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PW 2017 Storm Damage Repair - #80 Upper Toyon
City of San Rafael ♦ California Form of Agreement for 2017 Storm Damage Repair - #80 Upper Toyon This Agreement is made and entered into this ILP day of __1tA1u 2018 by and between the City of San Rafael (hereinafter called City) and Maggiora & Ghilotti, Anc.. (hereinafter called Contractor). Witnesseth, that the City and the Contractor, for the considerations hereinafter named, agree as follows: I - Scope of the Work The Contractor hereby agrees to furnish all of the materials and all of the equipment and labor necessary, and to perform all of the work described in the specifications for the project entitled: 2017 Storm Damage Repair - #80 Upper Toyon, all in accordance with the requirements and provisions of the Contract Documents as defined in the General Conditions which are hereby made a part of this Agreement. The required additional insured coverage for City under contractor's liability insurance policy shall be primary with respect to any insurance or coverage maintained by city and shall not call upon city's insurance or self-insurance for any contribution. II- Time of Completion (a) The work to be performed under this Contract shall be commenced within Five (5) Working Days after the date of written notice by the City to the Contractor to proceed. (b) All work shall be completed, including all punchlist work, within Forty (40) Working Days and with such extensions of time as are provided for in the General Provisions. III - Liquidated Damages It is agreed that, if all the work required by the contract is not finished or completed within the number of working days as set forth in the contract, damage will be sustained by the City, and that it is and will be impracticable and extremely difficult to ascertain and determine the actual damage which the City will sustain in the event of and by reason of such delay; and it is therefore agreed that the Contractor will pay to the City, the sum of $500 for each and every calendar day's delay in finishing the work in excess of the number of working days prescribed above; and the Contractor agrees to pay said liquidated damages herein provided for, and further agrees that the City may deduct the amount thereof from any moneys due or that may become due the Contractor under the contract. IV - The Contract Sum The City shall pay to the Contractor for the performance of the Contract the amounts determined for the total number of each of the units of work in the following schedule completed at the unit price stated. The number of units contained in this schedule is approximate only, and the final payment shall be made for the actual number of units that are incorporated in or made necessary by the work covered by the Contract; provided that the total compensation under this Contract shall not exceed Two Hundred Fifty - Nine Thousand Two Hundred Fifty -Nine Dollars and 00/100 ($259,259.00) unless a written amendment is executed by the City and the Contractor. /I- I --� 231a BASE BID ITEMS NO. ITEM QUANTI UNIT UNIT TOTAL PRICE TY S PRICE 1. Mobilization (3% of 1 LS $7,000.00 = $7,000.00 Base Bid) 2. Signs and Traffic Control 1 LS $7,994.00 $7,994.00 3• Clearing and Grubbing 1 LS $18,375.00 $18,375.00 4. Cast in Drilled Hole 60 LF $400.00 $24,000.00 (CIDH) Piles ** 5. Concrete Retaining Wall 30 CY $2,300.00 $69,000.00 ** 6. Tieback Anchorsl** 170 LF $175.00 $29,750.00 7. Excavation ** 130 CY $350.00 $45,500.00 8. MSE Block Wall 165 SF $900.00 $14,850.00 9. 3/4" Clean Crushed 70 70 $160.00 $11,200.00 Drainrock 10. Mirafi 140N Filter Fabric 920 SF $2.00 $1,840.00 11. 6" Diameter Perforated 100 LF $30.00 $3,000.00 Subdrain 12. Subdrain Cleanout 2 EA $1,000.00 $2,000.00 13. 6 Foot Conform Grind 1550 SF $60.00 $3,000.00 14. Hot Mix Asphalt 25 Ton $350.00 $8,750.00 15. Asphalt Berm 100 LF $35.00 $3,500.00 16. Timber Fence 50 LF $190.00 $9,500.00 BASE BID $259,259.00 V - Progress Payments (a) On not later than the 6th day of every month the Public Works Department shall prepare and submit an estimate covering the total quantities under each item of work that have been completed from the start of the job up to and including the 25th day of the preceding month, and the value of the work so completed determined in accordance with the schedule of unit prices for such items together with such supporting evidence as may be required by the City and/or Contractor. (b) As soon as possible after the preparation of the estimate, the City shall, after deducting previous payments made, pay to the Contractor 95% of the amount of the estimate as approved by the Public Works Department. (c) Final payment of all moneys due shall be made within 15 days after the expiration of 35 days following the filing of the notice of completion and acceptance of the work by the Public Works Department. (d) The Contractor may elect to receive 100% of payments due under the contract from time to time, without retention of any