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HomeMy WebLinkAboutPW Terra Linda Community Center Roof Walking Pad InstallationCity of San Rafael * California
Form of Agreement for Informal Bids
Terra Linda Community Center Roof Walking Pad Installation
This Agreement is made and entered into this IS day of W04e -1%10 r , 2018 by and between the City of San Rafael
(hereinafter called City) and Southwest Construction & Property Management, Inc. (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 time, materials, equipment, and labor necessary to perform the work for installing
roof access walking pads on the roof of the Terra Linda Community Center, located at 670 Del Ganado Rd. The scope of
work shall comprise procurement all necessary materials and installing/adhering roof access walking pads on the roof of the
Terra Linda Community Center.
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.
No bonds are required as part of this contract.
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 $100 for each and every working day 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 for work in the following scheduled completed at the unit price stated. This is an estimate of units required. The
amount may be less, but shall not exceed the estimated quantity. 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
$12,610.00 unless a written amendment is executed by the City and the Contractor.
BID ITEMS
ITEM DESCRIPTION ESTIMATED UNIT UNIT PRICE TOTAL PRICE
QUANTITY
1. Installation of New Walking Pads 1 LS $12,610.00 = $12,610.00
GRAND TOTAL BID $12,610.00
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
including the 25th day of the preceding month, and the value of the work so completed determined in accordance
Agreement • 1
Tss
ORIGINAL
with the schedule of unit prices for such items together with such supporting evidence as may be required by the
City an&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:
1. 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:
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
any contribution. The "primary and noncontributory" coverage in Contractor's policies shall be at least as
broad as ISO form CG20 0104 13.
Agreement • 2
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. 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. Furthermore, the requirements for coverage and limits shall be: (1) 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: (1) 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. Indemnification.
(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 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 performance 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 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
Agreement • 3
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 To Contractor: James T. Gardner
City of San Rafael Southwest Construction & Property Management, Inc.
111 Morphew Street P.O. Box 5410
San Rafael, CA 94901 South San Francisco, CA 94083
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.
(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,
Agreement • 4
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.
CITY O �ANFZkt___—
Jim s zitz
City NI ager
ATTEST:
Lindsay Lara
City Clerk
APPROVED AS TO FORM:
--L-.. a
Robert F. Epstein
City Attorney
File No.:06.01.237
Southwest C¢rstruction & Property Management
By: I1
Printed Na e: James T. Gardner
Title of Coate ate Officer: Vice President
Southwest o strucli'on & Property Management
By: , I
Title ofitorporate Officer: TCe--&i a ev t,
Agreement • 5
SOUTH -1 OP ID: Al
CERTIFICATE OF LIABILITY INSURANCE
DATE/
1 10/251201825/2018
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(les) 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
JSW Insurance Associates
P.O. Box 2516
CONTANAME: Andrea Hessler
PHONE FAX
AIC No): 925-737-1567
AIc Na E,1:925-737-1560 (AJC,
E-MAIL
ADDRESS: andrea SWinSUrance.COm
Dublin, CA 94568
Chris McAdams
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Travelers Indemnity Co of CT
INSURED Southwest Construction &
INSURERS: Travelers Property Casualty Co
Property Management
P.O. Box 5410
INSURER C: Arch Specialty Insurance 21199
X
S San Francisco, CA 94083
INSURER D:
INSURER E:
PREMDAMAGE ( RENTED
PREMISESS Ea occurrence) $ 300,000
INSURER F:
PERSONAL & ADV INJURY $ 1,000,000
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
ADD
SUBR
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MM/DD
LIMBS
GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FX] OCCUR
X
X
CO -2907M379
05/0112018
05/01/2019
PREMDAMAGE ( RENTED
PREMISESS Ea occurrence) $ 300,000
MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
C
X Pollution
12CPL1188000
05118/2018
05/18/2019
GENERAL AGGREGATE 5 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG $ 2,000,000
Poll Liab $ 5,000,000
POLICY X PRO LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT 1,000,000
Ea accident $
BODILY INJURY (Per person) $
B
X ANY AUTO
X
810-7B313422
05/01/2018
05/01/2019
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
PER ACCIDENT
X HIRED AUTOS Ix NON -OWNED
AUTOS
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE S 4,000,000
AGGREGATE S 4,000,000
B
EXCESS LIAR
CLAIMS -MADE
CUP-4J25325A
05/01/2018
05/01/2019
DED I X I RETENTIONS 10000
5
B
WORKERS COMPENSATIONX
AND EMPLOYERS' LWBILnYER
ANY PROPRIETORIPARTNER/EXECUTIVE YIN
X
UB -9J590696
01/0112018
01/01/2019
WC STATU- OTH-
E.L. EACH ACCIDENT $ 1,000,000
OFFICERIMEMBER EXCLUDED? ❑
(Mandatory in NH)
N 1 A
STOP GAP LIAB INCLUDED
01/0112018
01/01/2019
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT S 1,000,000
B
RentedLeased Equip
660-OC648430
05101/2018
05/01/2019
per item 100,000
B
RentedLeased Equip
660-OC648430
05/01/2018
05/01/2019
per time 200,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
The City of San Rafael, its officers, agents, employees & volunteers are
named as additional insured with respects to General Liability arising out
of work performed by the named insured per forms CGD316 & CGD246. Workers
Comp Waiver of Subrogation per form WC000313. re: Installation of new
walking pads @ Terra Linda Rec Ctr, 670 Del Ganado Rd, San Rafael, CA 94903
C:FRTIFICATF HCII nFR CONCFLI ATICIN
SANRAFA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of San Rafael DPW
Y
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
111 Morphew Street
San Rafael, CA 94915
AUTHORIZED REPRESENTATIVE
©1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
Named Insured: Southwest Construction & Property Mgmt GENERAL LIABILITY
Policy Number: CO -2907M379 ISSUE DATE: 5/01/2018
FORM# CGD3161111
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS XTEND ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury,
damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by
another endorsement to this 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 cover -age description
only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the
rest of your policy carefully to determine rights, duties, and what is and is not covered
I. Blanket Additional Insured — States Or Political
A. Aircraft Chartered With Pilot Subdivisions — Permits
B. Damage To Premises Rented To You J. Knowledge And Notice Of Occurrence Or
C. Increased Supplementary Payments Offense
D. Incidental Medical Malpractice
E. Who Is An Insured — Newly Acquired Or Formed
Organizations
F. Who Is An Insured — Broadened Named Insured —
Unnamed Subsidiaries
G. Blanket Additional Insured — Owners, Managers Or
Lessors Of Premises
H. Blanket Additional Insured — Lessors Of Leased
Equipment
PROVISIONS
A. AIRCRAFT CHARTERED WITH PILOT
The following is added to Exclusion g., Aircraft,
Auto Or Watercraft, in Paragraph 2. of SECTION
I — COVERAGES — COVERAGE A BODILY IN-
JURY AND PROPERTY DAMAGE LIABILITY:
This exclusion does not apply to an aircraft that is:
(a) Chartered with a pilot to any insured;
(b) Not owned by any insured; and
(c) Not being used to cant' any person or property
for a charge.
B. DAMAGE TO PREMISES RENTED TO YOU
1. The first paragraph of the exceptions in
Exclusion j., Damage To Property, in Para-
graph 2. of SECTION 1 — COVERAGES —
COVERAGE A BODILY INJURY AND
PROPERTY DAMAGE LIABILITY is deleted.
2. The following replaces the last paragraph of
Paragraph 2., Exclusions, of SECTION I —
COVERAGES — COVERAGE A. BODILY
INJURY AND PROPERTY DAMAGE
LIABILITY:
Exclusions c. and g. through n. do not apply
to "premises damage". Exclusion f.(1)(a)
K. Unintentional Omission
L. Blanket Waiver Of Subrogation
M. Amended Bodily Injury Definition
N. Contractual Liability — Railroads
does not apply to "premises damage" caused
by:
a. Fire;
b. Explosion;
c. Lightning;
d. Smoke resulting from such fire,
explosion, or lightning; or
e. Water,
unless Exclusion f. of Section I — Coverage A
— Bodily Injury And Property Damage Liability
is replaced by another endorsement to this
Coverage Part that has Exclusion — All
Pollution Injury Or Damage or Total Pollution
Exclusion in its title.
