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HomeMy WebLinkAboutPW Ghilotti Construction Cermenho Court ResurfacingCity of San Rafael. California
Fonn of Agreement for Informal Bids
Cermenho Court Resurfacing
This Agreement is made and entered into this ~day of rv'\ ~I{"C V\ ,2018 by and between the City of San Rafael
(hereinafter called City) and Ghilotti Construction Co. (hereinafter called Contractor). Witnesseth, that the City and the
Contractor, for the considerations hereinafter named, agree as follows:
1. Scope of the Work.
The Contractor hereby agrees to furnish all of the materials, equipment, and labor necessary to perform the work for the
project entitled "Cermenho Court Resurfacing," all in accordance with the requirements and provisions of the
Construction Plans attached hereto as Attachment A.
2. Prevailing Wages.
Pursuant to the requirements of California Labor Code Section 1771, and San Rafael Municipal Code Section 11.50.180 (C), the
general prevailing wage in the locality in which the work is to be performed, for each craft or type of worker needed to execute the
contract, shall be followed.
3. Bonds.
The Contractor shall provide and maintain during the course ofthe project, a Labor and Materials Bond issued by a surety
admitted in California, to cover the work under this Agreement, in the amount of $34,080.50.
4. 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, including punchlist items, shall be completed within 5 Working Days, and with such reasonable
extensions of time as may be requested by Contractor and approved by City.
5. Liquidated Damages.
It is agreed that, if all the work required by the contract is not finished or completed within the number of working days as
set forth in the contract, damage will be sustained by the City, and that it is and will be impracticable and extremely difficult
to ascertain and determine the actual damage which the City will sustain in the event of and by reason of such delay; and it is
therefore agreed that the Contractor will pay to the City, the sum of $500 for each and every working 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.
6. 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 untis for work in the following scheduled completed at the unit price stated. The number of units contained in this
schedule is approximately 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, provided that the total compensation under this Contract shall not
exceed $34,080.50 unless a written amendment is executed by the City and the Contractor.
BID ITEMS
ESTIMATED UNIT UNIT PRICE TOTAL PRICE QUANTITY ITEM DESCRIPTION
1. Mobililization LS @ $2,566.78 $2,567.00
2. Gring and Overlay 90 TON @ $350.15 $31,315.50
GRAND TOTAL BID $34.080.50
Agreement· 1
7. Progress Payments.
(a) On not later than the 6th day of every month the Public Works Department shall prepare and submit an estimate
covering the total quantities under each item of work that have been completed from the start of the job up to and
including the 25th day of the preceding month, and the value of the work so completed determined in accordance
with the schedule of unit prices for such items together with such supporting evidence as may be required by the
City and/or Contractor.
(b) As soon as possible after the preparation of the estimate, the City shall, after deducting previous payments made,
pay to the Contractor 95% of the amount of the estimate as approved by the Public Works Department.
( c) The Contractor may elect to receive 100% of payments due under the contract from time to time, without retention
of any portion of the payment by the public agency, by depositing securities of equivalent value with the public
agency in accordance with the provisions of Section 22300 of the Public Contract Code. Such securities, if
deposited by the Contractor, shall be valued by the City's Finance Director, whose decision on valuation of the
securities shall be final.
8. 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, shall be paid to the Contractor by the City as soon as possible,
(b) Before final payment is due the Contractor shall submit evidence satisfactory to the Engineer that all payrolls,
material bills, and other indebtedness connected with work have been paid, except that in case of disputed
indebtedness or liens the Contractor may submit in lieu of evidence of payment a surety bond satisfactory to the City
guaranteeing payment of all such disputed amounts when adjudicated in cases where such payment has not already
been guaranteed by surety bond.
(c) The making and acceptance of the final payment shall constitute a waiver of all claims by the City, other than those
arising from any of the following: (1) unsettled 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.
Such payment shall be made under the terms and conditions governing final payment, except that it shall not constitute a
waiver of claims.
9. Insurance.
(a). Scope of Coverage. During the term of this Agreement, Contractor shall maintain, at no expense to City, the following
insurance policies:
I. A commercial general liability insurance policy in the minimum amount of one million dollars ($1,000,000) per
occurrence/two million dollars ($2,000,000) aggregate, for death, bodily injury, personal injury, or property
damage.
2. An automobile liability (owned, non-owned, and hired vehicles) insurance policy in the minimum amount of
one million dollars ($1,000,000) dollars per occurrence.
3. If it employs any person, Contractor shall maintain worker's compensation insurance, as required by the State
of California, with statutory limits, and employer's liability insurance with limits of no less than one
million dollars ($1,000,000) per accident for bodily injury or disease .. Contractor's worker's compensation
insurance shall be specifically endorsed to waive any right of subrogation against City.
(b) Other Insurance Requirements. The insurance coverage required of the Contractor in subparagraph (a) of this section
above shall also meet the following requirements:
Agreement· 2
I. The insurance policies shall be specifically endorsed to include the City, its officers, agents, employees, and
volunteers, as additionally named insureds under the policies.
2. The additional insured coverage under Contractor's insurance policies shal1 be primary with respect to any
insurance or coverage maintained by City and shall not call upon City insurance or self-insurance coverage for
any contribution. The "primary and noncontributory" coverage in Contractor's policies shall be at least as broad
as ISO form CG20 0 I 04 13.
3. The insurance policies shall include, in their text or by endorsement, coverage for contractual liability and
personal injury.
4. By execution of this Contract, Contractor hereby grants to City a waiver of any right to subrogation which
any insurer of Contractor may acquire against City by virtue of the payment of any loss under such
insurance. Contractor agrees to obtain any endorsement that may be necessary to effect this waiver of
subrogation, but this provision applies regardless of whether or not City has received a waiver of
subrogation endorsement from the insurer.
5. If the insurance is written on a Claims Made Form, then, following termination of this Agreement, said
insurance coverage shall survive for a period of not less than five years.
6. The insurance policies shall provide for a retroactive date of placement coinciding with the effective date of this
Agreement.
7. The limits of insurance required in this Agreement may be satisfied by a combination of primary and umbrella
or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that
such coverage shall also apply on a primary and noncontributory basis for the benefit of City (if agreed to in a
written contract or agreement) before City's own insurance or self-insurance shall be called upon to protect it as
a named insured.
8. [t shall be a requirement under this Agreement that any available insurance proceeds broader than or in excess
of the specified minimum insurance coverage requirements and /or limits shall be available to City or any other
additional insured party. Furthermore, the requirements for coverage and limits shall be: (I) the minimum
coverage and limits specified in this Agreement; or (2) the broader coverage and maximum limits of coverage of
any insurance policy or proceeds available to the named insured; whichever is greater.
(c) Deductib[es and SIR's. Any deductibles or self-insured retentions in Contractor's insurance policies must be declared to
and approved by the City, and shall not reduce the limits ofliability. Policies containing any self-insured retention (S[R)
provision shall provide or be endorsed to provide that the SIR may be satisfied by either the named insured or City or
other additional insured party. At City's option, the deductibles or self-insured retentions with respect to City shall be
reduced or eliminated to City's satisfaction, or Contractor shall procure a bond guaranteeing payment of losses and
related investigations, claims administration, attorney's fees and defense expenses.
