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HomeMy WebLinkAboutPW Sidewalk Shaving Services FY2017-18City of San Rafael. California Fonn of Agreement for Infonnal Bids FY 2017-18 Sidewalk Shaving Services This Agreement is made and entered into this ~day of httt:.. C-.-It , 2018 by and between the City of San Rafael (hereinafter called City) and Precision Concrete Cutting, LLC. (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 "FY 2017-18 Sidewalk Shaving Services ," all in accordance with the requirements and provisions of the Proposal Detail 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 of the project, a Labor and Materials Bond issued by a surety admitted in California, to cover the work under this Agreement, in the amount of$50,000.00. 4. Time of Completion. (a) The work to be performed under this Contract shall be performed on an "on-call" basis and shall commence within (30) 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 between July I, 2017 and June 30, 2018, and with such reasonable·extensions oftime 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 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; provided that the total compensation under this Contract shall not exceed $50,000 unless a written amendment is executed by the City and the Contractor. BID ITEMS ESTIMATED UNIT UNIT PRICE TOTAL PRICE QUANTITY ITEM DESCRIPTION I. Inch-foot Sidewalk Shaving Services 1,500 LS @ $28.00 $42,000.00 2. Contingency N /A LS @ $28.00 $8,000.00 GRAND TOTAL BID $50 2000.00 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 Agreement· 1 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, shaH 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 City 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 City 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. e 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: (I) 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 shal1 be made under the terms and conditions governing final payment, except that it shal1 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 fol1owing insurance policies: 1. A commercial general liability insurance policy in the minimum amount of one million dol1ars ($1,000,000) per occurrence/two mi11ion dol1ars ($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 shaH 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 dol1ars ($1,000,000) per accident for bodily injury or disease. Contractor's worker's compensation insurance shal1 be specificaHy 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 fo11owing requirements: 1. 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 shall be primary with respect to any insurance or coverage maintained by City and shall not call upon City insurance or self-insurance coverage for Agreement· 2 any contribution . The "primary and noncontributory" coverage in Contractor's policies shall be at least as broad as ISO fonn CG20 01 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 Fonn, then, following tennination 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. It 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. Furthennore, the requirements for coverage and limits shall be: (l) 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) Deductibles 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 of liability. Policies containing any self-insured retention (SIR) 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 following: (I) Certificates ofInsurance 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 fonn and sufficiency by City. 10. Indemnification. (a) Contractor shall, to the fullest extent pennitted by law, indemnify, release, defend with counsel approved by City, and hold hannless City, its officers, agents, employees and volunteers (collectively, the "City Indemnitees"), 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 "CLAIMS"), arising out of Contractor's perfonnance of its obligations or conduct of its operations under this Agreement. The Contractor's 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 Agreement· 