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HomeMy WebLinkAboutPW Tamalpais Avenue Queue Cutter Improvement ProjectCity of San Rafael ♦ California
Form of Contract Agreement For
Tamalpais Avenue Queue Cutter Improvements Project
City Project No. 11272
This Agreement is made and entered into this '17W day of H#4,ei!�44 by and between the City of
San Rafael (hereinafter called "City") and Ghilotti Bros., Inc., (hereinafter called "Contractor"). Witnesseth, that
the City and the Contractor, for the considerations hereinafter named, agree as follows:
I - Scope of the Work
The Contractor hereby agrees to furnish all of the materials and all of the equipment and labor necessary, and to
perform all of the work described in the plans and specifications for the project entitled: Tamalpais Avenue Queue
Cutter Improvements Project, City Project No. 11272, all in accordance with the Specifications and Contract
Documents dated January 2016, which are hereby made a part of this Agreement.
lI- 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.
Ill - 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.
ITEM DESCRIPTION ESTIMATED UNIT UNIT PRICE TOTAL PRICE
QUANTITY
I' Mobilization I LS n $30,000 — $30,000
2. Signs and Traffic Control I LS (a), $150,000 — $150,000
3' Clearing and Grubbing 1 LS $213,665 $213,665
4. Minor Concrete — Minor Structures
a. Type A Curb and Gutter 570 LF a $68 — $38,760
b. 4 -inch Thick PCC Sidewalk (Type A/13) - Gray 2,600 SF $24 — $62,400
c. 4 -inch Thick PCC Sidewalk (Type A/B) - 2,400 SF $20 — $48,000
Colored
d. 6 -inch Thick PCC Driveway - Gray 30 SF (a), $40 — $1,200
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Page 1 of 4 `p� k! �p� HEgF N4
ITEM
DESCRIPTION
ESTIMATED
QUANTITY
UNIT
UNIT PRICE
TOTAL PRICE
6 Thick PCC Driveway Colored
100
SF
$34 —
$3,400
e. -inch -
(a),
f. 6" Tall Retaining Curb
70
LF
n
$75 —
$5,250
g. Type E Catch Basin
2
EA
(a),
$5,150 —
$10,300
h. Remove and Reset Brick Pavers
75
SF
I
$22 =
$1,650
5.
Hot Mix Asphalt
460
TON
$250 —
$115,000
6.
Storm Drain Pipe
a. 12" PVC (SDR -26)
50
LF
$420
—
$21,000
b. Sidewalk Underdrain (3" PVC)
I
EA
no,
$1,001 —
$1,001
7.
Adjust Existing Facilities to Grade
3
EA
$1,250
$3,750
a. Adjust City SD Manhole Cover
,
=
b. Install Sewer Cleanout Box and Cover
I
EA
n
$989
=
$989
c. Basement Access Door
I
EA
.
$5,000
—
$5,000
8.
Electrical Systems
a. 4`h and Tamalpais Queue Cutter Signal
1
LS
$163,000 —
$163,000
b. 5`h and Tamalpais Queue Cutter Signal
1
LS
��
$175,000 =
$175,000
c. Mission and Tamalpais Queue Cutter Signal
1
LS
1
$162,000 1
—
1 $162,000
9.
Roadside Signs
a. Install New Sign on Existing Pole
3
EA
n$100
=
$300
b. Remove and Reinstall Wayfinding Sign
1
EA
$150
=
$150
c. Install New Sign on New Post
3
EA
$250
=
$750
d. Relocate Existing Sign to Existing Pole
11
EA
$40
=
$440
10.
Traffic Stripes and Pavement Markings
a. Pavement Markings
2,000
SF
$3.25
—
$6,500
b. Detail 22
850
LF
a
$1.50
—
$1,275
c. Paint Curb Red
900
LF
$1.50
I —
I $1,350
d. 4" White Stripe
4
LF
$4 I —
$16
11.
Landscape Improvements
a. Install Tree in Tree Well
5
I EA
a,1
$5,000 =
$25,000
GRAND TOTAL BID $1,247,146.00
Page 2 of 4
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 4590 of the Government Code. Such securities,
if deposited by the Contractor, shall be valued by the City's Finance Director, whose decision on valuation of
the securities shall be final.
VI - Acceptance and Final Payment
(a) Upon receipt of written notice that the work is ready for final inspection and acceptance, the 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.
VII - Assignment of Warranties; Waiver of Subrogation
(a) Contractor hereby assigns to City all warranties, guarantees, or similar benefits such as insurance, provided by
or reasonably obtainable from the manufacturers or 'suppliers of equipment, material or fixtures that Contractor
has installed or provided in connection with the work performed under this Agreement.
(b) Contractor hereby agrees to waive and arrange by contract for its subcontractors to waive any subrogation
rights which any insurer of Contractor or its subcontractors might otherwise acquire in connection with the
insurer's payment to Contractor or its subcontractors of any insured loss with respect to work performed under
this Agreement. Contractor further agrees to obtain and to arrange for its subcontractors to obtain for City's
benefit any endorsements from insurers that may be necessary to effect such waiver of subrogation.
Specifically, any worker's compensation insurance policies of the Contractor or its subcontractors shall be
endorsed with a waiver of subrogation in favor of City for any work performed by Contractor or its
Page 3 of 4
subcontractors under this Agreement, and copies of such endorsements shall be provided to City.
IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute
this Agreement the day and year first written above.
ATTEST: CITY OF SAN RAFAEL:
Esther C. Beirne(Itiv
Sc rte
City Clerk M.ager
APPROVED AS TO FORM:
�.. .a _ 4 �V�1✓
Robert F. Epstein
City Attorney
File No.: 18.01.81
Page 4 of 4
GHILOTTI BROS., INC.
jaA1�� i�J/f��Title: -i-Achael M. Ghilotti
President/Treasurer
Bond Executed in Duplicate Bond No. 9211258
FAITHFUL PERFORMANCE BOND
PUBLIC WORK
(The premium charged on this bond is $ 7,214.00 being at
the rate of t 100,000 @ 7.94/m per thousand of the contract price)
next $400,000 @ 6.00/m, next $747,146 @ 5.38/m
KNOW ALL MEN BY THESE PRESENTS:
THAT, WHEREAS the City of San Rafael
State of California, entered into a contract dated March 7th 2016 , with
Ghilotti Bros., Inc.
hereinafter designated as the "Principal,"
for the work described as follows: Tamalpais Avenue Queue Cutter Improvements Project
City Project No. 11272
and
WHEREAS, the said Principal is rcquir;.d under the terms of said contract to furnish a bond for the faithful
performance of said contract.
NOW, THEREFORE, We, the Principal, and Fidelity and Deposit Company ofIviary•land . a
corporation organized and existing under the laws of the State of Maryland , and duly authori/ed to transact
business under the laws of the State of California, as Surety, are held and firmly bound unto
City of San Rafael in the penal sum of
One Million Two Hundred Forty Seven Thousand One Hundred Forty Six & 00/100 --Dollars ($ 1,247,146.00 ),
lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our
heirs, executors, administrators, and successors, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH, That, if the above bounden Principal, his or its heirs,
executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and
perform the covenants, conditions and agreements in the said contract and any alteration thereof made as therein
provided, on his or their part, to be kept and performed at the time and in the manner therein specified, and in all
respects according, to their true intent and meaning, and shall indemnify and save harmless the
City of San Rafael its officers and agents, as therein stipulated, then this obligation
shall become null and void; otherwise it shall be and remain in full force and virtue.
And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration
or addition to the terms of the contract or to the work to be performed thereunder or the specifications accompanying
the same shall in any wise affect its obligations on this bond, and it does hereby waive notice of any such change,
extension of time, alteration or addition to the terms of the contract or to the work or to the specifications.
IN WITNESS WHEREOF, We have hereunto set our hands and seals this 7th day of March 2016
PRF71001 CA0201 f
Ghilotti Bros., Inc.
Principal
By
Michael M. Ghilotti, President/Treasurer
Fidelity and Deposit Company of Maryland
By �LC f 4 4L&I—
Kelly Holtemann
Attorney -in -Fact
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
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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 March 23, 2016 before me, Renee Powers, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Michael M. Ghilotti
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/eFe
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/#ger/t:h& authorized capacity(ies), and that by his/bw/their signature(s) on the instrument the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
OMYRENEE POWERS d
COMM. #2119041 z
Notary Public - California oz Marin County m Comm. Expires JulX 11, 2019 i
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WIT my hand icial seal.
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Sign u
Signature of Notary Public
OPTIONAL
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Description of Attached Document
Title or Type of Document: Docum ate:
Number of Pages: Signer(s) Other T=Signer's
Capacity(ies) Claimed by Signer(s)
Signer's Name: e:
❑ Corporate Officer — Title(s): / ❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ Gene
El Partner — ❑Limited t General
❑ Individual ❑ Attorngy-K Fact ❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ dian or Conservator ❑ Trustee El Guardian or Conservator
El Other: ❑ Other:
Signer Is Representing: Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
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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 Califomia
County of Marin
On March 7th, 2016 before me, J. DeLuca, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Kelly Holtemann
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(&) whose name(s) is/ar�
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.
My COMM- Expires October 24, 2016
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand andy official seal.
Signature -
Signature of Notary Public
OPTIONAL
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Description of Attached Document
Title or Type of Document: Document D
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: gner's Name:
LJ Corporate Officer — Title(s): LJ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑ General ❑ Partner — ❑ Limited ElGeneral
❑ Individual LJ Attorne ' act ❑ Individual ElAttorney in Fact
171 Trustee tan or Conservator ElTrustee FJ Guardian or Conservator
ElOther: ❑ Other:
Signer I presenting: Signer Is Representing:
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02014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
J. DELUCA *r D
COMM. #1993570
�y.••
NOTARY PUBLIC -CALIFORNIA O
MARIN COUNTY
My COMM- Expires October 24, 2016
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand andy official seal.