portion of the payment by the public agency, by depositing securities of equivalent value with the public agency in accordance with the provisions of Section 22300 of the Public Contract Code. Such securities, if deposited by the Contractor, shall be valued by the City's Finance Director, whose decision on valuation of the securities shall be final. VI - Acceptance and Final Payment (a) Upon receipt of written notice that the work is ready for final inspection and acceptance, the Engineer shall within 5 days make such inspection, and when he finds the work acceptable under the Contract and the Contract fully performed, he will promptly issue a Notice of Completion, over his own signature, stating that the work required by this Contract has been completed and is accepted by him under the terms and conditions thereof, and the entire balance found to be due the Contractor, including the retained percentage, shall be paid to the Contractor by the City within 15 days after the expiration of 35 days following the date of recordation of said Notice of Completion. (b) Before final payment is due the Contractor shall submit evidence satisfactory to the Engineer that all payrolls, material bills, and other indebtedness connected with work have been paid, except that in case of disputed indebtedness or liens the Contractor may submit in lieu of evidence of payment a surety bond satisfactory to the City guaranteeing payment of all such disputed amounts when adjudicated in cases where such payment has not already been guaranteed by surety bond. (c) Contractor shall provide a "Defective Material and Workmanship Bond" for 50% of the Contract Price, before the final payment will be made. (d) The making and acceptance of the final payment shall constitute a waiver of all claims by the City, other than those arising from any of the following: (1) unsettled liens; (2) faulty work appearing within 12 months after final payment; (3) requirements of the specifications; or (4) manufacturers' guarantees. It shall also constitute a waiver of all claims by the Contractor, except those previously made and still unsettled. (e) If after the work has been substantially completed, full completion thereof is materially delayed through no fault of the Contractor, and the Engineer so certifies, the City shall, upon certificate of the Engineer, and without terminating the Contract, make payment of the balance due for that portion of the work fully completed and accepted. Such payment shall be made under the terms and conditions governing final payment, except that it shall not constitute a waiver of claims. VII - Assignment of Warranties; Waiver of Subrogation (a) Contractor hereby assigns to City all warranties, guarantees, or similar benefits such as insurance, provided by or reasonably obtainable from the manufacturers or suppliers of equipment, material or fixtures that Contractor has installed or provided in connection with the work performed under this Agreement. (b) Contractor hereby agrees to waive and arrange by contract for its subcontractors to waive any subrogation rights which any insurer of Contractor or its subcontractors might otherwise acquire in connection with the insurer's payment to Contractor or its subcontractors of any insured loss with respect to work performed under this Agreement. Contractor further agrees to obtain and to arrange for its subcontractors to obtain for City's benefit any endorsements from insurers that may be necessary to effect such waiver of subrogation. Specifically, any worker's compensation insurance policies of the Contractor or its subcontractors shall be endorsed with a waiver of subrogation in favor of City for any work performed by Contractor or its subcontractors under this Agreement, and copies of such endorsements shall be provided to City. IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute this Agreement the day and year first written above. ATTEST: Lindsay Lara City Clerk APPROVED AS TO FORM: L- a- , Rob Epstein City Attorney CITY OF SAN RAFAEL: Jimchut City n er CONTF09TOR: Ar('I( ( kw, u By: C . A' 1 T .7 [Print Name of Corporate Officer] [Title of Corporate Officer] and By: (V\ JA��-4.�--� [Print Name of Corporate Officer] [Title of Corporate Officer] MAGGI-1 OP ID: SD ACORO CERTIFICATE OF LIABILITY INSURANCE DATE F/24/20Y 07/24/208 18 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 Don Ramatici Insurance, Inc. P.O. Box 551 CONTACT NAME: Paul Ramatici PHONE FAX A1C Nc Ext : 707-782-9200 AIC, No): 707-782-9300 Petaluma, CA 94953 Paul Ramatici E-MAIL ADDRESS: 10/01/2017 10/01/2018 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Indemnity Co. of CT 25682 MED EXP (Any one person) $ 5+000 INSURED Maggiora & Ghilotti, Inc. INSURER 13: Travelers Prop.Cas.Co.America 25674 555 Du Bois Street San Rafael, CA 94901 INSURERC: -COMP/OP AGG $ 4+000+000 Emp Ben. $ 1,000,000 INSURER D: INSURER E: LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIRED AUTOS AUTOS 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 LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_] OCCUR X PD Ded $10k-Occ Y DT22CO9J210471TCT17 10/01/2017 10/01/2018 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 300 000 $ PREMISES Ea occurrence + MED EXP (Any one person) $ 5+000 X XCU/Ind Cont Incl PERSONAL & ADV INJURY $ 2,000+000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYa PRO- F] LOC JECTPRODUCTS OTHER: GENERAL AGGREGATE $ 4,000+000 -COMP/OP AGG $ 4+000+000 Emp Ben. $ 1,000,000 A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIRED AUTOS AUTOS Y DT8109J210471TCT17 10/01/2017 10/01/2018 COMBINED SINGLE LIMIT $ 2,000,000 Ea accident) BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Peraccident B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP9J6834101726 10/01/2017 10/01/2018 EACH OCCURRENCE S 4+000,000 AGGREGATE $ 4+000,000 DED I X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A Y UB9J2104711726G 10/01/2017 10/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1+000,000 E.L. DISEASE - EA EMPLOYEE1 $ 1,000,000 E.L. DISEASE - POLICY LIMIT I S 1+000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) *Certificate Holders as additional insured including primary & waiver of subro. verbiage when required by written contract per CGD2460805, CAT3530215 & WC990376. Umbrella follows form to GL, Auto & Em I.Liab. policies above. Job: 2017 Storm Damage Repair - #80 Upper Toyon / W&G #7684 *10 day notice sent on non-payment Lit City of San Rafael, its officers, agents, employees and volunteers* PO Box 151560 San Rafael, CA 94915 SANRAF4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0--- AAA P J1, ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Named Insured: Maggiora & Gli lolli, Inc. Policy #: D1'22C09J210471'rcr17 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section ll) Is amended to include any person or organization that you agree In a "written contract requiring Insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily Injury", "properly damage" or "personal Injury"; and b) If, and only to the extent that, the injury or damage is caused by arts or omissions of you or your subcontractor In the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization, The Insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring Insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring In- surance". This endorsement shall not In- crease the limits of insuranre described in Section III — Limits Of Insurance, b) The insurance provided to the additional In- sured does not apply to "bodily Injury", "prop- erly damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or falling to prepare or ap- prove, drawings and specifications; and ii, Supervisory, Inspection, architectural or engineering activities. c) The insurance provided to the additional In- sured does not apply to "bodily Injury" or "properly damage" caused by "your work" and Included In the "products -completed op- erations hazard" unless the "written contract requiring Insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily Injury" or "property damage" that oc- curs before the end of the period of lime for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The Insurance provided to the additional insured by this endorsement Is excess over any valid and collectible 'other Insurance", whether primary, excess, contingent or on any other basis, that is available to the additional Insured for a loss we rover under this endorsement. However, if the "written contract requiring Insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this Insurance is primary to 'other Insurance" available to the additional insured which covers that person or organization as a named Insured for such loss, and we will not share with that "other Insurance". But the Insurance provided to the additional insured by this endorsement still Is excess over any valid and collectible 'other In- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- llonal Insured when that person or organization Is an additional Insured under such 'other insur- ance", As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim, To the extent possible, such notice should include: CG D2 46 08 05 © 2005 The Sl. Paul Travelers Companies, Inc, Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the 'occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and III. The nature and location of any injury or damage arising out of the 'occurrence" or offense, b) If a claim is made or "suit' is brought against the additional Insured, the additional insured must: i. Immediately record the specifics of the claim or "suit' and the date received; and il. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicab.e. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions, d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of 'other insurance" which would cover the additional Insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to 'other Insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 Named Insured: Maggiora & Chilolli, Inc. Policy # DT8109J210471TCT17 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for arly injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage Is excluded or limited by such an endorsement. The following listing is a general coverage description only, Limitations and exclusions may apply to these coverages. Read all the provislons of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and Is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COVERAGE — INDEMNITY BASIS G, WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following Is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: Any organization you newly acquire or form during the policy period over which you maintain 50% or more ownership Interest and that is not separately insured for Business Auto Coverage. Coverage under this provision Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. B, BLANKET ADDITIONAL INSURED The following is added to Paragraph c. In A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: This Includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to narne H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS as an additional insured for Liability Coverage, but only for damages to which this Insurance applies and only to the extent of that person's or organization's liability for the conduct of another "Insured", C. EMPLOYEE HIRED AUTO 1, The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. The following replaces Paragraph b, in B,5„ Other Insurance, of SECTION IV — BUSINESS AUTO CONDITIONS: b, For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: CA T3 53 08 17 © 201 G The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with Its permission COMMERCIAL AUTO (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that Ind vidual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2,a,(2), of SECTION II — LIABILITY COVERAGE: (2) Up to $3,000 for (including bonds fo violations) required "accident" we cover, furnish these bonds. cost of ball bonds r related traffic law because of an We do not have to 2. The following replaces Paragraph A,2.a.(4), of SECTION II — LIABILITY COVERAGE: (4) All reasonable expenses Incurred by the "Insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COVERAGE — INDEMNITY BASIS The following replaces Subparagraph e, in Paragraph B.7., Policy Term, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDITIONS: e, Anywhere in the world, except any country or jurisdiction while any trade sanction, embargo, or similar regulation imposed by the United States of America applies to and prohibits the transaction of business with or within such country orjurisdiction, for Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that Is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households, (1) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (a) You must arrange to defend the "Insured" against, and Investigate or settle any such claim or "suit" and keep us advised of all proceedings and actions. (b) Neither you nor any other involved "insured" will make any settlement without our consent. (c) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (d) We will reimburse the "insured": (i) For sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "insured" pays with our consent, but only up to the limit described in Paragraph C., Limit Of Insurance, of SECTION II — LIABILITY COVERAGE; (ii) For the reasonable expenses incurred with our consent for your investigation of such claims and your defense of the "Insured" against any such "suit", but only up to and included within the limit described in Paragraph C., Limit Of Insurance, of SECTION II — LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (2) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess contingent or on any other basis. (3) This insurance is not a substitute for required or compulsory insurance in any country outside the United States, its Page 2 of 4 © 2016 The Travelers Indemnity Company. All rights reserved, CA T3 53 08 17 Includes copyrighted material of Insurance Services Office, Inc. with Its permission territories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such country up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory insurance requirements, (4) It is understood that we are not an admitted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Canada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE —GLASS The following Is added to Paragraph D., Deductible, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Paragraph A.4.b., Loss Of Use Expenses, of SECTION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Paragraph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense Incurred by you because of the total theft of a covered "auto" of the private passenger type. COMMERCIAL AUTO Personal Effects We will pay up to $400 for 'loss" to wearing apparel and other personal effects which are; (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage applies only In the event of a total theft of your covered "auto". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclusions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that inflate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Comprehensive Coverage under this policy; b. The airbags are not covered under any warranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following Is added to Paragraph A.2.a., of SECTION IV— BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representative prompt notice of the "accident" or "loss" applies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability company); (d) An executive officer, director or Insurance manager (if you are a corporation or other organization); or (e) Any "employee" authorized by you to give notice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION J. PERSONAL EFFECTS The following replaces Paragraph A.5., Transfer The following is added to Paragraph A.4., Of Rights Of Recovery Against Others To Us, Coverage Extensions, of SECTION III — of SECTION IV — BUSINESS AUTO CONDITIONS: PHYSICAL DAMAGE COVERAGE: CA T3 63 08 17 © 2016 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with Its permission COMMERCIAL AUTO 5, Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or 'loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B,2., Concealment, Misrepresentation, Or Fraud, of SECTION IV— BUSINESS AUTO CONDITIONS; The unintentional omisslon of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. However this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 0 2016 The Travelers Indemnity Company. All rights reserved. CA T3 53 08 17 Includes copyrighted material of Insurance Services Office, Inc with Its permission TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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 this endorsement shall be 2 % of the California workers' compensation premium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which It is attached and Is effective on the date Issued unless otherwise stated. (The Information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective: 10/01117 Policy No. UB9J2104711726G Endorsement No. Named Insured- Maggiore & Gliilotti, Inc. Premium Travelers Properly Casualty Insurance Co. Countersigned by __.------_____ Page 1 of 1 Liberty Mutual SURETY CONTRACT BOND - CALIFORNIA Bond 070206759 FAITHFUL PERFORMANCE - Initial premium charged for this bond is PUBLIC WORK $1,400.00 subject to adjustment upon completion of contract at applicable rate on final contract price. KNOW ALL BY THESE PRESENTS, That Maggiora & Ghilotti, Inc. of 555 Du Bois Street San Rafael CA 94901 as Principal, and the OHIO CASUALTY INSURANCE COMPANY , a corporation organized and existing under the laws of the State of New Hampshire and authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto City of San Rafael 1400 Fifth Avenue San Rafael CA 94901 in the sum of Two Hundred Fifty Nine Thousand Two Hundred Fifty Nine and 00/100 Dollars ( $259,259.00 ), for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That WHEREAS, the above -bounden Principal has entered into a Contract, dated '-kk 10 , with the City of San Rafael to do and perform the following work, to -wit: 2017 Storm Damage Repair - #80 Upper Toyon 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. FURTHER, Surety waives notice of modifications to the contract. 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 9th day of August 2018 Gary GhiloW President Maggi & Ghil ', nc. Principal �-0 INS(/ 555 Du Bois treet San Rafael CA 94901 yJPG�1iP Oq„ 1r�y Q 3 Fo V 1919 z Al so yHq*PS�N�a� The Ohio Casualty Insurance Company By I (A. i Awl) our, Attorney -in -Fact LMS -1081510199 THIS 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 8044168 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 corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Sandra J. Dunawav: Tom Griffith: Jennv Haaemann: Paul Ramatici: Jill Sevmour all of the city of PETALUMA , 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, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies 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 authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 21st day of March , 2018 y1N 11p� o':., :+;;, s. 5�: <<,,-:•'1; : ' <1'.,. The Ohio Casualty Insurance Company v Liberty Mutual Insurance Company 0 1919 0 1912 Y 1991 West American Insurance Company = STATE OF PENNSYLVANIA ss David M. Carey,'Assistant Secretary COUNTY OF MONTGOMERY La M d On this 21 st day of March 2018 , before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance v O Company, The Ohio Casualty Company, and West American Insurance Company, and that Ile, as such, being authorized so to do, execute the foregoing instrument for the purposes 0 therein contained by signing on behalf of the corporations by himself as a duly authorized officer. to N > 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. N3 yP PAST COMMONWEALTH OF PENNSYLVANIA Notarial Seal Teresa Pastella. Notary Public