Loading...
PW G Street Improvements; Phase ICity of San Rafael ♦ California Form of Agreement for G Street Improvements — Phase I Mission Ave to Cut -de -Sac This Agreement is made and entered into this 2 n day of � 2017 by and between the City of San Rafael (hereinafter called City) and Ghilotti Bros., Inc. (hereinafter called Contractor). Witnesseth, that the City and the Contractor, for the considerations hereinafter named, agree as follows: I - 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 described in the specifications for the project entitled: G Street Improvements — Phase I, City Project No. 11274, all in accordance with the requirements and provisions of the "Specifications and Contract Documents for G Street Improvements — Phase I; Mission Ave to Cul-de-sac" dated March 2017, which are hereby made a part of this Agreement. The liability insurance provided to City by Contractor under this contract shall be primary and excess of any other insurance available to the City. II- Time of Completion (a) The work to be performed under this Contract shall be commenced within Five (5) Workine Days after the date of written notice by the City to the Contractor to proceed. (b) All work shall be completed, including all punchlist work, within Thirtv (30) Workins Days and with such extensions of time as are provided for in the General Provisions. III - 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 $1,000 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 fi•om 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. ITEM DESCRIPTION -� ESTIMATED UNIT UNIT QUANTITY PRICE TOTAL PRICE 1. Mobilization 1 LS a $25,000 $25,000 2. Signs and Traffic Control 1 LS a $63,086 = $63,086 3. Clearing and Grubbing 1 LS a $75,000 = $75,000 4. Tree Removal/Installation 6 EA a $2,000 = $12,000 5. Minor Concrete a. Type A Curb and Gutter 350 LF @ $53.00 $18,550 AGREEMENT -1 ITEM DESCRIPTION b. 4" PCC Sidewalk c. 6" PCC Driveway c. Curb Ramp — Case A d. 6" Retaining Curb 6. Storm Drain Improvements a. Type E Catch Basin wl Gallery Inlet b. Modified Type E Catch Basin c. Type GT4 Catch Basin wl Gallery Inlet d. Redeck Existing Catch Basin e. 24" PVC Storm Drain Pipe f. 18" PVC Storm Drain Pipe g. Sidewalk Underdrains 7. Sanitary Sewer Improvements a. 8" PVC Sewer Pipe b. Sewer Manhole c. 4" Sewer Lateral 8. Full Width Grinding" 9. Hot Mix Asphalt a. Full Depth HMA Plug Paving b. Deep Lift Patching c. HMA Overlay 10. Adjust Existing Facility to Grade a. Adjust Sewer Manhole Castings to Grade b. Adjust Water Valve Cover to Grade c. Adjust Sewer Rodhole to Grade IL Roadside Signs a. New Sign on New Post ESTIMATED QUANTITY UNIT UNIT PRICE TOTAL PRICE 1,000 SF @ $17.00 — $17,000 200 SF @ $38.00 = $7,600 4 EA @ $3,500.00 = $14,000 60 EA @ $48.00 = $2,880 3 EA @ $4,400.00 $13,200 2 EA @ $2,600.00 $5 200 1 EA @ $5,300.00 - $5,300 1 EA @ $2,000.00 — $2,000 200 LF @ $215.00 = $43,000 40 LF @ $280.00 = $11,200 1 LS @ $5,000.00 = $5,000 25 LF @ $615.00 $15,375 1 EA @ $16,000.00 — $16,000 1 LS @ $18,000.00 $18,000 29,000 SF @ $0.60 $17,400 55 TON @ $330.00 — $18,150 25 TON @ $350.00 = $8,750 410 TON @ $147.00 = $60,270 3 EA @ $700.00 — $2,100 9 EA @ $99.00 $891 2 EA @ $420.00 = $840 I EA @ $300.00 — $300 AGREEMENT -2 ITEM DESCRIPTION ESTIMATED QUANTITY UNIT UNIT PRICE TOTAL PRICE b. Relocate Existing Sign(s) to New Post 4 EA @ $225.00 — $900 12. Striping and Pavement Markings a. Detail 22 (Thermoplastic) 250 LF a $2.00 - $500.00 b. Pavement Markings (Thermoplastic) 80 SF @ $4.00 = $320.00 c. Red Curb 55 LF @ $2.50 _ $137.50 GRAND TOTAL BID $479,949.50 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) As soon as possible after the preparation of the estimate, the City shall, after deducting previous payments made, pay to the Contractor 95% of the amount of the estimate as approved by the Public Works Department. (c) 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 Contractor, 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 City 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 City 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. (c) Contractor shall provide a "Defective Material and Workmanship Bond" for 50% of the Contract Price, before the final payment will be made. (d) 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. (e) If after the work has been substantially completed, full completion thereof