Signature -
Signature of Notary Public
OPTIONAL
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Description of Attached Document
Title or Type of Document: Document D
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: gner's Name:
LJ Corporate Officer — Title(s): LJ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑ General ❑ Partner — ❑ Limited ElGeneral
❑ Individual LJ Attorne ' act ❑ Individual ElAttorney in Fact
171 Trustee tan or Conservator ElTrustee FJ Guardian or Conservator
ElOther: ❑ Other:
Signer I presenting: Signer Is Representing:
� •CIX'G�f�.�-[G�Z.��/Tr�+Cr�VWWNWwWWY:.LWw`w"Vt-'V`-VnWri".VWl'fvY'VYfVTSY�IY�LCIQ WVWW �V4:IV SVS"VL.VTJV1=.VSV1/V
02014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
Bond Executed in Duplicate
PAYMENT BOND
PUBLIC WORK
Section 3247-3252 inclusive, Civil code)
(Premium included in Faithful Performance Bond)
KNOW ALL MEN BY THESE PRESENT:
That, Whereas
Bond No. 9211258
Premium: Included
City of San Rafael
has awarded to
Ghilotti Bros., Inc.
as Principal, a contract for the work described as follows:
Tamalpais Avenue Queue Cutter Improvements Project, City Project No. 11272
AND WHEREAS, said Principal is required ad to furnish a bond in connection with said contract, to secure the
payment of claims of laborers, mechanics, materialmen, and other persons as provided by law:
NOW, THEREFORE, We the undersigned Principal and Surety are held and firmly bound unto the
City of San Rafael
in the amount required by law, the sum of
One Million Two Hundred Forty Seven Thousand One Hundred Forty Six & 00/100 --
Dollars ($ 1,247,146.00 ) for which payment well and truly be made we bind ourselves, our heirs,
executors and administrators, successors and assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH, That if said Principal, his or its heirs, executors,
administrators, successors or assigns, or subcontractors, shall fail to pay any of the persons named in Civil Code
Section 3181, or amounts due under the Unemployment's Insurance Act with respect to work or labor performed
by any such claimant, or for any amounts required to be deducted, withheld, and paid over the Employment
Development Department from the wages of employees of the principals and his subcontractors pursuant to
section 13020 of the Unemployment Insurance Code, with respect to such work and labor, that the Surety or
Sureties herein will pay for the same in the amount not exceeding the sum specified in this bond, otherwise the
above obligation shall be void. In case suit is brought upon this bond, the said surety will pay a reasonable
attorney's fee to be fixed by the court.
PAY71001 CA0202f
In witness Whereof, We have hereunto set our hand and seals this 7th
day of March 2016
Ghilotti Bros., Inc.
Principal
By:
Michael M. Ghilotti, President/ Treasurer
Fidelity and Deposit Company of Maryland
By:
Kelly Holtendann , Attorney -In -Fac[
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
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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 March 23, 2016 before me, Renee Powers, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Michael M. Ghilotti
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/eFe
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/#ger/their signature(s) on the instrument the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
dRENEE POWERS d
w �.. COMM. #2119041 z
o _-• .Notary Public - California o
Cr" .y . Marin County m
1 My Comm. Expires July 11,_201 9 i
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITN and and official seal.
r
Signature LQ�
J Signature of Notary Public
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Title or Type of Document:
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Signer's Name: /
Corporate Officer — Title(s): /
❑ Partner — ❑ Limited C G nck'a1
❑ Individual ; Aft y in Fact
❑ Trustee uardian or Conservator
❑ Other:
Signer Representing:
Date:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
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02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
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A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
I document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of Califomia
County of Marin
On March 7th, 2016 before me, J. DeLuca, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Kelly Holtemann
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(&) whose name(s) is/ar-e
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
hWher/t'h6r authorized capacity(les), and that by his/her/#i& signature(s) on the instrument the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
My Comm. Expires October 24, 2016-L
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
OPTIONAL
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fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Number of Pages: Signer(s)
Document
Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
Ll Corporate Officer — Title(s):
❑ Partner — ❑ Limited General
❑ Individual ❑ Attorne • act
❑ Trustee ian or Conservator
❑ Other:
Signer I presenting:
miner's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
COMM.#1993570
NOTARY PUBLIC -CALIFORNIA
MARIN COUNTY O
My Comm. Expires October 24, 2016-L
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
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Description of Attached Document
Title or Type of Document:
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Document
Other Than Named Above:
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Signer's Name:
Ll Corporate Officer — Title(s):
❑ Partner — ❑ Limited General
❑ Individual ❑ Attorne • act
❑ Trustee ian or Conservator
❑ Other:
Signer I presenting:
miner's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
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
THOMAS O. MCCLELLAN, 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 Kelly HOLTEMANN and Joan DELUCA, both of San Francisco, 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.
IN 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 19th day of October, A.D. 2015.
ATTEST:
i, � "-), 1121�11�
Secretao,
Eric D. Barnes
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
cwl'p)
��c o[ros� �ji►wnsli a
~you*�
Vice PresidentY
Thomas O. McClellan
State of Maryland
County of Baltimore
On this 19th day of October, A.D. 2015, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, THOMAS O.
MCCLELLAN, Vice President, and ERIC D. BARNES, 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, 1 have hereunto set my hand and affixed my Official Seal the day and year first above written.
`
q��„ iiiii�` `'•
Maria D. Adamski, Notary Public
My Commission Expires: July 8, 2019
POA -F 016-0949H
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
1, 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.
Ik,TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies,
this _._� day of �Mt cr l 20AICL.
�O811AL
.w.
Michael Bond, Vice President
A� ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
3/23/2016
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).
CONTACT
PRODUCER NAME: Megan Montano
Woodruff -Sawyer & Co. PHONEmac_ No,: 415-989-9923
50 California Street, Floor 12 IA/C. Nn F,,• 415-391-2141
San Francisco CA 94111 A ,, ,,,.mmontano@wsandco.com
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
GBI Job #16403, Tamalpias Ave. Queue Cutter Improvements Project. The City of San Rafael and Sonoma -Marin Area Rail Transit
(SMART), its electrive and appointive Boards, Commissions, Officers, Agents and Employees are additional insured for General Liability per
HG 00 01 060 05. Coverage is Primary and Non-contributory per form HIS 00 0106 05 attached.
Excess liability/umbrella coverage is written on a following form basis.
Policies contain a 30 day notice of cancellation and a 10 day notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of San Rafael, ACCORDANCE WITH THE POLICY PROVISIONS.
its, officers, employees, agents and volunteers
111 Morphew Street AUTHORIZED REPRESENTATIVE
San Rafael CA 94915
I
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INSURER(S) AFFORDING COVERAGE NAIC #
INSURERA:Hartford Fire Insurance Company 19682
INSURED GHILBRO-01
INSURERB:Starr Indemnity & Liability Company 38318
Ghilotti Bros, Inc. I
INSURERC:Steadfast Insurance Company 26387
525 Jacoby Street I
San Rafael CA 94901
INSURER D:
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: 100335232
REVISION NUMBER:
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 'AUUL 5U6Ft
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER
POLICY EFF POLICY EXP LIMITS
(MM/DWYYYY� (MM/DD/YYYYI
A X COMMERCIAL GENERAL LIABILITY Y 57UENQT9730
10/1/2015 10/1/2016 52,000,000
CLAIMS -MADE ED OCCUR
DAMA_e%RENTED
I PREMISES (Ea occurrencel $300,000
MED EXP (Any one person) 510,000
PERSONAL & ADV INJURY 52,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE 54,000,000
PRO -
[�] F7
I PRODUCTS - COMP/OP AGG 54,000,000
POLICY ECT LOC
OTHER
$
A AUTOMOBILE LIABILITY 57UENQT9729
10/1/2015 10/1/2016 UUMBINEDJINGLEDMIf 51000,000
(Ea accident)
X ANY AUTO
BODILY INJURY (Per person) 5
ALL OWNED SCHEDULED
BODILY INJURY (Per acadenl) 5
AUTOS
NON -OWNED
PROPERTY DAMAGE $
I
H:RED AUTOS AUTOS
(Per accident)
5
B UMBRELLA LIAB NXOCCUR 1000022133
10/1+2015 10/1/2016 EACH OCCURRENCE 52,000,000
X EXCESS LIAR CLAIMS -MADE
AGGREGATE S2,000,000
DED I I RETENTIONS
S
A WORKERS COMPENSATION 57WEQT9728
10/1/2015 10/1/2016 X I STATUTE I I ERH
AND EMPLOYERS' LIABILITY
Y❑
ANY PROPRIETOR/PARTNER/EXECUTIVE
N / A
I E.L. EACH ACCIDENT 51,000,000
OFFICER/MEMBER EXCLUDED?
I
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE 51,000,000
If yes, describe under
DESCRIPTIONOFOPERATIONS below
E.L DISEASE -POLICY LIMIT $1,000,000
C Railroad Protective SCO019175600
4/18/2016 4/18/2017 $2,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
GBI Job #16403, Tamalpias Ave. Queue Cutter Improvements Project. The City of San Rafael and Sonoma -Marin Area Rail Transit
(SMART), its electrive and appointive Boards, Commissions, Officers, Agents and Employees are additional insured for General Liability per
HG 00 01 060 05. Coverage is Primary and Non-contributory per form HIS 00 0106 05 attached.
Excess liability/umbrella coverage is written on a following form basis.
Policies contain a 30 day notice of cancellation and a 10 day notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of San Rafael, ACCORDANCE WITH THE POLICY PROVISIONS.
its, officers, employees, agents and volunteers
111 Morphew Street AUTHORIZED REPRESENTATIVE
San Rafael CA 94915
I
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
Insured: Ghilotti, Bros., Inc.
Policy #: 57 UEN QT9730
have all your rights and duties under this Coverage
Part.
e. Unnamed Subsidiary
Any subsidiary, and subsidiary thereof, of yours
which is a legally incorporated entity of which you
own a financial interest of more than 50% of the
voting stock on the effective date of the Coverage
Part.
The insurance afforded herein for any subsidiary
not named in this Coverage Part as a named
insured does not apply to injury or damage with
respect to which an insured under this Coverage
Part is also an insured under another policy or
would be an insured under such policy but for its
termination or the exhaustion of its limits of
insurance.
3. Newly Acquired or Formed Organization
Any organization you newly acquire or form, other than
a partnership, joint venture or limited liability company,
and over which you maintain financial interest of more
than 50% of the voting stock, will qualify as a Named
Insured if there is no other similar insurance available
to that organization. However:
a. Coverage under this provision is afforded only until
the 180th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
b. Coverage A does not apply to "bodily injury" or
"property damage" that occurred before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury" arising out of an offense
committed before you acquired or formed the
organization.
