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HomeMy WebLinkAboutCC Resolution 12264 (Slurry Seal)RESOLUTION NO. 12264
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL
AWARDING THE CONTRACT FOR SLURRY SEAL 2006/2007, PROJECT NO.
11071, TO GRAHAM CONTRACTORS INC., IN THE AMOUNT OF $69,728.00.
WHEREAS, on the 17th day of May, 2007, pursuant to due and legal notice
published in the manner provided by law, inviting sealed bids for proposals for the work
hereinafter mentioned, as more fully appears from the Affidavit of Publication thereof on
file in the office of the City Clerk of the City of San Rafael, California, the City Clerk of
said City did publicly open, examine, and declare all sealed bids or proposals for doing
the following work in said City, to wit:
"SLURRY SEAL 2006/2007"
PROJECT NO. 11071
in accordance with the plans and specifications therefore on file in the office of said City
Clerk; and
WHEREAS, the bid of $69,728.00 at the unit prices stated in its bid was and is the
lowest and best bid for said work and said bidder is the lowest responsible bidder
therefore;
NOW, THEREFORE, IT IS HEREBY ORDERED AND RESOLVED that the
bid of $69,728.00 and the same is hereby accepted at said unit prices and that the contract
for said work and improvements be and the same is hereby awarded to said Graham
Contractors Inc. at the unit prices mentioned in said bid.
RESOLVED FURTHER, that the Mayor of said City be authorized and
directed to execute a contract with Graham Contractors Inc. for said work and to
return the bidders bond upon the execution of said contract. °�� rr�' n , I t ;j
LL
Al ,
I as 6(�-
RESOLVED FURTHER, that the Director of Public Works is hereby
authorized to take any and all such actions and make changes as may be necessary
to accomplish the purpose of this resolution.
I, JEANNE M. LEONCINI, City Clerk of the City of San Rafael, hereby
certify that the foregoing resolution was duly and regularly introduced and adopted
at a regular meeting of the Council of said City held on the 4th day of June, 2007,
by the following vote, to wit:
AYES: COUNCIL MEMBERS: Heller, Miller, Phillips and Vice -Mayor Cohen
NOES: COUNCIL MEMBERS: None
ABSENT: COUNCIL MEMBERS: Mayor Boro
Z5 qttCa G ,g, &L.,c c
FZR JEANNE M. LEONCINI, City Clerk
File No. 16.06.62
STREETS TO BE SLURRY SEALED
Note: Streets are listed alphabetically and are not in the order in which they will
be resurfaced.
Street
From
Alderwood Way Knight Drive
To
End of street
End of street
Bret Avenue
Alderwood Way
�Du Bois Street Irwin Street
Brentwood Drive (S)I
Brentwood Drive (N)
Bret Avenue
Woodland Avenue
End of street
Redding Way
End of street
End of street
End of street
IDu Bois Street
Robinhood Drive
Bret Avenue
Woodland Avenue
End of street
End of street
Brentwood Drive
Redding Way
End of street
Blossom Drive
Maplewood Drive
End of street
Maplewood Drive
Robinhood Drive
End of street
�1
12 Beechwood Court Rollingwood Drive
13 Billou Street
Du Bois Street
14 Brentwood Drive
Robinhood Drive
15 Bret Avenue
16 IBriarwood Drive
7 Dolores Street
IDu Bois Street
8 IDu Bois Street
lGlenaire Drive
19 lFriar Tuck Lane
Robinhood Drive
1101Harte Avenue
Irwin Street
111IHazel Court
Irwin Street
1121Hazelwood Lane
Robinhood Drive
1131Heartwood Court
Beechwood Court
1141Hillview Avenue
Irwin Street
1151Ironwood Drive
Rollingwood Drive
1161Irwin Street
IBaywood Street
1711rwin Street
Bret Avenue
181Lindenwood CourtlRollingwood Drive
1191Lockwood Drive
Robinhood Drive
1201Maplewood Drive
Rollingwood Drive
121 Meadow Avenue
Irwin Street
122 Millwood Court
Rollingwood Drive
Way
Hillview Avenue
�231Redding
24JRobinhood Drive
Knight Drive
Drive
Maplewood Drive
�251Robinhood
261Rollingwood DrivelKnight Drive
1271Rollingwood Drivelmaplewood Drive
I28ISolar Court
Redding Way
Street
From
Alderwood Way Knight Drive
To
End of street
End of street
