impair the rights of one insured against anotther insured and
the coverage afforded shall apply as though separate policies had been issued to each insured, but the inclusion of more
than one insured shall not operate to increase the limits of the Company's Liability.
CG 20 10 11 85 Copyright Insurance Services Office, Inc. 1984