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PW Victor Jones Park ImprovementsCity of San Rafael. California Agreement for Victor Jones Park Improvements City Project No. 11289 This Agreement is made and entered into this -.lL day of Dec. 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: 1-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: Victor Jones Park Improvements, City Project No. 11289, all in accordance with the requirements and provisions of the Contract Documents as defined in the "Specifications and Contract Documents" for the project, dated October 2017, which are hereby made a part of this Agreement. 11-Time of Completion (a) The work to be performed under this Contract shall be commenced within Five (5) Working 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 Fifty (50) Working 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 $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. ITEM DESCRIPTION 1. Mobilization 2. Clearing and Grubbing 3. Minor Concrete a. 4-inch Thick PCC Sidewalk b. 6-inch Thick PCC Sidewalk c.Concrete Mowband d. Playground Vertical Curb ESTIMATED QUANTITY 1,250 2,500 10 240 UNIT UNIT PRICE TOTAL PRICE LS $19,000.00 @ $19,000.00 LS $142,452.00 @ $142,452.00 SF $10.00 @ $12,500.00 SF $11.00 @ $27,500.00 LF $65.00 @ $650.00 EA $71.00 @ $17,040.00 AGREEMENT· 1 ITEM DESCRIPTION ESTIMATED UNIT UNIT PRICE TOTAL PRICE QUANTITY e. Playground Retaining Wall 30 LF $600.00 @ $18,000.00 4. Chain Link Fence and Gates LS $14,875.00 @ $14,875.00 5. Storm Drain System LS $16,000.00 @ $16,000.00 6. Domestic Water LS $22,000.00 @ $22,000.00 7. Sanitary Sewer Lateral LS $26,000.00 @ $26,000.00 8. Electrical Systems LS $39,980.00 @ $39,980.00 9. Site Furnishings LS $224,000.00 @ $224,000.00 10. Irrigation System/Landscape Improvements LS $70,000.00 @ $70,000.00 GRAND TOTAL BID: $649,997.00 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) 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 22300 of the Public Contract 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: (I) 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, AGREEMENT· 2 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. 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. ATTEST: Yof!.'.Esther C. Beirne City Clerk APPROVED AS TO FORM: La~ ,FE Rob Epstein I ~ City Attorney File No.: 22.04.44 CITY OF SAN RAFAEL: Ghilotti Bros., Inc.: ~iih L'-~~ ,bt Printed Name: 'ft. Title: .lIomas G. Barr, P.E., Vice President Ghilotti Bros., Inc.: Printed Name: Michael M. Ghilotti Title: President AGREEMENT· 3 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DAn: (MMIDD/yyyy) ~ 1/4/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER ~2~~~CT Megan MDntanD Woodruff-Sawyer & Co. rlJB~:oLEdl: 415-391-2141 I FAX 50 California Street, Floor 12 iAic No): 415-989-9923 .- San Francisco CA 94111 lDMDA~ss: mmDntanD@wsandco.com INSURER/51 AFFORDING COVERAGE NAICN INSURER A : Hartford Fire Insurance Company 19682 INSURED GHI LBRO-01 INSURER B : Hartford Underwriters Insurance Company 30104 Ghilotti Bros, Inc. INSURERC: 525 Jacoby Street San Rafael, CA 94901 INSURERD : INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER' 42258216 REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER IOD IN DICATED . 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 . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . IN5R TYPE OF INSURANCE ADDL I ~~ 1 /~~g~1 /~~~l LTR IN!:O POUCY NUMBER LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y 57UEAOT9730 10/112017 101112018 EACH OCCURRENCE 52 .000 .000 I-t:J CLAIMS-MADE 0 OCCUR ~~~~f§~~ ~E~~~nce l I-5300 .000 I-MED EXP (Anyone person) 510 .000 I-510.000 --PERSONAL & ADV INJURY S 2,000 .000 R'L AGGREGATE LI MIT APPLIES PER. GENERAL AGGREGATE S 4,000 ,000 o PRO -D PRODUCTS -COMP/OP AGG S 4,000 ,000 POLICY JECT LOC OTHER. S A AUTOMOBILE LIABILITY Y Y 57UEAOT9729 10/112017 10/112018 fE~~~~~~t~INGLE LIMIT 51000000 l- X ANY AUTO BOD IL Y IN JURY (Per person) 5 I-ALL OWNE D R """'",EO - AUTOS AUTOS I BODILY IN JURY (Per aCC ident) 5 I-NON-OWNED rp~~~~d~t~AMAGE - HIRED AUTOS AUTOS 5 7 - Phv . DamaQB-Hired Auto Comp o S1 ,OOO OED 5 Coil S1 .000 OED UMBRELLA LIAB H OCCUR EACH OCCURRENCE 5 I-EXCESSLIAB CLA IMS-MADE AGGREGATE 5 OED I I RETENT ION S 5 A WORKERS COMPENSATION Y 57WEAOT9728 10/112017 10/112018 X I ~¥~TUTE I I OTH - AND EMPLOYERS' LIABILITY ER Oed NA YIN ANY PROPRIETOR /PARTNER/EXECUTIVE D N/A E.L. EACH ACCIDENT 51 .000 .000 OFFICER/MEMBER EXC LUDED? (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE S 1.000 ,000 ~~~~~r~frg~ ~~'gPERATIONS below E.L. DISEASE -POLICY LIMIT S 1.000 .000 I I I , DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule , may be attached If more space Is required) GBI Job # #17425 Victor Jones Park -San Rafael. City Df San Rafael , its Dfficers , emplDyees , agents and volunteers are named additiDnal insured on GL and AutD cDverage per endorsements HG DO 01060510 and HA 99160312 attached . Coverage is primary and nDn-cDntributDry per endorsement HG 00 01 06 05 14 attached . PDlicies contain a 30 day nDtice Df cancellation and a 10 day nDtice of cancellation fDr nDn-payment Df premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of San Rafael, its officers, ACCORDANCE WITH THE POLICY PROVISIONS. employees, agents and volunteers 111 Morphew Street AUTHORIZED REPRESENTATIVE San Rafael CA 94915 ~ I © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Policy No . 