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PW 2017 Storm Damage Repair - #70 Irwin StreetCity of San Rafael ♦ California Form of Agreement for 2017 STORM DISASTER REPAIR #70 Irwin Street Project Number 11308 This Agreement is made and entered into this _�_ day of �t?{ • 2018 by and between the City of San Rafael (hereinafter called City) and Valentine Corporation. (hereinafter called Contractor). Witnesseth, that the City and the Contractor, for the considerations hereinafter named, agree as follows: I - Scope of the Work The Contractor hereby agrees to furnish all of the materials and all of the equipment and labor necessary, and to perform all of the work described in the specifications for the project entitled: 2017 STORM DISASTER REPAIR #70 Irwin Street, all in accordance with the requirements and provisions of the Contract Documents as defined in the General Conditions which are hereby made a part of this Agreement. The required additional insured coverage for City under contractor's liability insurance policy shall be primary with respect to any insurance or coverage maintained by city and shall not call upon city's insurance or self-insurance for any contribution. II- 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 Sixty (60) 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 $1,900 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. BASE BID ITEMS ITEM DESCRIPTION ESTIMATED UNIT UNIT TOTAL PRICE QUANTITY PRICE 1. Mobilization 2. Signs and Traffic Control 3. Clearing and Grubbing 4. Cast in Drilled Hole (CIDH) Piles ** 5. Concrete Retaining Wall ** 4-I--T-Zq 1 LS a 30,000.00 = 30,000.00 1 LS a 43,907.00 = 43,907.00 1 LS a 101,305.00 = 101,305.00 320 LF « 450.00 = 144,000.00 119 CY @ 1,430.00 = 170,170.00 ORL�, ,%A ITEM DESCRIPTION ESTIMATED UNIT UNIT TOTAL PRICE QUANTITY PRICE 6. Tieback Anchors ** 7. Excavation ** 8. Backfill ** 8. MSE Block Wall 9. '/<" Clean Crushed Drainrock 10. Mirafi 140 N Filter Fabric 11. 6" Diameter Perforated & Non Perforated Subdrain 12. Subdrain Cleanout 13. 6 Foot Conform Grind 14. Class 2 Aggregate Base 15. Hot Mix Asphalt Concrete 16. AC Berm 17. Redwood Fence 18. Furnish and Install 12" Diameter HDPE 19. Minor Concrete Minor Structures a. Driveway b. Sidewalk c. Curb and Gutter d. Type C Catch Basin e. Manhele f. Drop Inlet g. Wall Gutter (Type 133-6) h. Concrete Lined Ditch i. Down Drain Holddowns (Type D87B) i. Flagstone Steps 20. 6" Minus - Rock Rip Rap "Final Pay Item 745 LF a 219.00 = 163,155.00 213 CY @ 621.00 = 132,273.00 600 CY a 131.00 = 78,600.00 676 SF @ 64.00 = 43,264.00 170 TON a 183.00 = 31,110.00 5000 SF a 1.00 = 5,000.00 560 LF a 42.00 = 2,3520.00 12 EA a 380.00 = 4,560.00 40 LF a 145.00 = 5,800.00 50 TON 156.00 = 7,800.00 25 TON a 600.00 = 15,000.00 50 LF a 150.00 = 7,500.00 165 LF a 160.00 = 26,400.00 170 LF « 110.00 = 18,700.00 2 EA @ 500.00 = 1,000.00 800 SF a 25.00 = 20,000.00 80 LF a 145.00 = 11,600.00 1 EA « 6,000.00 = 6,000.00 -1 €A @e = 3 EA a 3,500.00 = 10,500.00 141 LF a 39.00 = 9,729.00 160 LF « 75.00 = 12,000.00 3 EA a 800.00 = 2,400.00 1 LS a 1,700.00 1,700.00 18 TON a 132.00 = 2,376.00 GRAND TOTAL BID S 1,129,369.00 One million one hundred twenty-nine thousand three hundred sixty-nine dollars and 00/100 (GRAND TOTAL BID WRITTEN IN WORDS) 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) Final payment of all moneys due shall be made within 15 days after the expiration of 35 days following the filing of the notice of completion and acceptance of the work by the Public Works Department. (d) The Contractor may elect to receive 100% of payments due under the contract from time to time, without retention of any portion of the payment by the public agency, by depositing securities of equivalent value with the public agency in accordance with the provisions of Section 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. (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. IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute this Agreement the day and year first written above. CITY OF SAN RAFAEL: .%i t h City ananagcr ATTEST: Lindsay Lara City Clerk APPROVED AS TO FORDO: L 6, ) L— Robert F. Epstein City Attorney File No. 16.01.285 Valentine Corporation. By: Printed Name Officer: Robert 0. Valentine Title of Corporate Officer: President and, r / Printed Name of Officer:Madeleine Valentine Title of Corporate Officer:Secretary/Treasurer EXECUTED IN TRIPLICATE Bond No.: 9291056 Premium: $8,187.00 THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A312 Performance Bond Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. CONTRACTOR (Name and Address): Valentine Corporation 111 Pelican Way San Rafael, CA 94901 OWNER (Name and Address): City of San Rafael 111 Morphew Street San Rafael, CA 94901 SURETY (Name and Principal Place of Business): Fidelity and Deposit Company of Maryland 525 Market Street, Suite 2900 San Francisco, CA 94105 CONSTRUCTION CONTRACT Date: Oj ILAI1,012) Amount: One Million One Hundred Twenty -Nine Thousand Three Hundred Sixty -Nine and 00/100 Dollars ($1,129,369.00) Description (Name and Location): 2017 Storm Disaster Repair #70 Irwin Street City Project No. 11308 BOND Date :September 4, 2018 Amount: One Million One Hundred Twenty -Nine Thousand Three Hundred Sixty -Nine and 00/100 Dollars ($1,129,369.00) Modifications to this Bond. 9 None I See Page 3 CONTRACTOR AS PRINCIPAL SURETY Fidelity and Deposit Company of Maryland Company: Valentine Corporation (Corporate Seal) Company: (Corporate Seal) Signature: t �0• Z'4 �� Signature: Name and Title -.,Robert 0. Valentine, Pres. Name and Itle:Jonathan Russell, Attorney -in -Fact (Any additional signatures appear on page 3) (FOR INFORMATION ONLY—Name, Address and Telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE (Architect, Engineer or Edgewood Partners Insurance Center (EPIC) other party): 1390 Willow Pass Rd, #800 Concord, CA 94520 925.822.9116 AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECFMBER 1984 ED • AIA a THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.. WASHINGTON, D.0 20006 A312-1984 1 THIRD PRINTING • MARCH 1987 I the Contractor and the Surety, jointly and severally bind themselves, their heirs, executors, administrators, successors arid assigns to the Owner for the performan( e of the Construction Contract, which is incorporated herein by reference. 