Bret Avenue
Alderwood Way
�Du Bois Street Irwin Street
Brentwood Drive (S)I
Brentwood Drive (N)
Bret Avenue
Woodland Avenue
End of street
Redding Way
End of street
End of street
End of street
IDu Bois Street
Robinhood Drive
Bret Avenue
Woodland Avenue
End of street
End of street
Brentwood Drive
Redding Way
End of street
Blossom Drive
Maplewood Drive
End of street
Maplewood Drive
Robinhood Drive
End of street
City of San Rafael ♦ California
Form of Contract Agreement
For
Slurry Seal 2006/2007
Project No. 11071
This Agreement is made and entered into this 4th day of June, 2007 by and between the
City of San Rafael (hereinafter called City) and Graham Contractors Inc. (hereinafter
called Contractor). Witnesseth, that the City and the Contractor, for the considerations
hereinafter named, agree as follows:
II - 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 shown on the plans and
described in the specifications for the project entitled: Slurry Seal 2006/2007,
Project No. 11071, 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.
III- Time of Completion
(a) The work to be performed under this Contract shall be commenced within five (5)
calendar days after the date of written notice by the City to the Contractor to
proceed.
(b) The work shall be completed within fifteen (15) working days after the date of such
notice and with such extensions of time as are provided for in the General
Conditions.
IV - Liquidated Damages
It is agreed that, if all the work required by the contract is not finished or completed
within the number of working days as set forth in the contract, damage will be
sustained by the City, and that it is and will be impracticable and extremely difficult
to ascertain and determine the actual damage which the City will sustain in the
event of and by reason of such delay; and it is therefore agreed that the Contractor
will pay to the City, the sum of $500.00 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.
V - 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.
AGREEMENT • 1
INO.
UNIT
ST
UNIT
ITEM
I ITEM
I QTY I
PRICE, $ I
TOTAL, $
1
Mobilization
LS
1
3,500.00
3,500.00
2
Slurry Seal
SY
42,400
1.22
51,728.00
3
Painted Traffic Stripes &
LS
1
7,000.00
7,000.00
Pavement
Markings
4
Traffic Control
LS
1
7,500.00
7,500.00
Grand Total
o'),718.00
VI - 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). On not later than the 15th day of the month, the City shall, after deducting previous
payments made, pay to the Contractor 90% 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 4590 of the Government Code. Such securities, if
deposited by the Contractr, shall be valued by the City's Finance Director, whose
decision on valuation of the securities shall be final.
VII - 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) 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
AGREEMENT • 2
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.
(d) 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.
ATTEST: CITY OF SAN RAFAEL:
Jeanne M. Leoncini Paul M. Cohen
City Clerk Vice -Mayor
r
GRAHAM CONTRACTORS INC.
for David Graham, Vice President
AGREEMENT* 3
PERFORMANCE BOND Bond 104940015; Prem: $523.00
KNOW ALL BY THESE PRESENTS, That we, Graham Contractors, Inc.
(hereinafter called the Principal), as Principal, and Travelers Casualtv and Suretv Companv of America , a corporation
duly organized under the laws of the State of Connecticut (hereinafter called the Surety), as Surety, are held and firmly
bound unto City of San Rafael
, (hereinafter called the Obligee),
in the sum of Sixty Nine Thousand Seven Hundred Twenty Eight and 00/100 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - ($ 69,728.00 ) Dollars, for the payment of which sum well and truly
to be made, we, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,
jointly and severally, firmly by these presents.
