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PW 3rd & Cijos Street Transit Center ImprovCity of San Rafael + California Form of Agreement For 3 rd Street and Cijos Street Transit Center Improvements City Project No. 11333 This Agreement is made and entered into this -day of fe'oMn~~M/ 20\\2 by and between the City of San Rafael (hereinafter called "City") and Maggiora & Ghilotti, Inc, a Call ornla corporation (heremafter 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 plans and specifications for the project entitled: 3rd Street and Cijos Street Intersection Improvements, City Project No. 11333, all in accordance with the Specifications and Contract Documents dated August 18 ,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 punch list work, within Twenty (20) 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 $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 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. However, any additional units not specifically enumerated in this Agreement that are to be incoroporated in or are made necessary by work covered by the Agreement, and any compensation in excess of the total Contract amount of $237,732.00, must be requested and approved in writing as an addendum to this Contract. ITEM # I. 2. 3. 4. 5 . DESCRIPTION Mobilization Signs and Traffic Control Clearing and Grubbing Full Width Grinding Minor Concrete -Minor Structures a. Type A Curb and Gutter ESTIMATED QUANTITY 160 Page 1 of3 UNIT UN IT PRICE TOTAL PRICE LS @ $7,000.00 -$7,000.00 LS @ $27,230 .00 -$27,230.00 LS @ $42,000 .00 $42,000.00 LS @ $8,500.00 $8,500.00 LF 1[, ___ $'-.-6-,-0_.0_0_ $9,600.00 ITEM DESCRIPTION # ESTIMATED UNIT UNIT PRICE TOTAL PRICE QUANTITY b. Type E Vertical Curb 75 LF @ $70.00 $5,250.00 c. 4" Thick PCC Sidewalk 1,500 SF @ $15.00 $22,500.00 d. 6" Thick PCC Pad (Parking) 800 SF @ $20.00 $16,000.00 e. Curb Ramp (Caltrans Std Case "A") 2 EA @ $7,500.00 $15,000.00 f. Type E Catch Basin wi Gallery Inlet 3 EA @ $5,000.00 $15,000.00 g. Modified Catch Basin EA @ $5,000.00 $5,000.00 6. Hot Mix Asphalt 165 TON @ $240.00 $39,600.00 7. Signs and Striping LS @ $8,000.00 $8,000.00 8. Storm drain Pipe 65 LF @ $215.00 $13,975.00 9. Adjust (E) Facilities to Grade a. Water Valve Cover 2 EA @ $267.00 $534.00 b. PG&EBox 2 EA @ $535.00 $1,070.00 c. Telephone Box EA @ $535.00 $535.00 d. SO Manhole Lid EA @ $938.00 $938.00 GRAND TOTAL BID: $237,732.00 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 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. Page 2 of3 (b) Before final payment is due the Contractor shall submit evidence satisfactory to the Engineer that all payrolls, material bills, and other indebtedness connected with work have been paid, except that in case of disputed indebtedness or liens the Contractor may submit in lieu of evidence of payment a surety bond satisfactory to the City guaranteeing payment of all such disputed amounts when adjudicated in cases where such payment has not already been guaranteed by surety bond. (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 Engineer so certifies, the City shall, upon certificate of the Engineer, and without terminating the Contract, make payment of the balance due for that portion of the work fully completed and accepted. Such payment shall be made under the terms and conditions governing final payment, except that it shall not constitute a waiver of claims. 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 affect 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: CITY OF SAN RAFAEL: ~~ ----------------------Lindsay Lara Interim City Clerk P~mte: Scoff Ghilotti TItle of Corporate Officer: V· P 'd Ice resl ent File No.: 16.16.18 Page 3 of3 Maggiora & Ghilotti, Inc. Letter of Transmittal Engineering Contractors 555 DuBois Street -San Rafael, Ca. 94901 Date: 01-08-18 I Job# 7672 (415) 459-8640 -Fax (415) 459-4884 Attn: RE: 3rd Street & Cijos Street Transit Center To: City_ of San Rafael Attn: Divid Nicholson 111 Morphew San Rafael, Ca. 94901 We are sending you 0 Attached Under separate cover via ________ the following items: 4 Shop Drawings DC f L tt opY 0 e er opies Date 3 1 1 Prints o Ch an~ No. e Od r er Contract o Plans DOth er Payment & Performance Bond Insurance Certificate These are Transmitted as checked below: o For Approval 0 Approved as Submitted o For Your Use 0 Approved as Noted o As Requested 0 Returned for Corrections o Review and Comment 0 Prints Returned After Loan to Us o For Bids Due ,20_ 0 Other o Samples o Specifications Description o Resubmit _ Copies for Approval o Submit _ Copies for Distribution o Return Corrected Prints Please return one signed contract for each project to my attention. Thank you Signed:_----:;i.r4r~4J'-----~-------­ Matthew Petray, Controller Bond No . 