2 If the Contractor performs the Construction Contract, the Surely and the C ontractor shall have no obligation under this Bond, except to participate in conferences as provided in Subparagraph 3.1. 3 If there is no Owner Default, the Surety's obligation under this Bond shall arise after. 3.1 The Owner has notified the Contractor and the Surety at its address described in Paragraph 10 below that the Owner is considering declaring a Contractor Default and has requested and attempted to arrange a conference with the Contractor and the Surety to be held not later than fifteen days after receipt of such notice to discuss methods of performing the Conslruc- lion Contract. If the Owner, the Contractor and the Surety agree, the Contractor shall be allowed a reason able time to perform the Construction Contract, but suc h an agreement shall not waive the Owner's right if any subsequently to declare a Contractor Default, and 3.2 The Owner has declared a Contractor Default and formally terminated the Contractor's right to complete the contract. Such Contractor Default shall not be de- clared earlier than twenty days after the Contractor and the Surety have received notice as provided In Sub- paragraph 3-1, and 3.3 The Owner has agreed to pay the Balance of the Contract Price to the Surety in accordance with the terms of the Construction Contra( I or to a contractor selected to perform the Construction Contract in accor- dance with the terms of the contract with the Owner 4 When the Owner has satisfied the conditions of Para- graph 3, the Surety shall promptly and at the Surety's ex- pense lake one of the following actions: 4.1 Arrange for the Contractor, with consent of the Owner, to perform and complete the Construction Contract; or 4.2 Undertake to perform and c omplele the Construc- tion Contract Itself, through its agents or through Inde- pendent contractors; or 4.3 Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner for a contract for performance and completion of the Con- struction Contract, arrange for a contract to be pre- pared for execution by the Owner and the contractor selected with the Owner's concurrence to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds Issued on the Construction Contract, and pay to the Owner the amount of damages as described in Paragraph 6 in ex- cess of the Balance of the Contract Price incurred by the Owner resulting from the Contractor's default, or 4.4 Waive its right to perform and complete, arrange far completion, or obtain a new contractor and with reasonable promptness under the circumstances. .1 After investigation, determine the amount for which it may be liable to the Owner and, as soon as praeti( able after the amount is deter- mined, tender payment therefor to the Owner; or .2 Deny liability in whole or m part and notify Ihc Owner citing reasons therefor 5 It the Surety does not proceed as provided in Paragraph 4 with reasonable promptness, the Surety shall he deemed to be In default on this Bond fifteen days after receipt of an additional written notice from the Owner to the Surety demanding that the Surety perform its obligations under this Bond, and the Owner shall be entitled to entorce anti remedy available to the Owner. If the Surety proceeds as provided in Subparagraph 4.4. and the Owner refuses Ihc payment tendered or the Surety has denied liabilm, in whole or in part; without further notice the Owner shall he entitled to enforce any remedy available to the Owner. 6 After the Owner has terminated the Contra( for s right to complete the Construction Contract, and if the Surety elects to act under Subparagraph 4.1, 4.2, or 4.3 above, then the responsibilities of the Surety to the (honer shall not be greater than those of the Contractor under the Construction Contract, and the responsibilities of Ihc Owner to the Surety shall not be greater than those of the Owner under the Conslruc lion Contract. To the limit of the amount of this Bond, but subject to commitment b� thu Owner of the Balance of the Contract Price to mitigation of costs and damages on the Consiruclion Contract theSure. ty is obligated without duplication for: 6.1 The responsibilities of the Contractor for corre(- lion of defective work and completion of the ( onstruc bon Contract: 6.2 Additional legal, design professional and delay costs resulting from the Contractor's Default. and re- sulting from the actions or failure to act of the Sure t� under Paragraph 4; and 6.3 Liquidated damages, or if no liquidated damages are specified in the Construction Contract, actual dam- ages caused by delayed performance or non-perfor- mance of the Contractor. 7 The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Con- struction Contract, and the Balance of the Contract Price shall not be reduced or set off on account of anv suc h unrelated obligations No right of action shall accrue on this Bond to any person or entity other than the Owner or its heirs, executors, administrators or successors. 8 The Surety hereby waives notice of any change, includ- ing changes of time, to the Construe tion Contra I or to related subcontracts: purchase orders and other obliga- tions. 