57UEAQT9729 COMMERCIAL AUTOMOBILE HA 9916 0312 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following : BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations The Named Insured shown in the Declarations is amended to include: (1) Any legal business entity other than a partnership or joint venture, formed as a subsidiary in which you have an ownership interest of more than 50% on the effective date of the Coverage Form . However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance . (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture, (b) That is an "insured" under any other policy, (c) That has exhausted its Limit of Insurance under any other policy, or (d) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization . B. Employees as Insureds Paragraph A .1. -WHO IS AN INSURED -of SECTION II -LIABILITY COVERAGE is amended to add : d. Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs . C. Lessors as Insureds Paragraph A .1. -WHO IS AN INSURED -of Section II -Liability Coverage is amended to add: e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire . D. Additional Insured if Required by Contract (1) Paragraph A.1. -WHO IS AN INSURED -of Section II -Liability Coverage is amended to add: f. When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for "bodily injury" or "property damage" caused by the conduct of an "insured" under paragraphs a. or b. of Who Is An Insured with regard to the ownership, maintenance or use of a covered "auto ." Form HA 99 16 03 12 © 2011, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission.) Page 1 of 5 The insurance afforded to any such additional insured applies only if the "bodily injury" or "property damage" occurs: (1) During the policy period, and (2) Subsequent to the execution of such written contract, and (3) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured. (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section . (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non- contributory with the additional insured's own insurance. (4) Duties in The Event Of Accident, Claim, Suit or Loss If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the additional insured shall be required to comply with the provisions in LOSS CONDITIONS 2. -DUTIES IN THE EVENT OF ACCIDENT, CLAIM , SUIT OR LOSS -OF SECTION IV - BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. E. Primary and Non-Contributory if Required by Contract Only with respect to insurance provided to an additional insured in 1.0. -Additional Insured If Required by Contract, the following provisions apply : (3) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary . If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance 5.d. (4) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (3) and (4) do not apply to other insurance to which the additional insured has been added as an additional insured . When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance . We will share the remaining loss, if any, by the method described in Other Insurance 5.d. 2. AUTOS RENTED BY EMPLOYEES Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire . The OTHER INSURANCE Condition is amended by adding the following: Form HA 99 16 03 12 © 2011, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission .) Page 2 of 5 If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. 3. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5 . -FELLOW EMPLOYEE -of SECTION II -LIABILITY COVERAGE does not apply if you have workers' compensation insurance in-force covering all of your "employees" . Coverage is excess over any other collectible insurance . 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive , Specified Causes of Loss , or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is : (1) $100,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible . The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning . Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident" . This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households . 5 . PHYSICAL DAMAGE ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4 .a. of SECTION III -PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1 ,000. 6. LOAN/LEASE GAP COVERAGE Under SECTION III -PHYSICAL DAMAGE COVERAGE, in the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance " of the loan/lease. "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments ; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees; security deposits not returned by the lessor; costs for extended warranties , credit life Insurance , health, accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases . 7. AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS -of SECTION III PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag . 8. ELECTRONIC EQUIPMENT -BROADENED COVERAGE a. The exceptions to Paragraphs B.4 EXCLUSIONS -of SECTION III -PHYSICAL DAMAGE COVERAGE are replaced by the follow ing : Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that , at the time of "loss ", is : (1) Permanently installed in or upon the covered "auto"; (2) Removable from a housing unit which is permanently installed in or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above ; or Form HA 99160312 © 2011, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission .) Page 3 of 5 (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. b. Section III -Version CA 00 01 03 10 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C.2 and Version CA 00 01 10 01 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C are each amended to add the following: $1,500 is the most we will pay for "loss" in anyone "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is : (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 9. EXTRA EXPENSE BROADENED COVERAGE Under Paragraph A. -COVERAGE -of SECTION III -PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR -WAIVER OF DEDUCTIBLE Under Paragraph D. -DEDUCTIBLE -of SECTION III -PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 11. TWO OR MORE DEDUCTIBLES Under Paragraph D. -DEDUCTIBLE -of SECTION III -PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group , Inc. company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT,CLAIM , SUIT OR LOSS -of SECTION IV -BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 14. HIRED AUTO -COVERAGE TERRITORY Paragraph e. of GENERAL CONDITIONS 7. - POLICY PERIOD, COVERAGE TERRITORY - of SECTION IV BUSINESS AUTO CONDITIONS is replaced by the following: e. For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 15. WAIVER OF SUBROGATION TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -of SECTION IV - BUSINESS AUTO CONDITIONS is amended by adding the following: Form HA 99 16 03 12 © 2011, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission.) Page 4 of 5 We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. 16. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death resulting from any of these . 17. EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS -CANCELLATION -applies except as follows: If we cancel for any reason other than nonpayment of premium , we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation . 18. HYBRID, ELECTRIC, OR NATURAL GAS VEHICLE PAYMENT COVERAGE In the event of a total loss to a "non-hybrid" auto for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form , then such Physical Damage Coverages are amended as follows: a.lf the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natural gas, we will pay an additional 10%, to a maximum of $2,500, of the "non-hybrid" auto's actual cash value or replacement cost , whichever is less, b. The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," c. Regardless of the number of autos deemed a total loss, the most we will pay under this Hybrid, Electric, or Natural Gas Vehicle Payment Coverage provision for anyone "loss" is $10,000. For the purposes of the coverage provision, a.A "non-hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas . b.A "hybrid " auto is defined as an auto with an internal combustion engine and one or more electric motors; and that uses the internal combustion engine and one or more electric motors to move the auto, or the internal combustion engine to charge one or more electric motors, which move the auto. 19. VEHICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive , Specified Causes of Loss, or Coll ision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended to add the following: In addition to the actual cash value of the "auto", we will pay up to $1 ,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss . Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage provision for anyone "loss" is $5 ,000 . For purposes of this coverage provision , signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps . Form HA 99 160312 © 2011, The Hartford (Includes copyrighted material of ISO Properties , Inc ., w ith its permission.) Page 5 of 5 Policy No . 57UEAQT9730 have all your rights and duties under this Coverage Part. e. Unnamed Subsidiary Any subsidiary, and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of the Coverage Part . The insurance afforded herein for any subsidiary not named in this Coverage Part as a named insured does not apply to injury or damage with respect to which an insured under this Coverage Part is also an insured under another policy or would be an insured under such policy but for its termination or the exhaustion of its limits of insurance. 