is materially delayed through no fault of the Contractor, and the City Engineer so certifies, the City shall, upon certificate of the City 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. AGREEMENT -3 VII - Assignment of Warranties; Waiver of Subrogation (a) Contractor hereby assigns to City all warranties, guarantees, or similar benefits such as insurance, provided by or reasonably obtainable from the manufacturers or suppliers of equipment, material or fixtures that Contractor has installed or provided in connection with the work performed under this Agreement. (b) Contractor hereby agrees to waive and arrange by contract for its subcontractors to waive any subrogation rights which any insurer of Contractor or its subcontractors might otherwise acquire in connection with the insurer's payment to Contractor or its subcontractors of any insured loss with respect to work performed under this Agreement. Contractor further agrees to obtain and to arrange for its subcontractors to obtain for City's benefit any endorsements from insurers that may be necessary to effect such waiver of subrogation. Specifically, any worker's compensation insurance policies of the Contractor or its subcontractors shall be endorsed with a waiver of subrogation in favor of City for any work performed by Contractor or its subcontractors under this Agreement, and copies of such endorsements shall be provided to City. IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute this Agreement the day and year first written above. CITY OF SAN RAFAEL: Jim Set1tz City Ma cr ATTEST: FZ- 140cx Esther C Beirne City Clerk G _ Bw, e..a . APPROVED AS TO FORM: L prac— Robert F. Epstein City Attorney File No. 16.01.280 Ghilotti Bros., Inc. By: Officer:Printed Name and, Printed Name of Officer: Title: &,U AGREEMENT -4 II INIT AL O -A :il . t Bond No. 57BCSHQ6203 Contract Bond Public Work California THE HARTFORD Premium Charge $3,403.00 Hartford Plaza, Hartford, Connecticut 05115 Bond Executed in Triplicate PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS - That we, Ghilotti Bros., Inc. as Principal, and the Hartford Fire Insurance Company , a Corporation organized and existing under the laws of the State of Connecticut and authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto .. City of San Rafael In the sum of Four Hundred Seventy Nine Thousand Nine Hundred, Forty Nine & 50/100 — - Dollars ($ 479,949.50 ) lawful money of the United States of America, for the payment whereof, well and truly to be made, we hereby bind ourselves, our heirs. exec- utors, administrators, successors and assigns, jointly and severally, firmly by these presents. SIGNED, sealed with our seals, and dated this 22nd day of . May, 2017 The condition of the foregoing obligation is such that, whereas the above bounden Principal ties entered Into a contract dated ... -. . May 15th, 2017 ,jg , with said City of San Rafael, to do and perform the following work, to -wit: G Street Improvements - Phase 1, City Project No. 11274 NOW, THEREFORE, if the above.bounden Principal shall ,veil and truly perform, or cause to be performed, each and ail of the requirements and obligations of said contract to be performed by said Principal, as in said contract set forth, then this bond shall be null and void; other- wise it shall remain in full force and effect. Ghilotti Bros., Inc. ;SEAL) Prinrpai Michael M. Ghilotti, President.; Treasurer HartfordFire Insurance Company By �L ` 6 {� — (SEAL) Attorney- m -fact Kelly Holtemann Form S-3665-1 (HF) Pr riled n U S A California All -Purpose A notary public or other officer completing this document to which this certificate is attached, State of California County of Marin ,��i�... �,: �.. w,.i',.a..... ���� .. �..�.... ,.,',....rr.��r .. �. �.... ,.v,....rr ��r .. �.:�...., t,...♦�. ���, .. r�v...