9 Any proceeding, legal or equitable under this Bond may be instituted in any court of competent jurisdiction in the location in which the work or part of the work is located and shall be instituted within two years after Contractor Default or within two years after the Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under this Bond, whichever oc- curs first. If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation avail - AIA DOCUMENT A312 - PERFORMANCE BOND AND PAYMENT BOND - DECEMBER 1984 ED - AIA -g THE AMERICAN INSTITUTE OF ARCHITECTS 1715 NEW 1ORh AVF N W WASHINGTON, D C IWO(, A312-19134 2 THIRD PRINT ING - MARCH 1987 able to sureties as a defense in the jurisdiction of the suit shall be applicable 10 Notice to the Surety, the Owner or the Contractor shall be mailed or delivered to the address shown on the sig- nature page. 11 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions con- forming to such statutory or other legal requirement shall be deemed incorporated herein. The intent is that this Bond shall be construed as a statutory bond and not as a common law bond. 12 DEFINITIONS 12.1 Balance of the Contract Price: The total amount payable by the Owner to the Contractor under the Construction Contract after all proper adjustments have been made, including allowance to the Con - MODIFICATIONS TO THIS BOND ARE AS FOLLOWS: tractor of any amounts received or to be received by the Owner in settlement of Insurance or other claims for damages to which the Contractor is entitled, re- duced by all valid and proper payments made to or on behalf of the Contractor under the Construction Con- tract. 12.2 Construction Contract; The agreement between the Owner and the Contractor identified on the sig- nature page, including all Contract Document~ and changes thereto. 12.3 Contractor Default - Failure of the contractor, which has neither been remedied nor waived. to per- form or otherwise to comply with the terms of the Construction Contract. 12.4 Owner Default. Failure of the Owner, which has neither been remedied nor waived, to pay the Con- tractor as required by the Construction Contract or to perform and complete or c omply with the other terms thereof (Space is provided below for additional signatures of added parties, other than tho-,P appearing on the cover page.) CONTRACTOR AS PRINCIPAL SURETY Company. (Corporate Seal) Company: (Corporate Seal) Signature: Name and Title:, Address - Signature: Name and Title: , Attomey-in-Fact Address: AIA DOCUMENT A312 - PERFORMANCE BOND AND PAYMENT BOND - DFCLMBER 1%4 ED. - AIA p 111E AMERICAN IN',TIIUTE OF ARCHITECTS, 1735 NEW YORA AVE , N.W.. WASHINGTON. D C 216RRw A312-1984 3 THIRD PRINTING • MARCH 1967 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attomevs-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate: and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this day of SCe+erA6#,Y 20_11. wa ot�of�i i Gj3'll-IisL�ti OlSf7K!►' -v ss SEAL �r+► .'' = s` leas �ji .,�. .A, b D_ Michael Bond, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT ALL REQUIRED INFORMATION TO: Zurich American Insurance Co- Attn: Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by DAVID MCVICKER, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Jeff PARKHURST, Kathleen BECK, Jonathan RUSSELL, Patricia Lynn DREW, Deepa NEUPANE and Sofia OCEGUEDA, all of Concord, California, EACH its true and lawful agent and Attomey-in-Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said Zt RICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 14th day of April, A.D. 2017. ATTEST: i _�1i(;;?1 �+ �'r i�.�t tip• - Assistant Secretary Dawn E. Brown ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Ott's �%iNst,�D'% Vice President David McVicker State of Maryland County of Baltimore On this 14th day of April, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, DAVID NICVICKER, Vice President, and DAWN E. BROWN, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Al Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 POA -F 016-6171 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 ��, � - •.. a:E'c..- ..xe:,:n •=c.4-..F^c,.t..,t- : - -_ rc �E=v:.rv•�. _ � � = ., A notary public or other officer completing this certificate verifies only the identity of the individual who signed fie document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Marin ) On 09/06/18 Dame personally appeared before me, Valorie McCauley, Notary Public Here Insert Name and Title of the Officer Robert 0. Valentine President Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s� whose name( is/tee subscribed to the within instrument and acknowledged to me that he/aFiefthay executed the same in his/ er' he authorized ca acit p y#es), and that by his/4eW+heir signature{s} on the instrument the person(; or the entity upon behalf of which the person(4acted, 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. VALORIE MCCAULEY Commission # 2135367 Z ;'� Notary Public - California z Signature Z Marin County ' Signature of Notary Public My Comm. Expires Nov 28, 2019 Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee E Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ©2016 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 CALIFORNIA ALL-PU RPOSE 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 Contra Costa J On September 4, 2018 before me, Kathleen Beck Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Jonathan Russell Name(s) of Signers) 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 KATHLEEN BECK 'tperson(s), Notary Public California or the entity upon behalf of which the person(s) _ z Contra C-sta County z z :6J�5rJ� ac ted executed the instrument. ZCommission # 2162674 ' My Comm. Expires Sep 11, 2020 1 certifyunder PENALTY OF PERJURY under the laws of the Stte of California that the foregoing paragraph is true and correct. Witness my hand nd fficial seal. Signature Place Notary Seal Above Si(fnaturb of Notary Public OPTIONAL Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent fraudulent removal anJ reattachment of the form to another document. Description of Attached Document Title or Type of Document: Performance Bond Document Date: September 4, 2018 Number of Pages: 3 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Jonathan Russell Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner ❑ Limited ❑ General ❑ Partner ❑ Limited ❑ General