(d) Proof of Insurance. Contractor shall provide to the City all of the fol1owing: (I) Certificates of Insurance evidencing the
insurance coverage required in this Agreement; (2) a copy of the policy declaration page and/or endorsement page listing
all policy endorsements for the commercial general liability policy, and (3) excerpts of policy language or specific
endorsements evidencing the other insurance requirements set forth in this Agreement. City reserves the right to obtain a
full certified copy of any insurance policy and endorsements from Contractor. Failure to exercise this right shall not
constitute a waiver of the right to exercise it later. The insurance shall be approved as to form and sufficiency by City.
10.lndemnifcation.
(a) Contractor shall, to the fullest extent permitted by law, indemnifY, release, defend with counsel approved by City,
and hold harmless City, its officers, agents, employees and volunteers (collectively, the "City [ndemnitees"), from
and against any claim, demand, suit, judgment, loss, liability or expense of any kind, including but not limited to
attorney's fees, expert fees and all other costs and fees of litigation, (collectively "CLA[MS"), arising out of
Contractor's performance of its obligations or conduct of its operations under this Agreement. The Contractor's
Agreement· 3
obligations apply regardless of whether or not a liability is caused or contributed to by the active or passive
negligence of the City Indemnitees. However, to the extent that liability is caused by the active negligence or
willful misconduct of the City Indemnitees, the Contractor's indemnification obligation shall be reduced in
proportion to the City Indemnitees' share of liability for the active negligence or willful misconduct. In addition,
the acceptance or approval of the Contractor's work or work product by the City or any of its directors, officers or
employees shall not relieve or reduce the Contractor's indemnification obligations. In the event the City
Indemnitees are made a party to any action, lawsuit, or other adversarial proceeding arising from Contractor's
performance of or operations under this Agreement, Contractor shall provide a defense to the City Indemnitees or at
City's option reimburse the City Indemnitees their costs of defense, including reasonable attorneys' fees, incurred in
defense of such claims.
(b) The defense and indemnification obligations of this Agreement are undertaken in addition to, and shall not in any
way be limited by, the insurance obligations contained in this Agreement, and shall survive the termination or
completion of this Agreement for the full period of time allowed by law.
11. Nondiscrimination.
Contractor shall not discriminate, in any way, against any person on the basis of age, sex, race, color, religion, ancestry, national
origin or disability in connection with or related to the performance of its duties and obligations under this Agreement.
12. Compliance with All Laws.
Contractor shall observe and comply with all applicable federal, state and local laws, ordinances, codes and regulations, in the
performance of its duties and obligations under this Agreement. Contractor shall perform all services under this Agreement in
accordance with these laws, ordinances, codes and regulations. Contractor shall release, defend, indemnifY and hold harmless
City, its officers, agents and employees from any and all damages, liabilities, penalties, fines and all other consequences from any
noncompliance or violation of any laws, ordinances, codes or regulations.
13. No Third Party Beneficiaries.
City and Contractor do not intend, by any provision of this Agreement, to create in any third party, any benefit or right owed by
one party, under the terms and conditions of this Agreement, to the other party.
14. Notices.
All notices and other communications required or permitted to be given under this Agreement, including any notice of change of
address, shall be in writing and given by personal delivery, or deposited with the United States Postal Service, postage prepaid,
addressed to the parties intended to be notified. Notice shall be deemed given as of the date of personal delivery, or if mailed,
upon the date of deposit with the United States Postal Service. Notice shall be given as follows:
To City: Public Works Director
City of San Rafael
1400 Fifth Avenue
P.O. Box 151560
San Rafael, CA 94915-1560
To Contractor: Ghilotti Construction Co.
246 Ghillotti Ave
Santa Rosa, CA 95407
15. Independent Contractor.
For the purposes, and for the duration, of this Agreement, Contractor, its officers, agents and employees shall act in the capacity of
an Independent Contractor, and not as employees of the City. Contractor and City expressly intend and agree that the status of
Contractor, its officers, agents and employees be that of an Independent Contractor and not that of an employee of City.
16. Entire Agreement; Amendments.
(a) The terms and conditions of this Agreement, all exhibits attached, and all documents expressly incorporated by reference,
represent the entire Agreement of the parties with respect to the subject matter of this Agreement.
Agreement·4
(b) This written Agreement shall supersede any and all prior agreements, oral or written, regarding the subject matter
between the Contractor and the City.
(c) No other agreement, promise or statement, written or oral, relating to the subject matter of this Agreement, shall be valid
or binding, except by way of a written amendment to this Agreement.
(d) The terms and conditions of this Agreement shall not be altered or modified except by a written amendment to this
Agreement signed by the Contractor and the City.
(e) If any conflicts arise between the terms and conditions of this Agreement, and the terms and conditions of the attached
exhibits or the documents expressly incorporated by reference, the terms and conditions of this Agreement shall control.
17. Waivers.
The waiver by either party of any breach or violation of any term, covenant or condition of this Agreement, or of any ordinance,
law or regulation, shall not be deemed to be a waiver of any other term, covenant, condition, ordinance, law or regulation, or of
any subsequent breach or violation of the same or other term, covenant, condition, ordinance, law or regulation. The subsequent
acceptance by either party of any fee, performance, or other consideration which may become due or owing under this Agreement,
shall not be deemed to be a waiver of any preceding breach or violation by the other party of any term, condition, covenant of this
Agreement or any applicable law, ordinance or regulation.
18. City Business License; Other Taxes.
Contractor shall obtain and maintain during the duration of this Agreement, a City business license as required by the San Rafael
Municipal Code Contractor shall pay any and all state and federal taxes and any other applicable taxes. City shall not be required
to pay for any work performed under this Agreement, until Contractor has provided City with a completed Internal Revenue
Service Form W-9 (Request for Taxpayer Identification Number and Certification).
19. Warranty.
(a) Except as otherwise expressly provided in the Agreement, and excepting only items of routine maintenance, ordinary
wear and tear and unusual abuse or neglect by City, Contractor warrants and guarantees all work executed and all
supplies, materials and devices of whatsoever nature incorporated in or attached to the work, or otherwise provided as a
part of the work pursuant to the Agreement, to be absolutely free of all defects of workmanship and materials for a period
of one year after final acceptance of the entire work by the City. Contractor shall repair or replace all work or material,
together with any other work or material that may be displaced or damaged in so doing, that may prove defective in
workmanship or material within this one year warranty period without expense or charge of any nature whatsoever to
City.
(b) In the event that Contractor shall fail to comply with the conditions of the foregoing warranty within ten (10) days after
being notified of the defect in writing, City shall have the right, but shall not be obligated, to repair, or obtain the repair
of, the defect and Contractor shall pay to City on demand all costs and expense of such repair. Notwithstanding anything
herein to the contrary, in the event that any defect in workmanship or material covered by the foregoing warranty results
in a condition that constitutes an immediate hazard to public health or safety, or any property interest, or any person, City
shall have the right to immediately repair, or cause to be repaired, such defect, and Contractor shall pay to City on
demand all costs and expense of such repair. The foregoing statement relating to hazards to health, safety or property
shall be deemed to include both temporary and permanent repairs that may be required as determined in the sole
discretion and judgment of City.
