HomeMy WebLinkAboutCC Resolution 9575 (Beach Park Road)RESOLUTION NO. 9 5 7 5
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN
RAFAEL AUTHORIZING THE PUBLIC WORKS DIRECTOR TO
EXECUTE AN AGREEMENT FOR THE CONSTRUCTION OF
BEACH PARK ROAD WITH HERBERT A. CROCKER AND
WILLIAM H. MCDEVITT.
BE IT RESOLVED by the Council of the City of San Rafael as follows:
WHEREAS, approximately four years ago, the Redevelopment Agency
budgeted funds to construct Beach Park Road on City right of way adjacent to lands
owned by Messieurs Crocker and McDevitt; and
WHEREAS, the construction of this roadway was part of an overall plan
to support the construction of a Honda Dealership on the eastern side of the lands owned
by Messieurs Crocker and McDevitt; and
WHEREAS, Plans for the construction of the roadway were dropped
primarily because the construction of the Honda Dealership was no longer viable; and
WHEREAS, it is apparent that the construction of this road would benefit
the Crocker/McDevitt property.
NOW, THEREFORE, BE IT RESOLVED by the Council of the City of
San Rafael that the Council:
1. Authorizes the Director of Public Works to execute an agreement with
Herbert A. Crocker and William H. McDevitt for the construction of
Beach Park Road at no cost to the City of San Rafael. Said agreement
shall be subject to review and approval as to form by the City Attorney,
and said construction shall be subject to and conditioned upon any
appropriate required environmental reviews.
2. Requires any development on the Crocker/McDevitt property would be
subject to the requirements of the zoning ordinance and appropriate
environmental reviews.
3. Grants to Crocker/McDevitt a first right of refusal for the lease of
Beach Park for ten years. The terms of such lease shall be determined
upon submittal of a specific plan by either Crocker/McDevitt or their
authorized representatives, and shall be subject to the Council's final
approval.
U �i U6l8Hlas^'
I, JEANNE M. LEONCINI, 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 on the 1" day of April, 1996, by the following vote, to wit:
AYES: COUNCILMEMBERS:Cohen, Heller, Phillips, Zappetini &
Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
E M. CrINI, City Clerk
CITY OF SAN RAFAEL, CALIFORNIA
IMPROVEMENT AGREEMENT FOR THE
CONSTRUCTION OF PUBLIC ]IMPROVEMENTS
THIS AGREEMENT is made and entered into by and between the City of San Rafael
(hereinafter referred to as "City"), and Crocker—McDevitt Enterprisepiereinafter referred to
as "Developer").
RECITALS:
Developer has presented to City for approval some Improvement Plans for the Construction of Park
Avenue.
The plans have been filed with the City Engineer of City for presentation to the City Council of the City
for its approval, which plans are hereby referred to and incorporated herein.
1. Performance of Work
All of the work and improvements and materials shall be done, performed and installed in strict
accordance with the approved plans and specifications for said work on file in the office of the City
Engineer of City, which said plans and specifications and standards are hereby referred to and adopted
and made a part of this agreement. In case there are not any standard specifications of City for any of
said work, it is agreed that the same shall be done and performed in accordance with the standards and
specifications of the State of California Department of Transportation. Developer will do and perform,
or cause to be done and performed, at Developer's own expense, in a good workmanlike manner, and
furnish all required materials, all under the direction and to the satisfaction of the City Engineer of City,
who shall endorse his approval thereon, all of the work and improvements referenced above and subject
to the conditions, requirements and recommendations as set forth in the reports of the City Engineer
which reports shall be incorporated herein by reference. Developer shall also do all work and furnish all
materials which, in the opinion of the City Engineer and on his order, are necessary to complete the
improvements in accordance with the plans and specifications on file as herein before specified, or with
any changes required or ordered by said Engineer, which in his opinion are necessary or required to
complete the work.
2. Soils Engineering Contractor
It is mutually agreed that the City shall determine the soils compaction engineering firm to perform
required soils testing and investigation during the construction of public improvements.
3. Work. Places and Grades to be Fixed by Engineer
All of said work is to be done at the places, of the materials, in the manner, and at the grades, all as
shown upon the plans and specifications therefor, approved by the City Engineer and upon which he has
endorsed his approval, and to the satisfaction of the City Engineer.