3. Newly Acquired or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this prov ision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization . 4. Mobile Equipment With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your permission . Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to : a. "Bodily injury" to a co-"employee" of the person driving the equipment; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. Page 10 of 18 5. Nonowned Watercraft With respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons for a charge, any person is an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. ''Bodily injury" to a co-"employee" of the person operating the watercraft; or b . "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision . 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The following person(s) or organization(s) are an additional insured when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement. A person or organization is an additional insured under this provision only for that period of time required by the contract or agreement. However, no such person or organization is an insured under this provision if such person or organization is included as an insured by an endorsement issued by us and made a part of this Coverage Part. a. Vendors Any person(s) or organization(s) (referred to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products- completed operations hazard". (1) The insurance afforded the vendor is subject to the following additional exclusions: This insurance does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; HG 00 010605 Policy NO .57UEAQT9730 that are in excess of the applicable limit of insurance . An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative . 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows : a. Primary Insurance This insurance is primary except when b. below applies . If other insurance is also primary, we will share with all that other insurance by the method described in c. below . b. Excess Insurance This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis : (1) Your Work That is Fire, Extended Coverage, Builder's Risk , Installation Risk or similar coverage for "your work"; (2) Premises Rented To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (3) Tenant Liability That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (4) Aircraft, Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I -Coverage A -Bodily Injury And Property Damage Liability; (5) Property Damage to Borrowed Equipment Or Use Of Elevators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion j. of Section I -Coverage A -Bodily Injury And Property Damage Liability; (6) When You Are Added As An Additional Insured To other Insurance Any other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations , for which you have been added as an additional insured by that insurance; or Page 14 of 18 (7) When You Add Others As An Additional Insured To This Insurance Any other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this coverage part . (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary . If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract , written agreement , or permit that this insurance is primary and non-contributory with the additional insured's own insurance , this insurance is primary and we will not seek contribution from that other insurance . Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers . When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance ; and (2) The total of all deductible and self-insured amounts under all that other insurance . We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares , we will follow this method also . Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. HG 00 010605 Policy No . 57UEAQT9730 If any of the other insurance does not permit contribution by equal shares, we will contribute by limits . Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers . 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates . b. Premium shown in this Coverage Part as advance premium is a deposit premium only . At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured . The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earnE\ld premium, we will return the excess to the first Named Insured . c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations a. When You Accept This Policy By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; (2) Those statements are based upon representations you made to us; and (3) We have issued this policy in reliance upon your representations. b. Unintentional Failure To Disclose Hazards If unintentionally you should fail to disclose all hazards relating to the conduct of your business that exist at the inception date of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies : a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us a. Transfer of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us . The insured must do nothing after loss to impair them . At our request, the HG 00 010605 insured will bring "suit" or transfer those rights to us and help us enforce them . b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments , we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage . 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice . SECTION V -DEFINITIONS 1. "Advertisement" means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through : a. (1) Radio; (2) Television; (3) Billboard ; (4) Magazine; (5) Newspaper; or b. Any other publication that is given widespread public distribution . However, "advertisement" does not include : a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods or products; or b. An interactive conversation between or among persons through a computer network. 2. "Advertising idea" means any idea for an "advertisement" . 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means a land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 5. "Bodily injury" means physical : a. Injury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above , mental anguish or death at any time . Page 15 of 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA Policy Number: 57WEAQT9728 Endorsement Number: Effective Date: 10/01/1 7 Effective hour is the same as stated on the Information Page of the policy . Named Insured and Address: GHILOTTI BROS INC 525 JACOBY ST SAN RAFAEL, CA 94901 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be premium otherwise due on such remuneration . 2 % of the California workers' compensation SCHEDULE Person or Organization ANY PERSON 08 O~('q'J ZA ION ER..)M WHOfV] YOU AR'~ Rf.QllIR:::D --,y ftJRITTEN CONTR.ACT OR AGREEMENT TO 0B'lAIN THI.:o \v.lHvEK. 0" {.G" • S fRO!'] LS Job Description AS e .. ' lIR";D 9'v ~v'( rTTE I CuNTRAC':' Countersigned by ____________________ _ ______ _ Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 9/26/2017 Policy Expiration Date: 010 , 8 ~ THE HARTFORD Bond No... ..?.7I?.~$Ij.P~6 .82 ................... . Contract Bond Public Work -California Premium Charge $4,593 .00 Hartford Plaza, Hartford, Connecticut 06115 Bond E xecuted in Triplicate PERFORMANCE BOND '''This bond supersedes any previously issued bond '" KNOW ALL MEN BY THESE PRESENTS : That we, . G.h!IQW ~.r.()~., In9: ..... .. ... .. ......... . . ... . ..• as Principa I, and the Hartford Fire Insurance Company , a Corporation organ'lzed and existing under the laws of the State of Connecticut and authorized to transact surety business in the State of California, as Surety, are he ld and firm l y bound unto . . City of San R.~fael . in the sum of SIX Hu~dred Forty Nine Thous~nd Nine Hundred .N inety ~even & 00/100. ~~~ ..... Dollars ($. 649,997.00 . ",), 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 ..... 19th day of .... January . ...... . The condition of the foregoinB obligation is such that, whereas the above bounden Principal has entered Into a contract dated ............. . December 14, 2017 ,-+9: . . ,wi th said ... . City of.S~n. .. R~,fa.e.I ................ " ......... .... .... ...... . " .. to do and perform the followinn work, lo·wit: Victor Jones Park Improvements -City Project No. 11289 The surety companies shall familiarize themselves with all of the conditions and provisions of the contract, and shall waive the right of special notification of change or modification of the contract, or of any other act or acts by the City or its authorized agents. under the terms of the contract. Failure to notify the surety companies of changes shall in no way relieve them of their obligations under the contract. NOW, THEREFORE, if the above·bounden Principal shall well and truly perform , or cause to be performed, each and all of the requirements and obligations 01 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 (orce and effect. , ................. 9 ~!.I ()tt.i .~.r<?s.: .... !X!c:, ... " ................................................... , . , .. ... . .... .. ..... " ....... (SEAL) Principal Michael M . Ghilotti, President 1 Treasurer Hartford Fire Insurance Company j~~ BY ----.. -. (SEAL) Attorney·i n·t act Joan Deluca Form 5-3665-1 (HF) Pri nted 'In U.S.A. CALIFORNIA CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the Identity of the Indfvldual 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 ..c:.cM:..:..;acc.:.rc.:..in-'--______ _ On January 25,2018 before me, Deborah Petersen, Notary Public (here insert name and t itle of the office r) personally appeared Michael M . Ghilotti, President who proved to me on the basis of satisfactory evidence to be the persont.;) whose namets) isfere subscribed to the within instrument and acknowledged to me that he/!ineltlley executed the same in his/I.el/tl.eir authorized capacit~), and that by his/hel/tl .eir signaturefs) on the instrument the personfs), or the entity upon behalf of which the personfs) 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. Signature ------~------------------------------(Seal) Optional Information Although the information In this section is not required by law, It could prevent fraudu lent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to pe rsons relying on the attached document. Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of 17425 Victor Jones Park Bonds containing ~ pages, and dated ~ 119!..-/1!..:8<--.. ______ _ The signer(s) capacity or authority is/are as: o Indlvldual(s) o Attorney-in -Fact fKl Corporate Officer(s) President ----~~~~----~T~it~le(~s)-- o Guardian/Conservator o Partner -Limited/General o Trustee(s) o Other: _________________________________ _ represent ing: Ghilotti Bros., Inc. Name(s' of Penon(s) or Enllly (l es, Signer Is Representing iMl1l • U;.uJ1 I Method of Signer Identification --- Proved to me on the basis of satisfactory evidence: o form(s) of Identl~catlon o credible wltness(es) Notarial event Is detailed In notary journal on: Page U Entry # ----- Notary contact: Other o Additional Slgner(sl o Signer(s) Thumbprint(s) 0 o Copyright 2007 2016 Notary Rotary. Inc. PO BOK 41400. Des Molnos. IA 50311·0S07 . All Hlghls Reserved . item Number 101772 . PI.a,e conlact your Authorized Resellerto purchase copies of Ihls form. 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 Marin on----J '>----l"i . ~ 1 <Sol before me, ____ K_, _Holtemann, Notary Public Date Here Insert Name and Title of the Officer personally appeared _____________ Jo_a_n_D_e_L_u_ca _____________ _ Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islar.e- subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hislher/fl:teir authorized capacity(ies), and that by hislher/tOOif' signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s} acted, executed the instrument. Place Notary Seal Above I certify under PENAL TV 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: _________ _ Number of Pages : ___ Signer(s) Other Than Named Above:~~_ Capacity(ies) Claimed by Signer(s) Signer's Name: ____________ ~ [,J Corporate Officer -Title(s): ___ --=-~_ gner's Name: ____________ _ n Corporate Officer -Title(s): ______ _ n Partner -n Limited il General II Partner -n Limited n General o Individual [J Attorne ' o Individual i Attorney in Fact o Trustee I I o Trustee 0 Guardian or Conservator o Other: _-",...~ ___________ _ o Other: _____________ _ Signer Is Representing: _________ _ x,'@.., .. ;(,~~'<~'!,:.(.;<x.'(.".(,'(~'Q:-~=<)<_~'<~"<'_<.,~~'{".(,'<X,'<:,(.;<,.:<,,~'q(,,~'Q(.;<,".<.'<"I,,'<,..<.:~".(,~'C(,~'Q(,'!;(,~~'<;«,~"g;,'g."q(,'g.~"C{,'(;;<,'@.., .. ©2014 National Notary Association' www.NationaINotary.org • 1-800-US NOTARY (1-000-876-6827) Item #5907 POWER OF ATTORNEY Direct Inquiries/Claims to: THE HARTFORD BOND, T-12 One Hartford Plaza Hartford, Connecticut 06155 Bond.Claims@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 ~ Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut D Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut D Twin City Fire Insurance Company, a corporation duly organized under the laws of the State oflndiana D Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of1llinois D Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State oflndiana D 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(ies) 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. John Gray, Assistant !lecretary STATE OF CONNECTICUT} 55. Hartford COUNlY OF HARTFORD M. Ross Fisher, Senior Vice President 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. CERTIFICATE POA 2016 Nora M. Stranko Notary Public My Commission Expires March 31, 2018 Kevin Heckman, Assistant Vice President Contract Bond Public Work -California KNOW ALL MEN BY THESE PRESENTS : That we. . X. THE HARTFORD Bond Executed in Triplicate LABOR AND MATERIAL PAYMENT BOND "'This bond supersedes any previously issued bond'" Bond No ••• ~.?§.~.~!.!~.~~~.? ................... . Premium Charge Included In Premium Charged for Performance Bond Ghilotti Bros .. I nc . . ...... ........ ............. .... ....... ...... ......... ..... .......... .................... ........ ......... '" ............................................................................................................... as Principal. and ........ .ti.!'!rtJ9.[i;I .. f.jr~Jn:lklr.