070021305 Premium : $1,284 .00 The Ohio Casualty Insurance Company Perfonnance Bond KNOW ALL MEN BY THESE PRESENTS. That we MAGGIORA & GHILOTTI, INC . . as Principal. (hereinaller called Principal) and The Ohio Casualty Insurance Company , with principal offices in Keene New Hampshire as Surety, (hcreinafter called Surety) arc held and firmly bound unto City of San Rafael PO Box 151560 San Rafael CA 94915 as Obligee , (hereinafter called Obligee). in the amount of Two Hundred Thirty Seven Thousand Seven Hundred Thirty Two and no/100 Dollars $ 237,732.00 ----------~------------------------~-------------------------------------------f()r payment of which sum well and truly to be made, we bind ourselves , our heirs. executors, administrators. successors and assigns Jirmly by these presents. WIIEREAS. the Principal did on February 09,2018 ----~-----------------------------------------------------------enter into a contract with said Obligee for 3rd Street and Cijos Street Transit Center Improvements -City Project No 11333 which contract is by reference made a part hereof and is hereinafter referred to as the contract. NOW, TIlEREFORE, THE CONDITION OF THIS OBLIGATION, is such that if the Principal shall indemnify the Obligee against any loss or damage directly arising by reason ofthe failure of the Principal to faithfully perform said contract, then this obligation shall be null amI void: otherwise to remain in full force and effect. This bonu is executed and accepted subject to the following conditions: (I) That thc Obligec shall faithfully and punctually pertorm all the terms and conditions of said contract to be perfonncd by the Obligee . (2) T hat the Obligee shall notit)' the Surety by registercd Ictter, addresscd and mailed to it at its home office, 136 North Third Street. Hamilton. Ohio 45025. of any breach of said contract within a reasonable time aller such breach shall have come to the knowledge of the Obligee. (3) No suit at law or proceedings in equity to recover on this bonu shall be instituted aller one (I) year from the date of acceptance of the project. SIGNED. SEALED AND DATED: February 09,2018 S-13 8 (Pert) Principal By: ----~~--~~---+~--~~------~------------------ The Ohio Casualty Insurance Company s t-~ By: J...lI<7 'OM Jill Seym r (A ttorney-in-F act) THis POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certifi cate No. 7893498 Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Oh io Casua lty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutua l Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Sandra J. Dunaway; Tom Griffith; Jenny Hagemann; Paul Ramatici; Jill Seymour all of the cily of PETALUMA , state of CA each individually if Ihere be more than one named, its true and lawful attorney·in-fact to make, execute, seal, acknowledge and del iver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by Ihe president and attested by the secretary of the Companies in Iheir own proper persons. IN WITNESS WHEREOF, th is Power of Attorney has been subscribed by an author ized officer or official of the Companies and Ihe corporate seals of the Companies have been affixed thereto this 19th day of September . ~. STATE OF PENNSYLVANIA COUNTY OF MONTGOMERY ss The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West ~merican Insurance Company . /) ,/'J By: ~~~/~/~~.~~~'.~~~~~~ /_~~p~~ __________________ _ David M. Carer:Assistant Secretary On this ~ day of September ,2017 , before me personally appeared David M. Carey, who acknow ledg ed himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being auth orized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the co rporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subs cribed my name and affixed my notarial seal at King of Prussia, Penn syl vania, on the day and year first above written . OF COMMONWEALTH OF PENNSYLVANI A ----~.-.-.. --.---.-.~---- NOlilrial Seal TereSi) Pastelia, NottJry Pub lic: Upper Merion Twp .. Monlgomery County My Commiss io n Expires March 28,2021 ~ ~ 'h ''Vf.'SV\,~\>o'' ~ Oi.qRY ~v Memhor. P ennsylvania Association l" Nutar io:> BY:.~~~ Teresa Pastella, Notary Public This Power of Attorney is made and execute d pursuant to and by authority of the following By-laws and Auth ori zations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect re adi ng as follows : ARTICLE IV -OFFICERS -Section 12. Power of Attorney . Any officer or other official of the Corporation authorized for that purpose in writing by tile Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys-in-fact, as may be necessary 10 act in behalf of the Corporation 10 make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations. Such attorneys-in-fact, subject to the limitations sel forth in Iheir respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the Presidenl and attesled to by the Secrelary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII-Execution of Contracts -SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for Ihat purpose in writing by the chairman or the president, and subject to such limitalions as the chairman or Ihe president may prescribe, shall appoint such attorneys-in-fact, as may be necessary 10 act in behalf of Ihe Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations . Such attorneys-in-fact subject to the limitations sel forth in their respeclive powers of attorney, shall have full power to bind the Company by their signalure and execution of any such inslruments and 10 attach Ihereto Ihe seal of Ihe Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation -The President of the Company, acting pursuant 10 the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surely any and all undertakings, bonds, recognizances and other surety obligations. Authorization -By unanimous consent of Ihe Company's Board of Directors, the Company consents Ihal facsimile or mechanically reproduced signalure of any assistanl secretary of the Company, wherever appearing upon a certified copy of any power of attomey issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manua ll y affixed. I, Renee C. Llewellyn, the undersigned , Ass istant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby cert ify that the original power of attomey of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. q-tJ;. IN TESTIMONY WHEREOF , I have hereunto sel my hand and affixed Ihe seals of said Companies Ihis day of , 20...1.!i-. BY:--~~--__ -t __ ~ ________________ _ 44 of 75 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 Sonoma On [;k (~5]." iiC2( g bebe me, Jenny Anne Hagemann -Notary Public j (insert name and title of the officer) personally appeared Jill Seymour who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 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. Signat ~c::.....:....:"'!"';':-+.-!~!.J..A.~~~~~L!.!...I-_ (Seal) " Bond No. 070021305 Premium: Included in Performance Bond The Ohio Casualty Insurance Company KNOW ALL MEN BY THESE PRESENTS, That we MAGGI ORA & GHILOTII, INC . PaYlnent Bond (hereinatier called Principal) and The Ohio Casualty Insurance Company New Hampshire, as Surety, (hereinat1.er called Surety) are held and tilmly bound unto City of San Rafael PO Box 151560 San Rafael CA 94915 as Obligee, (hereinatler called Obligee), in the amount of Two Hundred Thirty Seven Thousand Seven Hundred Thirty Two and no/100 , as Principal , , with principal orfices in Keene. Dollars $ 237,732.00 for payment of which sum well and truly to be made. we bind ourselves. our heirs , executors. administrators, successors and assigns tirml) by these presents. WHEREAS, the Principal did on February 09,2018 -------------------------------------------------------------------enter into a contract with said Obligee ror 3rd Street and Cijos Street Transit Center Improvements -City Project No 11333 \\ hich contract is by reference made u part hcreof and is hereinafter referred to as the contract. NOW. THEREFORE. THE CONDITION OF THIS OBLIGATION. is such that if the Principal shall indemnify the Obligee against any loss or damage directly arising by reuson ofthe railure of the Principal to pay all just claims for labor and material furnished in the completion of said contract by persons, tirms or corporations having direct contracts with the Principul. then this obligation shall be null and void: otherwise to remain in full rorce and effect. This bond is executed and accepted subject to the following conditions : ( I) That the Obligee shall faithfully and punctually perform all the terms and conditions of said contract to be pcrfonned by the Obligee. (2) That the Obligee shall notify the Surety by registered lelter. addressed and mailed to it at its home oflice, 62 Maple Avenue, Keene, New Hampshire 03431, of any breach of said contract within a reasonable time after such breach shall have come to the knowledgc of the Obligee. (3) No suit at law or proceedings in equity to recover on this bond shall be instituted after one (I) year from the date of acceptance or the project. SIGNED, SEALED AND DATED: February 09,2018 --------------------------------------------------------------- By: --~---+~~~~~~------~~~----~-------------------------- The Ohio Casualty Insurance Company ~~ ~ By: ~7~ Jill Sour (A ttorney-in-Fact) S-13X(Pa y ) THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certifi cate No . 7893497 Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS : That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Ind iana (herein collectively called the "Companies"). pursuant to and by authority herein set forth, does hereby name, constitute and appoint. Sandra J. Dunaway; Tom Griffithj Jenny Hagemannj Paul Ramaticij Jill Seymour all of the city of PETALUMA , state of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and de li ver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and sha ll be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons, tN WITNESS WHEREOF, th is Power of Attorney has been subscribed by an authorized officer or offic ial of the Companies and the corporate seals of the Companies have been affixed thereto this 19th day of September , ~. STATE OF PENNSYLVANtA COUNTY OF MONTGOMERY ss The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West American Insurance Company ./7 1,,// By: ~~22·~~'~~~~~/'~'/(._·~~·~ ________________ _ David M. Carey-:Assistant Secretary On this ~ day of September ,2017 , before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do , execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. tN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. COMMONWEALTH OF PENNSYLVANIA Notarial Senl Teresa Pasteila. Notary P ublic Up per Merion Twp., Monlgomery County My Comm ission Expires March 28.2021 Member. Pennsylvania Association of NfJtmies By:~#J ~ Teresa Pastella , Notary Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West Amer ican Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV -OFFICERS -Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the PreSident may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII -Execution of Contracts -SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact. as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation -The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization -By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. 1. Renee C. Llewellyn, the undersigned, Assistant Secretary, The Oh io Casua lty Insurance Company, Liberty Mutual Insurance Company, and West Amer ic an Insurance Company do hereby certify that the original power of attorney of which the foregoing is a fu ll, true and correct copy of the Power of Attorney executed by said Companies, is In full force and effect and has not been revoked. q-t:b- IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the sea ls of said Companies th is day of ,20 11 By: __ ~~ ____ ~~~ ______________ __ , ssistant Secretary 43 of 75 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 Sonoma On 6ln ~ 9, ZO/ {!; before me, Jenny Anne Hagemann -Notary Public (insert name and title of the officer) personally appeared Jill Seymour who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 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. (Seal) MAGGI-1 OP 10' 50 ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) ~ 02108/2018 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 ~~~~~CT Paul Ramatici Don Ramatici Insurance, Inc. WgN~o Ext}; 707-782-9200 I rfi~ No): 707-782-9300 P.O. Box 551 Petaluma, CA 94953 E·MAIL ADDRESS: Paul Ramatici INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Travelers Indemnity Co. of CT 25682 INSURED Maggiora & Ghilotti, Inc. INSURER B : Travelers Prop .Cas.Co.America 25674 555 Ou Bois Street INSURER c: San Rafael, CA 94901 INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER' REVISION NUMBER' THIS IS TO CERT)FY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL I~; '(~~T~g~) ,(~~~g~) LIMITS LTR IINSD POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 -o CLAIMS·MADE 0 OCCUR ~~~~~~J?E~~~~~~encel y DT22C09J210471TCT17 10/01/2017 10/01/2018 s 300,000 X PO Oed $10k-Occ MED EXP (Anyone person) S 5,000 X XCu/lnd Cont Incl PERSONAL & ADV INJURY S 2,000,000 - ~'L AGGREGATE LIMIT APPLIES PER . GENERAL AGGREGATE S 4,000,000 o PRO· D PRODUCTS· COM PlOP AGG 4,000,000 POLICY JECT LOC S OTHER. Emp Ben. S 1,000,000 AUTOMOBILE LIABILITY if=~~~~~~~tfINGLE LIMIT $ 2,000,000 -:-;-A X ANY AUTO Y DT81 09J21 0471TCT17 10/01/2017 10/01/2018 BODILY INJURY (Per person) $ -ALLOWNED ,--SCHEDULED BODILY INJURY (Per accident) S AUTOS AUTOS X rx NON-OWNED rp~~~~~d~~t~AMAGE $ HIRED AUTOS AUTOS -l- S ~ UMBRELLA LIAB M OCCUR EACH OCCURRENCE S 4,000,000 B EXCESS LIAB CLAIMS-MADE CUP9J6834101726 10/01/2017 10/01/2018 AGGREGATE s 4,000,000 OED I X I RETE NTION S 10,000 $ WORKERS COMPENSATION X I ~-\%UTE I 1 0TH• AND EMPLOYERS' LIABILITY ER YIN B ANY PROPRI ETORIPARTNERIEXECUTIVE D y UB9J2104711726G 10/01/2017 10/01/2018 E.L. EACH ACCIDENT $ 1,000,000 OFF IC ERIM EM8ER EXCLUDED? N/A (Mandatary In NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, descri be under DE SC RIPTI O N OF OPERAT IONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESC RIPTION OF OPERATIONS I LOCATIONS I VEH ICLES (ACORD 101 , Additional Remarks Schedule, may be attached If more space Is required) *Certificate Holder as additional ins ured with prima:x verbia2e when required by written contract per CGD2460805, CAT3 30215 WC990376 attached. Umbrella follows form to GL, Auto & Employers Liability policies above. Job: 3rd Street & Cijos Street Transit Center Improvements 1 M&G #7672 *10 day notice sent on non-payment C ERTIFICATE HOLDER CANCELLATION SANRAF4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANC ELLED BEFORE City of San Rafael THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. officers, agents, employees and volunteers* AUTHORIZED REPRESENTATIVE PO Box 151560 qaOCMM~ San Rafael, CA 94915 I © 1988-2014 ACORD CORPORATION. All rig hts reserved. AC ORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Named Insured: Muggiora & Ghilotli, Inc. Policy #: DT22C09]210471TCT17 COMMERCIAL GENERAL LIAS IL ITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED -(Section II) Is amended c) The Insurance provided to the additional In- sured does not