� r . ,...., r �'i'µ Certificate of Acknowledgment certificate verifies only the identity of the individual who signed the I and not the truthfulness, accuracy, or validity of that document. On IIV 1[�� before me, personally appeared Michael M. Ghilotti Victoria M. Hawkins iv 1i ui rvuidry Public, Title Name of Signer (1) i who proved to me on the basis of satisfactory evidence to be the person(Y) whose name(90 is/a`gsubscribed to the within instrument and acknowledged to me that he/ffMF4 executed the same in his/ILMI authorized capacity(), and that by his/lir signature() on the instrument the person(io, or the entity upon behalf of which the person(g) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. UVv��a►��► � t �f Notary Public OPTIONAL INFORMATION VICTORIA M. HAWKINS c COMM #2144910 Z Notary : 011C . California Mat u) County Mi Comm. Expires Mar. 3,.202D �cdl Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this arrmowledgm­ it to an un,,ithorized docurnent and may prove useful to persons relying on the attached docurnent Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of Te�r Identification e on the basis of satisfactory evidence: C form(s) of identification ❑ credible witness(es) r containing pages, and dated _ Notarial event is detailed in notary journal on: _. The signer(s) capacity or authority is/a �5 Page # Entry # ❑ Individual(s) Notary contact: _ ❑ Attomey-in-fact ❑ Corporate Officer(s) other ❑ Additional Signer ❑ Signer(s) Thumbprints(s) El ❑ GuardianlC servator _ ❑ Partn imitedlGeneral ❑ stee(s) Other: representing: - Narne(s) of Person(s) Entdy(tes) Signer is Representing i .......,r..........._. r.. n..,..r.t.r.....,r_..... n.......,.u....u..•r...r,......,.t.u....u.. r... nn....,.t.u...,t...,� 2009-2015 Notary Learning Center - All Rights Reserved You can purchase copies of this form from our web site at www.TheNotarysStore.com CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of . On MLI Marin ZZ 26 L —1 before me, J. DeLuca, Notary Public Date Here Insert Name and Title of the Officer personally appeared Kelly Holtemann Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) War& subscribed to the within instrument and acknowledged to me that he/she/" executed the same in his/her/f4eir authorized capacity(ies), and that by his/her/#ti& signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. DELUCA Notary Public - California Z Marin County D i-' Commission #t 2166061 l My Comm. Expires Oct 24, 2020 7 - Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. nn t � Y Signature Signature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _ Document Number of Pages: __. Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: L] Corporate Officer — Title(s): _ II I Partner — 1-1 Limited —1 General Ll Individual I Attorne ' act Ll Trustee tan or Conservator U Other: Signer I presenting miner's Name: Corporate Officer — Title(s): F-1 Partner — n Limited 1-1 General ❑ Individual ❑ Attorney in Fact Cl Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: __... .. _.__ ...... 02014 National Notary Association • www.NationaiNotary.org - 1 -800 -US NOTARY (1-800-876-6827) Item #5907 Direct Inquiries/Claims to: THE HARTFORD POWER OF ATTORNEY BONDectic One Hartford Plaza Hartford, Connecticut 06155 Bond. Claims(ab.thehartford.com call.• 888-266-3488 or fax: 860-757-5835 Agency Name: WOODRUFF SAWYER & COMPANY KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code: 57-554795 = Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut Hartford Casualty insurance Company, a corporation duly organized under the laws of the State of Indiana 0 Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies") do hereby make, constitute and appoint, up to the amount of Unlimited : Nerissa S. Bartolome, Lawrence J. Coyne, Alicia Dass, Joan DeLuca, Roger C. Dickinson, Patrick R Diebel, Nancy L. Hamilton, Kelly Holtemann, Thomas E. Hughes, Stanley D. Loar, Mark M. Munekawa, Yvonne Roncagliolo, Charles R. Shoemaker of SAN FRANCISCO, California their true and lawful Attorneys) -in -Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by ®, and to execute, seal and acknowledge any and ail bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6, 2015 the Companies have caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. ��1Y�j� / � �9. .. Jar •' �'• _ �-��r'..'•.� �•y,: 31' r a ���•1867r� � i 10�r _ddd///-f. �^_- ?•a'su`r'�=-±� "rA�� # `� _ • �c�.rr,nrv�� r•otaw► . 1p70 �."tt�D7g ,. I9T9 • } "41: i.. ?' '*`"� Jr�A � trot d • •,�`%a :,r•ar5' � ••�� ��:.