4. Work. Time for Commencement and Performance
work to be commenced on or before July 1, 1996 and completed on or
before June 30, 1097.
Improvement Agreement 1
tiro -zomgmrnc�gqnt-pfi s&id wwlo h ?bX tater ix7(6 rn�r�t s� �ftes
We�ey pt/ At least fifteen (15) calendar ays prior to commencement of work ere un er, eveloper
shall notify City Engineer in writing of the date fixed by Developer for commencement thereof so that
the City Engineer shall be able to provide services for inspection.
5. Time is of Essence - Extension
Time is of the essence of this agreement; provided that in the event good cause is shown therefor, the
City Council may extend the time for completion of the improvements here under. Any such extension
may be granted without notice to the Developer's surety, and extensions so granted shall not relieve the
surety's liability on the bond to secure the faithful performance of this agreement. The City Council shall
be the sole and final judge as to whether or not good cause has been shown to entitle Developer to an
extension.
6. Repairs and Replacements
Developer shall replace, or have replaced, or repair, or have repaired, as the case may be, all pipes and
monuments shown on the map which have been destroyed or damaged, as the case may be, or pay to the
owner, the entire cost of replacement or repairs, of any and all property damaged or destroyed by reason
of any work done here under, whether such property be owned by the United States or any agency
thereof, or the State of California, or any public agency or political subdivision thereof, or by the City or
by any person whomsoever, or by any combination of such owners. Any such repair or replacement
shall be to the satisfaction, and subject to the approval of the City Engineer.
7. Permits. Compliance With Law
Developer shall, at Developer's expense, obtain all necessary permits and licenses for the construction of
such improvements, give all necessary notices and pay all fees and taxes required by law.
8. Superintendence by Developer
Developer shall give personal superintendence to the work on said improvement, or have a competent
foreman or superintendent, satisfactory to the City Engineer, on the work at all times during progress,
with authority to act for Developer.
9. Inspections by City
Developer shall at all times maintain proper facilities, and provide safe access for inspection by City to
all parts of the work and to the shops wherein the work is in preparation.
The inspection of work shall not relieve the Developer of any of his obligations to complete the
improvements as prescribed. Defective work shall be made good and unsuitable materials may be
rejected, notwithstanding the fact that such defective work and unsuitable materials may have been
previously overlooked and accepted by the City Engineer.
10. Improvement Security
Midr/t64WVg ni /o�`�d�s{rd�ro6/off` �vf�/�CJeI►�e!�El����l6 �r/s i�l� % �e�it't�o�aEidlfde, 4z d�Vel
C` tt�///df// Aad///RrAM///:i
Improvement Agreement 2
Letter of Credit in the amount of One Hundred Sixty FiveThousand,
Seven Hundred Sixtv One Pollars ($165 761.0(1).
ry/I1�,t,porwp
q"P/dl'��9�'/�'����/�'����I��°�°/'�
9'1�9�9y/
�i�a,Kvt�' /idd�ef /skid/1/ofid/sl'i�lY,l;�/rdl�a�s�d'��dd,��ir(�t;'ofi/df/tfi�/rhe(uSv�d/it%��oG�i�ie�crfs'-fd�itr�
11. Alternate Improvement Security
The Developer may deposit at the time for submission of the bonds mentioned in paragraph 10 above, in
lieu of a surety bond, cash in the amount of said required bond with the City Treasurer of the City as a
guarantee for the faithful performance of this agreement. The City Treasurer may disburse progress
payments to the Developer on his order as the work progresses; provided first that the Developer shall
submit a demand for a progress payment and the demand for payment and the amount is approved, in
writing, by the City Engineer of the City. No progress payment allowable here under shall be made for
more than ninety percent (90%) of the value of any installment of work and not before each installment
of work shall have been completed to the satisfaction of the City Engineer.
The final payment for the work to be performed under this agreement shall be made 35 days after formal
acceptance of the improvements by the City upon determination of the City Engineer that all public
improvements required by this agreement have been completed to his full and complete satisfaction. As
the herein above-mentioned deposit is a guarantee for the faithful performance of this agreement, the
City may, upon a breach, default, or violation of any of the provisions of this agreement resort to the
herein above mentioned deposit for the purposes of taking over the work and prosecuting the same to
completion. Upon breach, default or other violation of this agreement requiring the City to take over the
work, the City Treasurer shall release, to the City Engineer, upon written demand of the City Engineer,
such amount or amounts of the deposit remaining as the City Engineer estimates is reasonably necessary
to complete the work.