A separate limit of insurance applies to
"premises damage" as described in
Para -graph 6. of SECTION III — LIMITS
OF INSURANCE.
3. The following replaces Paragraph 6. of SEC-
TION III — LIMITS OF INSURANCE:
Subject to 5. above, the Damage To Premises
Rented To You Limit is the most we will pay
under Coverage A for damages because of
"premises damage" to any one premises. The
Damage To Premises Rented To You Limit
will apply to all "property damage"
proximately caused by the same
"occurrence", whether such damage results
from: fire; explosion; lightning; smoke
resulting from such fire, explosion, or
lightning; or water, or any combination of any
of these causes.
The Damage To Premises Rented To You Limit
will be:
a. The amount shown for the Damage To
Premises Rented To You Limit on the
Declarations of this Coverage Part; or
b. $300,000 if no amount is shown for the
Damage To Premises Rented To You
Limit on the Declarations of this
Coverage Part.
4. The following replaces Paragraph a. of the
definition of "insured contract" in the DEFINI-
TIONS Section:
a. A contract for a lease of premises. How-
ever, that portion of the contract for a
lease of premises that indemnifies any
person or organization for "premises
damage" is not an "insured contract';
5. The following is added to the DEFINITIONS
Section:
"Premises damage" means "property dam -age" to:
a. Any premises while rented to you or
temporarily occupied by you with
permission of the owner, or
b. The contents of any premises while such
premises is rented to you, if you rent
such premises for a period of seven or
fewer consecutive days.
6. The following replaces Paragraph 4.b.(1)(b) of
SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:
(b) That is insurance for "premises damage';
or
Paragraph 4.b.(1)(c) of SECTION IV —
COMMERCIAL GENERAL LIABILITY CON-
DITIONS is deleted.
C. INCREASED SUPPLEMENTARY PAYMENTS
1. The following replaces Paragraph 1.b. of
SUPPLEMENTARY PAYMENTS — COVER-
AGES A AND B of SECTION I — COVER-
AGE:
b. Up to $2,500 for the cost of bail
bonds required because of accidents or
traffic law violations arising out of the
use of any vehicle to which the Bodily
Injury Liability Coverage applies. We do
not have to furnish these bonds.
2. The following replaces Paragraph 1.d. of
SUPPLEMENTARY PAYMENTS —
COVERAGES A AND B of SECTION I —
COVER -AGES:
d. All reasonable expenses incurred by
the insured at our request to assist us in
the investigation or defense of the claim
or "suit", including actual loss of
earnings up to $500 a day because of
time off from work.
D. INCIDENTAL MEDICAL MALPRACTICE
1. The following is added to the definition of
"occurrence" in the DEFINITIONS Section:
"Occurrence" also means an act or omission
committed in providing or failing to provide
"incidental medical services", first aid or
"Good Samaritan services" to a person.
2. The following is added to Paragraph
2.a.(1) of SECTION 11 — WHO IS AN
INSURED:
Paragraph (1)(d) above does not apply to
"bodily injury" arising out of providing or fail-
ing to provide:
(1) "Incidental medical services" by any
of your "employees" who is a nurse
practitioner, registered nurse, licensed
practical nurse, nurse assistant,
emergency medical technician or
paramedic; or
(ii) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor. Any such "employees"
or "volunteer workers" providing or
failing to provide first aid or "Good
Samaritan ser -vices" during their work
hours for you will be deemed to be
acting within the scope of their
employment by you or performing duties
related to the conduct of your business.
3. The following is added to Paragraph 5. of
SECTION III — LIMITS OF INSURANCE:
For the purposes of determining the applicable
Each Occurrence Limit, all related acts or
omissions committed in providing or failing to
provide "incidental medical services", first aid
or "Good Samaritan services" to any one per-
son will be deemed to be one "occurrence".
4. The following exclusion is added to Para -graph
2., Exclusions, of SECTION I — COV-
ERAGES — COVERAGE A BODILY INJURY
AND PROPERTY DAMAGE LIABILITY:
Sale Of Pharmaceuticals
"Bodily injury" or "property damage" arising out of
the willful violation of a penal statute or
ordinance relating to the sale of
pharmaceuticals committed by, or with the
knowledge or consent of, the insured.