�irtati•� John Gray, Assistant Secretary M. Ross Fisher, Senior Vice President STATE OF CONNECTICUT ss. Hartford COUNTY OF HARTFORD On this 11th day of January, 2016, before me personally came M. Ross Fisher, to me known, who being by me duly sworn, did depose and say: that he resides in the County of Hartford, State of Connecticut; that he is the Senior Vice President of the Companies, the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. war = r° �IAr�4i c •/x ���✓✓ Nora M. Stranko Notary Public CERTIFICATE My Commission Expires March 31, 2013 I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is still in full force effective as of May 22nd, 2017 Signed and sealed at the City of Hartford. Tt ryU V�s+Pgy tr r }.if r+ : rJ µt coo �,y : lwa•ne.rtc : �0� T t' _ r7� '� �! -? s�oaa,V ; ^-� c..r,nM,., r•srrw► •' �� ,;"'`, •`x„•a,ti Y`` ��•.�.+5 •4y���. t Kevin Heckman, Assistant Vice President Contract Bond Public Work — California Bond Executed in Triplicate KNOW ALL MEN BY THESE PRESENTS. That we, THE HARTFORD LABOR AND MATERIAL PAYMENT BOND 57BCSH06203 BondNo ................................................... Premium Charge Included In Premium Charged for Performance Bond ........... - Ghilotti Bros., Inc. ....... .. as Principal, . ...................................... ....................... and ...-.. Hartford, Fire IOsurance Cpmparty a Corporation organized and axsling under the 'aws of the State of Connecticut and authorized to transact surety business In the State of California, as Surety, are held and firmly bound unto the State of California for the use and benefit of the State Treasurer as ex offirao treasurer and custodian of the Unemployment Fund and any and all materiafinen, persons, companies or corporations furnishing materials, provisions, provender or other supplies used in, upon, for or about the perform- ance of the work contracted to be executed or performed under the contract hereinafter mentioned, and all persons, companies or corporations renting or hiring teams, of Impsments or machinery, for or contributing to said work to be done. and all persons performing work or labor upon the same and a l persons supplying both work and materials as aforesaid, in the sum of . ....................................................... ........... .. ... .. Four Hundred,Seventy Nine Thousand Nine Hundred FoNine & 50/100 — 479 949.50 .. ._ .................. .. ($.......�........ ....... .. ). lawlul money of the United Slates of America, for the payment whereof well and truly to be made, we hereby bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. SIGNED, sealed with our seals and dated this..................22nd.,,,,...,, day of. .May, 2017 -te ... The condition of the foregoing obligation is such that, whereas the above -bounden Principal has entered roto a contract, dated. -May 15th, 2017 ....... A9 ........ ., with ............ City of San Rafael .... ..... to do and perform the following work to wit' G Street Improvements - Phase 1, City Project No. 11274 NOW THEREFORE, if the above -bounden Principal, or ........................ Ghilotti Bros., Inc. sub -contractor, fails to pay for any materials. provisions, provender or other supplies or teams, used in, upon. for or about the performance of the work contracted to be done under said contract, or for any work or labor done thereon of any kind, or for amounts due under the Unemployment Insurance Act with respect to such work. the Surety on this bond will pay the same, in an amount not exceeding the sum specified In this bond, and, also, in case suit is brought upon this bond. a reasonable attorney's fee to be fixed by the Court and to be taxed as costs and to be included in the judgment therein rendered- PROVIDED that this bond is filed by the Principal to comply with the provisions of Chapter 7, Title XV of the Civil Code of California and other applicable provisions of said Title XV relating to Public Work and liability hereunder is subject to the provisions of said section and acts amendatory thereof, and sect,ons of other codes of the State of California referred to therein and acts amendatory thereof. Ghilotti Bros, Inc. EA. Principal Michael M. Ghilotti, President., Treasurer Hartford Fire Insurance, Company, By.... -... 44t .... ................. ... (SEAL) Attorney-in-fact- Kelly Hollemann Form S-3574.3 Printed to LI S A -*p...,.n.., ......... .. i........_.....rr.-� .......... . n......., .......w..rno.0 ., .................... .. ...............u.....................0 . i ..,..........o..........,o...u........n .