In lieu of the surety bond or cash as required by Title 15 of the San Rafael Municipal Code, an
instrument or instruments of credit in the amount of said required bond may be deposited with City upon
condition the financial institution furnishing the credit pledges to the City it has the funds necessary, that
they are on deposit as guarantee for payment of the public improvements required and that the said funds
are held in trust for the purposes set forth in this agreement, said instrument of credit must be reviewed
and approved by the City Engineer and must be in a form acceptable to the City Attorney, prior to
acceptance of the instrument of credit as a substitute for a bond or cash.
Developer shall furnish a bond or cash deposit in the amount of Not Annlicable Dollars guaranteeing
the payment for installation of permanent monumentation. The monumentation shall be done to the
satisfaction of the City Engineer and shall be completed 365 calendar days from the actual date of
commencement.
1
��P'��'J�qi�'��°�'��'97`�gi't,�'�9t���9
Improvement Agreement 3
14. Hold Harmless Agreement
Developer hereby agrees to, and shall, hold City, its elective and appointive boards, commissions,
officers, agents, and employees harmless from any liability for damage or claims for damage for personal
injury, including death, as well as from claims for property damage which may arise from Developer or
Developer's contractors, subcontractors, agents, or employees of the Developer's contractors,
subcontractors, or by any one or more persons directly or indirectly employed by, or acting as agent for,
Developer or any of Developer's contractors or subcontractors. Developer agrees to, and shall, defend,
indemnify and hold harmless the City and its elective and appointive boards, commissions, officers,
agents, volunteers, and employees from any suits or actions at law or in equity for damages caused, or
alleged to have been caused, by reason of any of the aforesaid operations.
A. City does not, and shall not, waive any rights against Developer which it may have by reason of
the aforesaid hold harmless agreement, because of the acceptance by City of the deposit with
City by Developer of any of the insurance policies described in paragraph 10 hereof.
B. The aforesaid hold harmless agreement by Developer shall apply to all damages and claims for
damages of every kind suffered, or alleged to have been suffered, by reason of any of the
aforesaid operations, regardless of whether or not City has prepared, supplied or approved of
plans, specifications, or either, for the subdivision, and regardless of whether or not any
insurance policies shall have been determined to be applicable to any of such damages or claims
for damages.
C. Developer agrees that the use of any and all streets and public improvements herein above
required to be constructed shall be, at all times prior to the final acceptance of the improvements
by the City, the sole and exclusive risk of the Developer. The City may, at its sole option, issue
permission to occupy all or a portion of the Public Improvements prior to Final Acceptance of
said Public Improvements. The issuance of any permission to occupy such Public Improvements
located within the said plans shall not be construed in any manner to be an acceptance and
approval of any or all of said streets and improvements in said plans, or that stage of
development of said streets and improvements represented by their conditions at the time of
issuance of said occupancy permit or permits, or any stage of their development reached between
the period commencing with the issuance of any occupancy permit, and the final acceptance of
said plans. Additionally, the Developer shall hold the City harmless, as stated in the paragraphs
of this section, for any damage or injury resulting from City's grant of permission to occupy all
or a portion of the Public Improvements prior to final acceptance of said Public Improvements.
15. Protection of Public Safety
The Developer is obligated to protect the public safety during all phases of the work, and shall erect and
maintain all necessary barricades, signs and warning devices necessary to ensure public protection. In
the event that City discovers a condition on the site which in its determination constitutes an immediate
danger to public safety, and Developer cannot respond at once, City may erect any barriers, signs and
warning devices it deems necessary. In such event, Developer shall pay for the labor of City's crews at
the rate of thirty five ($35.00) dollars per hour per man, plus the cost of any materials used and a
reasonable fee for use of any barricades found necessary. In no event shall Developer pay less than one
hour minimum per man assigned if City takes action pursuant to this paragraph.
16. Developer's Insurance
Developer shall not commence work under this agreement until Developer shall have obtained all
insurance required under this paragraph and such insurance shall have been approved by the City
Attorney as to form and City Manager as to sufficiency, nor shall Developer allow any contractor or
Improvement Agreement 4
subcontractor to commence work on his contract or subcontract until all similar insurance required of the
contractor or subcontractor shall have been so obtained and approved. All requirements herein provided
shall appear either in the body of the insurance policies or as endorsements and shall specifically bind the
insurance carrier.