4. Mobile Equipment
With respect to "mobile equipment" registered in your
name under any motor vehicle registration law, any
person is an insured while driving such equipment
along a public highway with your permission. Any other
person or organization responsible for the conduct of
such person is also an insured, but only with respect to
liability arising out of the operation of the equipment,
and only if no other insurance of any kind is available
to that person or organization for this liability. However,
no person or organization is an insured with respect to:
a. "Bodily injury" to a co -"employee" of the person
driving the equipment; or
b. "Property damage" to property owned by, rented to,
in the charge of or occupied by you or the employer
of any person who is an insured under this
provision.
5. Nonowned Watercraft
With respect to watercraft you do not own that is less
than 51 feet long and is not being used to carry
persons for a charge, any person is an insured while
operating such watercraft with your permission. Any
other person or organization responsible for the
conduct of such person is also an insured, but only
with respect to liability arising out of the operation of
the watercraft, and only if no other insurance of any
kind is available to that person or organization for this
liability.
However, no person or organization is an insured with
respect to:
a. "Bodily injury" to a co -"employee" of the person
operating the watercraft; or
b. "Property damage" to property owned by, rented to,
in the charge of or occupied by you or the employer
of any person who is an insured under this
provision.
6. Additional Insureds When Required By Written
Contract, Written Agreement Or Permit
The following person(s) or organization(s) are an
additional insured when you have agreed, in a written
contract, written agreement or because of a permit
issued by a state or political subdivision, that such
person or organization be added as an additional
insured on your policy, provided the injury or damage
occurs subsequent to the execution of the contract or
agreement.
A person or organization is an additional insured under
this provision only for that period of time required by
the contract or agreement.
However, no such person or organization is an insured
under this provision if such person or organization is
included as an insured by an endorsement issued by
us and made a part of this Coverage Part.
a. Vendors
Any person(s) or organization(s) (referred to below
as vendor), but only with respect to "bodily injury"
or "property damage" arising out of "your products"
which are distributed or sold in the regular course
of the vendor's business and only if this Coverage
Part provides coverage for "bodily injury" or
"property damage" included within the "products -
completed operations hazard".
(1) The insurance afforded the vendor is subject to
the following additional exclusions:
This insurance does not apply to:
(a) "Bodily injury" or "property damage" for
which the vendor is obligated to pay
damages by reason of the assumption of
liability in a contract or agreement. This
exclusion does not apply to liability for
damages that the vendor would have in the
absence of the contract or agreement;
Page 10 of 18 HG 00 01 06 05
have all your rights and duties under this Coverage
Part.
e. Unnamed Subsidiary
Any subsidiary, and subsidiary thereof, of yours
which is a legally incorporated entity of which you
own a financial interest of more than 50% of the
voting stock on the effective date of the Coverage
Part.
The insurance afforded herein for any subsidiary
not named in this Coverage Part as a named
insured does not apply to injury or damage with
respect to which an insured under this Coverage
Part is also an insured under another policy or
would be an insured under such policy but for its
termination or the exhaustion of its limits of
insurance.
3. Newly Acquired or Formed Organization
Any organization you newly acquire or form, other than
a partnership, joint venture or limited liability company,
and over which you maintain financial interest of more
than 50% of the voting stock, will qualify as a Named
Insured if there is no other similar insurance available
to that organization. However:
a. Coverage under this provision is afforded only until
the 180th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
b. Coverage A does not apply to "bodily injury" or
"property damage" that occurred before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury" arising out of an offense
committed before you acquired or formed the
organization.
4. Mobile Equipment
With respect to "mobile equipment" registered in your
name under any motor vehicle registration law, any
person is an insured while driving such equipment
along a public highway with your permission. Any other
person or organization responsible for the conduct of
such person is also an insured, but only with respect to
liability arising out of the operation of the equipment,
and only if no other insurance of any kind is available
to that person or organization for this liability. However,
no person or organization is an insured with respect to:
a. "Bodily injury" to a co -"employee" of the person
driving the equipment; or
b. "Property damage" to property owned by, rented to,
in the charge of or occupied by you or the employer
of any person who is an insured under this
provision.
5. Nonowned Watercraft
With respect to watercraft you do not own that is less
than 51 feet long and is not being used to carry
persons for a charge, any person is an insured while
operating such watercraft with your permission. Any
other person or organization responsible for the
conduct of such person is also an insured, but only
with respect to liability arising out of the operation of
the watercraft, and only if no other insurance of any
kind is available to that person or organization for this
liability.
However, no person or organization is an insured with
respect to:
a. "Bodily injury" to a co -"employee" of the person
operating the watercraft; or
b. "Property damage" to property owned by, rented to,
in the charge of or occupied by you or the employer
of any person who is an insured under this
provision.
6. Additional Insureds When Required By Written
Contract, Written Agreement Or Permit
The following person(s) or organization(s) are an
additional insured when you have agreed, in a written
contract, written agreement or because of a permit
issued by a state or political subdivision, that such
person or organization be added as an additional
insured on your policy, provided the injury or damage
occurs subsequent to the execution of the contract or
agreement.
A person or organization is an additional insured under
this provision only for that period of time required by
the contract or agreement.
However, no such person or organization is an insured
under this provision if such person or organization is
included as an insured by an endorsement issued by
us and made a part of this Coverage Part.
a. Vendors
Any person(s) or organization(s) (referred to below
as vendor), but only with respect to "bodily injury"
or "property damage" arising out of "your products"
which are distributed or sold in the regular course
of the vendor's business and only if this Coverage
Part provides coverage for "bodily injury" or
"property damage" included within the "products -
completed operations hazard".
(1) The insurance afforded the vendor is subject to
the following additional exclusions:
This insurance does not apply to:
(a) "Bodily injury" or "property damage" for
which the vendor is obligated to pay
damages by reason of the assumption of
liability in a contract or agreement. This
exclusion does not apply to liability for
damages that the vendor would have in the
absence of the contract or agreement;
Page 10 of 18 HG 00 01 06 05
(b) Any express warranty unauthorized by you;
(c) Any physical or chemical change in the
product made intentionally by the vendor;
(d) Repackaging, except when unpacked solely
for the purpose of inspection, demonstration,
testing, or the substitution of parts under
instructions from the manufacturer, and then
repackaged in the original container;
(e) Any failure to make such inspections,
adjustments, tests or servicing as the vendor
has agreed to make or normally undertakes
to make in the usual course of business, in
connection with the distribution or sale of the
products;
(f) Demonstration, installation, servicing or
repair operations, except such operations
performed at the vendor's premises in
connection with the sale of the product;
(g) Products which, after distribution or sale by
you, have been labeled or relabeled or used
as a container, part or ingredient of any
other thing or substance by or for the
vendor; or
(h) "Bodily injury" or "property damage" arising
out of the sole negligence of the vendor for
its own acts or omissions or those of its
employees or anyone else acting on its
behalf. However, this exclusion does not
apply to:
(i) The exceptions contained in Sub-
paragraphs (d) or (f); or
(ii) Such inspections, adjustments, tests or
servicing as the vendor has agreed to
make or normally undertakes to make in
the usual course of business, in
connection with the distribution or sale of
the products.
c. Lessors of Land or Premises
Any person or organization from whom you lease
land or premises, but only with respect to liability
arising out of the ownership, maintenance or use of
that part of the land or premises leased to you.
With respect to the insurance afforded these
additional insureds the following additional
exclusions apply:
This insurance does not apply to:
1. Any "occurrence" which takes place after you
cease to lease that land; or
2. Structural alterations, new construction or
demolition operations performed by or on behalf
of such person or organization.
d. Architects, Engineers or Surveyors
(2) This insurance does not apply to any insured
person or organization, from whom you have
acquired such products, or any ingredient, part
or container, entering into, accompanying or e'
containing such products.
b. Lessors of Equipment
(1) Any person or organization from whom you
lease equipment; but only with respect to their
liability for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your maintenance, operation
or use of equipment leased to you by such
person or organization.
(2) With respect to the insurance afforded to these
additional insureds this insurance does not
apply to any "occurrence" which takes place
after the equipment lease expires.
Any architect, engineer, or surveyor, but only with
respect to liability for "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:
(1) In connection with your premises; or
(2) In the performance of your ongoing operations
performed by you or on your behalf.
With respect to the insurance afforded these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to "bodily injury",
"property damage" or "personal and advertising
injury" arising out of the rendering of or the failure
to render any professional services by or for you,
including:
1. The preparing, approving, or failing to prepare
or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders or
drawings and specifications; or
2. Supervisory, inspection, architectural or
engineering activities.
Permits Issued By State Or Political
Subdivisions
Any state or political subdivision, but only with
respect to operations performed by you or on your
behalf for which the state or political subdivision
has issued a permit,
With respect to the insurance afforded. these
additional insureds, this insurance does not apply
to:
(1) "Bodily injury", "property damage" or "personal
and advertising injury" arising out of operations
performed for the state or municipality; or
(2) "Bodily injury" or "property damage" included
within the "products -completed operations
hazard".
HG 00 01 06 05 Page 11 of 18
f. Any Other Party
Any other person or organization who is not an
insured under Paragraphs a. through e. above, but
only with respect to liability for "bodily injury",
"property damage" or "personal and advertising
injury" caused, in whole or in part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:
(1) In the performance of your ongoing operations;
(2) In connection with your premises owned by or
rented to you; or
(3) In connection with "your work" and included
within the "products -completed operations
hazard", but only if
(a) The written contract or agreement requires
you to provide such coverage to such
additional insured; and
(b) This Coverage Part provides coverage for
"bodily injury" or "property damage" included
within the "products -completed operations
hazard".
With respect to the insurance afforded to these
additional insureds, this insurance does not apply
to:
"Bodily injury", "property damage" or "personal and
advertising injury" arising out of the rendering of, or
the failure to render, any professional architectural,
engineering or surveying services, including:
(1) The preparing, approving, or failing to prepare
or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders or
drawings and specifications; or
(2) Supervisory, inspection, architectural or
engineering activities.
The limits of insurance that apply to additional insureds
under this provision is described in Section III — Limits
Of Insurance.