-r4 California All -Purpose Certificate of Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Marin S.S. _ On V v lOU1 7i"1 t /�+�� 1 before me, Victoria M. Hawkins ii Nannie of Notary Public, Title personally appeared Michael M. Ghilotti = i Narne of Signer (1) y who proved to me on the basis of satisfactory evidence to be the person(u) whose name(s _ is/aU subscribed to the within instrument and acknowledged to me that he/ff%AV4 executed the same in his/I r authorized capacity(19), and that by his/I&PWS signature() on the - instrument the person(, or the entity upon behalf of which the person(X) acted, executed the _ instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. } VICTORIA M. HAWKINS j COMM #2144910 z WITNESS my hand and official seal. Notary r blit • California a = Mann County ° My Comm. Expires Mar. 3, 2020 vA-�—W�A Signature of Notary Public OPTIONAL INFORMATION Although the information in this section rs not requfreu oy raw, a coula prevent fraudulent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document Description of Attached Document The preceding Certificate of Acknowledgment is attached to a Method of Signer Idea# kation document titled/for the purpose of Provedeon the basis of satisfactory evidence: ❑ form(s) of identification ❑ credible vdtness(es) containingpages, and dated Notarial event is detailed in notary journal on: c The signer(s) capacity or authority is/are as: Page # Entry # ❑ Individual(s) Notary contact: ❑ Attomey-in-fact ❑ Corporate Officer(s) Other Title(s) ❑ Additional Signer ❑ Signer(s) Thumbprints(s) El ❑ Guardian servator ❑ Pa -LimitedtGeneral ❑ T steels) ❑ Other: =_ representing: i Name(s) or Person(s) Entayties) Signer is Representing = ......................, ... n....u.r.u....u..•r... n.......,.......u... r..........,.,.u..n,,... © 2009-2015 Notary Learning Center - All Rights Reserved You can purchase copies of this form from our web site at www TheNotarysStore corn CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 rcrc�,c< <coroccxr.�ccic�n�rnmarcs„cr,�rcccrcccr.�.r�,crcac-cxrc rcccr,�r�r,�cc.�,orss�:ccrcccr�scccrsrcr.�s� A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate s attached, and not the truthfulness, accuracy, or validity of that document. State of California County of .. Marin On 1�� ZZ 2tD IL before me, Da?e personally appeared J. DeLuca, Notary Public Here Insert Name and Title of the Officer Kelly Holtemann Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ar& subscribed to the within instrument and acknowledged to me that he/she/" executed the same in hWher/t'heir authorized capacity(ies), and that by hWher/t- ei� signature(s) on the instrument the personH, or the entity upon behalf of which the person(s) acted, executed the instrument. DELUCA Notary Public California = _ Marin County > Z ' Commission # 2166061 l MY Comm Expires Oct 24, 2020 7 Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: '_1 Corporate Officer — Title(s): Partner — F-1 Limited it General Individual IJ Attorney' act Trustee ian or Conservator Other: _ Signer I presenting: _ BIggner's Name: f I Corporate Officer — Title(s): F-1 Partner — F] Limited n General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator F, Other: Signer Is Representing: Cx=(X1C.1c(1vK11CX u)cC.Y. VIkI`C-i.(XI 4c :rCX CY C� �1� crY C44X CX (� Gc 4� ZcX 4CX CX�i?4 C3SZ c{)c C c (v C Gc C,r (� C f C� �� {Y Gc i2� Gv ©2014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 0 Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut 0 Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana 0 Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies') do hereby make constitute and appoint, up to the amount of Unlimited : Nerissa S. Bartolome, Lawrence J. Coyne, Alicia Dass, Joan DeLuca, Roger C. Dickinson, Patrick R Diebel, Nancy L. Hamilton, Kelly Holtemann, Thomas E. Hughes, Stanley D. Loar, Mark M. Munekawa, Yvonne Roncagliolo, Charles R. Shoemaker of SAN FRANCISCO, California their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(les) only as delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6, 2015 the Companies have caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. ;''�•.Y�: � �wr•nl.+re: i a 4 r � n3 j �0 �•+'��� �z_ .:? � �� \ :`r;; .•*� .' .� P', a!\[hlV;` • �••rb' '•ii t9T0t:f ;�: 1974 d 79T4 + * �:j,..� `ba"•eaSN' �ja'A • 1+��� j • fi 'I��a'iinatti 5 �y��'•y ?