By of O d upper blerionTwp.. Montgomery County Teresa Pastella, Notary Public `�P My Commission Expires March 28.2021 60 y,5YiN G r OTq Pu�v� Member, Pennsylvania kssoriati;:n of Notariesm Ct'v 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 y Z Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: d ARTICLE IV— OFFICERS — Section 12. Power ofAttorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject 04; 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, O ,S acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective E of 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 0 m 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, >L 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, U 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 Z 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 which 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 day of 20 . <. grip o `1919n 1912 .�1991 By: By: o Renee C. Ile ssistant Secretary dye% v.r.•:'�`?� 9/;��s�-;: _ �' +,wra. 72 of 75 LNIS_12873_022017 U) rn d c N XI C O vCn �'W a1 C E 0a Q M O� d C O E .M A o so r O C .a:' N > Q yo d' E 00 ` N w= M 0 00 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Sonoma On nJ! r v ���� �', 2,01 X before me, Jenny Anne Hagemann - Notary Public (insert name and title of the officer) personally appeared Al Seymour who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JENNY ANNE HAGEWANN COMM. #2156191 zz O Notary Public • California o WITNESS my hand and official seal. z Sonoma County M Comm. Ex ires June 11, 2020 �-- (Seal) Liberty Mutual SURETY CONTRACT BOND - CALIFORNIA PAYMENT BOND Bond 070206759 Premium: Included in Performance Bond KNOW ALL BY THESE PRESENTS, That we, Maggiora & Ghilotti, Inc. 555 Du Bois Street San Rafael CA 94901 and the OHIO CASUALTY INSURANCE COMPANY a corporation organized and existing under the laws of the State of New Hampshire and authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto City of San Rafael 1400 Fifth Avenue San Rafael CA 94901 as Obligee, in the sum of Two Hundred Fiftv Nine Thousand Two Hundred Fiftv Nine and 00/100 Dollars ( $259,259.00 ), for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That WHEREAS, the above -bounden Principal has entered into a contract, dated l LP day of J U� �-1 ZO , with the Obligee to do and perform the following work, to -wit: 2017 Storm Damage Repair - #80 Upper Toyon 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. FURTHER, Surety waives notice of modifications to the contract. 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 9th day of August 1 2018 No premium is charged for this bond. It is executed in connection with a bond for the performance of the contract. � tY INS V� �� r �o m 00 0 1919 2 � o /Y MP �aS1 \h'1 ,t 1•N� LMS -10816 10199 Maggiora & Ghilotti, Inc. Principal 555 Du Bois Street San Rafael CA 94901 MIA The Ohio Casualty Insurance Company By i m r, Attorney -in -Fact THIS 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. 8135665 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 corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Sandra J. Dunaway; Tom Griffith; Jenny Hagemann; Paul Ramatici; Jill Seymour all of the city of PETALUMA , 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, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies 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 authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 22nd day of June 2018 j, O ,.: "'1�,. << .• . The Ohio Casualty Insurance Company Vv' Liberty Mutual Insurance Company rn (D < 1991 West American Insurance Company ° 4 52 = Q=— David M. Carey, Assistant Secretary A C STATE OF PENNSYLVANIA ss +� COUNTY OF MONTGOMERY c — O dt m On this 22nd day of June 2018 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance v F— v O Company, The Ohio Casualty Company, and West American Insurance Company, and that 11e, as such, being authorized so to do, execute the foregoing instrument for the purposesW p O therein contained by signing on behalf of the corporations by himself as a duly authorized officer. OE L' L d > 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. O CL .� �yP PAST COMMONWEALTH .— --- -- Nial Seat ----- n_OFPENNSYLVANIA`'��'M wEv ��Notarial C �o e7! /I y By: O = Teresa Paslella, Notary Public. _ _._ of 0 C O �. Upper MerinnTwp , Montgomery County Teresa Pastella, Notary Public O = L F�,, �P My Commission Expires March 28, ^021 4" '�'ySYI`1P�\ G 3 fC N O Opq� PU�,V� Member, Pennsylvania i+ssonatinn nl Mn4vius O a Od e 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 rn O y"N Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: P Y, P Y 9 �O 4— rho d ARTICLE IV—OFFICERS— Section 12. Power of Attorney. Any officer or other official of the Corporation authorized far that purpose in writing by the Chairman or the President, and subject r e 4? 