Signed and sealed this 4th day of June , 2007
WHEREAS, said Principal has entered into a written Contract with said Obligee, dated 06/04/2007
for Slurry Seal 2006/2007
in accordance with the terms and conditions of said Contract, which is hereby referred to and made a part hereof as if fully set forth
herein:
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That if the abovt bounden Principal shall well and truly
keep, do and perform each and every, all and singular, the matters and things in said contract set forth and specified to be by said
Principal kept, done and performed, at the times and in the manner in said contract specified, or shall pay over, make good and
reimburse to the above named Obligee, all loss and damage which said Obligee may sustain by reason of failure or default on the part
of said Principal so to do, then this obligation shall be null and void; otherwise shall remain in full force and effect.
NO SUIT, ACTION OR PROCEEDING by the Obligee to recover on this bond shall be sustained unless the same be commenced
within two (2) years following the date on which Principal ceased work on said Contract.
Graham Contractors, Inc.
Principal
B ��/y
David Graham, Vice President
Travelers Casualty and Surety Company of
By``'r
Bryan D. Martin, Attorney -in -Fact
S-0757/GEEF 10/99
California All Purpose
Acknowledgment
State of California
County of San Mateo
On June 4, 2007 , before me, Jean L. Neu, Notary Public
Date Name & Title of Officer/Notary
personally appeared Bryan D. Martin
Names(s) of Signers(s)
personally known to me to be the person whose name is subscribed to the within
instrument and acknowledged to me that he executed the some in his authorized
capacity, and that by his signature on the instrument the person, or the entity upon
behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.,.,_..
�.. .
JEAN L. NEU
Commission # 1626526
Notary Public -California >
Z ,tt San Mateo County
rAy comm. Expires Dec 21,20091"
/�� ' G�. e�•,m.�,��s-aye•,�,--•.:,�--a,�--�.f-�.s--.�-ti:
Notary Public
--_---------------------------------OPT/ONAL--=---------------------------------------
(The information below is not required by law)
Description of Attached Document
Title/type of Document
Date of Document
Other Signer(s)
h:\docs\surely\forms\notary.doc
No. of Pages
BOND 104940015
CONTRACT BOND - CALIFORNIA
PAYMENT BOND
KNOW ALL BY THESE PRESENTS, That we, Graham Contractors, Inc.
and the Travelers Casualty and Surety Company of America , a corporation organized and existing under the laws of the State
of Connecticut and authorized to transact surety business in the State of California, as Surety, are held and firmly
bound unto City of San Rafael
, as Obligee,
in the sum of Sixty Nine Thousand Seven Hundred Twenty Eight and 00/100 ---------------------------------
---------------------------------------------------------- Dollars ($ 69,728.00 )�
for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors
and assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That WHEREAS, the above -bounden Principal has
entered into a contract, dated 4rh day of June 2007 , with the Obligee to do
and perform the following work, to -wit: Slurry Seal 2006/2007
NOW, THEREFORE, if the above -bounden Principal or his/her subcontractors fail to pay any of the persons named in Section 3181 of
the Civil Code of the State of California, or amounts due under the Unemployment Insurance Code with respect to work or labor
performed under the Contract, or any amounts required to be deducted, withheld and paid over to the Franchise Tax Board from the
wages of employees of the Principal or his/her subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with
respect to such work and labor, Surety will pay for the same, in an amount not exceeding the amount specified in this bond, and also, in
case suit is brought upon this bond, a reasonable attorney's fee, to be fixed by the court.
This bond shall inure to the benefit of any and all persons, companies or corporations entitled to file claims under Section 3181 of the
Civil Code of the State of California, so as to give a right of action to them or their assigns in any suit brought upon this bond.
Signed, sealed and dated this 4th
No premium is charged for this bond. It is executed in
connection with a bond for the performance of the
contract.