5. The following is added to the DEFINITIONS
Section:
"Incidental medical services" means:
a. Medical, surgical, dental, laboratory, x-ray
or nursing service or treatment, advice
or instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.
"Good Samaritan services" means any emergency
medical services for which no compensation
is demanded or received.
6. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV — COM-
MERCIAL GENERAL LIABILITY CONDI-
TIONS:
The insurance is excess over any valid and
collectible other insurance available to the
insured, whether primary, excess, contingent
or on any other basis, that is available to any
of your "employees" or "volunteer workers"
for "bodily injury" that arises out of providing
or failing to provide "incidental medical ser-
vices", first aid or "Good Samaritan services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section II — Who Is An
Insured.
E. WHO IS AN INSURED — NEWLY ACQUIRED OR
FORMED ORGANIZATIONS
The following replaces Paragraph 4. of SECTION II —
WHO IS AN INSURED:
4. Any organization you newly acquire or
form, other than a partnership, joint venture
or limited liability company, of which you are
the sole owner or in which you maintain the
majority ownership interest, will qualify as a
Named Insured if there is no other insurance
which provides similar coverage to that
organization. However:
a. Coverage under this provision is afforded
only:
(1) Until the 180th day after you acquire
or form the organization or the end of
the policy period, whichever is earlier, if
you do not report such organization in
writing to us within 180 days after you
acquire or form it; or
(2) Until the end of the policy period,
when that date is later than 180 days
after you acquire or form such
organization, if you report such
organization in writing to us within 180
days after you acquire or form it, and we
agree in writing that it will continue to be
a Named Insured until the end of the
policy period;
b. Coverage A does not apply to "bodily
injury" or "property damage" that occurred
before you acquired or formed the
organization; and
c. Coverage B does not apply to "personal in-
jury" or "advertising injury" arising out of an
offense committed before you acquired or
farmed the organization.
F. WHO IS AN INSURED — BROADENED
NAMED INSURED —UNNAMED SUBSIDIARIES
The following is added to SECTION II — WHO IS
AN INSURED:
Any of your subsidiaries, other than a partnership,
joint venture or limited liability company, that is not
shown as a Named Insured in the Declarations is
a Named Insured if you maintain an ownership
interest of more than 50% in such subsidiary on
the first day of the policy period. No such
subsidiary is an insured for "bodily injury" or
"property damage" that occurred, or "personal
injury" or "advertising injury" caused by an offense
committed after the date, if any, during the policy
period, that you no longer maintain an ownership
interest of more than 50% in such subsidiary.
G. BLANKET ADDITIONAL INSURED — OWNERS,
MANAGERS OR LESSORS OF PREMISES
The following is added to SECTION II — WHO IS
AN INSURED:
Any person or organization that is a premises
owner, manager or lessor and that you have
agreed in a written contract or agreement to
include as an additional insured on this Coverage
Part is an insured, but only with respect to liability
for "bodily injury", "property damage", "personal
injury" or "advertising injury" that:
a. Is "bodily injury" or "property damage" that
occurs, or is "personal injury" or "advertising
injury" caused by an offense that is
committed, subsequent to the execution of
that con -tract or agreement; and
b. Arises out of the ownership, maintenance or
use of that part of any premises leased to
you.
The insurance provided to such premises owner,
manager or lessor is subject to the following pro-
visions:
a. The limits of insurance provided to such
premises owner, manager or lessor will be
the minimum limits which you agreed to pro-
vide in the written contract or agreement, or
the limits shown on the Declarations, which-
ever are less.
b. The insurance provided to such premises
owner, manager or lessor does not apply to:
(1) Any "bodily injury" or "property damage"
that occurs, or "personal injury" or
"advertising injury" caused by an offense
that is committed, after you cease to be
a tenant in that premises; or
(2) Structural alterations, new construction or
demolition operations performed by or
on behalf of such premises owner,
lessor or manager.
c. The insurance provided to such premises
owner, manager or lessor is excess over any valid
and collectible other insurance available to such
premises owner, manager or lessor, whether
primary, excess, contingent or on any other basis,
unless you have agreed in the written contract or
agreement that this insurance must be primary to,
or non-contributory with, such other insurance, in
which case this insurance will be primary to, and
non-contributory with, such other insurance. H.