d Attorney in Fact RIGHT THUMBPRINT❑ Attorney in Fact RIGHT THUMBPRINT ❑ Trustee OF ❑ Trustee OF ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: Fidelity and Deposit Company of Maryland EXECUTED IN TRIPLICATE Bond No.: 9291056 Premium: Included on Performance Bond THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A.312 Payment Bond Any singular relerence to Contractor, Surety, Owner or other party shall be considered plural where applicable CONTRACTOR (Name and Address): Valentine Corporation 111 Pelican Way San Rafael, CA 94901 OWNER (Name and Address). City of San Rafael 111 Morphew Street San Rafael, CA 94901 SURETY (Name and Principal Place of Business) Fidelity and Deposit Company of Maryland 525 Market Street, Suite 2900 San Francisco, CA 94105 CONSTRUCT�N CONTRACT Date '' '11417,01b Amount: One Million One Hundred Twenty -Nine Thousand Three Hundred Sixty -Nine and 00/100 Dollars ($1,129,369.00) Description (Name and Location): 2017 Storm Disaster Repair #70 Irwin Street City Project No. 11308 BOND Date: August 27, 2018 Amount: One Million One Hundred Twenty -Nine Thousand Three Hundred Sixty -Nine and 00/100 Dollars ($1,129,369.00) Modifications to this Bond: N None L , See Page 6 CONTRACTOR AS PRINCIPAL SURETY Fidelity and Deposit Company of Maryland Company: Valentine Corporation (Corporate Seal) Company: (Corporate Seal) Signature: _/ ` �9L��" '� • (/�' Signature: Name and Title:, Robert 0. Valentine, Pres. Name andle: Jonathan Russell, Attorney -in -Fact (Any additional signatures appear on page 6) (FOR INFORMATION ONLY -Name, Address and Telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE (Architect, Engineer or Edgewood Partners Insurance Center (EPIC) other party): 1390 Willow Pass Rd, #800 Concord, CA 94520 925.822.9116 AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED • AIA A THE AMERICAN INSTITUTE OF ARCHITECTS 1735 NEW YORK AVE. N W WASHINGTON. O C 2(X)(16 A312 -19M 4 THIRD PRINTING • MARCH 1967 1 The Contractor and the Surety, jointly and severally, bind themselves, their heirs, executors, administrators. successors and assigns to the Owner to pay for labor, materials and equipment furnished for use in the perfor- mance of the Construction Contract, which Is incorpo- rated herein by reference 2 With respect to the Owner, this obligation shall be null and void if the Contractor. 2.1 Promptly makes payment, directly or indirectly, for all sums due Claimants and 2.2 Defends, indemnifies and holds harmless the Owner from claims, demands, liens or suits by any person or entity whose claim, demand, lien or suit is for the payment for labor, materials or equipment fur- nished for use in the performance of the Construction Contract, provided the Owner has promptly notified the Contractor and the Surety (at the address described in Paragraph 12) of any claims, demands, liens or suits and tendered defense of such claims, demands, liens or suits to the Contractor and the Surety, and provided there is no Owner Default 3 With respect to Claimants, this obligation shall be null and void If the Contractor promptly makes pay ment, directly or indirectly, for all sums due 4 The Surety shall have no obligation to Claimants under this Bond until 4,1 Claimants who are employed by or have a direct contract with the Contractor have given notice to the Surety (at the address described in Paragraph 12) and sent a copy, or notice thereof, to the Owner, stating that a claim is being made under this Bond and, with substantial accuracy, the amount of the claim 4.2 Claimants who do not have a direct contract with the Contractor - 1 Have furnished written notice to the Con- tractor and sent a copy, or notice thereof, to the Owner, within 90 days after having last performed labor or last furnished materials or equipment included in the claim stating, with substantial accuracy, the amount of the claim and the name of the party to whom the materials were furnished or supplied or for whom the labor was done or performed, and .2 Have either received a rejection in whole or in part from the Contractor, or not received within 30 days of furnishing the above no- tice any communication from the Contractor by which the Contractor has indicated the claim will be paid directly or indirectly, and .3 Not having been paid within the above 30 days, have sent a written notice to the Surety (at the address described in Paragraph 12) and sent a copy, or notice thereof, to the Owner, stating that a claim is being made under this Bond and enclosing a copy of the previous written notice furnished to the Contractor 5 If a notice required by Paragraph 4 is given by the Owner to the Contractor or to the Surety. that is suffi- cient compliance 6 When the Claimant has satisfied the conditions of Paragraph 4, the Surety shall promptly and at the Surety's expense take the following actions 6.1 Send an answer to the Claimant: with a copy to the Owner, within 45 days after receipt of the claim stating the amounts that are undisputed and the basis for challenging any amounts that are disputed 6.2 Pay or arrange for payment of any undisputed amounts 7 The Surety's total obligation shall not exceed the amount of this Bond, and the amount of this Bond shall be credited for any payments made in good faith by the Surety 8 Amounts owed by the Owner to the Contractor under the Construction Contract shall be used for the perfor mance of the Construction Contract and to satisfy claims if any under any Construction Performance Bond By the Contractor furnishing and the Owner accepting this Bond, they agree that all funds earned by the Contractor in the performance of the Construction Contract are dedicated to satisfy obligations of the Contractor and the Surety under this Bond, subject to the Owner's prior ity to use the funds for the completion of the work 9 The Surety shall not be liable to the Owner, Claimants or others for obligations of the Contractor that are unrelat- ed to the Construction