Developer and/or his contractors and/or subcontractors shall procure and maintain for the duration of the
contract insurance against claims for injuries to persons or damages to property which may arise from or
in connection with the performance of the work here under by the Developer, his agents, representatives,
employees, contractors or subcontractors.
A. Minimum Scope of Insurance—Coverage shall be at least as broad as:
Insurance Services Office Commercial General Liability coverage (occurrence from
CGY 000 1).
2. Insurance Services Office form number CA 0001 (Ed. 1/87) covering Automobile
Liability, code 1 (any auto).
3. Workers' Compensation insurance as required by the State of California and Employer's
Liability Insurance.
B. Minimum Limits of Insurance—Developer shall maintain limits no less than:
General Liability: $1,000,000 per occurrence for bodily injury, personal injury and
property damage. If Commercial General Liability Insurance or other form with a
general aggregate liability is used, either the general aggregate limit shall apply
separately to this project/location or the general aggregate limit shall be twice the
required occurrence limit.
Automobile Liability: $1,000,000 per accident for bodily injury and property damage.
Employer's Liability: $ 1,000,000 per accident for bodily injury or disease.
C. Deductibles and Self -Insured Retentions
Any deductibles or self-insured retentions must be declared to and approved by the City. At the
option of the City, either: the insurer shall reduce or eliminate such deductibles or self insured
retentions as respects the City, its officers, officials, employees, and volunteers, or the Developer
shall procure a bond guaranteeing payment of losses and related investigations, claim
administration and defense expenses.
D. Other Insurance Provisions
The general liability and automobile policies are to contain, or be endorsed to contain, the
following provisions:
1. The City. its officers, officials, employees, agents and volunteers are to be covered as
insureds as respects: liability arising out of activities performed by or on behalf of the
Developer; products and completed operations of the Developer, premises owned or used by
the Developer; or automobiles owned, leased, hired or borrowed by the Developer. The
coverage shall contain no special limitations on the scope of protection afforded to the City,
its officers, officials, employees, agents or volunteers.
2. For any claims related to this project, the Developer's insurance coverage shall be
primary insurance as respects the City, its officers, officials, employees, agents and
volunteers. Any insurance or self-insurance maintained by the City, its officers,
officials, employees, agents or volunteers shall be excess of the Developer's insurance
required and shall not contribute with it.
Improvement Agreement 5
Any failure to comply with reporting or other provisions of the policies including
breaches of warranties shall not affect coverage provided to the City, its officers,
officials, employees, agents or volunteers.
4. The Developer's insurance shall apply separately to each insured against whom claim is
made or suit is brought except, with respect to the limits of the insured's liability.
Each insurance policy required by this clause shall be endorsed to state that coverage
shall not be suspended, voided, canceled by either party, reduced in coverage or In limits
except after thirty (30) days' prior to written notice by certified mail, return receipt
requested, has been given.
E. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best's rating of no less than "A".
F. Verification of Coverage
Developer shall furnish the City with original endorsements effecting coverage required by this
clause. The endorsements are to be signed by a person authorized by that insurer to bind
coverage on its behalf. All endorsements are to be received and approved by the City before
work commences. The Contractor's insurer may provide complete, certified copies of all
required insurance policies, including endorsements effecting the coverage required by these
specifications.
G. Subcontractors
Developer shall include all subcontractors as insureds under its policies or shall furnish separate
certificates and endorsements for each subcontractor. All coverages for subcontractors shall be
subject to all of the requirements stated herein.
17. Title of Improvements
Title to, and ownership of, all improvements constructed here under by Developer shall vest absolutely
in City, upon completion and acceptance of such improvements by City.
18. Repair or Reconstruction of Defective Work
If, within a period of one year after final acceptance of the work performed under this agreement, any
structure or part of any structure furnished or installed or constructed, or caused to be installed or
constructed by Developer, or any of the work done under this agreement fails to fulfill any of the
requirements of this agreement or the specifications referred to herein, Developer shall without delay and
without cost to City, repair or replace or reconstruct any defective or otherwise unsatisfactory part or
parts of the work or structure. Liability under the contracts of surety or guarantee referred to in
paragraphs 11 and 12 of this agreement shall be released upon the completion of all work and public
improvements to the satisfaction of the City Engineer as provided and permitted. Should Developer fail
to act promptly or in accordance with this requirement, or should the exigencies of the case require
repairs or replacements to be made before Developer can be notified, City may, at its option, make the
necessary repairs or replacements or perform the necessary work, and Developer shall pay to the City the
actual cost of such repairs plus fifteen percent (15%).