apply to "bodity Injury" or "property damage" caused by "your work" and Included In Ihe "products-compleled op- erations hazard" unless the "written contract requiring Insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional Insured applies only to such "bodily Injury" or "property damage" Ihat oc- curs before the end of the period of time for which the "wrltlen conlract requiring Insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. to Include any person or organization that you agree In a "written contracl requiring Insurance" to include as an additional insured on this Cover- age Pari, bul: a) Only wilh respect to liability for "bodily Injury", "property damage" or "personal Injury"; and b) If, and only to the extent that, the injury or damage Is caused by acts or omissions of you or your subcontractor In Ihe performance of "your work" 10 which the "written contract requiring insurance" applies. The person or organlzalion does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2, The Insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of tills Coverage Part shown In the Declarations exceed the limits of liability required by the "wrilten contract requiring Insurance", the In- surance provided to the additional insured shall be limited to the limits of liability re- quired by thaI "written contract requiring In- surance". This endorsemenl shall not In- crease the limits of insurance described in Section III -Limits Of Insurance. b) The Insurance provided 10 the additional In- sured does not apply 10 "bodily InJury", "prop- erty damage" or "personal Injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: I. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or Ihe preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and II. Supervisory, Inspection, architeclural or engineering activities. 3, The Insurance provided to Ihe additional Insured by Ihis endorsement Is excess over any valid and collectible "other Insurance", whether primary, excess, contingent or on any other basis, Ihat Is available to the additional Insured for a loss we cover under this endorsement. However, If the "written contract requiring Insurance" specifically requires that Ihls insurance apply on a primary basis or a primary and non-contributory basis, Ihls Insurance Is primary to "olher Insurance" available to the additional Insured which covers that person or organization as a named Insured for sur.h loss, and we will not share with thaI "other Insurance". But the Insurance provided to Ihe additional insured by this endorsement stili Is excess over any valid and collectible "other In- surance", whether primary, excess, contingent or on any other basis, lhal Is available 10 lhe addi- tional Insured when thaI person or organization Is an additional Insured under such "olher insur- ance". 4, As a condillon of coverage provided to the additional Insured by Ihls endorsement: a) The additional insured must give us written nollce as soon as practicable of an "occur- rence" or an offense which may resuil In a claim. To Ihe extent possible, such notice should Include: CG 02460805 © 2005 The st. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence " or offense took place; Ii. The names and addresses of any injured persons and witnesses; and III. The natura and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim Is made or "suit" is brought against the additional insured, the additional insured must: I. I mmediately record the specifics of the claim or "suit" and the date received; and iI. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit " as soon as practicable. c) The additional insured must immediate ly send us copies of all legal papers received In connection with the claim or "suit", cooperate with us in tile investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other Insurance" which would cover the addition a Insured for a loss we cover under this endorsement. However. this condition does not affect whether the Insur- ance provided to the additional insured by this endorsement is primary to "other Insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. -DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement Is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 Named Insured: M,lggiora & Ghilolli, Inc. Policy # DT8109]2lO171TCT17 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However. coverage for allY inJury, damage or medical expenses described In any of the provisions of this endorsement may be excluded or limited by anolher endorsemenl to Ihe Coverage Part, and tilese coverage broadening provisions do not apply to the extenl thai coverage Is excluded or limited by such an endorsement. The fol/owlng listing is a general coverage description only . Limitations and exclusions may apply to these coverages. Read aI/the provisions of this endorsemenl and Ihe resl of your policy carefully to delermlnc rights, duties, and what Is and Is not covered . A. BROAD FORM NAMED INSURED 8. BLANKET ADDITtONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS F, HIRED AUTO LIMITED WORLDWIDE COVERAGE -INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE -GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following Is added to Paragraph A.1., Who Is An Insured, of SECTION " -LIABILITY COVERAGE: Any organization you newly acquire or form during the policy period over which you malnlain 50% or more ownership Interest and that Is not separately insured for Business Auto Coverage. Coverage under this provision Is afforded only until the 1BOth day after you acquire or form the organization or the end of the policy period, whichever Is earlier. B. BLANKET ADDITIONAL INSURED The fol/owing Is added to Paragraph c. In A,1., Wt)O Is An Insured, of SECTION II -LIABILITY COVERAGE: This Includes any person or organizallon wllo you are required under a writlen contract or agreemenl between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is In effect during the policy period, to name H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L, NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N, UNINTENTIONAL ERRORS OR OMISSIONS as an additional insured (or Liability Coverage, but only for damages to which this Insurance applies and only to the exlent or that person's or organization's liability for the conduct of another "Insured". C. EMPLOYEE HIRED AUTO 1, The fol/owlng Is added to Paragraph A.1., Who Is An Insured, or SECTION " - LiABILITY COVERAGE: An "employee" of yours Is an "insured" while operating an "auto" hired or rented under a contract or agreement In that "employee's" name, with your permiSSion, while performing duties related to the conduct of your business. 2. The fol/owlng replaces Paragraph b, in B.5., Other Insurance, of SECTION IV - BUSINESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Coverage, the fol/owlng are deemed to be covered "autos" you own: CA T3 5308 17 © 201 G The Travelers Indemnlly Company. Allrlghls reserved. Page 1 of 4 Includes copyrlghled malerlal or Illsurance SerYlces Office, Inc. wllhlls permission COMMERCIAL AUTO (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that Individual "employee's" name, with your permission, while performing duties related to tile conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto", D. EMPLOYEES AS INSURED The following is added to Paragraph A, 1., Who Is An Insured, of SECTION " -LIABILITY COVERAGE: Any "employee" of yours Is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs . E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION" -LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds, 2. The following replaces Paragraph A.2.a.(4), of SECTION II -LIABILITY COVERAGE : (4) All reasonab le expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. F. HIRED AUTO LIMITED WORLDWIDE COVERAGE -INDEMNITY BASIS The following replaces Subparagraph e. in Paragraph B. 7., Policy Term, Coverage Territory, of SECTION IV -BUSINESS AUTO CONDITIONS: e. Anywhere in the world, except any country or jurisdiction while any trade sanction, embargo, or similar regulation imposed by the United States of America applies to and prohibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that Is not an "auto" you lease , hire, rent 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, (1) With respect to any claim made or "suit" brought outside the United States of America, tile territories and possess ions of the United States of America, Puerto Rico and Canada : (a) You must arrange to defend the "Insured" against, and Investigate or settle any such claim or "suit" and keep us advised of all proceed ings and actions , (b) Neither you nor any other Involved "insured" will make any settlement without our consent. (c) We may, at our discretion, participate in defending the "Insured" against, or in the settlement of, any claim or "suit", (d) We will reimburse the "insured"; (I) For sums that the "Insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "insured" pays with our consent, but only up to the limit described In Paragraph C., limit Of Insurance, of SECTION II - LlABIL TY COVERAGE; (Ii) For the reasonable expenses Incurred with our consent for your investigallon of such claims and your defense of the "Insured" against any such "suit", but only up to and Included within the limit described in Paragraph C., Limit Of Insurance, of SECTION II - LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (2) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess contingent or on any other basis. (3) This insurance is not a substitute for required or compulsory insurance in any country outside th e United States, Its Page 2 of 4 © 2016 The Travelers Indemnity Company. All rights reserved CA T3 530817 Includes copyrighted material of Insurance Services Office, Inc. with Its permission territories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such country up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory insurance requirements. (4) It Is understood that we are not an