3 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 AU 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: Precision Concrete Cutting, LLC. PO Box 25265 San Mateo, CA 94401 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 ofthis Agreement. (b) This written Agreement shaH 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. Agreement· 4 (d) The tenns 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 tenns and conditions of this Agreement, and the tenns and conditions of the attached exhibits or the documents expressly incorporated by reference, the tenns and conditions of this Agreement shall control. 17. Waivers. The waiver by either party of any breach or violation of any tenn, covenant or condition of this Agreement, or of any ordinance, law or regulation, shall not be deemed to be a waiver of any other tenn, covenant, condition, ordinance, law or regulation, or of any subsequent breach or violation of the same or other tenn, covenant, condition, ordinance, law or regulation. The subsequent acceptance by either party of any fee, perfonnance, 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 tenn, condition, covenant ofthis 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 perfonned under this Agreement, until Contractor has provided City with a completed Internal Revenue Service Fonn 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 nahlre 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 pennanent repairs that may be required as detennined in the sole discretion andjudgrnent 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. CITY OF SAN RAFAEL: Agreement· 5 ATTEST: Lindsay Lara Interim City Clerk APPROVED AS TO FORM: ~a~1".~ Robert F. pstein ~ . 0..-"" City Attorney FileNo.: 16.04.17 Precision Concrete Cutting, LLC. By: Printed Officer Name: I-VW'...c. CUS<;fr-lo ( Title: ~A-6-tlv6 H.f.M6tR ICED. and By: Printed Officer Name : Title: Agreement· 6 PAYMENT BOND PUBLIC WORKS [Civ. Code Secs. 3247 -3248] KNOW ALL BY -rHESE PRESENTS: Bond No. 63544350 Any claim under this Bond should be sent to the following address: WESTERN SURETY COMPANY 101 S. REID ST. « STE. 300 SIOUX FALLS SD 57103 7Q46 That we, Precision Emprise Inc. DBA: Precision Concrete Cutting and WESTERN SURETY COMPANY , as Principal, , a corporation organized and existing under the laws of the State of __ ~S~O~UwT,-=H~D~A~K~O:..=T~A~ _____ .....,....~_-:-::--.,.....-:_---:-__ 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 FIFTY THOUSAND AND NO CENTS Dollars ($ 5 0 , 0 0 0 0 0 ) lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION of the above obligation is such that, whereas the Principal has entered Into a contract dated 3 11/2 0 18 , with the Obligee to do and perform the following work, to-wit: SIDEWALK INSPECTION AND REPAIRS as is more specifically set forth in the contract documents, reference to which is hereby made. NOW THEREFORE, if the Principal or a subcontractor fails to pay any of the persons named in Section 3181 of the Civil Code, or amounts due under the Unemployment Insurance Code with respect to work or labor performed under the contract, or for any amounts required to be deducted, withheld and paid over to the Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to such work and labor, the Surety will pay for the same, in an amount not exceeding the sum specified In this bond, and also, in case suit is brought upon this bond, a reasonably attorney's fee, to be fixed by the court. This bond shall ensure to the benefit of any of the persons named in Section 3181 of the Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon this bond. 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. SIGNED AND SEALED, this __ =2 =8 T""'H ........ ___ day of __ --"F ..... E:::..oB:<.OR~U"""A .... R~Y .......... «'___=2"_'0:<..:1""8"__ ____ _ (SEAL) (SEAL) Precision Emprise Inc. DBA: Precision Concrete Cutti"ng WESTERN SURETY COMPANY I . t A .. (Principi!l- By: ____ ~LAI __ v~v~~~~-~----------- (Signature) VALERIE ANN Jl..BER (Signature) (SEAL AND ACKNOWLEDGMENT OF NOTARy) " , 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 ATIACHED, AND NOT THE TRUTHFULNESS, ACCURACY, OR VALIDITY OF THAT DOCUMENT STATE OF ARI ZONA COUNTY OF MARICOPA }ss. BEFORE ME, EZRA TIMOTHY NORRIS PERSONALLY APPEARED VALERIE ANN ABERt ATTORNEY-IN-FACT WHO PROVED TO ME ON THE BASIS OF SATISFACTORY EVIDENCE TO BE TI-IE 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(lES) AND THAT BY HIS /HER/THEIR SIGNA TURE(S) ON THE INSTRUMENT THE PERSON(S), OR THE ENTITY UPON BEHALF OF WHICH THE PERSON(S) ACTED, EXECUTED THE INSTRUMENT. I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF ARIZONA THAT THE FOREGOING PARAGRAPH IS TRUE AND CORRECT. WITNESS All' HAND AND OFFICIAL SEAL. SIGNATURE __ ~:..........:~~=::........: ___ • __________ _ EZRA TIMOTHY NORRIS Notary Public -Slale of Arizona MARICOPA COUNTY My Commission Expires November 30. 2021 THIS AREA FOR OFFICIAL NOTORIAL SEAL Western Surety Company POWER OF ATTORNEY -CERTIFIED COPY Bond No . 63544350 Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company"), does by these presents make, constitute and appoint ----"V-'a"-'l!o.e~r_"i'_'e"____'A<:!!!n"'n'____'A"'b""_"e""r~ ___________________________ _ its true and lawful attorney(s)-in-fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its behalf as Surety, bonds for: Principal: Precisi o n Emprise Inc . dba Precision Concrete Cutting Obligee: C i ty o f San Rafael Amount: $50,000.00 and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Vice President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s)-in- fact may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety Company which remains in full force and effect. "Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, 01' undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." If Bond No. 63544350 is not issued on or before midnight of June 30th, 201 S , all authority conferred in this Power of Attorney shall expire and terminate. In Witness Whereof, Western Surety Company has caused these presents to be signed by its Vice President, Paul T . Bruflat, and its corpurate .sea) to be affixed this 28th day of February , 2018 . ,\\~"u n. 11'''1: .~\~·~f{ E r t~ ';.:/,,, ,,~~ ~ ............ :~ .. ~,~.,~,. ~~.e.t; ,.... nO a '\~~" ;;: 4.I,~ -:',; ,;, 1,.1 ....... ~ ........ :::b\..~.· e\' i/"}. ~~~ ~~~Y-~"1~~ a'tilItr'~ 0<FJ8QU'P H n~it::iT.-A } ss ~ * .. ... Ji:;. /'it;r: . .::-C6WJ%~·o.f. MINNF.fi~A ·~·~~(jr. ·t!A~f,".-! "..;-.' . '~/4 l-'1 WI ar..~\. On tliiy wll-28 'tn day of February ,in the year 2018 ,before me, a notary public, personally appeared Paul T . Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and deed of said corporation . -................................................. + ~ J. MOHR ~ s s ~~NOTARY PUBLIC~~ s SOUTH DAKOTA s s s + .............................................. + My Co mmission Expires June 23, 2021 I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as set forth in the Power of Attorney is now in force. In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this ____ ... 2"'S<...t"'h!..!..... ____ day of Febru a ry 201S To validate bond authenticity, go to www.cnasurety.cQrn > Owner/Obligee Services> Validate Bond Coverage. Form FS306-10-2017 PRECEMP-01 TCHIN ACORD" CERTIFICATE OF LIABILITY INSURANCE 1 DATE (MM/DD!YYYY) ~ 02109/2018 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 BYTHE 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 have ADDITIONAL INSURED provisions or 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 License # 0021146 ~2~I~CT Partners Service Group San Francisco, CA -Equity Risk Partners -HUB International California rllgN,ro, Exl): (415) 874-7168 I FAX 456 MontHomery Street (AlC, No):(415) 874-7170 Suite 120 ~DMDA~~SS' psg@equityrisk.com San Francisco, CA 94104 INSURERISl AFFORDING COVERAGE NAIC# INSURER A : West American Insurance Co 44393 INSURED INSURER B : American Fire and Casualty Company 24066 Precision Emprise Inc. DBA: Precision Concrete Cutting INSURER c: P.O. Box 25265 INSURER 0: San Mateo, CA 94402 INSUR ER E : INSURER F : COVERAGES CERTIFICATE NUMBER' 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 TYPE OF INSURANCE !