~m(;~ .. G.9mP..i;V.W ...................................................... , a Corporation organized and existing under the laws of the State of Connecticut and authorized to transact surety business in the State of Californ·la. as Surety. are held and firmly bound unto the State of California for the use and benefit of the State Treasurer as ex officio treasurer and custodian of the Unemploymenl Fund and any and all materialmen. persons. companies or corporations furnishing materials, provisions. provender or other supplies used In, upon, for or about the perlorm. ance 01 the work contracted to be executed or performed under the contract -hereinafter mentioned. and all persons. companies or corporations renling or hiring teams. or Implements or machinery. for or contribuling to said work to be done. and all persons performing work or labor upon the same and all persons supplying both work and materials as aforesaid. in the sum of .................................................................................................... . ................. ............ .... §.i~ .. 1;-!.~.~.9 f.E?9.. F..<?~ .. ~ If)~ .. !~.<?.~~~f.1.~ .. ~i.~~ .. I;-!.If.~~ r.~.~. ~! ~~~Y .. :.?~.y.~~ .. ~. q9.~~qq .. :~:: ....... Doliars ($ .... ?~.~ ~ ~~!:P9 ......................... ), lawful money of the United States of America. for the payment whereof well end 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 ..................... ~.~~.~ ......................... day of ........................... ~~.~.~a.~ ......................................... , ·H~c.?a.1.8 The cond ition of the forego ing obligation is such that. whereas the above·bounden Principal has entered inlo a contract. dated ............................... . ..... .P.~~~.fl1.~~.r:.~.~~.~.' .. ?q.~.? .... Hb ........ with .................... ~.i.~y..9f .. $.";1.r:J .. R.~f§.E?I ................................................................................................................... . ................................ ........................................................................................................................................ to do and perform the follow ing work. to wit: Victor Jones Park Improvements· City Project No. 11289 Th e surety companies shall familiarize themselves with all of the conditions and provisions of the con tracl, and shall waive the right of special notification of change or modification of the contact. or of any other act or acts by the City or its aulhorized agents. unde r the terms of the contact. Failure to notify the surety companies of changes shall in no way relieve them of their obligation under the contract. NOW THEREFORE. if the above-bounden Principaf . or ............................ ~~.i.l.C?~~i.I3.~!J~:: .. I.~~: ........................................................................................ .. sub-contractor. fails to pay for any materials. provisions. provender or other supplies or teams. used in. upon. for or about the periormance 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 Ihosame. in an amount not exceeding the sum specified in this bond. and, also. in case suit is brought upon this bond, a reasonable allorney'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 Ihis bond is filed by the Principal to comply wilh the provisions of Chapter 7. Ti lle XV of the C ivil Code of California and other applicable provisions of said Tille' XV relating to Public Work and liability hereunder is subject to the provisions of said section and acts amendatory thereof. and sections of other codes of the Stale of California referred to therein and acts amendatory thoroof. Ghilotti Bros, Inc . ................................................................................................ {SEAL) Principal Michael M. Ghilotti. President / Treasurer ..................... Hf!r.\(Qri;l .. F.ir.~ . .I.mH-!f.~nR~ .. 99.r:nRi'!.Q.Y .................. . \~L 8~ ................................................... :7:-:::: ......... (SEAL) Attorney-in-fact. Joan Deluca rorm S·3674·:J PrintAc1 in U.S.A. CALIFORNIA 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 ..:...M'-'-a:..:..:cr..:..:..in'----______ _ On Janua ry 25 , 2018 before me, Deborah Petersen, Notary Public (here insert name and title of the office rl personally appeared Michael M. Ghilotti, President who proved to me on the basis of satisfactory evidence to be the persont.;) whose namets) ishtre subscribed to the within instrument and acknowledged to me that he!sneltliey executed the same in his/lielitl,eir authorized capacityties), and that by his/l,ell'tl,eir signaturE$) on the instrument the personfs), or the entity upon behalf of which the personfs) 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. Signature __ i/L----_________ ~ ___ ~ __ _ (Seal) Optional Information Although the information In this section is not required by law, it could prevent fraudu lent 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 document titled/for the purpose of 17425 Victor Jones Park Bonds containing ~ pages, and dated _1:..:.1...!..1 ~9/,--,1-=8,----_____ _ The signer(s) capacity or authority is/are as: o Indlvldual{s) o Attorney-in -Fact !Kl Corporate Officer(s) President ----~~~~------T~it~le(~s)----------------- o Guardian/Conservator o Partner -Limited/General o Trustee{s) o Other: ____________________________________________ __ representing : Ghilotti Bros., Inc. Name(s) of Penon(s) or Entlly(les) Signer Is Representing IMIflOhr.rt1I 'ill. . Method of Signer Identification Proved to me on the baSis of satisfactory evidence: o form(sl of Ident(ficatlon o credible wltness(es) Notarial event is detailed In notary Journal on: Page U Entry n ----- Notary contact: Other o Additional Signer(s) o Slgner(s)Thumbprint(s) 0 Cl Copyright 2007 ·20 16 Notary Rota ry. Inc. PO Box 41400. De. Molnos. IA 50311·0507. All Hlghls Reserved. lIem Num ber 101772. Pl ease conl.ct your Author ized Heseller to pureha •• copies of this form . 