How this insurance applies when other insurance is
available to the additional insured is described in the
Other Insurance Condition in Section IV — Commercial
General Liability Conditions.
No person or organization is an insured with respect to the
conduct of any current or past partnership, joint venture or
limited liability company that is not shown as a Named
Insured in the Declarations.
SECTION III — LIMITS OF INSURANCE
1. The Most We will Pay
The Limits of Insurance shown in the Declarations and
the rules below fix the most we will pay regardless of
the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing
"suits".
2. General Aggregate Limit
The General Aggregate Limit is the most we will pay
for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages
because of "bodily injury" or "property damage"
included in the "products -completed operations
hazard"; and
c. Damages under Coverage B.
3. Products -Completed Operations Aggregate Limit
The Products -Completed Operations Aggregate Limit
is the most we will pay under Coverage A for damages
because of "bodily injury" and "property damage"
included in the "products -completed operations
hazard".
4. Personal and Advertising Injury Limit
Subject to 2. above, the Personal and Advertising
Injury Limit is the most we will pay under Coverage B
for the sum of all damages because of all "personal
and advertising injury" sustained by any one person or
organization.
5. Each Occurrence Limit
Subject to 2. or 3. above, whichever applies, the Each
Occurrence Limit is the most we will pay for the sum
of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of all "bodily injury" and "property damage"
arising out of any one 'occurrence".
6. Damage To Premises Rented To You Limit
Subject to 5. above, the Damage To Premises Rented
To You Limit is the most we will pay under Coverage A
for damages because of "property damage" to any one
premises, while rented to you, or in the case of
damage by fire, lightning or explosion, while rented to
you or temporarily occupied by you with permission of
the owner.
In the case of damage by fire, lightning or explosion,
the Damage to Premises Rented To You Limit applies
to all damage proximately caused by the same event,
whether such damage results from fire, lightning or
explosion or any combination of these.
7. Medical Expense Limit
Subject to S. above, the Medical Expense Limit is the
most we will pay under Coverage C for all medical
expenses because of "bodily injury" sustained by any
one person.
8. How Limits Apply To Additional Insureds
If you have agreed in a written contract or written
agreement that another person or organization be
Page 12 of 18 HG 00 01 06 05
Insured: Ghilotti, Bros., Inc.
Policy #: 57 LIEN QT9730
that are in excess of the applicable limit of insurance.
An agreed settlement means a settlement and release
of liability signed by us, the insured and the claimant or
the claimant's legal representative.
4. Other Insurance
If other valid and collectible insurance is available to
the insured for a loss we cover under Coverages A or
B of this Coverage Part, our obligations are limited as
follows:
a. Primary Insurance
This insurance is primary except when b. below
applies. If other insurance is also primary, we will
share with all that other insurance by the method
described in c. below.
b. Excess Insurance
This insurance is excess over any of the other
insurance, whether primary, excess, contingent or
on any other basis:
(1) Your Work
That is Fire, Extended Coverage, Builders Risk,
Installation Risk or similar coverage for "your
work";
(2) Premises Rented To You
That is fire, lightning or explosion insurance for
premises rented to you or temporarily occupied
by you with permission of the owner;
(3) Tenant Liability
That is insurance purchased by you to cover
your liability as a tenant for "property damage"
to premises rented to you or temporarily
occupied by you with permission of the owner;
(4) Aircraft, Auto Or Watercraft
If the loss arises out of the maintenance or use
of aircraft, "autos" or watercraft to the extent not
subject to Exclusion g. of Section I — Coverage
A — Bodily Injury And Property Damage Liability;
(5) Property Damage to Borrowed Equipment Or
Use Of Elevators
If the loss arises out of "property damage" to
borrowed equipment or the use of elevators to
the extent not subject to Exclusion j. of Section
- Coverage A - Bodily Injury And Property
Damage Liability;
(6) When You Are Added As An Additional
Insured To Other Insurance
Any other insurance available to you covering
liability for damages arising out of the premises
or operations, or products and completed
operations, for which you have been added as
an additional insured by that insurance; or
Page 14 of 18
(7) When You Add Others As An Additional
Insured To This Insurance
Any other insurance available to an additional
insured.
However, the following provisions apply to other
insurance available to any person or
organization who is an additional insured under
this coverage part.
(a) Primary Insurance When Required By
Contract
This insurance is primary if you have agreed
in a written contract or written agreement
that this insurance be primary. If other
insurance is also primary, we will share with
all that other insurance by the method
described in c. below.
(b) Primary And Non -Contributory To Other
Insurance When Required By Contract
If you have agreed in a written contract,
written agreement, or permit that this
insurance is primary and non-contributory
with the additional insured's own insurance,
this insurance is primary and we will not
seek contribution from that other insurance.
Paragraphs (a) and (b) do not apply to other
insurance to which the additional insured has
been added as an additional insured.
When this insurance is excess, we will have no
duty under Coverages A or B to defend the insured
against any "suit" if any other insurer has a duty to
defend the insured against that "suit". If no other
insurer defends, we will undertake to do so, but we
will be entitled to the insured's rights against all
those other insurers.
When this insurance is excess over other
insurance, we will pay only our share of the amount
of the loss, if any, that exceeds the sum of:
(1) The total amount that all such other insurance
would pay for the loss in the absence of this
insurance; and
(2) The total of all deductible and self-insured
amounts under all that other insurance.
We will share the remaining loss, if any, with any
other insurance that is not described in this Excess
Insurance provision and was not bought specifically
to apply in excess of the Limits of Insurance shown
in the Declarations of this Coverage Part.
c. Method Of Sharing
If all of the other insurance permits contribution by
equal shares, we will follow this method also. Under
this approach each insurer contributes equal
amounts until it has paid its applicable limit of
insurance or none of the loss remains, whichever
comes first.
HG 00 01 06 06
m
Disclosure Statement ZURICH
It is our pleasure to present the enclosed policy to you
for presentation to your customer.
INSTRUCTION TO AGENT OR BROKER:
WE REQUIRE THAT YOU TRANSMIT THE ATTACHED/ENCLOSED DISCLOSURE STATEMENT TO THE CUSTOMER
WITH THE POLICY.
Once again, thank you for your interest, and we look forward to meeting your needs and those of your customers.
U -GU -873-A CW (06/11)
Pagel of 1
Disclosure Statement ZURICH
NOTICE OF DISCLOSURE FOR AGENT & BROKER COMPENSATION
If you want to learn more about the compensation Zurich pays agents and brokers visit:
http://www.zurichnaproducercompensation.com
or call the following toll-free number: (866) 903-1192.
This Notice is provided on behalf of Zurich American Insurance Company
and its underwriting subsidiaries.
U -GU -874-A CW (06/11)
Page 1 of 1
Important Notice to Policyholders
QD
ZURICH
The address for the headquarters of Zurich North America will change after August 1, 2016 due to a relocation of our
office in the same city. The new address is:
Customer Inquiry Center
Zurich North America
1299 Zurich Way
Schaumburg, IL 60196
1-800-382-2150
For specific questions regarding your policy, please contact your agent or broker. For other questions, you may contact
the Customer Inquiry Center of Zurich North America. Any references to post office boxes previously provided remain
unchanged.
U -GU -1194-A CW (08/15)
Page 1 of 1
Insured Name: SONOMA MARIN AREA RAIL TRANSIT
Policy Number: SCO 0191756-00
Effective Date: 04/18/2016 ZURICH
THIS DISCLOSURE IS ATTACHED TO AND MADE PART OF YOUR POLICY.
DISCLOSURE OF IMPORTANT INFORMATION
RELATING TO TERRORISM RISK INSURANCE ACT
SCHEDULE*
Premium attributable to risk of loss from certified acts of terrorism for lines of insurance subject to TRIA:
Not Applicable - Terrorism Exclusion
*Any information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Disclosure of Premium
In accordance with the federal Terrorism Risk Insurance Act ("TRIA"), as amended, we are required to provide you
with a notice disclosing the portion of your premium, if any, attributable to the risk of loss from terrorist acts certified
under that Act for lines subject to TRIA. That portion of premium attributable is shown in the Schedule above. The
premium shown in the Schedule above is subject to adjustment upon premium audit, if applicable.
B. Disclosure of Federal Participation in Payment of Terrorism Losses
The United States Government may pay a share of insured losses resulting from an act of terrorism. The federal
share will decrease by 5% from 85% to 80% over a five year period while the insurer share increases by the same
amount during the same period. The schedule below illustrates the decrease in the federal share:
January 1, 2015 — December 31, 2015 federal share: 85%
January 1, 2016 — December 31, 2016 federal share: 84%
January 1, 2017 — December 31, 2017 federal share: 83%
January 1, 2018 — December 31, 2018 federal share: 82%
January 1, 2019 — December 31, 2019 federal share: 81%
January 1, 2020 — December 31, 2020 federal share: 80%
C. Disclosure of $100 Billion Cap on All Insurer and Federal Obligations
If aggregate insured losses attributable to terrorist acts certified under TRIA exceed $100 billion in a calendar year
(January 1 through December 31) and an insurer has met its deductible under the program, that insurer shall not be
liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured
losses up to that amount are subject to pro rata allocation in accordance with procedures established by the
Secretary of Treasury.
D. Availability
As required by TRIA, we have made available to you for lines subject to TRIA coverage for losses resulting from acts
of terrorism certified under TRIA with terms, amounts and limitations that do not differ materially from those for losses
arising from events other than acts of terrorism.
Copyright © 2015 Zurich American Insurance Company U -GU -630-D CW (01/15)
Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2
E. Definition of Act of Terrorism under TRIA
TRIA defines "act of terrorism" as any act that is certified by the Secretary of the Treasury, in accordance with the
provisions of the federal Terrorism Risk Insurance Act ("TRIA"), to be an act of terrorism. The Terrorism Risk
Insurance Act provides that the Secretary of Treasury shall certify an act of terrorism:
1. To be an act of terrorism;
2. To be a violent act or an act that is dangerous to human life, property or infrastructure;
3. To have resulted in damage within the United States, or outside of the United States in the case of an air carrier
(as defined in section 40102 of Title 49, United States Code) or a United States flag vessel (or a vessel based
principally in the United States, on which United States income tax is paid and whose insurance coverage is
subject to regulation in the United States), or the premises of a United States mission; and
4. To have been committed by an individual or individuals as part of an effort to coerce the civilian population of the
United States or to influence the policy or affect the conduct of the United States Government by coercion.