Contract The Owner shall not be liable for payment of any costs or expenses of any Claim- ant under this Bond, and shall have under this Bond no obli- gations to make payments to, give notices on behalf of, or otherwise have obligations to Claimants under this Bond. 10 The Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purchase orders and other obligations 11 No suit or action shall be commenced by a Claimant under this Bond other than in a court of competent juris diction in the location in which the work or part of the work is located or after the expiration of one year from the date (1) on which the Claimant gave the notice required by Subparagraph 4.1 or Clause 4.2.3, or (2) on which the last labor or service was performed by anyone or the last mate- rials or equipment were furnished by anyone under the Con- struction Contract, whichever of (1) or (2) first occurs If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation available to sureties as a defense In the jurisdiction of the suit shall be applicable 12 Notice to the Surety, the Owner or the Contractor shall be mailed or delivered to the address shown on the signature page Actual receipt of notice by Surety, the Owner or the Contractor, however accomplished shall be sufficient compliance as of the date received at the address shown on the signature page 13 When this Bond has been furnished to comply with a statutory or other legal requirement In the location where the construction was to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions con- forming to such statutory or other legal requirement shall be deemed incorporated herein The intent is that this AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED • AIA' THE AMERICAN INSTITUTE OF ARCHIIEC 15 1715 NEW YORK AVE. N W. WASHINGTON DC 2000b A312-1984 5 THIRD PRINTI'J(, • MARCH 1987 Bond shall be construed as a statutory bond and not as a common law bond. 14 Upon request by any person or entity appearing to be a potential beneficiary of this Bond, the Contractor shall promptly furnish a copy of this Bond or shall permit a copy to be made. 15 DEFINITIONS 15.1 Claimant: An Individual or entity having a direct contract with the Contractor or with a subcontractor of the Contractor to furnish labor, materials or equip- ment for use in the performance of the Contract. The intent of this Bond shall be to Include without limita- tion in the terms "labor, materials or equipment" that part of water, gas, power, light, heat, oil, gasoline, telephone service or rental equipment used in the MODIFICATIONS TO THIS BOND ARE AS FOLLOWS: Construction Contract, architectural and engineering services required for performance of the work of the Contractor and the Contractor's subcontractors, and all other items for which a mechanic's lien may be asserted in the jurisdiction where the labor, materials or equipment were furnished. 15.2 Construction Contract: The agreement between the Owner and the Contractor identified on the sig- nature page, including all Contract Documents and changes thereto. 15.3 Owner Default: Failure of the Owner, which has neither been remedied nor waived, to pay the Con- tractor as required by the Construction Contract or to perform and complete or comply with the other terms thereof. (Space is provided below for additional signatures of added parties, other than those appearing on the cover page.) CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Signature: Name and Title:, Address: Signature: Name and Title:, Attorney -in -Fact Address: AU DOCUMENT A312 - PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA 0 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE, N.W., WASHINGTON, D C 20006 A312-1984 6 THIRD PRINTING 9 MARCH 1987 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attornevs-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this !!' day of 20. ZZ 0a.- 11B SEAL . ��. 199a !f; Michael Bond, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT ALL REQUIRED INFORMATION TO: Zurich American Insurance Co. Attn: Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by DAVID MCVICKER, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Jeff PARKHURST, Kathleen BECK, Jonathan RUSSELL, Patricia Lynn DREW, Deepa NEUPANE and Sofia OCEGUEDA, all of Concord, California, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. M WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 14th day of April, A.D. 2017. ATTEST: W. ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Assistant Secretary Vice President Dawn E Brown David X1cVicker State of Maryland County of Baltimore On this 14th day of April, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, DAVID NICVICKER, Vice President, and DAWN E. BROWN, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Aoy . Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 POA -F 016-6171 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVi[.. CODE § 1189 :�5.... �':�=^,c-'<"a,'.�„'r=�.c...Pc•.ct.r.^S.tr.,.�.•.�:._-„�..^c•:.V:r;:�:^mss FS:ar” - r.C��,�=^...=J:. �'YF- --.,.s.,.c- - - - - - _ -- - _ .�_. 