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 Marin Oii--~ ~ 1'9 ) .,)....01 q before me, _____ K_. H_o_l_te_m_a_n_n,;....N_o_t_ary-'--P_u_b_lic ________ -' Date Here Insert Name and TItle of the Officer personally appeared ____________ J_o_a_n_D_e_L_u_ca _____________ _ Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islar-e- subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hisiher/tAeir authorized capacity(ies), and that by hislher/{-heif signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s} acted, executed the instrument. 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 Y-~ 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: ____________ _ Number of Pages : __ Signer(s) Other Than Named Above:~",,-_____ ~ ____ _ Capacity(ies) Claimed by Signer(s) Signer's Name: _____________ ~ o Corporate Officer -Title(s): ___ ---".."...,'--_ gner's Name: ___________ _ [-1 Corporate Officer -Title(s): _____ _ n Partner -n Limited Ll General 11 Partner -I-I Limited n General o Individual [] Attorne . o Individual LI Attorney in Fact [I Trustee [I Trustee 0 Guardian or Conservator [J Other: _~-=-__ o Other: _____________ _ Signer I Signer Is Representing: ________ _ ;,<.,w.,"'<;~'C(;,'G(.'<:;<;<;:(.;<;.<.,'C(;,-.;;(.,_g.~~h'(;.c.,'C(;,'<;(.,·<;_<;<x.,'<;,(.,~ .. .(.;C(.,'C(;,'C(.'<";(..'~,.;<.:.(.;<.·;,.;<~<;~;.<..'(l'.x:<.'(,X,-g,~'g.;~:,(;~"C(,'<;<.~_g."<;<,_g,~~_g, .. ©2014 National Notary Association' www.Nationa INotary.org • 1 .. 800 .. US NOTARY (1-800 .. 876 .. 6827) Item #5907 Direct Inquiries/Claims to: THE HARTFORD BOND, T-12 POWER OF ATTORNEY One Hartford Plaza Hartford, Connecticut 06155 Bond.Claims@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 [K:J Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut ID Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State oflndiana [K:J Hartford Accident and Indemnity Company, a corporation duly organized under the laws ofthe State of Connecticut D Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut D Twin City Fire Insurance Company, a corporation duly organized under the laws of the State oflndiana D Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois D Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State oflndiana D 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(ies) 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. John Gray, Assistant Secretary STATE OF CONNECTICUT} ss. Hartford COUNTY OF HARTFORD M. Ross Fisher, Senior Vice President 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 a nd that he signed his name thereto by like authority. CERTIFICATE POA2016 Nora M. Stranko Notary Public My Commission Expires March 3 1, 2018 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: Shawn Graf Extension: 5347 Contractor Name: Ghilotti Bros., Inc. Contractor's Contact: Debbie Patterson Contact's Email: Debbiep@ghilottibros.com o FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION DEPARTMENT 1 Project Manager a. Email PINS Introductory Notice to Contractor b. Email contract (in Word) & attachments to City Atty c/o Laraine.Gittens@cityofsanrafael.org 2 City Attorney a. Review, revise, and comment on draft agreement and return to Project Manager b. Confirm insurance requirements, create Job on PINS, send PINS insurance notice to contractor 3 Project Manager Forward at least two originals of final agreement to contractor for their signature 4 Project Manager When necessary, * contractor-signed agreement agendized for Council approval *PSA > $20,000; or Purchase> $35,000; or Public Works Contract> $125,000 Date of Council approval PRINT CONTINUE ROUTING PROCESS WITH HARD COPY 5 Project Manager Forward signed original agreements to City Attorney with printed copy of this routing form 6 City Attorney Review and approve hard copy of signed agreement 7 City Attorney Review and approve insurance in PINS and, and bonds (for Public Works Contracts) 8 City Manager / Mayor Agreement executed by Council authorized official 9 City Clerk Attest signatures, retains original agreement and forwards copies to Project Manager COMPLETED DATE Click here to enter a clate. 11/2/2017 11/3/2017 11/3/2017 12/7/2017 0 N/A Or 11/20/2017 1/8/2018 1/'30 J I~ I /3D J I 'if' 2 -J--1t; 2 l v /lf> REVIEWER Check/Initial 0 IZI HY IZI LAG IZI LAG IZI SPG IZI SPG IZI SPG ~ ~ K/ '--J bf~