�� John Gray, Assistant Secretary M. Ross Fisher, Senior Vice President STATE OF CONNECTICUT ss. Hartford COUNTY OF HARTFORD On this 11th day of January, 2016, before me personally came M. Ross Fisher, to me known, who being by me duly sworn, did depose and say: that he resides in the County of Hartford, State of Connecticut; that he is the Senior Vice President of the Companies, the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. �w aT t ? wOr+utysf _ a Nom'vl. Stmnko Notary Public CERTIFICATE My Commission Expires March 31, 2013 I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is still in full force effective as of May 22nd, 20117 Signed and sealed at the City of Hartford. O �Y� r � �,ca•rll.tf<: i t0 _��� ��; utL ,•�•+?t Y 1dpdW 1� :�'-anr.r,r�r • � _ 1 9 : I9t4 + a4s;„-. __;1� ti'f�sA IA � 1.•• 9'cit•a15 j\`I•rM�•• w Kevin Heckman, Assistant Vice President Direct Inquiries/Claims to: THE HARTFORD BOND, T-12 POWER OF ATTORNEY Haford HartfOne ord, Conne ticcut06155 Bond. CIaims(a).thehartford.com call: 888-266-3488 or fax. 860-757-5835 Agency Name: WOODRUFF SAWYER & COMPANY KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code: 57-554795 0 Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut 0 Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana 0 Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies') do hereby make constitute and appoint, up to the amount of Unlimited : Nerissa S. Bartolome, Lawrence J. Coyne, Alicia Dass, Joan DeLuca, Roger C. Dickinson, Patrick R Diebel, Nancy L. Hamilton, Kelly Holtemann, Thomas E. Hughes, Stanley D. Loar, Mark M. Munekawa, Yvonne Roncagliolo, Charles R. Shoemaker of SAN FRANCISCO, California their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(les) only as delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6, 2015 the Companies have caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. ;''�•.Y�: � �wr•nl.+re: i a 4 r � n3 j �0 �•+'��� �z_ .:? � �� \ :`r;; .•*� .' .� P', a!\[hlV;` • �••rb' '•ii t9T0t:f ;�: 1974 d 79T4 + * �:j,..� `ba"•eaSN' �ja'A • 1+��� j • fi 'I��a'iinatti 5 �y��'•y ?�� John Gray, Assistant Secretary M. Ross Fisher, Senior Vice President STATE OF CONNECTICUT ss. Hartford COUNTY OF HARTFORD On this 11th day of January, 2016, before me personally came M. Ross Fisher, to me known, who being by me duly sworn, did depose and say: that he resides in the County of Hartford, State of Connecticut; that he is the Senior Vice President of the Companies, the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. �w aT t ? wOr+utysf _ a Nom'vl. Stmnko Notary Public CERTIFICATE My Commission Expires March 31, 2013 I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is still in full force effective as of May 22nd, 20117 Signed and sealed at the City of Hartford. O �Y� r � �,ca•rll.tf<: i t0 _��� ��; utL ,•�•+?t Y 1dpdW 1� :�'-anr.r,r�r • � _ 1 9 : I9t4 + a4s;„-. __;1� ti'f�sA IA � 1.•• 9'cit•a15 j\`I•rM�•• w Kevin Heckman, Assistant Vice President CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Public Works Project Manager: Hunter Young Extension: 3408 Contractor Name: Ghilotti Bros., Inc. Contractor's Contact: Tori Hawkins Contact's Email: torih@ghilottibros.com ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED REVIEWER DEPARTMENT DATE Check/Initial 1 Project Manager a. Email PINS Introductory Notice to Contractor Click here to ❑ enter a date. b. Email contract (in Word) & attachments to City 5/3/2017 ® HY Atty c/o Laraine.Gittens@cityofsanrafael.org 2 City Attorney a. Review, revise, and comment on draft agreement 5/6/2017 ® LG and return to Project Manager 5/6/2017 ® LG b. Confirm insurance requirements, create Job on PINS, send PINS insurance notice to contractor 3 Project Manager I Forward at least two originals of final agreement to 5/10/2017 N HY contractor for their signature 4 Project Manager When necessary, * contractor -signed agreement ❑ N/A agendized for Council approval *PSA > $20,000; or Purchase > $35,000; or Or Public Works Contract > $125,000 Date of Council approval 5/15/2017 PRINT CONTINUE ROUTING PROCESS WITH HARD COPY 5 Project Manager Forward signed original agreements to City 5/31/2017 ® HY Attorney with printed copy of this routing form I I 6 City Attorney Review and approve hard copy of signed 7 City Attorney agreement Review and approve insurance in PINS and , and A// -7 bonds (for Public Works Contracts) I ! n 8 City Manager/ Mayor Agreement executed by Council authorized official 9 City Clerk Attest signatures, retains original agreement and forwards copies to Project Manager -7 �z l