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 09/06/18 Date personally appeared before me, Valorie McCauley, Notary Public Here Insert Name and Title of the Officer Robert 0. Valentine President Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose name(s) is/afe subscribed to the within instrument and acknowledged to me that he/ehefthey executed the same in his their authorized capacity#es), and that by his/14e##K,it'signature*s on the instrument the persor4c4; or the entity upon behalf of which the persons}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. VALORIE MCCAULEY Commission # 2135367 Z .'mom Notary Public - California z Signature Marin County ' Signature of Notary Public My Comm. Expires Nov 28, 2019 Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ©2016 National Notary Association • www. National Notary. org - 1-800-US`NOTARY (1-800-876-6827) Item #5907 CALIFORNIA ALL-PURPOSE 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 Contra Costa J On September 4, 2018 before me, Kathleen Beck , Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Jonathan Russell Name(s) of Signer(s) KATHLEEN BECK : t 0 Notary Public - California z Contra Costa County zz z:.. z Commission # 2162674 My Comm. Expires Sep 11, 2020 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 a d o idial seal. Signature 1 G� Place Notary Seal Above S!Oturd of Notary Public OPTIONAL Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Payment Bond Document Date: _September 4, 2018 Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: Jonathan Russell ❑ Individual ❑ Corporate Officer—Title(s):— El Partner ❑ Limited ❑ General 9 Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing - Fidelity and Deposit Company of Maryland Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s): — ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: TO '`�`R " CERTIFICATE OF LIABILITY INSURANCE DATE06 /2018 Y) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 09/06/2018 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 CA LIC OB29370 1-925-798-3334 CONTACT Sara Dorrise y Edgewood Partners Insurance Center (EPIC)PHONED NAME: - Branch ID 15469] 925-822-9009 AIC No: 925-887-6815 IA N[Concord P.O. Box 5668 E-MAIL ADDRESS: sara.dorrisey@epicbrokers.com INSURERS AFFORDING COVERAGE NAIC # INSURERA: FIRST SPECIALTY INS CORP 34916 Concord, CA 94524 INSURER B: AMERICAN GUAR & LIAB INS 26247 INSURED Valentine Corporation &ADV INJURY $ 2,000,000 -PERSONAL GENERAL AGGREGATE $ 4,000,000 INSURER C: RSUI IND CO 22314 INSURER D: ZURICH AMER INS CO 16535 111 Pelican Way INSURER E: _ San Rafael, CA 94901 1 INSURER F: COVERAGES CERTIFICATE NUMBER: 53892358 RFVISIC]N NIIMRFR- THIS IS TO CERTIFY 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 I TYPE OF INSURANCE ADDL SUBR - .___ POLICY EFF POLE - LTR D POLICY NUMBER MM/DD/YYYY) (MM/DD[YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR X X IRG200274402 09/30/17 09/30/18 EACH OCCURRENCE $ 2,000,000 DAMAGETO100,000 PREMISESSEa occurrence $ MED EXP (Any one person) _$ Excluded X Ded: $10,000 .. &ADV INJURY $ 2,000,000 -PERSONAL GENERAL AGGREGATE $ 4,000,000 hENIAGGREGATE LIMIT APPLIES PER: POLICY PRO ❑ LOC JECT PRODUCTS $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY X X BAP018504202 09/30/17 09/30/18 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident) ccident $ X Comp/Coll X Ded $1,000 $ C UMBRELLA LIAB X OCCUR NHA243425 09/30/17 09/30/18 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 X I EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ly I N / A X WC018504302 10/01/17 10/01/18 X PER OTH- STATUTE ER -" _--'---'--- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 (Mandatory In NH) If yes, describe under - E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Project #11308, 2017 Storm Disaster Repair #70, Irwin Street. Additional Insured(s): City of San Rafael, its officers, employees, agents and volunteers. When required by written contract, additional insured status with primary coverage applies to General Liability and Automobile Liability and waiver of subrogation applies to General Liability, Automobile Liability, and Workers' Compensation, all per the attached endorsements. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) PATRA01 53892358 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of San Rafael THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 111 Morphew Street AUTHORIZED REPRESENTATIVE San Rafael, CA 94901 !� !G USA ACORD 25 (2014/01) PATRA01 53892358 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 09/06/2018 NAME OF INSURED: valentine Corporation Additional Description of Operations/Remarks from Page 1 Additional Information: sUrr (U51U4) J_ Policy NO. 1 Ef"r. Data of Pol. I Exp. Data of Pol. I Eff. Date o4 End. I Producw No. I Add% Prem I Return Prem. IBAP0185042021 09/30/2017 109/30/2018 —1109/30/2017 7HOS ENDORSENIEN7 CHAWOES THE Iia UCV. (FL E&SE READ OT CAREFULLY. This endorsement modifies Insurance provided under the: Businer,s Auto Coverage (Form Motor Carrier Coverage Form A. Amended Who is An lnsured 'i. The following is added to the Who Is An insured Provision in Section ii — Covered Autos Liarblllty Coverage: The following are also "insureds": a. Any "employee" of yours is an insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an 'insured° while operating an 'auto* hired or rented under a contract or agreement In an 'employee's' name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, We or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.9.e. and A.I.b. in this endorsement. d. Where and to the extent permitted by law, any parson(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organizations) directing your worts pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following Is added to the Other Insuranc® Condition in the Business Auto Coverage Form and the Other insurance — Primary and Excess Insurance Provisions Cond Won in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured' will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. S. Amendment — Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section li — Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to fumish these bonds. (4) All reasonable expenses incurred by the °insured° at our request, including actual loss of earnings up to $500 a day because of time off from work. U -CA -424-F CIN (04-14) Page t of B Includes copyrighted material of Insurance Services Office, Inc., with its permission. C. [Fellow Employee Coverage The Fellow Employee e=xclusion contained in Section ll — Coverad Autos Liability Coverage does not apply. D. ®elver Safety Program Liability and Physical Damage Coverage I. The following is added to the Racing Exclusion In Section Of — Covered Autos I-laWlity Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. 