No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by
Congress (except for workers' compensation) or if losses resulting from the act, in the aggregate for insurance
subject to TRIA, do not exceed $5,000,000.
Copyright © 2015 Zurich American Insurance Company U -GU -630-D CW (01/15)
Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2
Railroad Protective Liability
Declarations
J
ZURICH
Steadfast Insurance Company
Dover, Delaware
Administrative Offices - 1400 American Lane
Schaumburg, Illinois 60196-1056
Policy Number: SCO 0191756-00
Item 1. Named Insured and Mailing Address:
SONOMA MARIN AREA RAIL TRANSIT
5401 Old Redwood Highway, Suite 200
Petaluma, CA 94954
Renewal of Number: -----
Producer: ----
Producer:
WOODRUFF -SAWYER & CO.
50 CALIFORNIA ST FL 12
SAN FRANCISCO, CA 94111-4646
Item 2. Policy Period: From: 04/18/2016 To: 04/18/2017
12:01 A.M. Standard time at the address of the first Named Insured shown above.
(Both days inclusive.)
Item 3. Designated Contractor: Ghilotti Brothers, Inc.
Mailing Address: 525 Jacoby Street, San Rafael, CA 94901
Item 4. Name and Address of Involved Governmental Authority to Other Contracting Party:
City of San Rafael Department of Public Works
111 Morphew Street, San Rafael, CA 94901
Item 5. Location of Covered Operations: Tamalpais Avenue, in the area between Laurel Place and 3rd Street,
San Rafael, CA
Item 6. Limits of Insurance: $2,000,000 Each Occurrence $6,000,000 Policy Aggregate
Item 7. Business Description:
Form of Business: CORPORATION
Item 8. Description of Operation: Project #11272. Ground level work including utility line parallel or adjacent to the
RR Tracks
Item 9. Premium: $9,371 Fully Earned at Inception
Classification Code No. Premium Basis Rate of Adjustment
40012 Railroad Protective Liab -(RR is FLAT
named insd) -Construction Ops (RR)
-Ops for Interests Other than RR
Total Advance Premium $9,371
Item 10. Forms and Endorsements: See Attached Schedule of Forms and Endorsements
STF-RRP-D-106-B CW (10/08)
Page 1 of 1
Schedule Of Forms And Endorsements
Policy No. Eff. Date of Pol. Exp. Date of Pol
SCO 0191756-00 04/18/2016 04/18/2017
Named Insured and Mailing Address:
SONOMA MARIN AREA RAIL TRANSIT
5401 Old Redwood Highway, Suite 200
Petaluma, CA 94954
ZURICH
Eff. Date of End. Producer Add'I Prem.
04/18/2016 70724000 ----------
Producer:
WOODRUFF -SAWYER & CO.
50 CALIFORNIA ST FL 12
SAN FRANCISCO, CA 94111-4646
This endorsement modifies insurance provided by the following:
Return Prem.
Signed by: C�u�aaxrid_2(J•E''_�,,,, 03/24/2016
Authorized Representative Date
STF-GU-647-A CW (10/09)
Pagel of 1
Endorsement
Form Number
Number
Form Name
STF-GU-199-B (01/09)
Important Notice - Service of Suit and In Witness Clause
U -GU -630-D CW (01/15)
Disclosure of Important Information Relating to Terrorism
Risk Insurance Act
STF-RRP-D-106-B CW (10/08)
Railroad Protective Liability Policy
STF-RRP-106-A CW (10/08)
Railroad Protective Liability Coverage Form
STF-GU-657-A CW (01/11)
01
Exclusion of Certified Acts of Terrorism and Other Acts of
Terrorism
STF-CGL-1516-A CW (06/09)
02
Evacuation And Evacuation Expenses - Inclusion
STF-RRP-124-B CW (10/08)
03
Employment Practices Liability - Exclusion
STF-RRP-125-B CW (10/08)
04
Pollution Exclusion Amendment
STF-RRP-205-A CW (10/08)
05
Limited Seepage, Pollution and Contamination Coverage
Endorsement
STF-RRP-223-A CW (10/08)
06
Asbestos Exclusion Endorsement
STF-GU-643-A CW (09/08)
07
Nuclear Energy Liability Exclusion Endorsement (Broad
Form)
STF-SLA-100-A CA (10/08)
Notice to Policyholders
U -GU -1191-A CW (03/15)
08
Sanctions Exclusion Endorsement
Signed by: C�u�aaxrid_2(J•E''_�,,,, 03/24/2016
Authorized Representative Date
STF-GU-647-A CW (10/09)
Pagel of 1
Railroad Protective Liability Coverage Form ZURICH
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what
is and is not covered.
Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations. The words
"we", "us" and "our" refer to the Company providing this insurance.
The word "insured" means any person or organization qualifying as such under WHO IS AN INSURED (SECTION II).
Other words and phrases that appear in quotation marks have special meaning. Refer to DEFINITIONS (SECTION V).
SECTION I - COVERAGES
COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily
injury" or "property damage" to which this insurance applies. We will have the right and duty to defend any
"suit" seeking those damages. We may at our discretion investigate any occurrence and settle any claim or
"suit" that may result. But:
(1) The amount we will pay for damages is limited as described in LIMITS OF INSURANCE (Section III); and
(2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of
judgments or settlements.
No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for
under SUPPLEMENTARY PAYMENTS - COVERAGE A.
b. This insurance applies to "bodily injury" and "property damage" only if:
(1) The "bodily injury" or "property damage" occurs during the policy period; and
(2) The "bodily injury" or "property damage" arises out of acts or omissions at the "job location", which are
related to or are in connection with the "work" described in the Declarations.
c. Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of
services or death resulting at any time from the "bodily injury".
2. Exclusions
This insurance does not apply to:
a. Expected or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion
does not apply to "bodily injury" resulting from the use of reasonable force to protect persons or property.
b. Contractual Liability
"Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the
assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages
assumed in a contract or agreement that is a "covered contract".
c. Completed Work
"Bodily injury" or "property damage" occurring after the "work" is completed. The "work" will be deemed
completed at the earliest of the following times:
(1) When all the "work" called for in the "contractor's contract has been completed.
STF-RRP-106-A CW (10/08)
Page 1 of 7
(2) When all the "work" to be done at the "job location" has been completed.
(3) When that part of the "work" done at the "job location" has been put to its intended use by you, the
governmental authority or *other contracting party.
This exclusion does not apply to "bodily injury" or "property damage" resulting from the existence of or removal of
tools, uninstalled equipment or abandoned or unused materials.
d. Acts or Omissions of Insured
"Bodily injury" or "property damage", the sole proximate cause of which is an act or omission of any insured other
than acts or omissions of any of "your designated employees". This exclusion does not apply to injury or damage
sustained at the "job location" by any of "your designated employees" or employee of the "contractor", or by any
employee of the governmental authority or any other contracting party (other than you) specified in the
Declarations.
e. Workers Compensation and Similar Laws
Any obligation of the insured under a workers compensation, disability benefits or unemployment compensation
law or any similar law. This exclusion does not apply to any obligation of the insured under the Federal Employers
Liability Act, as amended.
f. Pollution
"Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage,
migration, release or escape of pollutants at or from the "job location".
(1) Due to the past or present use of the "job location" by you or for you or others for the handling, storage,
disposal, processing or treatment of waste; or
(2) Due to the dumping or disposal of waste on the "job location" by the "contractor" with the knowledge of you or
any of "your designated employees"; or
(3) On which you or "contractors" working directly or indirectly on any insured's behalf are performing operations.
(a) If the pollutants are brought on or to the "job location" in connection with such operations by such
insured, contractors or subcontractor; or
(b) If the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any
way respond to, or assess the effects of pollutants.
Subparagraph (3) (a) does not apply to "bodily injury" or "property damage" arising out of heat, smoke, or fumes
from a hostile fire.
As used in this exclusion, a hostile fire means one which becomes uncontrollable or breaks out from where it was
intended to be.
Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot,
fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed.
g. Damage to Owned, Leased or Entrusted Property
"Property damage" to property owned by you or leased or entrusted to you under a lease or trust agreement.
COVERAGE B - PHYSICAL DAMAGE TO PROPERTY
1. Insuring Agreement
We will pay for "physical damage to property" to which this insurance applies. The "physical damage to property" must
occur during the policy period. The "physical damage to property" must arise out of acts or omissions at the "job
location" which are related to or in connection with the "work" described in the Declarations. The property must be
owned by or leased or entrusted to you under a lease or trust agreement.
2. Exclusions
This insurance does not apply to "physical damage to property":
a. Completed Work
STF-RRP-106-A CW (10/08)
Page 2 of 7
Occurring after the "work" is completed. The "work" will be deemed completed at the earliest of the following
times:
(1) When all the "work" called for in the "contractor's contract has been completed.
(2) When all the "work" to be done at the "job location" has been completed.
(3) When the part of the "work" done at the "job location" has been put to its intended use by you, the
governmental authority or other contracting party.
This exclusion does not apply to "physical damage to property" resulting from the existence of tools, uninstalled
equipment or abandoned or unused materials.
b. Acts or Omissions of Insured
The sole proximate cause of which is an act or omission of any insured other than acts or omissions of any of
"your designated employees".
c. Nuclear Incidents or Conditions
Due to nuclear reaction, nuclear radiation or radioactive contamination or to any related act or condition.
d. Pollution
Due to the discharge, dispersal, seepage, migration, release or escape of pollutants excluded under exclusion f.,
Coverage A.
SUPPLEMENTARY PAYMENTS - COVERAGE A
We will pay, with respect to any claim or "suit" we defend:
1. All expenses we incur.
2. All costs taxed against the insured in the "suit".
3. All interests on the full amount of any judgment accrues after entry of the judgment and before we have paid, offered
to pay or deposited in court the part of the judgment that is within the applicable limit of insurance.
4. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do
not have to furnish these bonds.
5. Expenses incurred by the insured for first aid to others at the time of an accident, for "bodily injury" to which this
insurance applies.
6. All reasonable expenses, incurred by the insured at our request to assist us in the investigation or defense of claim or
"suit" including actual loss of earnings up to $100 a day because of time off from work.
7. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the
applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer.
These payments will not reduce the limits of insurance.
SECTION II -WHO IS AN INSURED
1. You are an insured.
2. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers and directors.
3. Your stockholders are insureds, but only with respect to their liability as stockholders.
4. Any railroad operating over your tracks is an insured.
SECTION III - LIMITS OF INSURANCE
1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the
number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organization making claims or bringing "suits".
STF-RRP-106-A CW (10/08)
Page 3 of 7
2. The Aggregate Limit is the most we will pay for the sum of all damages because of all "bodily injury", all "property
damage" and all "physical damage to property".
3. Subject to 2. above, the Each Occurrence Limit is the most we will pay for the sum of all damages because of all
"bodily injury", all "property damage" and all "physical damage to property" arising out of any one occurrence.
4. Subject to 3. above, the payment for "physical damage to property" shall not exceed the lesser of:
a. the actual cash value of the property at the time of loss; or
b. the cost to repair or replace the property with other property of like kind or quality.
The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining
period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy
period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be
deemed part of the last preceding period for purposes of determining the Limits of Insurance.
SECTION IV - CONDITIONS
A. The following Conditions apply to Coverages A and B:
1. Assignment
Assignment of interest under this Coverage Part shall not bind us unless we issue an endorsement consenting to
the assignment.
2. Bankruptcy
Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this
Coverage Part.
3. Cancellation
a. You may cancel this policy by mailing or delivering to us advance written notice of cancellation.
b. We may cancel this policy by mailing or delivering to you, the "contractor" and any involved governmental
authority or other contracting party designated in the Declarations, at the respective mailing addresses last
known to us, written notice of cancellation at least 60 days before the effective date of cancellation.
c. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date.
d. If this policy is cancelled, any unearned premium will be refunded. If we cancel, the refund will be pro rata. If
you cancel, the refund may be less than pro rata. The cancellation will be effective even if we have not made
or offered a refund.
e. If notice is mailed, proof of mailing will be sufficient proof of notice.
4. Changes
This policy contains all the agreements between you and us concerning the insurance afforded. You are authorized
to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by
endorsement issued by us and made a part of this policy.
5. Inspections And Surveys
We have the right but are not obligated to:
a. Make inspections and surveys at any time;
b. Give you reports on the conditions we find; and
C. Recommend changes.
Any inspections, surveys, reports or recommendations relate only to insurability and the premiums to be charged.
We do not make safety inspections. We do not undertake to perform the duty of any person or organization to
provide for the health or safety of workers or the public. And we do not warrant that conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or standards.
STF-RRP-106-A CW (10/08)
Page 4 of 7
This condition applies not only to us, but also to any rating, advisory, rate service or similar organization which
makes insurance inspections, surveys, reports or recommendations.
6. Other Insurance
The insurance afforded by this policy is:
a. Primary insurance and we will not seek contribution from any other insurance available to you except if the other
insurance is provided by a contractor other than the designated contractor for the same operation and "job
location'; and
b. If the other insurance is available, we will share with that other insurance by the method described below.
If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this
approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the
loss remains, whichever comes first.
7. Premium And Premium Audit
a. We will compute all premiums for this Coverage Part in accordance with our rules and rates.
b. Contract cost, the premium base shown in the Declarations, means the total cost of the operations described in
the Declarations.
c. The premium shown in the Declarations as advance premium is a deposit premium only. At the close of each
audit period we will compute the earned premium for that period. Audit premiums are due and payable on notice
to the contractor designated in the Declarations. If the sum of the advance and audit premiums paid for the
policy period is greater than the earned premium, we will return the excess to the contractor designated in the
Declarations.
In no event shall the payment of premium be your obligation.
8. Transfer Of Rights Of Recovery Against Others To Us
If the insured has rights to recover all or part of any payment we have made under this policy, those rights are
transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit"
or transfer those rights to us and help us enforce them.
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the
Declarations written notice of the nonrenewal not less than 30 days before the expiration date.
If notice is mailed, proof of mailing will be sufficient proof of notice.
B. The following Conditions apply to Coverage A only:
1. Legal Action Against Us
No person or organization has a right under this policy:
a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or
b. To sue us on this policy unless all of its terms have been fully complied with.
A person or organization may sue us to recover on an agreed settlement or on a final judgment
against an insured obtained after an actual trial; but we will not be liable for damages that are not payable under the
terms of this policy or that are in excess of the applicable limit of insurance. An agreed settlement means a
settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative.
2. Duties In The Event Of Occurrence, Claim Or Suit
a. You must see to it that we are notified as soon as practicable of an occurrence which may result in a claim. To
the extent possible, notice should include:
(1) How, when and where the occurrence took place;
(2) The names and addresses of any injured persons witnesses; and
STF-RRP-106-A CW (10/08)
Page 5 of 7
(3) The nature and location of any injury or damage arising out of the occurrence.
b. If a claim is made or "suit" is brought against any insured, you must:
(1) Immediately record the specifics of the claim or "suit" and the date received; and
(2) Notify us as soon as practicable.
You must see to it that we receive written notice of the claim or "suit" as soon as practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection
with the claim or "suit";
(2) Authorize us to obtain records and other information;
(3) Cooperate with us in the investigation settlement or defense of the claim or "suit"; and
(4) Assist us, upon our request, in this endorsement of any right against any person or organization which
may be liable to the insured because of injury or damage to which this insurance may also apply.
d. No insureds will, except at their own cost, voluntarily make a payment, assume any obligation, or incur any
expense, other than for the first aid, without our consent.
3. Separation of Insureds
Except with respect to the Limits of Insurance this insurance applies:
a. As if each Named Insured were the only Named Insured; and
b. Separately to each insured against whom claim is made or "suit" is brought.
C. The following Conditions apply to Coverage B only:
1. Appraisal
If you fail to agree with us on the value of the property, or the amount of loss, either you or we may make written
demand for an appraisal of the loss within sixty (60) days after proof of loss is filed. In this event, each party will
select a competent appraiser. The two appraisers will select a competent and impartial umpire. The appraisers
will state separately the value of the property and the amount of loss. If they fail to agree, they will submit their
differences to the umpire. A decision agreed to by any two will be binding. Each party will:
a. Pay its chosen appraiser; and
b. Bear the other expenses of the appraisal and umpire equally.
If we submit to an appraisal, we still retain our right to deny the claim.
2. No Benefit To Bailee
No person or organization, other than you, having custody of the property will benefit from this insurance.
3. Insured's Duties In The Event Of A Loss
You must:
a. Protect the property, whether or not the loss is covered by this policy. Any further loss due to your failure to
protect the property shall not be recoverable under this policy. Reasonable expenses incurred in affording
such protection shall be deemed to be incurred at our request; and
b. Submit to us, as soon after the loss as possible, your sworn proof of loss constraining the information we
request to settle the loss and, at our request, make available the damaged property for examination.
4. Legal Action Against Us
No person or organization has a right under this policy to sue us on this policy unless all of its terms have been
fully complied with and until 30 days after proof of loss is filed and the amount of loss is determined as provided in
this policy.
STF-RRP-106-A CW (10108)
Page 6 of 7
5. Payment Of Loss
We may pay for the loss in money, but there can be no abandonment of any property to us.
SECTION V - DEFINITIONS
1. 'Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of
these at any time.
2. "Contractor" means the contractor designated in the Declarations and includes all subcontractors working directly or
indirectly for that "contractor" but does not include you.
3. "Covered contract' means any contract or agreement to carry a person or property for a charge or any interchange
contract or agreement respecting motive power, or rolling stock equipment.
4. "Executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws
or any other similar governing document.
5. "Job location" means the job location designated in the Declarations including any area directly related to the "work"
designated in the Declarations. "Job location" includes the ways next to it.
6. "Physical damage to property" means direct and accidental loss of or damage to rolling stock and their contents,
mechanical construction equipment or motive power equipment, railroad tracks, roadbeds, catenaries, signals,
bridges or buildings.
7. "Property damage" means:
a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall
be deemed to occur at the time of the physical injury that caused it; or
b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the
time of the occurrence that caused it.
8. "Suit' means a civil proceeding in which damages because of "bodily injury" or "property damage" to which this
insurance applies are alleged. "Suit' includes:
a. An arbitration proceeding in which such damages are claimed and to which you must submit or do submit with our
consent; or
b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which you submit
with our consent.
9. "Work" means work or operations performed by the "contractor" including materials, parts or equipment furnished in
connection with the work or operations.
10. "Your designated employee" means:
a. Any supervisory employee of yours at the "job location";
b. Any employee of yours while operating, attached to or engaged in work trains or other railroad equipment at the
"job location" which are assigned exclusively to the "contractor"; or
c. Any employee of yours not described in a. or b. above who is specifically loaned or assigned to the work of the
"contractor" for the prevention of accidents or protection of property.
STF-RRP-106-A CW (10/08)
Page 7 of 7
Endorsement # 01
Exclusion of Certified Acts of Terrorism and Other
Acts of Terrorism
Pol'cy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer
sl 0 0191756-00 04/182016 04/18/2017 04/18/2016 70724000
QD
ZURICH
Add9 Prem. I Return Prem.
Named Insured and Mailing Address: Producer:
SONOMA MARIN AREA RAIL TRANSIT WOODRUFF -SAWYER & CO.
5401 Old Redwood Highway, Suite 200 50 CALIFORNIA ST FL 12
Petaluma, CA 94954 SAN FRANCISCO, CA 94111-4646
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Railroad Protective Liability Policy - Railroad
Commercial General Liability Policy - Railroad
A. The following exclusion is added to Item II. Exclusions of Section I. — Insuring Agreement for Covered Injury:
II. Exclusions
This insurance does not apply to:
Terrorism
"Bodily injury" or "property damage" arising, directly or indirectly, out of a "certified act of terrorism" or "other act
of terrorism", including any action taken in hindering or defending against an actual or expected "certified act of
terrorism" or 'other act of terrorism". This exclusion applies regardless of any other cause or event that
contributes concurrently or in any sequence to the injury or damage.