S-4449/GEEF 7/98
day of June 2007
Graham Contractors, Inc.
Principal
�� % i tea"��sr'f � - --
David Graham, Vice President
Travelers Casualty and Surety Company of America
Surety
By G -
Bryan D. Martin Attorney -in -Fact
California All Purpose
Acknowledgment
State of
County of
California
San Mateo
On June 4, 2007
Date
before me, Jean L. Neu, Notary Public
Name & Title of Officer/Notary
personally appeared Bryan D. Martin
Names(s) of Signers(s)
personally known to me to be the person whose name is subscribed to the within
instrument and acknowledged to me that he executed the same in his authorized
capacity, and that by his signature on the instrument the person, or the entity upon
behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
JEAN L. NEU -
:1 / " 'i'�ja• Commission # 7626528
Notary Public - California z
San Mateo County�>
My Comm. Expires Dec 2, 20094'
:�•�-�:�-:��'�..�..�..--�.---k�--,.�--.� te=a
(The information below is not required by law)
Description of Attached Document
Title/type of Document
Date of Document
Other Signer(s)
h Adocs\surety\forms\notary.doc
No. of Pages
A Nt�' -: t IS PO ER OF TTORNEY IS INVALID WM
OUT THE BORDER
TRAVELERS POWER OF ATTORNEY
Farmington Casualty Company St. Paul Guardian Insurance Company
Fidelity and Guaranty Insurance Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company
Seaboard Surety Company Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
Attorney -In Fact No. 218559
Certificate No. 001632033
KNOW ALL MEN BY THESE PRESENTS: That Seaboard Surety Company is a corporation duly organized under the laws of the State of New York, that St. Paul
Fire and Marine Insurance Company, St. Paul Guardian Insurance Company and St. Paul Mercury Insurance Company are corporations duly organized under the laws
of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and Travelers Casualty and Surety Company of America are
corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty Company is a corporation duly organized under the
laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and
Guaranty Insurance Underwriters, Inc. is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that
the Companies do hereby make, constitute and appoint
Bryan D. Martin, Erin Bautista, Jean L. Neu, Nancy L. Wallis, and B. A. Poitevin
of the City of Redwood City , State of California , their true and lawful Attomey(s)-in-Fact,
each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
1
IN WITNEU WHEREOF, the Compatu�e tt7ve caused this instrument to be signed and their corporate seals to be hereto affixed, this
day of MM y ' L uu ��
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
Seaboard Surety Company
St. Paul Fire and Marine Insurance Company
11th
St. Paul Guardian Insurance Company
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
•i(00
5�:SEAL:'aF� '
State of Connecticut
City of Hartford ss.
By: )'
,��--
Georg6Thompson, enior ice President
11th May 2007
On this the day of before me personally appeared George W. Thompson, who acknowledged
himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters,
Inc., Seaboard Surety Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers
Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being
authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
In Witness Whereof, I hereunto set my hand and official seal. �A
My Commission expires the 30th day of June, 2011. p�"G
58440-8-06 Printed in U.S.A.
Marie C. Teireault, Notary Public
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
Client#: 44517
GRAHACONT
GERTIFICA' _®F
LIABILITY INSUE-NCE
DATE
YY)ACQPDM
$
—
/
PRODUCER
_
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Construction Unit (F) (650) 839-6964
GEN'L AGGREGATE LIMIT APPLIES PER:
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ABD Insurance &Financial Services
POLICY ] JECOT- n LOC
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
C AUTOMOBILE LIABILITY DPA5500001
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
305 Walnut Street
X ANY AUTO
(Ea accident)
($1,000,000
Redwood City, CA 94063
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER Lexington Insurance Co.
I$
Graham Contractors Inc.