2. The following is added to Paragraph 2. in the Enclusionc of Section Ill — physical Damage Coverage o`r the Business Auto Coverage Form and Paragraph 2.Ib. in the Exclusloma of Section UV — PhysicI (�auvoage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truth agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverago Section: Lease Or Loan Gap Coverage In the event of a total 'loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto', less: a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and b. Any: (9) Overdue lease or loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Cary -over balances from previous leases or loans. F. Towing and Labor Paragraph A.2, of the PhgGicml Damage Coverage Section is replaced by the following: We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Enter ded Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Mired Auto Physical Damage — Increased Loss of Usa Expenses The Coverage Extension for Loss IN Use [Fstpenses in the Physical Damage Coverage Section Is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver sunder a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: U-CA424-F CW (D4-14) Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc„ with its permission. (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto'; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered 'auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Covera We will pay up to $750 for "loss" to personal effects which are: (1) Personal property owned by an "insured"; and (2) In or on a covered "auto". b. Subject to Paragraph al. above, the amount to be paid for "loss" to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided In Paragraphs a. and b. above, only applies In the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for 'loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. ('s) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same 'loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph 8.6.a. of Section Ill — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 9.2.c. of Section IV - Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an "insured'; and (b) Are in a covered "auto" at the time of "loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such "loss". U -CA -424-F CW (04-14) Page 3 of 0 Includes copyrighted material of Insurance Services Office, Inc., with its permission. K. Airbag Coverage The Exclusion in Paragraph 8.3.a. of Section III — Physical Damage Coverage fn the Business Auto Coverage Form and the Exclusion in Paragraph 8.4.e. of Section IV — Physlctnl Damage Coverage in the Motor Carrier Coverage Form does not apply to the accidental discharge of an airbag. Two or Mor` Deductibles The following is added to the [deductible Provision of the (Physical Damage Coverage Section: If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you by us, the following applies for each covered "auto" on a per vehicle basis: 1. If the deductible on this policy or Coverage Form is the smaller (or smallest) deductible, it will be waived; or If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. M. Physical Damage — Comp9rehenslve Coverage — Deductible The following is added to the Deductible Provision of the Physical Damage coverage Section: Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss" from any one cause is $5,000 or the deductible shown in the Declarations, whichever is greater. N. Temporary Substitute Autos — Physical Damage 9. The following is added to Section 0 — Covered Autos: Temporary Substitute Autos — Physical Damage If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following types of vehicles are also covered "autos" for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto" you do own but is out of service because of its: 1. Breakdown,- 2. reakdown;2. Repair; S. Servicing; 4. "Loss"; or 5. Destruction, 2. The following is added to the Paragraph A. Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos — Physical Damage We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties In The (went Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition Is replaced by the following: al. In the event of "acciderk", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any U -CA -424-F CW (04-14) Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy. Include, as soon as practicable: (9) Flow, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit"; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following Is added to the Transfer Of Rights Of Recovery Againsa Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos m Phyaical Damage Paragraph b. of the Other Insurance Condition In the Business Auto Coverage Form and Paragraph f. of the Other Insurance ® Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or elected or appointed official with your permission while being operated within the course and scope of that "employee's" employment by you or that elected or appointed official's duties as respect their obligations to you. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" R. Unintentional Failure to Dissclooe Ho-mards The following is added to the Concealment, Rgisrepresentation Or Fraud Condition: However, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (a) Make an error, omission, improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto — World Wide Coverage Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, Bodily Injury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U -CA -424-F CW (04-14) Pegs 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. U. Expected Or Intended Injury The IEupected Or Intended Injury Exclusion in Paragraph S. Exclusions under Section II — Covered Auto Liability Coverage is replaced by the following: Expected Cr Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. V. Physical Damage —Additional Temporary Transportation Expense Coverage Paragraph A.4.a. of Section IN — Physical Damage Coverage is replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for Its "loss". W. Replacement of a Private Passenger Auto wkh a hybrid or Alternative Panel Source Auto The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section: In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or "auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum of $2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement. To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas, either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source. X. Return of Stolen Automobile The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section: If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto" to you. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. All other terms, conditions, provisions and exclusions of this policy remain the same. U -CA -424-F CW (04-14) Page 6 of 6 Includes copyrighted material of Insurance Services Office, Inc., withIts permission. POLICY NUMBER: IRG2 0 02 744 02 COMMERCIAL GENERAL LIABILITY CG 20 10 11 85 rHIS ENDORSEMENT CHANGES) THE POLICY. PLEASE READ IT CAREFULLY. CONTRACT 01. RS - (FORPt-M PS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name oG Per3on or Organization. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. (if no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. Hart Forms & Services Reorder No. 149399 CO 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 9 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILrI Y COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATION'S LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM Section IV: Comdidoas, Other Insurance, and all subparts thereof, as contained in the policy is deleted in its entirety and replaced with the following condition as respects the Third Party shown below: Secflom IV: CondlganG CribttrIn n'-sa e: With respect to the Third Party shown below, the insurance provided by this policy shall be primary and non-contributing insurance. Any and all other valid and collectible insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for a loss covered by this policy, shall in no instance be considered as primary, co-insurance; or contributing insurance. Rather, any such other insurance shall be considered excess over and above the inourance provided by this policy. The Third Party to whom this endorsement applies is: When required by written and executed contract Absence of a specifically named Third Party above means that the provisions of this endorsement apply "as required by written contractual agreement with any Third Party for whom you are performing work." All other terms and conditions of this policy shall remain unchanged. This endorsement forms a part of the policy to which attached, effective on the inception date of the policy unless otherwise stated herein. Policy Number. I RG2 0 0 2 7 4 4 02 Named Insured: Valentine Corporation Endorsement Effective Date: 09/30/2017 FSIC 33313 0611 Includes copyrighted material of Insurance Services office, Inc. with its permission. Page 1 of l POLICYNUMBER: TRG200274402 CO MERMAL GENERAL LIABILITY CG2404050'J• This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Marne Of Person Or Organization: Any person or organization when you and such person or organization have agreed in writing in a contract or agreement that you will waive any right of recovery against such person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. J The following is added to Paragraph S. Transfer Of Rights Of Recovery Against Others 4o Us of Sac - tion IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for Injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 TM Wolters Kluwer Financial services I Uniform Forms WORKERS' C®Mi ]PIEVSA7f ON AND Ell ff LOY ERF I.IAD£1IL1'TY WSURANC1E POLICY WC 04 ilk +Its (Ed. 4-&L) VVAIVER OF OUR IQR- SIT TO RECOVER FROM OTHE+ S ENDORSEMENT -- f f UFORNI A 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 0.0 % of the California workers' compensation pre- mium otherwise due on such remuneration. Person ar ®rganiudon ALL LDF. RS0kJS Aires/OR ®1�YXER-TIONS 'PTI AM REQUIMD BY MaTTEnY CONTRACT OR AGREMONT WITH THE INSURED, 1CLDTM PRIOR 20 THE ACCIDENT OR LOSS, TRW WAIVER or SUBROGA210 9 BE PROVIDED IyMM THIS POLICY FOR NORK PERPOMM BY YOU FOR TEPR PERSON A—MIOR 0R'G°MI ZAT IOF Policy #WC018504302 WC 252 (4-84) WC 04 03 06 (Ed. 4-84) &h eduN ,Dote pDes> dptlon ALL CA OPERATIOkTS 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: DPW Project Manager: Shawn Graf Extension: 5437 Contractor Name: Valentine Corporation Contractor's Contact: Stephanie Gindlesperger Contact's Email: sgindlesperger@valentinecorp.com ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED REVIEWER DEPARTMENT a. Email PINS Introductory Notice to Contractor DATE Check/Initial 1 Project Manager 8/22/2018 ❑x b. Email contract (in Word) & attachments to City SG Atty c/o Laraine.Gittens@cityofsanrafael.org ❑x 2 City Attorney a. Review, revise, and comment on draft agreement 8/22/2018 ❑x LG and return to Project Manager 8/22/2018 ❑x LG b. Confirm insurance requirements, create Job on Project Manager PINS, send PINS insurance notice to contractor 8/22/2018 3 Forward three (3) originals of final agreement to ❑X Project Manager contractor for their signature When necessary, * contractor -signed agreement ❑x N/A SG 4 agendized for Council approval *PSA > $20,000; or Purchase > $35,000; or Or SSG Public Works Contract > $125,000 9/4/2018 Date of Council approval PRINT CONTINUE ROUTING PROCESS WITH HARD COPY 5 Project Manager Forward signed original agreements to City 8/28/2018 SG Attorney with printed copy of this routing form 6 City Attorney Review and approve hard copy of signed 9//o/1'e, Q L hAd- agreement 7 City Attorney Review and approve insurance in PINS , and bonds 4 /lO City Manager/ Mayor City Clerk (for Public Works Contracts) r l 8 Agreement executed by Council authorized official Attest signatures, retains original agreement and I l I 9 forwards copies to Project Manager �1-1-�29