admitted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Canada. We assume no responsibility for the furnishing of certificates of Insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE -GLASS The following is added to Paragraph D., Deductible, of SECTION III -PHYSICAL DAMAGE COVERAGE: No deductible for a covered "aulo" will apply 10 glass damage If the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT The following replaces the last sentence of Paragraph A.4.b., Loss Of Use Expenses, of SECTION III PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for anyone "accident". I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT The following replaces the first sentence In Paragraph A.4.a" Transportation Expenses, of SECTION III PHYSICAL DAMAGE COVERAGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportalion expense Incurred by you because of the total theft of a covered "auto" of the private passenger type . J. PERSONAL EFFECTS The following is added to Paragraph A.4., Coverage Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: COMMERCIAL AUTO Personal Effects We will pay up to $400 for "loss" to wearing apparel and other personal effects which are: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage applies only In the event of a total theft of your covered "auto". No deduclibles apply to this Personal Effects coverage. K. AJRBAGS The following is added to Paragraph 8.3., Exclusions, of SECTION III -PHYSICAL DAMAGE COVERAGE : Exclusion 3.a. does not apply to "loss" to one or more alrbags in a covered "auto" you own thai infiate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Comprehensive Coverage under this policy; b. The airbags are not covered under any warranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following Is added to Paragraph A.2,a., of SECTION IV -BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representative prompt notice of the "accident" or "loss" applies only when the "accident" or "loss" is known to: (a) You (if you are an Individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability company); (d) An executive officer, director or Insurance manager (if you are a corporation or olher organization); or (e) Any "employee" authorized by you \0 give notice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV BUSINESS AUTO CONDITIONS: CAT3530817 ~ 2016 The Travelers Indemnlly Company . All rights reserved. Page 3 of 4 Includes copyrlghled material of Insurance Services Office, Inc. with Its permission COMMERCIAL AUTO 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Concealment, Misrepresentation, Or Fraud, of SECTION IV -BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insura nee . However this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. Page 4 of 4 © 2016 The Travelers Indemnity Company. All rights reserved. CA T3 530817 Includes copyrighted material of Insurance Services Ornee, Inc. with lis permission ~ TRAVELERSJ WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A)- WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right againsl the person or organizalion named In the Schedule . Tile additional premium for this endorsement shall be 2 % of the California workers' compensation premium. Schedule Person or Organization ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Job Description This endorsement changes the policy to which It is attached and Is effective on the date Issued unless otherwise stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective: 10/01/17 Policy No. UB9J2104711726G Endorsement No. Named Insured: Maggiora & Ghilottl, Inc. Premium Travelers Property Casually Insurance Co. Countersigned by __________________ _ Page 1 of 1 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: Dave Nicholson Extension: 3454 Contractor Name: Maggiora & Ghilotti, Inc. (Project No. 11333 -3'd and Cijos Transit Center Improvements) Contractor's Contact: Scott Ghilotti Contact's Email: Ghilotti@gmail.com o FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED DEPARTMENT DATE 1 Project Manager a. Email PINS Introductory Notice to Contractor 1/22/2018 1/22/2018 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 1/23/2018 and return to Project Manager 1/23/2018 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 0 N/A agendized for Council approval *P5A> $20,000 ; or Purchase> $35,000 ; or Or Public Works Contract> $125 ,000 Date of Council approval 2/5/2018 PRINT CONTINUE ROUTING PROCESS WITH HARD COPY 5 Project Manager Forward signed original agreements to City 2/12/18 Attorney with printed copy of this routing form 6 City Attorney Review and approve hard copy of signed v~ II ~ //tf agreement 7 City Attorney Review and approve insurance in PINS and, and ;2/) Lf I '"i bonds (for Public Works Contracts) REVIEWER Check/Initial ~ DN ~ DN ~ LG ~ LG 0 ~ ~ ~ -~ 8 City Manager / Mayor Agreement executed by Council authorized official 7~llb' 'I ~-tl( 9 City Clerk Attest signatures, retains original agreement and -, ~ forwards copies to Project Manager 1J lllll'~'