(c) In addition to the above, the Contractor shall make a written assignment of any applicable manufacturers' and other
product warranties to the City, prior to completion and final acceptance of the work by City.
IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute this Agreement the
day and year first written above.
Agreement· 5
'" • J ~
CITY OF SAN RAFAEL:
ATTEST:
Lindsay Lara
Interim City Clerk
APPROVED AS TO FORM:
Ghilotti Construction Co.
Ry:
~::~ Brian Ongara
Vice President
Ghilotti Construction Co.
Ry:
tKci ~4.-~Ef£ Robert F. Epstein I Printed Name:
City Attorney Title:
FileNo.:16.16.19
Agreement· 6
2/14/2018 San Rafael
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" PARCELS
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LAT 37999321 LON ·122549426 · No selection 1 4761905 58779.41625111)
http ://g is . c ityofsa nrafael . org/sa n rafael/fus ion. ph p 111
ACOROfiD
CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYVYY)
~ 2/28/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED , subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER ~2~1~CT Cass Hamann
Woodruff-Sawyer & Co. rllgNrfo Ext\: 415-391-2141 I FAX
50 California Street, Floor 12 CAlC Nol: 415-989-9923
San Francisco CA 94111 l~DA~~ss: chamann@wsandco .com
INSURER(S) AFFORDING COVERAGE NAIC#
INSURER A : Executive Risk Indemnity, Inc. 35181
INSURED GH ILCON·01 INSURER B : Federal Insurance Company 20281
Ghilotti Construction Company, Inc. INSURER c : 246 Ghilotti Avenue
Santa Rosa CA 95407 INSURER 0 :
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER' 1278402698 REVISION NUMBER'
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEE N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER IOD
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 T HE POLICIES DESCRIBED HEREIN IS SUBJ ECT TO AL L THE TERMS ,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES , LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ,
-INSR I ~~~ci" I ~~ 1~~}-JgM~1 ! l~g}-Jg~VvI LTR TYPE OF INSURANCE POLICY NUMBER LIMITS
A X COMMERCIAL GENERAL LIABILITY Y Y 54303067 3/3112017 , 3/3112018 EACH OCCURRENCE S 2,000 ,000 i--DAM ~~E !U_ RENTED PREMISES rEa occurrencel $ 200 ,000 -o CLAIMS·MADE 0 OCCUR -
---MED EXP (Anyone person) $ 5,000
PERSONAL & ADV IN JU RY $ 2,000 ,000
r-
R'L AGGREGATE LIMIT APPLIES PER-GENERAL AGGREGATE $ 4,000 ,000 o PRO · D POLICY JECT LOC PRODUCTS -COMP/OP AGG $ 4,000 ,000
OTHER: $
B AUTOMOBILE LIABILITY Y Y 54303066 3/31/2017 3/31/2018 PE~~~~~~~IFI NGLE LIMIT $1000000 i--
X ANY AUTO BODILY INJURY (Per person) $
r--ALL OWNED -SCHEDULED
AUTOS AUTOS BODILY INJURY (Per acc ide nl) $
i---NON -OWNED rp~?~~~d~gAMAG E HIRED AUTOS AUTOS $
r---$
UMBRELLA L1AB EACH OCCURRENCE $ r--H OCCUR -
EXCESS LIAB CLA IMS -MADE AGGREGATE $
OED 1 I RE TE NTION $ $
B WORKERS COMPENSATION Y 54303068 4/2/2017 4/2/2018 ' 1 PER I I OTH -
AND EMPLOYERS' LIABILITY X STATUTE ER Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE
D I N/A I
E.L. EACH ACCIDENT $1 ,000 ,000 OFF ICER/MEMBER EXCLUDED? (Mandatory In NH) E L. DISEASE -EA EMPLOYEE $1 ,000 ,000
If yes , descr ibe under
E.L. DISEASE -POLICY LIMIT $1 ,000 ,000 DESCRIPTION OF OPERAT IO NS be low
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule , may be attached If more space Is requ Ired)
GCC job #1876 , CermenhD Court Resurfacing . City of San Rafael is included as Additional Insured per the attached form . Wa iver of Subrogation applies to per
attached form . Contractual Liability is included in the policy form. Coverage is primary & non-contributory per the attached .
Policies contain a 3D day notice of cancellation and a 10 day notice of cancellation for non-payment of premium .
CERTIFICATE HOLDER
City of San Rafael
111 Morphew Street
San Rafael CA 94901
ACORD 25 (2014/01)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
The ACORD name and logo are registered marks of ACORD
-
Policy No. 54303066
COMMERCIAL AUTOMOBILE
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
This endorsement modifies the Business Auto Coverage Form.
1. EXTENDED CANCELLATION CONDITION
Paragraph A.2.b. -CANCELLATION -of the
COMMON POLICY CONDITIONS form IL 0017 is
deleted and replaced with the following:
b. 60 days before the effective date of cancellation if
we cancel for any other reason.
2. BROAD FORM INSURED
A. Subsidiaries and Newly Acquired or Formed
Organizations As Insureds
The Named Insured shown in the Declarations is
amended to include:
1. Any legally incorporated subsidiary in which
you own more than 50% of the voting stock on
the effective date of the Coverage Form.
However, the Named Insured does not include
any subsidiary that is an "insured" under any
other automobile policy or would be an
"insured" under such a policy but for its
termination or the exhaustion of its Limit of
Insurance.
2. Any organization that is acquired or formed by
you and over which you maintain majority
ownership. However, the Named Insured
does not include any newly formed or acquired
organization:
(a) That is an "insured" under any other
automobile policy;
(b) That has exhausted its Limit of Insurance
under any other policy; or
(c) 180 days or more after its acquisition or
formation by you, unless you have given
us written notice of the acquisition or
formation.
Coverage does not apply to "bodily injury" or
"property damage" that results from an "accident"
that occurred before you formed or acquired the
organization.
B. Employees as Insureds
Paragraph A.1. -WHO IS AN INSURED -of
SECTION II -LIABILITY COVERAGE is amended to
add the following:
d. Any "employee" of yours while using a
covered "auto" you don't own, hire or
borrow in your business or your personal
affairs.
C. Lessors as Insureds
Paragraph A.1. -WHO IS AN INSURED -of
SECTION II -LIABILITY COVERAGE is
amended to add the following:
e. The lessor of a covered "auto" while the
"auto" is leased to you under a written
agreement if:
(1) The agreement requires you to
provide direct primary insurance for
the lessor; and
(2) The "auto" is leased without a driver.
Such leased "auto" will be considered a
covered "auto" you own and not a covered
"auto" you hire.
However, the lessor is an "insured" only
for "bodily injury" or "property damage"
resulting from the acts or omissions by:
1. You;
2. Any of your "employees" or agents;
or
3. Any person, except the lessor or
any "employee" or agent of the
lessor, operating an "auto" with the
permission of any of 1. and/or 2.
above.
D. Persons And Organizations As Insureds
Under A Written Insured Contract
Paragraph A.1 -WHO IS AN INSURED -of
SECTION II -LIABILITY COVERAGE is
amended to add the following:
f. Any person or organization with respect to
the operation, maintenance or use of a
covered "auto", provided that you and
such person or organization have agreed
under an express provision in a written
"insured contract", written agreement or a
written permit issued to you by a
governmental or public authority to add
such person or organization to this policy
as an "insured".