However, with respect to an 'other act of terrorism" this exclusion only applies if one or more of the following are
attributable to such act:
(1) The total of insured damage to all types of property exceeds $25,000,000. In determining whether the
$25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all persons
and entities affected by the terrorism and business interruption losses sustained by owners or occupants of
the damaged property. For the purpose of this provision, insured damage means damage that is covered by
any insurance plus damage that would be covered by any insurance but for the application of any terrorism
exclusions; or
(2) Fifty or more persons sustain death or serious physical injury. For the purposes of this provision, serious
physical injury means:
(a) Physical injury that involves a substantial risk of death; or
(b) Protracted and obvious physical disfigurement; or
(c) Protracted loss or impairment of the function of a bodily member or organ; or
(3) The terrorism involves the use, release or escape of nuclear materials, or directly or indirectly results in
nucleareaction or radiation or radioactive contamination; or
(4) The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or
chemical materials; or
STF-GU-657-A CW (01/11)
Page 1 of 2
(5) Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of th
terrorism was to release such materials.
B. The following definitions are added to Section V. Definitions:
" Certified act of terrorism" means any act that is certified by the Secretary of the Treasury, in concurrence with
the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the
federal Terrorism Risk Insurance Act of 2002. Section 102 of the Terrorism Risk Insurance Act of 2002 sets forth
the criteria and process that the Secretary of the Treasury shall use to determine whether to certify an act of
terrorism.
"Other act of terrorism" means a violent act or an act that is dangerous to human life, property or infrastructure
that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian
population or to influence the policy or affect the conduct of any government by coercion, but that is not a
"certified act of terrorism". However, 'other act of terrorism" does not include an act which meets the criteria set
forth in the definition of "certified act of terrorism" when such act resulted in aggregate losses of $5 million or less.
Multiple 'other acts of terrorism" which occur within a seventy-two hour period and appear to be carried out in
concert or to have a related purpose or common leadership shall be considered to be one 'other act of terrorism".
All other terms and conditions remain unchanged.
STP -GU -657-A CW (01/11)
Page 2 of 2
Endorsement # 02
Evacuation And Evacuation Expenses - Inclusion
Policy No. I Eff. Date of Pol.
SCO 0191756-00 1 04/182016
Exp. Date of Pol.
04/18/2017
Named Insured and Mailing Address:
SONOMA MARIN AREA RAIL TRANSIT
5401 Old Redwood Highway, Suite 200
Petaluma, CA 94954
Eff. Date of End. Producer
04/18/2016 70724000
Producer:
ZURICH
Add'I Prem. Return Prem.
WOODRUFF -SAWYER & CO.
50 CALIFORNIA ST FL 12
SAN FRANCISCO, CA 94111-4646
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED BY THE FOLLOWING:
RAILROAD PROTECTIVE LIABILITY COVERAGE FORM
In consideration of the premium charged, it is agreed that SECTION I - COVERAGES, COVERAGE A. BODILY INJURY
AND PROPERTY DAMAGE LIABILITY, Item 1. INSURING AGREEMENT is amended to include the following:
SECTION I — COVERAGES
COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY
1. INSURING AGREEMENT
d. This insurance applies to "bodily injury" and "property damage" arising out of an "occurrence" and
resulting in an "evacuation" including "evacuation expenses".
It is further agreed that SECTION V - DEFINITIONS is amended to include:
11. "Evacuation" means the removal of persons other than you or your employees from a dangerous area to a
designated safe area whether required by any public authority or at the instigation of any insured, solely as a
result of a railroad accident. An "evacuation" shall be deemed to be over when the dangerous area is considered
safe, by any public authority, for the persons to return.
12. "Evacuation expenses" means expenses for which you are liable for persons other than you or your employees
for food, travel and accommodation arising out of an "evacuation". "Evacuation expenses" does not include the
salaries, overtime or any other compensation of your officers or employees nor any compensation for your use of
your facilities or equipment.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED.
STF-CGL-1516-A CW (06/09)
Page 1 of 1
Endorsement # 03
Employment Practices Liability - Exclusion
Policy No. Eff. Date of Pol. Exp. Date of Pol.
SCO 0191756 00 04/18/2016 04/18/2017
Named Insured and Mailing Address:
SONOMA MARIN AREA RAIL TRANSIT
5401 Old Redwood Highway, Suite 200
Petaluma, CA 94954
Eff. Date of End. I Producer
ZURICH
Add'I Prem. I Return Prem.
04/18/2016 1 70724000 ----------
Producer:
WOODRUFF -SAWYER & CO.
50 CALIFORNIA ST FL 12
SAN FRANCISCO, CA 94111-4646
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
In consideration of the premiums charged, it is agreed that this policy does not apply to any Liability arising out of
Employment Practices Liability as stated below:
1. Refusal to employ
2. Termination of Employment
3. Coercion, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or
other employment related practices, policies, acts, or omissions; or
This exclusion applies whether or not the insured may be held liable as an employer or in any other capacity and to any
obligation to share damages with or to repay someone else who must pay damages because of the injury.
All other terms and conditions remain unchanged.
STF-RRP-124-B CW (10/08)
Page 1 of 1
Endorsement # 04
Pollution Exclusion Amendment
Policy No. Eff. Date of Pol. Exp. Date of Pol.
SCO 0191756-00 04/182016 04/18/2017
Named Insured and Mailing Address:
SONOMA MARIN AREA RAIL TRANSIT
5401 Old Redwood Highway, Suite 200
Petaluma, CA 94954
ZURICH
Eff. Date of End. Producer Add'I Prem.
04/18/2016 70724000 ----------
Producer:
WOODRUFF -SAWYER & CO.
50 CALIFORNIA ST FL 12
SAN FRANCISCO, CA 94111-4646
Return Prem.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
In consideration of the premium charged, it is agreed that paragraph (a) of exclusion f.(3) of COVERAGE A - BODILY
INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - Coverages) is replaced as follows:
This insurance does not apply to:
f. "Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage,
migration, release or escape of pollutants at or from the "job location":
(3) On which you or "contractors" working directly or indirectly on any insured's behalf are performing operations:
(a) If the pollutants, other than fuels or lubricants for equipment used at the "job location", are brought on or to
the "job location" in connection with such operations by you, the "contractor" or "your designated employee".
All other terms and conditions remain unchanged.
STF-RRP-125-B CW (10/08)
Page 1 of 1
Endorsement # 05
Limited Seepage, Pollution and Contamination
Coverage Endorsement
Policy No.Eff. Date of Pol. Exp. Date of Pol.
SCO 0191756-00 04/18/2016 04/18/2017
Named Insured and Mailing Address:
SONOMA MARIN AREA RAIL TRANSIT
5401 Old Redwood Highway, Suite 200
Petaluma, CA 94954
Eff. Date of End. I Producer
04/18/2016 I 70724000
Producer:
ZURICH
Add'] Prem. I Return Prem.
WOODRUFF -SAWYER & CO.
50 CALIFORNIA ST FL 12
SAN FRANCISCO, CA 94111-4646
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
In consideration of the premiums charged, it is agreed that Exclusion f. of this Policy shall not apply to the liability of the
Insured resulting from seepage and/or pollution and/or contamination caused solely by:
a) Unintended fire, lightning or explosion; or
b) A collision or overturning of a road vehicle; or
c) A collision or overturning or derailment of a train.
Notwithstanding the foregoing, it is agreed that the coverage provided by this Endorsement shall not apply to:
1. Loss of, damage to or loss of use of property directly or indirectly resulting from sub -surface operations of the insured
and/or removal of, loss of or damage to sub -surface oil, gas or any other substance;
2. Any site or location used in whole or in part for the handling, processing, treatment, storage, disposal or dumping of
any waste materials or substance;
3. The cost of evaluating and/or monitoring and/or controlling seeping and/or polluting and/or contaminating substances;
4. The cost of removing and/or nullifying and/or cleaning up seeping and/or polluting and/or contaminating substances
on property at any time owned and/or leased and/or rented by the Insured and/or under the control of the Insured.
All other terms and conditions remain unchanged.
STF-RRP-205 A CW (10/08)
Page 1 of 1
Endorsement # 06
Asbestos Exclusion Endorsement
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer
SCO 0191756-00 04/18/2016 04/18/2017 04/18/2016 70724000
ZURICH
Add'I Prem. Return Prem.
Named Insured and Mailing Address: Producer:
SONOMA MARIN AREA RAIL TRANSIT WOODRUFF -SAWYER & CO.
5401 Old Redwood Highway, Suite 200 50 CALIFORNIA ST FL 12
Petaluma, CA 94954 SAN FRANCISCO, CA 94111-4646
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
The following exclusion is added to paragraph 2. Exclusions of Section I - Coverage A — Bodily Injury And Property
Damage Liability and Coverage B - Physical Damage to Property:
2. Exclusions
This insurance does not apply to:
Asbestos
A. "Bodily injury", "property damage" or "personal and advertising injury" arising out of or which would not have
occurred, in whole or in part, but for the actual, alleged or threatened discharge, dispersal, release, leakage,
leaching, friability, flaking, escape or presence of asbestos, regardless of whether any other cause, event,
material or product contributed concurrently or in any sequence to the injury or damage; or
B. Any sums that any insured or other entity must pay, repay or reimburse because of any:
1. Request, demand, order, statutory or regulatory requirement, direction or determination that any insured or
others test for, investigate, monitor, clean up, remove, study, contain, treat, encapsulate, control or take any
other action regarding asbestos; or
2. Claim or "suit" for damages arising out of or relating in any way to any request, demand, order, statutory or
regulatory requirement, direction or determination that any insured or others test for, investigate, monitor,
clean up, remove, study, contain, treat, encapsulate, control or take any other action regarding asbestos; or
C. Any other loss, cost or expense arising out of or relating in any way to asbestos.
All other terms and conditions remain unchanged.
STF-RRP-223-A CW (10/08)
Page 1 of 1
Important Notice
Service of Suit and In Witness Clause
Service of Suit
ZURICH
In the event an action or proceeding arises under the contract, it is agreed that the Company, at your request, will submit
to the jurisdiction of a court of competent jurisdiction within the United States. Nothing in this condition constitutes or
should be understood to constitute a waiver or limitation of the right to arbitration as set forth herein or to commence an
action in any court of competent jurisdiction in the United States to remove an action to a United States District Court or
to seek a transfer of a case to another court as permitted by the laws of the United States or any state in the United
States. It is further agreed that service of process in such suit may be made upon Illinois Corporation Service Company,
801 Adlai Stevenson Drive, Springfield, IL 62703. In any suit instituted against the Company upon this policy, the
Company will abide by the final decision of such court or of any appellate court in the event of an appeal.