19. Developer Not Agent of City
Neither Developer nor any of Developer's agents or contractors are or shall be considered to be agents of
City in connection with the performance of Developer's obligations under this agreement.
Improvement Agreement 6
20. Notice of Breach and Default
If Developer refuses or fails to obtain prosecution of the work, or any severable part thereof, with such
diligence as will ensure its completion within the time specified, or any extensions thereof, or fails to
obtain completion of said work within such time. or if Developer should be adjudged a bankrupt, or
Developer should make a general assignment for the benefit of Developer's insolvency, or if Developer,
or any of Developer's contractors, subcontractors, agents or employees, should violate any of the
provisions of this agreement, City Engineer or City Council may serve written notice upon Developer
and Developer's surety, of breach of this agreement, or of any portion thereof, and default of Developer.
21. Breach of Agreement. Performance by Surety or City
In the event of any such notice, Developer's surety shall have the duty to take over and complete the
work and improvements herein specified; provided however, that if the surety, within thirty (30) days
after the serving upon it of such notice of breach, does not give City written notice of its intention to take
over the performance of the contract and does not commence performance, City may elect to take over
the work and prosecute the same to completion, by contract or by any other method City may deem
advisable, for the account and at the expense of Developer, and in such event, City without liability for
so doing, may take possession of and utilize in completing the work, such materials, appliances, plant
and other property belonging to Developer as may be on the site of the work and necessary therefor. The
Developer shall be liable to the City for any excess costs, claims, damages, liability, or expenses of
whatever nature or kind, direct or indirect, including reasonable attorney fees which are directly or
indirectly caused by the execution and enforcement of this agreement.
22. Notices
All notices herein required shall be in writing and delivered in person or sent by registered or certified
mail, postage prepaid. Notices required to be given shall be addressed as follows:
City:
City Engineer
City of San Rafael
San Rafael, CA 94915-1560
Developer:
Crocker—McDevitt Enterprises
511 Francisco Boulevard
San Rafael, CA 9d901
Surety of Developer:
Letter of Credit
Developer Insurance Company:
by Ghilotti Construction Comnanv
(see attached Certificate of Insurance)
It is provided that any party or the surety may change such address by notice in writing to the other party
and thereafter notices shall be addressed and transmitted to the new address.
23. Binding of Agreement
This agreement shall bind, and the benefits inure to, the respective parties thereto, their legal
representatives, executors, administrators, successors in office or interest, and assigns.
Improvement Agreement 7
24. Legal Fees
In the event that legal action is necessary to enforce any provision of this agreement, the prevailing party
shall be entitled to reasonable attorney fees and legal costs.
25. Special Conditions
Incorporated herein and attached hereto is City Council Resolution 9575 dated April 1, 1996. Also,
attached hereto is the City Council report. Both documents, and the specific conditions contained
therein, shall be considered an integral part of this agreement and binding upon both parties.
Dated this � day of �, 19
Crocker—McDevitt Enterprises
CITY O RAF DEVELOPER
fi
gy:w y lam'
Albert Boro ' Owner
Mayor Title:
ATTEST:
Jeanne M. Leoncini
City Clerk
City Attorney
APPROVED AS TO CONTENT:
zz zz/� YJ N
David M. Bernardi
City Engineer
Herbert A. Crocker & Companv
BV :
Title: Owner
Improvement Agreement 8
WA VV&
U. -A
0., -
-.10
Air401HIARF
QR7
L% UIr *1
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ARS of Northern California HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
One Market ALTER THE COVERAGE AFFORDED VY THE POLICIES BELOW.
Spear Street Tower Ste. 2100 COMPANIES AFFORDING COVFRAQE
Son Francisco, CA 94105 COMPANY
415-543-9350 A Firemen's Fund InIM.Unre Cc
INSUMP COMPANY
Ghilalli Construction Co. 0 Cendon America 10j Cc
246 Ghilotti Avenue COMPANY
Sonia Ross, CA 95407 C F*d*Evl Insurance ComDanv
COWAW
t
...........