However, such person or organization is
an "insured" only:
Form: 16-02-0292 (Rev. 4-11) Page 1 of3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission"
(1) with respect to the operation,
maintenance or use of a covered
"auto"; and
(2) for "bodily injury" or "property damage"
caused by an "accident" which takes
place after:
(a) You executed the "insured
contract" or written agreement; or
(b) The permit has been issued to
you.
3. FELLOW EMPLOYEE COVERAGE
EXCLUSION B.5. -FELLOW EMPLOYEE -of
SECTION II -LIABILITY COVERAGE does not apply.
4. PHYSICAL DAMAGE -ADDITIONAL TEMPORARY
TRANSPORTATION EXPENSE COVERAGE
Paragraph AA.a. -TRANSPORTATION EXPENSES
-of SECTION 111-PHYSICAL DAMAGE
COVERAGE is amended to provide a limit of $50 per
day for temporary transportation expense, subject to a
maximum limit of $1,000.
5. AUTO LOAN/LEASE GAP COVERAGE
Paragraph A. 4. -COVERAGE EXTENSIONS -of
SECTION 111-PHYSICAL DAMAGE COVERAGE is
amended to add the following:
c. Unpaid Loan or Lease Amounts
In the event of a total "loss" to a covered "auto", we will
pay any unpaid amount due on the loan or lease for a
covered "auto" minus:
1. The amount paid under the Physical Damage
Coverage Section of the policy; and
2. Any:
a. Overdue loan/lease payments at the time of
the "loss";
b. Financial penalties imposed under a lease for
excessive use, abnormal wear and tear or
high mileage;
c. Security deposits not returned by the lessor:
d. Costs for extended warranties, Credit Life
Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease;
and
e. Carry-over balances from previous loans or
leases.
We will pay for any unpaid amount due on the loan or
lease if caused by:
1. Other than Collision Coverage only if the
Declarations indicate that Comprehensive
Coverage is provided for any covered "auto";
2. Specified Causes of Loss Coverage only if the
Declarations indicate that Specified Causes of
Loss Coverage is provided for any covered "auto";
or
3. Collision Coverage only if the Declarations indicate
that Collision Coverage is provided for any
covered "auto.
6. RENTAL AGENCY EXPENSE
Paragraph A. 4. -COVERAGE EXTENSIONS -of
SECTION III -PHYSICAL DAMAGE COVERAGE
is amended to add the following:
d. Rental Expense
We will pay the following expenses that you or
any of your "employees" are legally obligated
to pay because of a written contract or
agreement entered into for use of a rental
vehicle in the conduct of your business:
MAXIMUM WE WILL PAY FOR ANY ONE
CONTRACT OR AGREEMENT:
1. $2,500 for loss of income incurred by the
rental agency during the period of time that
vehicle is out of use because of actual
damage to, or "loss" of, that vehicle, including
income lost due to absence of that vehicle for
use as a replacement;
2. $2,500 for decrease in trade-in value of the
rental vehicle because of actual damage to
that vehicle arising out of a covered "loss"; and
3. $2,500 for administrative expenses incurred
by the rental agency, as stated in the contract
or agreement.
4. $7,500 maximum total amount for paragraphs
1., 2. and 3. combined.
7. EXTRA EXPENSE -BROADENED COVERAGE
Paragraph A.4. -COVERAGE EXTENSIONS -of
SECTION III -PHYSICAL DAMAGE COVERAGE
is amended to add the following:
e. Recovery Expense
We will pay for the expense of returning a
stolen covered "auto" to you.
8. AIRBAG COVERAGE
Paragraph B.3.a. -EXCLUSIONS -of SECTION
111-PHYSICAL DAMAGE COVERAGE does not
apply to the accidental or unintended discharge of
an airbag. Coverage is excess over any other
collectible insurance or warranty specifically
designed to provide this coverage.
9. AUDIO, VISUAL AND DATA ELECTRONIC
EQUIPMENT -BROADENED COVERAGE
Paragraph C.2. -LIMIT OF INSURACE -of
SECTION III -PHYSICAL DAMAGE is deleted
and replaced with the following:
2. $2,000 is the most we will pay for "loss" in any
one "accident" to all electronic equipment that
reproduces, receives or transmits audio, visual
or data signals which, at the time of "loss", is:
a. Permanently installed in or upon the
covered "auto" in a housing, opening or
other location that is not normally used by
the "auto" manufacturer for the installation
of such equipment;
b. Removable from a permanently installed
housing unit as described in Paragraph
2.a. above or is an integral part of that
equipment; or
c. An integral part of such equipment.
Fonn: 16-02-0292 (Rev. 4-11) Page 2 of3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission"
10. GLASS REPAIR -WAIVER OF DEDUCTIBLE
Under Paragraph D. -DEDUCTIBLE -of
SECTION III -PHYSICAL DAMAGE COVERAGE
the following is added:
No deductible applies to glass damage if the glass
is repaired rather than replaced.
11. TWO OR MORE DEDUCTIBLES
Paragraph D.-DEDUCTIBLE -of SECTION 111-
PHYSICAL DAMAGE COVERAGE is amended to
add the following:
If this Coverage Form and any other Coverage
Form or policy issued to you by us that is not an
automobile policy or Coverage Form applies to the
same "accident", the following applies:
1. If the deductible under this Business Auto
Coverage Form is the smaller (or smallest)
deductible, it will be waived; or
2. If the deductible under this Business Auto
Coverage Form is not the smaller (or smallest)
deductible, it will be reduced by the amount of
the smaller (or smallest) deductible.
12. AMENDED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
Paragraph A.2.a. -DUTIES IN THE EVENT OF
AN ACCIDENT, CLAIM, SUIT OR LOSS of
SECTION IV -BUSINESS AUTO CONDITIONS is
deleted and replaced with the following:
a. In the event of "accident", claim, "suit" or
"loss", you must promptly notify us when the
"accident" is known to:
(1) You or your authorized representative, if
you are an individual;
(2) A partner, or any authorized
representative, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer, insurance manager,
or authorized representative, if you are an
organization other than a partnership or
limited liability company.
Knowledge of an "accident", claim, "suit" or
"loss" by other persons does not imply that the
persons listed above have such knowledge.
Notice to us should include:
(1) How, when and where the "accident" or
"loss" occurred;
(2) The "insured's" name and address; and
(3) To the extent possible, the names and
addresses of any injured persons or
witnesses.
13. WAIVER OF SUBROGATION
Paragraph A.5. -TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US of
SECTION IV -BUSINESS AUTO CONDITIONS is
deleted and replaced with the following:
5. We will waive the right of recovery we would
otherwise have against another person or
organization for "loss" to which this insurance
applies, provided the "insured" has waived
their rights of recovery against such person or
organization under a contract or agreement
that is entered into before such "loss".
To the extent that the "insured's" rights to
recover damages for all or part of any
payment made under this insurance has not
been waived, those rights are transferred to
us. That person or organization must do
everything necessary to secure our rights and
must do nothing after "accident" or "loss" to
impair them. At our request, the insured will
bring suit or transfer those rights to us and
help us enforce them.
14. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
Paragraph B.2. -CONCEALMENT,
MISREPRESENTATION or FRAUD of SECTION
IV -BUSINESS AUTO CONDITIONS -is deleted
and replaced with the following:
If you unintentionally fail to disclose any hazards
existing at the inception date of your policy, we will
not void coverage under this Coverage Form
because of such failure.
15. AUTOS RENTED BY EMPLOYEES
Paragraph B.5. -OTHER INSURANCE of
SECTION IV -BUSINESS AUTO CONDITIONS -
is amended to add the following:
e. Any "auto" hired or rented by your "employee"
on your behalf and at your direction will be
considered an "auto" you hire. If an
"employee's" personal insurance also applies
on an excess basis to a covered "auto" hired
or rented by your "employee" on your behalf
and at your direction, this insurance will be
primary to the "employee's" personal
insurance.
16. HIRED AUTO -COVERAGE TERRITORY
Paragraph B.7.b.(5).(a) -POLICY PERIOD,
COVERAGE TERRITORY of SECTION IV -
BUSINESS AUTO CONDITIONS is deleted and
replaced with the following:
(a) A covered "auto" of the private passenger
type is leased, hired, rented or borrowed
without a driver for a period of 45 days or
less; and
17. RESULTANT MENTAL ANGUISH COVERAGE
Paragraph C. of -SECTION V -DEFINITIONS is
deleted and replaced by the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by any person, including
mental anguish or death as a result of the "bodily
injury" sustained by that person.
Form: 16-02-0292 (Rev. 4-11) .. . Page ~ ~f~,
"Includes copyrighted material of Insurance Services Office, Inc. With Its permission
Policy No 54303066
B. General Conditions
1. Bankruptcy
Bankruptcy or insolvency of the "insured" or the
"insured's" estate will not relieve us of any obli-
gations under this coverage form.
2. Concealment, Misrepresentation Or Fraud
This coverage form is void in any case of fraud
by you at any time as it relates to this coverage
form. It is also void if you or any other "in-
sured", at any time, intentionally conceal or
misrepresent a material fact concerning:
a. This coverage form;
b. The covered "auto";
c. Your interest in the covered "auto"; or
d. A claim under this coverage form.
3. Liberalization
If we revise this coverage form to provide more
coverage without additional premium charge,
your policy will automatically provide the addi-
tional coverage as of the day the revision is ef-
fective in your state.
4. No Benefit To Bailee -Physical Damage
Coverages
We will not recognize any assignment or grant
any coverage for the benefit of any person or
organization holding, storing or transporting
property for a fee regardless of any other pro-
vision of this coverage form.
5. Other Insurance
a. For any covered "auto" you own, this cov-
erage form provides primary insurance. For
any covered "auto" you don't own, the in-
surance provided by this coverage form is
excess over any other collectible insurance.
However, while a covered "auto" which is a
"trailer" is connected to another vehicle, the
Liability Coverage this coverage form pro-
vides for the "trailer" is:
(1) Excess while it is connected to a motor
vehicle you do not own.
(2) Primary while it is connected to a cov-
ered "auto" you own.
b. For Hired Auto Physical Damage Coverage,
any covered "auto" you lease, hire, rent or
borrow is deemed to be a covered "auto"
you own. However, any "auto" that is
leased, hired, rented or borrowed with a
driver is not a covered "auto".
c. Regardless of the provisions of Paragraph
a. above, this coverage form's Liability
Coverage is primary for any liability as-
sumed under an "insured contract".
d. When this coverage form and any other
coverage form or policy covers on the same
basis, either excess or primary, we will pay
only our share. Our share is the proportion
that the Limit of Insurance of our coverage
form bears to the total of the limits of all the
coverage forms and policies covering on
the same basis.
6. Premium Audit
a. The estimated premium for this coverage
form is based on the exposures you told us
you would have when this policy began. We
will compute the final premium due when
we determine your actual exposures. The
estimated total premium will be credited
against the final premium due and the first
Named Insured will be billed for the bal-
ance, if any. The due date for the final pre-
mium or retrospective premium is the date
shown as the due date on the bill. If the es·
timated total premium exceeds the final
premium due, the first Named Insured will
get a refund.
b. If this policy is issued for more than one
year, the premium for this coverage form
will be computed annually based on our
rates or premiums in effect at the beginning
of each year of the policy.
7. Policy Period, Coverage Territory
Under this coverage form, we cover "accidents"
and "losses" occurring:
a. During the policy period shown in the Dec-
larations; and
b. Within the coverage territory.
The coverage territory is:
(1) The United States of America;
(2) The territories and possessions of the Unit-
ed States of America;
(3) Puerto Rico;
(4) Canada; and
(5) Anywhere in the world if:
(a) A covered "auto" of the private passen-
ger type is leased, hired, rented or bor-
rowed without a driver for a period of 30
days or less; and
(b) The "insured's" responsibility to pay
damages is determined in a "suit" on the
merits, in the United States of America,
the territories and possessions of the
United States of America, Puerto Rico
or Canada or in a settlement we agree
to.
CA 00010310 © Insurance Services Office, Inc., 2009 Page 9 of 12 o
POLICY NUMBER : 54303067 COMMERCIAL GENERAL LIABILITY
CG 20 100704
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -OWNERS, LESSEES OR
CONTRACTORS -SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following :
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Org anization(s ): Location(s ) Of Covered Op erations
WHERE REQUIRED BY WRITTEN CONTRACT.
Information re quired to com plete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II -Who Is An Insured is amended to
include as an additional insured the person{s} or
organization(s} shown in the Schedule, but only
with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured{s} at the location(s} desig-
nated above.
B. With respect to the insurance afforded to these
additional insureds, the following additional exclu-
sions apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
1. All work, including materials, parts or equip-
ment furnished in connection with such work,
on the project (other than service, maintenance
or repairs) to be performed by or on behalf of
the additional insured(s} at the location of the
covered operations has been completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its in-
tended use by any person or organization other
than another contractor or subcontractor en-
gaged in performing operations for a principal
as a part of the same project.
CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 o
POLICY NUMBER : 54303067 COMMERCIAL GENERAL LIABILITY
CG 20 37 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -OWNERS, LESSEES OR
CONTRACTORS -COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Org anization(s ): Location And Descri ption Of Comp leted O p erations
WHERE REQUIRED BY WRITTEN CONTRACT •. BU If ONLY WHERE THE CONTRACT SPECIFIES
COVERAGE FOR COMPLETED OPERATIONS.
Information re quired to com plete this Schedule, if not shown above, will be shown in the Declarations.
Section II -Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only with
respect to liability for "bodily injury" or "property dam-
age" caused, in whole or in part, by "your work" at
the location designated and described in the sched-
ule of this endorsement performed for that additional
insured and included in the "products-completed
operations hazard".
CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 o
Policy No. 54303067
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method al-
so. Under this approach each insurer contrib-
utes equal amounts until it has paid its appli-
cable limit of insurance or none of the loss
remains, whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable lim-
it of insurance to the total applicable limits of
insurance of all insurers.