INSURER B Arch Specialty Insurance Group
P.O. Box 26770
I INSURER C Delos Insurance
San Jose, CA 95159
INSURER D I
INSURER E'
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR'ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE IMM/DD/YY) DATE (MM/DD/YY) LIMITS
A GENERAL LIABILITY 7353688 05/01/07 05/0, EACH OCCURRENCE $1,000000
X COMMERCIAL GENERAL LIABILITY
I DAMAGE TO RENTED
PREMISES fEa occurrences
$100.000
1
CLAIMS MADE 51OCCUR
I MED EXP (Any one person)
$
—
I PERSONAL & ADV INJURY
1$1,000,000
_
I GENERAL AGGREGATE
I $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
I PRODUCTS -COMP/OP AGG
1$2,000,000
POLICY ] JECOT- n LOC
C AUTOMOBILE LIABILITY DPA5500001
05/01/07 05/01/08 COMBINED SINGLE LIMIT
X ANY AUTO
(Ea accident)
($1,000,000
ALL OWNED AUTOS
BODILY INJURY
_ SCHEDULED AUTOS
(Per person)
I$
X HIRED AUTOS
BODILY INJURY
$
X NON -OWNED AUTOS
(Per accident)
—
IPROPERTY DAMAGEI
$
(Per accident)
GARAGE LIABILITY
I AUTO ONLY - EA ACCIDENT
I $
ANY AUTO
I OTHER THAN EA ACC
AUTO ONLY:
l+ $
AGG
$
B EXCESS/UMBRELLA LIABILITY ULP000608902
05/01/07 05/01/08 EACH OCCURRENCE
$10,000,000
X1 OCCUR FICLAIMS MADE
I AGGREGATE
1$10,000,000
I$
DEDUCTIBLE
I
I $
RETENTION $
I
I $
WORKERS COMPENSATION AND
WC STATU-
TORY LIMITS I I OFR
EMPLOYERS' LIABILITY
I E.L EACH ACCIDENT
I $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
I E.L DISEASE - EA EMPLOYE $
If yes, describe under
I
I
SPECIAL PROVISIONS below
E.L DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Re: Project No. 11071; Slurry Seal 2006/2007.
The City of San Rafael, its elective and appointive Boards, Commissions,
Officers, Agents and Employees are named as additional insured as respects
general liability and automobile liability per endorsements attached.
CERTIFICATE HOLDER
City of San Rafael
Public Works - Admin/Engineering
111 Morphew Street,
P.O. Box 151560
San Rafael, CA 94915-1560
ACORD 25 (2001/08)1 of 2 #S994086/M982448
CANCELLATION Ten Dav Notice for Non-Pavment of Premium
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENjQj *9)WMWIL in DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B1jMjt)(pigQi7(=R9 JWA (XX
4fIRDi;iWCOl0C9i:007tOFl�QCCQEiWt,.:...w�,..:�, vr;�!Itl'lit(tl�,/F.0�0JOXl(�fORii9E7E06)f9C,�EkR9NItiCxxx t
1XIMMSIRMXxxxx -;-I
AUTHORIZED REPRESENTATIVE G 1
C�a,vre—
GRAHACONT JTH © ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (2001/08) 2 of 2 #S994086/M982448
POLICYNUMBER: 7353688 ENDORSEMENT
COMMERCIAL GENERAL LIABILITY
CG 20 10 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
As required by written contract.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
A. Section II • Who Is An Insured 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 ongoing operations
performed for that insured.
S. With respect to the insurance afforded to these
additional insureds, the following exclusion is
added:
2. Exclusions
This insurance does not apply to "bodily in-
jury" or "property damage" occurring after:
(1) All work, including materials, parts or
equipment furnished in connection with
such work, on the project (other than
service, maintenance or repairs) to be
performed by or on behalf of the additional
insured(s) at the site of the covered
operations has been completed; or
(2) That portion of "your work" out of which
the injury or damage arises has been put
to its intended use by any person or
organization other than another contractor
or subcontractor engaged in performing
operations for a principal as a part of the
same project.