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, >% a0i O,= 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 =p E ai 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 d 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 > c Tthe 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. CD 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, E o. >d 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, ! M — O 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 00 Z v 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 v executed such instruments shall be as binding as if signed by the president and attested by the secretary, ee 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 - H 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 which 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 day of 201 . n 91"191? 1991 By: Renee C. Llewe ssistant Secretary " o 3 of 100 LMS 12873 022017 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Sonoma ) On nu C4 A g 2.L I K before me, Jenny Anne Hagemann - Notary Public (insert name and title of the officer) personally appeared Jill Seymour who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ..-� WITNESS my hand and official seal LNotary NNE NAGEMANN . #2156191 z o ublic •California O zoma CountyMEx ires June 11,2020 Signatu � 0 "Cf.4 f-- (Seal) �1 y0 C,Y WITH P - 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: 2017 Storm Damage Repair - 80 Upper Toyon Contractor's Contact: Scott Ghilotti - Maggiora and Ghilotti Contract's Email: 459-8640 Step RESPONSIBLE DEPARTMENT DESCRIPTION COMPLETED DATE REVIEWER Initial a. Email PINS Introductory Notice to Contractor On File KM b. Email Contract (in Word) & attachments to City Attorney c/o 1 Project Manager Laraine.Gittensa cityofsanrafael.org 6/29/2018 KM a. Review, revise and comment on draft aereement and return to Project Manager 7/2/2018 LG b. Confirm insurance requirements, create Job on PINS, send PINS 2 City Attorney insurance notice to contractor. 7/2/2018 zlg Forward three (3) originals of final agreement to contractor for their 3 Project Manager signature. 7/9/2018 SG 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 7/16/2018 SG PRINT CONTINUE ROUTING PROCESS WITH HARD COPY Forward signed original agreement to City Attorney with printed copy of 5 Project Manager this routing form 7/31/20181 SG 6 City Attorney Review and approve hard copy of signed agreement 1� g Review and approve insurance in PINS, and bonds (for public works 7 City Attorney contracts) p 8 City Manager/Mayor Agreement executed by Council authorized official I 2, —I IIIJJJ--- 9 City Clerk Attest signatures, retains original agreement and forwards copies to manager project 10 Project Manager Forward Final Copy to Contractor )A - \--�npf Record Without Fee Per GC 27383 and ' When recorded mail to: 111111111111 lllll 11111111111111111111111111111111111 ll1111111111111111 2018-0043012 When recorded mail to: City of San Rafael Lindsay Lara, City Clerk 1400 Fifth Avenue P. 0. Box 151560 San Rafael, CA 94915-1560 Recorded Offlc:lal Records Counl-y of Marin RICHARD N. BENSON Assessor-Recorder CountyOerk 12:03PM 18-Dec-2018 REC FEE 0.00 CONFORMED COPY O. 00 a Page 1 of 2 SP ACE ABOVE THIS LINE FOR RECORDER'S USE CITY OF SAN RAFAEL NOTICE OF COMPLETION OF IMPROVEMENT TO ALL PERSONS WHOM IT MAY CONCERN: NOTICE IS HEREBY GIVEN for and on behalf of the City of San Rafael, County of Marin, State of California, that there has been a cessation of labor upon the work or improvement and that said work or improvement was completed upon the 19 th day of October, 2018 and accepted the 17 th day of December, 2018; that the name, address and nature of the title of the party giving this notice is as follows: The City of San Rafael, 1400 Fifth A venue, San Rafael, California, 94901, a municipal corporation, in the County of Marin, State of California, within the boundaries of which said work or improvement was made upon land owned by said City and /or over which said City has an easement; that said work or improvement is described as follows: 2017 Storm Damage Repair -#80 Upper Toyon" City Project No. 11329 and reference is hereby made for a further description thereof to the plans and specifications approved for said work or improvements now on file in the office of the Department of Public Works, and said plans and specifications are hereby incorporated herein by reference thereto; and that the name of the Contractor who contracted to perform said work and make such improvement is Maggiora & Ghilotti, Inc. I declare under penalty of perjury that the foregoing is true and correct. Executed at San Rafael, California, on 'f)~l-t Mg£ a... I b , 20 I 0 . CITY OF SAN RAFAEL A Municipal Corporation By Em)--- BILL GUERIN Director of Public Works A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF MARIN Subscribed and sworn to ( or affinned) before me on this \ '& day of P-t..l!.-m b L-V , 20~, by Bill Guerin, proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. WITNESS my hand and official seal. Signature___,~---~---~~~-~-------- LINDSA Y LARA San Rafael City Clerk File: 16.11.42