5. Premium Audit
a. We will compute all premiums for this Cover-
age Part in accordance with our rules and
rates.
b. We may audit your books and records as they
relate to this insurance at any time during the
term of this policy and up to three years after-
wards.
c. The first Named Insured must keep records of
the information we need for premium computa-
tion, and send us copies at such times as we
may request.
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are accu-
rate and complete;
b. Those statements are based upon representa-
tions you made to us; and
c. We have issued this policy in reliance upon
your representations.
7. Separation Of Insureds
Except with respect to the limits of Insurance, and
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this in-
surance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
claim is made or "suit" is brought.
8. Transfer Or Waiver Of Rights Of Recovery
Against Others To Us
We will waive the right of recovery we would oth-
erwise have had against another person or organ-
ization, for loss to which this insurance applies,
provided the insured has waived their rights of re-
covery against such person or organization in a
contract or agreement that is executed before
such loss.
To the extent that the insured's rights to recover
all or part of any payment made under this Cover-
age Part have not been waived, those rights are
transferred to us. The insured must do nothing af-
ter loss to impair them. At our request, the insured
will bring "suit" or transfer those rights to us and
help us enforce them.
This condition does not apply to Coverage C.
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 expi-
ration date.
If notice is mailed, proof of mailing will be sufficient
proof of notice.
SECTION V -DEFINITIONS
1. "Advertisement" means an electronic, oral, written
or other notice, about goods, products or services,
designed for the specific purpose of attracting the
general public or a specific market segment to use
such goods, products or services.
"Advertisement" does not include any e-mail ad-
dress, Internet domain name or other electronic
address or metalanguage.
2. "Advertising injury" means injury, other than "bodi-
ly injury", "property damage" or "personal injury",
sustained by a person or organization and caused
by an offense of infringing, in that particular part of
your "advertisement" about your goods, products
or services, upon their:
a. Copyrighted "advertisement"; or
b. Registered collective mark, registered service
mark or other registered trademarked name,
slogan, symbol or title.
3. "Asbestos" means asbestos in any form, including
its presence or use in any alloy, by-product, com-
pound or other material or "waste".
4. "Auto" means:
a. A land motor vehicle, trailer or semitrailer de-
signed for travel on public roads, including any
attached machinery or equipment; or
b. Any other land vehicle that is subject to a com-
pulsory or financial responsibility law or other
motor vehicle insurance law in the state where
it is licensed or principally garaged.
However, "auto" does not include "mobile equip-
ment".
5."Bodily injury" means physical:
a. Injury;
b. Sickness; or
c. Disease;
Page 12 of 16 Includes copyrighted material of ISO Properties,
Inc., with its permission
Form 10-02-1800 (Rev. 6-09)
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY
we 99 03 04 (Ed. 7-08)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
This endorsement changes the policy to which it is attached effective on the inception date of the policy
unless a different date is indicated below.
(The following "attaching clause" need to be completed only when this endorsement is issued subsequent to preparation of the
policy.)
4/2/17 This endorsement, effective on
(DATE)
Policy No.
54303068
issued to
Ghilotti Construction Co.
Endorsement No.
of the
at 12:01 A. M. standard time, forms a part of
(NAME OF INSURANCE COMPANY)
\)~~-
Authorized Representative
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will
not enforce our right against the person or organization named in the Schedule. The additional premium for
the blanket waiver offered by this endorsement shall be 0.00 % of total California premium .
Schedule
Person or Organization Job Description
Where required by written contract
we 99 03 04 (Ed. 7-08)
POLICY NUMBER: 54303067 COMMERCIAL GENERAL LIABILITY
10-02-2461 (Ed. 7-15)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY INSURANCE FOR
SCHEDULED ADDITIONAL INSURED
This endorsement modifies insurance provided under the following :
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Additional Insured: Location Of Covered Operations:
WHERE REQUIRED BY WRITTEN CONTRACT
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
With respect only to the Additional Insured and at the
Location Of Covered Operations shown in the
Schedule, the following is added to SECTION IV -
COMMERCIAL GENERAL LIABILITY CONDITIONS,
Paragraph 4. Other Insurance and supersedes any
provision to the contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
the Additional Insured with respect to the Location
Of Covered Operations shown in the Schedule
under this policy provided that:
(1) The Additional Insured is a named insured
under such other insurance; and
(2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution from
any other insurance available to the
Additional Insured.
10-02-2461 (Ed. 7-15) Includes copyrighted material of Insurance Services Office, Inc.,
with its permission.
Page 1 of 1
~'Lib~rtx ~ Mutual..
SURETY
CONTRACT BOND -CALIFORNIA
FAITHFUL PERFORMANCE -
PUBLIC WORK
Executed in Triplicate Bond #070011149
Initial premium charged for this bond is
$184.00 subject to
adjustment upon completion of contract
at applicable rate on final contract price.
KNOW ALL BY THESE PRESENTS, That Ghilotti Construction Company, Inc.
~~=-------------~~~---------------------------------------of 246 Ghilotti Avenue, Santa Rosa, CA 95407 as Principal,
and the Liberty Mutual Insurance Company , a corporation organized and existing
under the laws of the State of Massachusetts and authorized to transact surety business in the State of California, as ~~~~~~~-=---------
Surety, are held and firmly bound unto City of San Rafael
--~--------------------------------------------------------------
in the sum of Thirty-four Thousand Eighty-zero Dollars And Fifty-zero Cents
Dollars ($34,080.50 ),
for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors and
assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That WHEREAS, the above-bounden Principal has entered into a
Contract, dated February 28 , 2018 , with the City of San Rafael --~-----------------------------------------
to do and perform the following work, to-wit:
Cermenho Court Resurfacing
NOW, THEREFORE, if the above-bounden Principal shall faithfully perform all the provisions of said Contract, then this obligation shall
be void; otherwise to remain in full.force and effect.
PROVIDED FURTHER THAT, Any suit under this bond must be instituted before the expiration of two (2) years from the date of
substantial completion of the work to be performed under the Contract.
Signed and sealed this __ 2_8_th _____ day of ___ F_e_b_ru_a __ ry"--___ , _20 __ 18 ____ __
GhiloUi Construction Company, Inc.
Principal
Brian Ongara
Vice President
BYJank,~
Liberty MUluallnSUra@(ny
Attorney-in-Fact
LMS-1081510/99
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California I
County of Pacer
On February 28, 2018 before me, Kathy Rangel, Notary Public
(insert name and title of the officer)
personally appeared _J_a_n_a_B_,_P_il_g_a_rd ___________________ _
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TV OF PERJURY under the laws of the State of California that the foregOing
paragraph is true and correct.
WITNESS my hand and official seal.
• "N ..... r't.Y ............. y .................... v. ................ ~
:: ' : -.'. ' KATHY RANGEL ~
~ ."'" COMM. # 2179600 ;f;:
(.) .. NOTARY PUBLIC • CALIFORNIA ~ lil .\ PLACER COUNTY ~
:; . Comm Expires FEB. 11. 2021 ~ :: ................................................................................. .
Signature ~ e,,=,,~ (Seal)
~Libertx \P Mutucil.
SURETY
C ONTRACT BOND -CALIFORNIA
PAYMENT BOND
Executed in Triplicate Bond #070011149
KNOW ALL BY THESE PRESENTS, That we, Ghilotti Construction Company, Inc.