CG 20 10 10 01 ©ISO Properties, Inc., 2000 Page 1 of 1 O
LX9605
POLICYNUMBER: 7353688 ENDORSEMENT COMMERCIAL GENERAL LIABILITY
CO 20 37 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
F1,411111 W
I'' •' �• • •'1 a •
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
As required by written contract for commercial
operations only. Residential work Is excluded.
Residential Is defined In the Non -Commercial
Dwelling & Residential Exclusion endorsement.
Location And Description of Completed Operations:
Additional Premium:
(If no entry appears above, information required to complete this endorsement will be shown in the Declara-
tions as applicable to this endorsement.)
Section II - Who Is An Insured is amended to include as an insured the person or organization shov�,n in the
Schedule, but only with respect to liability arising out of "your work" at the location designated and described in
the schedule of this endorsement performed for that insured and included in the "products -completed
operations hazard".
CG 20 37 10 01 ©ISO Properties, Inc., 2000 Page 1 of 1 ❑
LX9604
POLICY NUMBER: DPA5500001
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
GARAGE COVERAGE PART
TRUCKERS COVERAGE PART
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-
fied by the endorsement.
SCHEDULE
Name of Person or Organization:
City of San Rafael
Public Works - Admin/Engineering
111 Morphew Street,
P.O. Box 151560
San Rafael, CA 94915-1560
A. WHO IS AN INSURED is amended to include as
an "Insured" the person or organization shown in
the Schedule as an Additional Insured. The cov-
erage afforded to the Additional Insured is solely
limited to liability specifically resulting from the
conduct of the Named Insured which may be
imputed to the Additional Insured. However, the
naming of the person or organization shown in
the Schedule as an Additional Insured does not
increase or alter the Limit of Insurance nor the
scope of coverage of this policy.
B. EXCLUSIONS
This insurance does not apply to:
1. "Bodily injury" or "property damage" for
which the Additional Insured is obligated to
pa , damages by reason of the assumption
of liability in a contract or agreement. But
this exclusion does not apply to liability for
damages that the Additional Insured would
have in the absence of the contract or
agreement.
2. "Bodily injury" or "property damage" arising
out of the use of your "products" or work you
performed for the Additional Insured.
3. "Property damage" to:
a. Property owned, used or occupied by or
rented to the Additional Insured.
b. Property in the care, custody or control
of the Additional Insured for any purpose
of exercising physical control.
C. Any coverage provided by this policy shall be
excess only, over any other valid and collectible
insurance which would apply in the absence of
this policy. However, this policy shall not be ex-
cess over any policy written as specific excess.
Re: Project No. 11071; Slurry Seal 2006/2007. The City of San Rafael,
its elective and appointive Boards, Commissions, Officers, Agents and
Employees are named as additional insured as respects automobile
liability.
CL/CA 99 09 08 95
CERTHOLDER COPY NA
STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807
COMPENSATION
INSURANCE
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 05-04-2007 GROUP: 000467
POLICY NUMBER: 0000488-2007
CERTIFICATE ID: 2200
CERTIFICATE EXPIRES: 04-01-2008
04-01-2007/04-01-2008
CITY OF SAN RAFAEL NA JOB:PROJECT NO. 11071; SLURRY SEAL 2006-2007
PUBLIC WORKS - ADMIN ENGINEERING
111 MORPHEW ST SAN RAFAEL
SAN RAFAEL CA 94901-5508 CA
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
tTHORIZED REPRESENTATI PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #1600 - GERALD GRAHAM PRE - EXCLUDED.
ENDORSEMENT #1600 - STEVE GRAHAM VICE PRESIDENT - EXCLUDED.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04-01-2001 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
EMPLOYER
GRAHAM CONTRACTORS, INC NA
PO BOX 25770
SAN JOSE CA 95159
[B18,NAI
(REV.2-05I PRINTED : 06-04-2007