Further, pursuant to any statute of any state, territory, or district of the United States which makes provision therefore, the
Company hereby designates the Superintendent, Commissioner or Director of Insurance, other officer specified for that
purpose in the statute, or his successors in office as its true and lawful attorney upon whom may be served any lawful
process in any action, suit, or proceeding instituted by or on behalf of the Insured of any beneficiary hereunder arising out
of this policy of insurance and hereby designates the above named Illinois Corporation Service Company as the entity to
whom the said officer is authorized to mail such process or a true copy thereof.
In Witness Clause
In return for the payment of premium, and subject to the terms of this policy, coverage is provided as stated in this policy.
IN WITNESS WHEREOF, this Company has executed and attested these presents and, where required by law, has
caused this policy to be countersigned by its duly Authorized Representative(s).
President
Corporate Secre ary
QUESTIONS ABOUT YOUR INSURANCE? Your agent or broker is best equipped to provide information about
your insurance. Should you require additional information or assistance in resolving a complaint, call or write to
the following (please have your policy or claim number ready):
Zurich in North America
Customer Inquiry Center
1400 American Lane
Schaumburg, Illinois 60196-1056
1-800-382-2150 (Business Hours: 8am - 4pm [CT])
Email: info.source@zurichna.com
STF-GU-199-B (01/09)
Page 1 of 1
Endorsement # 07
Nuclear Energy Liability Exclusion Endorsement
(Broad Form)
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer
SCO 0191756-00 04/18/2016 04/18/2017 04/18/2016 70724000
ZURICH
Add'I Prem. I Return Prem.
Named Insured and Mailing Address: Producer:
SONOMA MARIN AREA RAIL TRANSIT WOODRUFF -SAWYER & CO.
5401 Old Redwood Highway, Suite 200 50 CALIFORNIA ST FL 12
Petaluma, CA 94954 SAN FRANCISCO, CA 94111-4646
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
FARM COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
MEDICAL PROFESSIONAL LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
1. The insurance does not apply:
A. Under any Liability Coverage, to "bodily injury" or "property damage":
(1) With respect to which an "insured" under the policy is also an insured under a nuclear energy liability policy
issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters,
Nuclear Insurance Association of Canada or any of their successors, or would be an insured under any such
policy but for its termination upon exhaustion of its limit of liability; or
(2) Resulting from the "hazardous properties" of "nuclear material" and with respect to which (a) any person or
organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law
amendatory thereof, or (b) the "insured" is, or had this policy not been issued would be, entitled to indemnity
from the United States of America, or any agency thereof, under any agreement entered into by the United
States of America, or any agency thereof, with any person or organization.
B. Under any Medical Payments coverage, to expenses incurred with respect to "bodily injury" resulting from the
"hazardous properties" of "nuclear material" and arising out of the operation of a "nuclear facility" by any person
or organization.
C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazardous properties" of
"nuclear material", if:
(1) The "nuclear material" (a) is at any "nuclear facility" owned by, or operated by or on behalf of, an "insured" or
(b) has been discharged or dispersed therefrom;
(2) The "nuclear material" is contained in "spent fuel" or "waste" at any time possessed, handled, used,
processed, stored, transported or disposed of, by or on behalf of an "insured"; or
STF-GU-643-A CW (09/08)
Page 1 of 2
(3) The "bodily injury" or "property damage" arises out of the furnishing by an "insured" of services, materials,
parts or equipment in connection with the planning, construction, maintenance, operation or use of any
"nuclear facility", but if such facility is located within the United States of America, its territories or
possessions or Canada, this exclusion (3) applies only to "property damage" to such "nuclear facility" and any
property thereat.
2. As used in this endorsement:
"Hazardous properties" includes radioactive, toxic or explosive properties.
"Nuclear material" means "source material', "special nuclear material' or "by-product material".
"Source material", "special nuclear material', and "by-product material' have the meanings given them in the Atomic
Energy Act of 1954 or in any law amendatory thereof.
"Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation
in a "nuclear reactor".
"Waste" means any waste material (a) containing "by-product material' other than the tailings or wastes produced by
the extraction or concentration of uranium or thorium from any ore processed primarily for its "source material'
content, and (b) resulting from the operation by any person or organization of any "nuclear facility" included under the
first two paragraphs of the definition of "nuclear facility".
"Nuclear facility" means:
(a) Any "nuclear reactor';
(b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2)
processing or utilizing "spent fuel', or (3) handling, processing or packaging "waste";
(c) Any equipment or device used for the processing, fabricating or alloying of "special nuclear material' if at any
time the total amount of such material in the custody of the "insured" at the premises where such equipment
or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any
combination thereof, or more than 250 grams of uranium 235;
(d) Any structure, basin, excavation, premises or place prepared or used for the storage or disposal of "waste";
and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises
used for such operations.
"Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction
or to contain a critical mass of fissionable material.
"Property damage" includes all forms of radioactive contamination of property.
All other terms and conditions of the policy shall apply and remain unchanged.
STF-GU-643-A CW (09/08)
Page 2 of 2
m
Notice To Policyholders ZURICH
THIS IS VERY IMPORTANT. PLEASE READ IT CAREFULLY.
1. THE INSURANCE POLICY THAT YOU HAVE PURCHASED IS BEING ISSUED BY AN INSURER THAT IS NOT
LICENSED BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED "NONADMITTED" OR
"SURPLUS LINE" INSURERS.
2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT WHICH
APPLIES TO CALIFORNIA LICENSED INSURERS.
3. THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY
CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS
IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED.
4. CALIFORNIA MAINTAINS A LIST OF ELIGIBLE SURPLUS LINE INSURERS APPROVED BY THE INSURANCE
COMMISSIONER. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST, OR VIEW THAT LIST
AT THE WEB SITE OF THE CALIFORNIA DEPARTMENT OF INSURANCE: WWW.INSURANCE.CA.GOV.
5. FOR ADDITIONAL INFORMATION ABOUT THE INSURER YOU SHOULD ASK QUESTIONS OF YOUR
INSURANCE AGENT, BROKER, OR "SURPLUS LINES" BROKER OR CONTACT THE CALIFORNIA
DEPARTMENT OF INSURANCE, AT THE FOLLOWING TOLL-FREE TELEPHONE NUMBER: 1-800-927-4357.
6. IF YOU, AS THE APPLICANT, REQUIRED THAT THE INSURANCE POLICY YOU HAVE PURCHASED BE BOUND
IMMEDIATELY. EITHER BECAUSE EXISTING COVERAGE WAS GOING TO LAPSE WITHIN TWO BUSINESS
DAYS OR BECAUSE YOU WERE REQUIRED TO HAVE COVERAGE WITHIN TWO BUSINESS DAYS, AND YOU
DID NOT RECEIVE THIS DISCLOSURE FORM AND A REQUEST FOR YOUR SIGNATURE UNTIL AFTER
COVERAGE BECAME EFFECTIVE, YOU HAVE THE RIGHT TO CANCEL THIS POLICY WITHIN FIVE DAYS OF
RECEIVING THIS DISCLOSURE. IF YOU CANCEL COVERAGE, THE PREMIUM WILL BE PRORATED AND ANY
BROKER FEE CHARGES FOR THIS INSURANCE WILL BE RETURNED TO YOU.
STF-SLA-100-A CA (10/08)
Page 1 of 1
Endorsement # 08
Sanctions Exclusion Endorsement
Policyholder: SONOMA MARIN AREA RAIL TRANSIT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ZURICH
The following exclusion is added to the policy to which it is attached and supersedes any existing sanctions language in
the policy, whether included in an Exclusion Section or otherwise:
SANCTIONS EXCLUSION
Notwithstanding any other terms under this policy, we shall not provide coverage nor will we make any payments or
provide any service or benefit to any insured, beneficiary, or third party who may have any rights under this policy to the
extent that such cover, payment, service, benefit, or any business or activity of the insured would violate any applicable
trade or economic sanctions law or regulation.
The term policy may be comprised of common policy terms and conditions, the declarations, notices, schedule, coverage
parts, insuring agreement, application, enrollment form, and endorsements or riders, if any, for each coverage provided.
Policy may also be referred to as contract or agreement.
We may be referred to as insurer, underwriter, we, us, and our, or as otherwise defined in the policy, and shall mean the
company providing the coverage.
Insured may be referred to as policyholder, named insured, covered person, additional insured or claimant, or as
otherwise defined in the policy, and shall mean the party, person or entity having defined rights under the policy.
These definitions may be found in various parts of the policy and any applicable riders or endorsements.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED
U -GU -1191-A CW (03/15)
Page 1 of 1
PROFESSIONAL SERVICES AGREEMENT/CONTRACT
COMPLETION CHECKLIST AND ROUTING SLIP
Below is the process for getting your professional services agreements/contracts finalized and
executed. Please attach this "Completion Checklist and Routing Slip" to the front of your
contract as you circulate it for review and signatures. Please use this form for all professional
services aLire ements/contracts (not just those requiring City Council approval).
This process should occur in the order presented below.
Step
Responsible
Description
Completion
Department
„pate
1
City Attorney
Review, revise, and comment on draft
agreement.
2
Contracting Department
Forward final agreement to contractor for
their signature. Obtain at least two signed
_ _ ^�
originals from contractor.
\�
3
Contracting Department
Agendize contractor -signed agreement for
_
'
Council approval, if Council approval
necessary (as defined by City Attorney/City(J
4
City Attorney
Ordinance*).
Review and approve form of agreement;
bonds, and insurance certificates and
endorsements.
5
City Manager / Mayor / or
Agreement executed by Council authorized
Department Head
official.
6
City Clerk
City Clerk attests signatures, retains original
G�
agreement and forwards copies to the
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contracting department.
To be completed by Contracting Department:
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Project Manager: IKN-11-J) Project Name: Cl') l u c -Lc- r �-CLj, 01 u l t r t l
Agendized for City Council Meeting of (if necessary): IL
If you have questions on this process, please contact the City Attorney's Office at 485-3080.
* Council approval is required if contract is over $20,000 on a cumulative basis.