------------------~~------------------------------------
and the Liberty Mutual Insurance Company , a corporatio n organized and existing under the laws of the State of
Massachusetts and authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto
C ity of San Rafael
, as Obligee,
~~----~~~~~~----~~~-=~--~~~~~~-----------------------------------in the sum of Thirty-four Thousand Eighty Dollars And Fifty Cents
Dollars ( $34,080.50 ),
~~------------~----------------~--~--~-------------------------for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors
and assigns, jointly and severally, fimlly by these presents .
THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That WHEREAS, the above-bounden Principal has entered into a
contract, dated 28th day of February , 2018 , with the Obligee to do and perform the following
work, to-wit: Cermenho Court Resurfacing
NOW, THEREFORE, if the above-bounden Principal or his/her subcontractors fail to pay any of the persons named in Section 9100 of
the Civil Code of the State of California, or amounts due under the Unemployment Insurance Code with respect to work or labor
performed under the Contract, Surety will pay for the same, in an amount not exceeding the amount specified in this bond , and also, in
case suit is brought upon th is bond, a reasonable attorney's fee , to be fixed by the court.
This bond shall inure to the benefit of any and all persons, companies or corporations entitled to file claims under Section 9100 of the
Civil Code ofthe State of California, so as to g ive a right of action to them or their assigns in any suit brought upon this bond .
Signed, sealed and dated this day of February , 2018 --------------------------~----------------------------------28th
No premium is charged for this bond. It is executed in
connection with a bond for the performance of the
contract.
LMS ·1081610/99
Ghilotti Construction Company, Inc.
Principal
Bria n Onaaro
Vice Pres ident
By
----~~~---------=~--------------Jana Attorney-in-Fact
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California I
County of Pacer
On February 28, 2018 before me, Kathy Rangel, Notary Public
(insert name and title of the officer)
personally appeared _J_a_n_a_B_"_P_il_g_a_rd ____________________ _
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isfare
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TV OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal. :: .......... 'V. ........... " ........ " •• V\ ................................... .,. ..... ..,. ... -.,.
:: .. : .... ,. KATHY RANGEL ~
l; '" COMM # 2179600
Cl < NOTARY PUBLIC. CALIFORNIA ~ ~ ! II. PLACER COUNTY ~
:: • ,"".,..~. Corrm Expims FEB 11 2021 ~ ........................................ ~ .•••••........••••......•• ~ ............... ~
(Seal)
THIS (DOWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated.
Certificate No . 7831681
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS : That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire , that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corpora ti on duly
organ ized under tile laws of the State of Ind iana (herein collectively called the "Companies"). pursuant to and by authority herein set forth, does hereby name, cons ti tute and appoint ,
Dona Lisa Buschmann; Edward D. Johnson; J. Buschmann; Jana B. Pilgard; Julie A. Shiroma; Karina Palmer; Kathy Rangel; Robert D. Laux; Stephen
D. Bender
all of the cily of Sacramento , state of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal , acknowledge
and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, re,cognizances and other surety obligations, in pursuance of these presents and shall
be as binding upon the Compan ies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF, th is Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto th is 10th dayof July ,~.
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
ss
The Ohio Casualty Insurance Company
Liberty Mutual Insurance Company
wes~~merican Insurance Company
By: ~.!~~/V=/=· _7'-'-'./"7f-.._~::...,," ______ _
David M. Carey-:Assistant Secretary
On this ~ day of July , 2017, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such , being authorized so to do, execute the foregoing instrument for the purposes
therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Teresa Pastella, Notary Public
Upper Menon Twp., Monlgomery Counly
My Commission Expires Marc h 28.2021
Member. Pcnnsylvilfl l<J ASSll Cl(lllon 01 Notaries
By:~#J ~
Teresa Pastella, Notary Public
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
ARTICLE IV -OFFICERS -Section 12. Power of AIIorney. Any officer or other official of the Corporation aulhorized for thai purpose in writing by the Chairman or the President, and subject
to such limitalion as the Chairman or the Presidenl may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporalion to make, execute, seal,
acknowledge and deliver as surely any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective
powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so
executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under
the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII -Execution of Contracts -SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,
and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact. as may be necessary to act in behalf of the Company to make, execute,
seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their
respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so
executed such instruments shall be as binding as if signed by the president and attested by the secretary.
Certificate of Designation -The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in-
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization -By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed .
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of wh ich the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 28 t h day of February ,W BY}?=-~'-
Renee C Lie\'! ssistant Secretary
18
284 of 350
~~i~ertx ~ Mutual..
SURETY
CONTRACT BOND -CALIFORNIA
FAITHFUL PERFORMANCE -
PUBLIC WORK
Executed in Triplicate Bond #070011149
Initial premium charged for this bond is
$184.00 subject to
adjustment upon completion of contract
at applicable rate on final contract price.
KNOW ALL BY THESE PRESENTS, That ..".G-=h-:-ilo~tt::-i _C_o_n_st_ru_c_ti_o_n_C_o_m ...... p_a_n"""y,..;;._nc_. ________________ _
of 246 Ghilotti Avenue, Santa Rosa, CA 95407 as Principal,
and the Liberty Mutual Insurance Company , a corporation organized and existing
under the laws ofthe State of Massachusetts and authorized to transact surety business in the State of California, as ~~~~~~-------------
Surety, are held and fmnly bound unto _C_ity~o_f_S_a_n_R_a_fa_e_I ________________________ _
in the sum of Thirty-four Thousand Eighty-zero Dollars And Fifty-zero Cents
Dollars ($34,080.50 ),
for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors and
assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That WHEREAS, the above-bounden Principal has entered into a
Contract, dated February 28 ,2018, with the ..;;.C..;,.;ity,,-,-o_f S..:....:.;.an""-'-R..;;.a-"fa-"e:....;.I ______________ _
to do and perform the following work, to-wit:
Cermenho Court Resurfacing
NOW, THEREFORE, if the above-bounden Principal shall faithfully perform all the provisions of said Contract, then this obligation shall
be void; otherwise to remain in full.force and effect.
PROVIDED FURTHER THAT, Any suit under this bond must be instituted before the expiration of two (2) years from the date of
substantial completion of the work to be performed under the Contract.
Signed and sealed this 28th day of __ -"F-=e'-b..;,.;ru:;.:a'-ryi-___ , _20_1_8 __ _
GhiioUi Construction Company, Inc.
Principal
Brian Ong ara
Vice Presid ent
By __ -+~~~~~~~ __ ---------
Attorney-in-Fact Jan
LMS-1081510/99
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California I
County of Pacer
On February 28, 2018 before me, Kathy Rangel, Notary Public
(insert name and title of the officer)
personally appeared _J_a_n_a_B_,_P_il_g_a_rd ___________________ _
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TV OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
: ................... ,.,.. ............................................................... :-
~ . KATHY RANGEL ~
;:. COMM. # 2179800 15 NOTARY PUBLIC. CALIFORNIA ~ ~ PLACER COUNTY ~
~ ." Comm Expires FEB. 11,2021 ': ......................................................................................
Signature t<~ ~ (Seal)
~Libertx \:P Mutuat
SURETY
CONTRACT BOND -CALIFORNIA
PAYMENT BOND
Executed in Triplicate Bond #070011149
KNOW ALL BY THESE PRESENTS, That we, Ghifotti Construction Company, Inc .