T HIS IS 7 0 CERTIFY THAT T HE POLICTES OF INSURANCE LIST ED BELOWMA vr: BEENISSUED TO T HE INSURED NAME[) ABOVE FOR T HE POL ICY PEMOD
INDICA TED. NOT WIT HST ANOINrJANV PEOLIAEMEN 1, 1 EFM ORCQNDI IONOF ANY CONT RAC 7 ORO T HEADOCUMENT wiTHRESPECT TO WH104 T HIS
CERTIFICATE MAY OFLISSUED OPMAY PERTAIN. TIIE INSURANCE AFFORDED BY THE POLICIES DESCPOED HEREIN IS SUBjECT YO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LMITS SHOWNMAN HAVE BEEN REDUCED BY PAID CLAMS
00 PoLIOVEMOfNe PftWT1xrMAT"W
TVM*f 01MAhV9 PoLloy"umoiiIn LTa DATIC ("WODITY) 04TLI CA011110011VIF) Lllufre
90"ALLIMILrTV GENERAL AOUREGAIE 9 2000000
COMMERCIALOEWRAI.LIADLIly TNCO699/94/0159 10101/95 10/01/96 PROULICTS-COMPIOP AM 1 1000000
CLAIS MADErI^ OCCUR PERSONAL L ADV IKURY 1
1000000
CWHE"L CONTRACIOR-5 PROT EACH OCCUFIRIEKE 1 1000000
FIRE DAMAGE (" &W fire) S 50000
'ED EXP (" one pwson) 1 5222—
LtARL"y COMBIWO SIWLE LIMIT I
A X ANY AUTO OXAS0154500 10/01/95 10/01196 1000000
ALL E)WrCU AUTOS OMILV INAAV
SCI-COULCO AUTOS (Par pw—)
X HIRED ALFICS BODILY IK JURY
NON OWNED AUTOS (Par sovidwI)
TI)POPERTY DAMAGE
@ARAM LIABLffV AUTO ONLY - EA ACCIDENT S
ANY AUTO OIHEA THAN AUTO ONLY
EACH ACCIDENT j
I AcutFOAIE I
exleesauAaLnr EAW OCCOMMCE I 10000000
C �UNCAELLA FORM 79750550 10/01/95 10/01/96 A00REGATE 1 101300900
OTHER THAN U111"LLA FORM
IrOWON CDP WONATION AND4XrA?UI0AY LIMITS
CNIIIIIIICY"WLSAALFFY 459500149 10/01/95 10/01/9
6
CA ACCIDENT I
TUC PROPRIETOR/ INCL DISEASE - POLICY LIMIT 1 1000000
PART NEFIS(EXECUT ivE M
OrFrCERS ARE - EXCL DISEASE - EACH EMPLOYEE 1 1000000
9114191111
MCI W I j 11 141 1, 1 LIMA I 1111! - SbfPKr3WaMLrIML I it! M
RE: Beach Park Street Improvements
(SEE ATTACHED ENDORSEMENT CIS 2010 FOR ADDITIONAL INSUREDS.1
ZHU" WIF C# TN! Wave ves"Wro PM10" me gunumm ouwm THE
r"Jople" pArt T"VWW. T"ff WWWO DOWafty WLL ZIMICAVOR TO MAIL
William McDevitt 30 DAra wwrrTm NOTME to T"a OMWIG&TV 04OLM Name to T"a LE",
sil rrancisco Blvd. WT FALYK 10 MAL WJ094 MTW 04ALL IMPOSt ho 9MIGNTION Oft LIA8&ffV
Son Rafael, CA 94901 or ANY KooTwo 00 V. as an
/11"?'', 1 - 003541000
—:V
— — -- -- +v..i-" aI.— — — L1 . 11 V111110110C1 F11.00
POLICY NUMBER: NC/0698/94/0159 COMM. MAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -- OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies the insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization:
William McDevitt RE: Beach Park Street Improvements
Herbert A. Crocker
City of San Rafael Job. N 4144
(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 our of "your work' for that insured by or for you.
CG 20 10 1185 Copyright, Insurance Services Offices, Inc., 1985 0
Wj VVJ