~~DL SUBR POLICY NUMBER .I:~%~ I (~~~J~~ LIMITS LTR SO WVD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1 ,000,000 r---::=J CLAIMS·MADE 00 OCCUR ~~~~~~J9E~~~~~ncel 500,000 BKS (18) 58134152 06/30/2017 06/30/2018 s r--- 15,000 MED EXP IAnv one oersonl S r---1,000,000 PERSONA L & ADV INJURY S r---2,000,000 R'L AGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE S POLICY [[] ~~8T D LOC PRODUCTS· COMP/OP AGG S 2 ,000,000 OTHER : S AUTOMOBILE LIABILITY c-- fE~~~~~;~I~ING LE LIMIT S ANY AUTO BOD ILY INJURY IPer Dersonl S r---OWNED -SCHEDULED - r---AUTOS ONLY c---AU TOS BOD ILY INJURY IPer accide nt) $ - ~~1?SONLY NON'()WNED rp~?~&:~[j1J,I?AMAGE r---r--AUTOS ONLY S S B ~ UMBRELLA LIAB M OCCUR EACH OCCU RRENCE S 2,000,000 EXCESS LIAB CLAIMS-MADE ESA(18)58134152 06/30/2017 06/30/2018 AGGREGATE s 2,000,000 OED I I RETEN TION $ S WORKERS COMPENSATION I PER I 1 0TH . AND EMPLOYERS' LIABILITY STATUTE ER -YIN ANY PROPRIETOR/PARTNER/EXECUT IVE [J !1fI~ai:::~l~~~~ EXC LU DED? N /A EL. EACH ACCI DENT $ EL. DISEASE· EA EMPLOYEE $ If yes , describe under DESCRIPTION OF OPERAT IONS below E.L. DISEASE · POLICY LIMI T S , I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AC ORD 101, Addilional Remarks Schedule , may b. aUached If more space Is required) City of San Rafael its officers agents, employees and volunteers are named as additional insured as it relates to general & auto liability & waiver of subrogation is granted as it relates to general and auto liability and workers comp in accordance with the terms and conditions of the policies. Umbrella follows form as it relates to additional insureds. The above coverage is primary and noncontributory where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of San Rafael THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 111 Morphew Street San Rafael, CA 94901 AUTHORIZED REPRESENTATIVE I ~tJa~ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ... MAR 05 201 R PUBLIC WORK S DEPT. em OF SAN RAfAEL 812 South Railroad Avenue, San Mateo, CA 944011650-867-86571 admin@dontgrind.com March 1, 2018 Talia Smith City of San Rafael Department of Public Works 111 Morphew Street San Rafael, CA 94901 Dear Talia Smith: Enclosed please find: • Contract signed by Precision Concrete Cutting (2 copies) • Performance Bond • Payment Bond • Certificate of Liability Insurance Please feel free to contact me if you have any questions or concerns. Sincerely, Marc Cussenot Managing Member / CEO Precision Concrete Cutting 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: KM Extension: 3389 Project Name: Sidewalk Shavin~ FY 2017-18 Contractor's Contact: Joseph Ortega Contract's Email: jortega@dontgrind.com RESPONSIBLE Step DEPARTMENT DESCRIPTION a. Email PINS Introductory Notice to Contractor b. Email Contract (in Word) & attachments to City Attorney c/o I Project Manager Laraine.Gittens@ citr°fsanrafael.org a. Review, revise and comment on draft agreement and return to Project Manager b. Confirm insurance requirements, create Job on PINS, send PINS 2 City Attorney insurance notice to contractor. Forward three (3) originals of final agreement to contractor for their 3 Project Manager signature. When necessary, * contractor-signed agreement agendized for Council approval * PSA > $20,000 or Purchase > $35,000: or Public Works Contract> 4 Project Manager $125,000 PRINT CONTINUE RO UTING PROCESS WITH HARD COPY Forward signed original agreement to City Attorney with printed copy of 5 Project Manager this routing form 6 City Attorney Review and approve hard copy of signed agreement Review and approve insurance in PINS, and bonds (for public works 7 City Attorney contracts) City 8 Manager/Mayor Agreement executed by Council authorized official Attest signatures, retains original agreement and forwards copies to 9 City Clerk prolect manager 10 Project Manager Forward Final Copy to Contractor , I I ", I . ' - COMPLETED DATE 1128/2018 2/26/2018 N/A 3/9/2018 3/2.711~ ?;/Z7/}9' ]-Z~/f~ 3J1-tt 11'0 REVIEWER Initial TS TS TS ~ Ut--4~