------------------~~~----------------------------------
and the Liberty Mutual Insurance Company , a corporation organized and existing under the laws of the State of
Massachusetts and authorized to transact surety business in the State of California, as Surety , are held and firmly bound unto
City of San Rafael
, as Obligee,
~~----~~~~~~----~~~-=~--~~~~~~-----------------------------------in the sum of Thirty-four Thousand Eighty Dollars And Fifty Cents
Dollars ( $34,080 .50 ),
~~------------~----------------~----~~----------------------~ for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors
and ass igns, jointly and severally, finnly by these presents .
THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH , That WHEREAS, the above-bounden Principal has entered into a
contract, dated 28th day of February , 2018 , with the Obligee to do and perform the following
work , to-wit: Cermenho Court Resurfacing
NOW, THEREFORE, if the above-bounden Principal or his/her subcontractors fail to pay any of the persons named in Section 9100 of
the Civil Code of the State of California, or amounts due under the Unemployment Insurance Code with respect to work or labor
performed under the Contract, Surety will pay for the same, in an amount not exceeding the amount specified in this bond, and also, in
case suit is brought upon this bond, a reasonable attorney's fee, to be fixed by the court.
This bond shall inure to the benefit of any and all persons, companies or corporations entitled to file claims under Section 9100 of the
Civil Code of the State of California, so as to give a right of action to them or their assigns in any suit brought upon this bond.
Signed, sealed and dated this 2 8th day of Fe bruary , 2018
----------~-----------------------------------
No premium is charged for this bond. It is executed in
connection with a bond for the performance of the
contract.
LMS-1081610/99
Ghilotti Construction Company, Inc.
Principal
Brian Ongara
Vice President
Attorney-in-Fact
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validityof that document.
State of California I
County of Pacer )
On February 28, 2018 before me, Kathy Rangel, Notary Public
(insert name and title of the officer)
pe~onallyappeared~J_a_n_a_B_._P_il_g_a_rd~~~~~~~~~~~~~~~~~~~~
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TV OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
...... ...,... ............................................................ Yrl\l\. .... :-
:. ''-. KATHY RANGEL .;
;:, ........ '" COMM. # 2179800 ~
g' NOTARY PUBLIC. CALIFORNIA ~
::: PLACER COUNTY ~
:: • ,:~ Comm Expires FEB. 11, 2021 ~ :: .................................................................................. .
Signature _.J.........:~:::...s.~~~~~boII--¥-~-(Seal)
~rH i S POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated.
Certificate No. 7831683
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company West American Insurance Company
POWER OF ATTORNEY
KNOWN AL L PERSONS BY THESE PRESENTS : That The Ohio Casualty Insura nc e Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutua l Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly
organized under the laws of the State of Ind iana (herein collective ly called the "Compan ies"), pursua nt to and by authority herein set forth, does hereby name, constitute and appoint,
Dona Lisa Buschmann; Edward D. Johnson; J. Buschmann; Jana B. Pilgard; Julie A. Shiroma; Karina Palmer; Kathy Rangel; Robert D. Laux; Stephen
D. Bender
all of the city of Sacramento , state of CA each individually if there be more than one named. its true and lawful attorney-in-fact to make, execute, seal. acknowledge
and del iver, for and on its behalf as surety and as its act and deed , any and all undertak in gs , bon ds, recognizances and other surety obligations, in pursuance of these presents and shall
be as binding upon the Compan ies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an author ized officer or offi cia l of the Companies and the corporate seals of the Companies have been affixed
thereto this 10th day of July , ~.
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
ss
The Ohio Casualty Insurance Company
Liberty Mutual Insurance Company
West J\merican Insurance Company
By: ---=;/!2,-,V=.=· --,-,-:(-:;/.._~",-, ______ _
David M. Carey;Assistant Secretary
On this ~ day of July , 2017. before me personally appeared Dav id M. Carey, who ackno wledged himself to be the Assistant Secretary of Liberty Mutual Insurance
Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes
there in contained by signing on behalf of the corporations by himse lf as a du ly authorized officer.
IN WITNESS WHEREOF, I have hereunto subs cribed my name and affixed my notarial seal at King of Prussia, Pe nnsylvania , on the day and year first above written .
COMMONWEALTH OF PENNSY LVANIA
Notarial Seal
Teresa Pnstelia, Notary Publi c:
Upper Merio n Twp .. Monlgomery County
My Commiss ion Expires March 28.2021
M urnbcr, Pcrll1 sylviJnta As~:illClatlon of NutilrlcS
By;fiMuJ ~
Teresa Pastelia, Notary Public
This Power of Attorney is made and executed pursuant to and by authority of the follow ing By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
ARTICLE IV -OFFtCERS -Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President. and subject
to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal,
acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective
powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so
executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under
the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII-Execution of Contracts -SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president ,
and subject to such limitations as the chairman or the president may prescribe. shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute.
seal . acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their
respective powers of attomey, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so
executed such instruments shall be as binding as if signed by the president and attested by the secretary.
Certificate of Designation -The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in-
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization -By unanimous consent of the Company's Board of Directors. the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned , Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West Americ2'l1 Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companie!;, is in ~JII force and effect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 28 t h day of February 20 18
~//1 "
By; __ ~~~~--~f~~ ~~~ ______________ __
• Renee C. UeW~ssistant Secretary
286 of 350
.1
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below.
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department: Public Works
Project Manager: Shawn Graf
Extension: 5347
Contractor Name: Ghilotti Construction Co. (Cermenho Court Resurfacing)
Contractor's Contact: Riley Genazzi
Contact's Email: riley@ghilottLcom
D FPPC: Check if Contractor/Consultant must file Form 700
Step
1
2
3
4
5
6
7
8
9
RESPONSIBLE
DEPARTMENT
Project Manager
City Attorney
Project Manager
Project Manager
PRINT
Project Manager
City Attorney
City Attorney
City Manager / Mayor
City Clerk
DESCRIPTION
a. Email PINS Introductory Notice to Contractor
b. Email contract (in Word) & attachments to City
Atty c/o Laraine.Gittens@cityofsanrafael.org
a. Review, revise, and comment on draft agreement
and return to Project Manager
b. Confirm insurance requirements, create Job on
PINS, send PINS insurance notice to contractor
Forward three (3) originals of final agreement to
contractor for their signature
When necessary, * contractor-signed agreement
agendized for Council approval
*PSA > $20,000; or Purchase> $35,000; or
Public Works Contract> $125,000
Date of Council approval
CONTINUE ROUTING PROCESS WITH HARD COPY
Forward signed original agreements to City
Attorney with printed copy of this routing form
Review and approve hard copy of signed
agreement
Review and approve insurance in PINS, and bonds
(for Public Works Contracts)
Agreement executed by Council authorized official
Attest signatures, retains original agreement and
forwards copies to Project Manager
COMPLETED
DATE
N/A
2/15/2018
2/23/2018
2/23/2018
Click here to
enter a date.
~ N/A
Or
Click here to
enter a date.
3/6/2018
REVIEWER
Check/Initial
~ LG
~ LG
D
SG
~