BLANKET ADDITIONAL INSURED — LESSORS
OF LEASED EQUIPMENT
The following is added to SECTION II — WHO IS
AN INSURED:
Any person or organization that is an equipment
lessor and that you have agreed in a written con-
tract or agreement to include as an insured on this
Coverage Part is an insured, but only with respect
to liability for "bodily injury", "property dam -age",
"personal injury" or "advertising injury" that:
a. Is "bodily injury" or "property damage" that
occurs, or is "personal injury" or "advertising
injury" caused by an offense that is
committed, subsequent to the execution of
that con -tract or agreement; and
b. Is caused, in whole or in part, by your acts
or omissions in the maintenance, operation or
use of equipment leased to you by such
equipment lessor.
The insurance provided to such equipment lessor
is subject to the following provisions:
a. The limits of insurance provided to such
equipment lessor will be the minimum limits
which you agreed to provide in the written
contract or agreement, or the limits shown on
the Declarations, whichever are less.
b. The insurance provided to such equipment
lessor does not apply to any "bodily injury" or
"property damage" that occurs, or "personal
injury" or "advertising injury" caused by an of-
fense that is committed, after the equipment
lease expires.
c. The insurance provided to such equipment
lessor is excess over any valid and collectible
other insurance available to such equipment
lessor, whether primary, excess, contingent
or on any other basis, unless you have
agreed in the written contract or agreement
that this insurance must be primary to, or
non-contributory with, such other insurance,
in which case this insurance will be primary
to, and non-contributory with, such other
insurance.
I. BLANKET ADDITIONAL INSURED — STATES
OR POLITICAL SUBDIVISIONS — PERMITS
The following is added to SECTION II — WHO IS
AN INSURED:
Any state or political subdivision that has issued a
permit in connection with operations performed by
you or on your behalf and that you are required
by any ordinance, law or building code to include
as an additional insured on this Coverage Part is
an insured, but only with respect to liability for
"bodily injury", "property damage", "personal in-
jury" or "advertising injury" arising out of such
operations.
The insurance provided to such state or political
subdivision does not apply to:
a. Any "bodily injury," "property damage,"
"personal injury" or "advertising injury" arising
out of operations performed for that state or
political subdivision; or
b. Any "bodily injury" or "property damage"
included in the "products -completed
operations hazard".
J. KNOWLEDGE AND NOTICE OF OCCUR-RENCE
OR OFFENSE
The following is added to Paragraph 2., Duties In
The Event of Occurrence, Offense, Claim or
Suit, of SECTION IV — COMMERCIAL GEN-
ERAL LIABILITY CONDITIONS:
e. The following provisions apply to Paragraph a.
above, but only for the purposes of the
insurance provided under this Coverage Part
to you or any insured listed in Paragraph 1. or
2. of Section II —Who Is An Insured:
(1) Notice to us of such "occurrence" or
offense must be given as soon as
practicable only after the "occurrence" or
offense is known by you (if you are an
individual), any of your partners or
members who is an individual (if you are
a partnership or joint venture), any of
your managers who is an individual (if
you are a limited liability company), any
of your "executive officers" or directors
(if you are an organization other than a
partnership, joint venture or limited
liability company) or any "employee"
authorized by you to give notice of an
"occurrence" or offense.
(2) If you are a partnership, joint venture or
limited liability company, and none of
your partners, joint venture members or
managers are individuals, notice to us of
such "occurrence" or offense must be
given as soon as practicable only after
the "occurrence" or offense is known by:
(a) Any individual who is:
(i) A partner or member of any partnership or joint
venture;
(ii) A manager of any limited liability company; or
(iii) An executive officer or director of any other
organization;
that is your partner, joint venture member or manager;
or
(b) Any "employee" authorized by such partnership,
joint venture, limited li-ability company or other
organization to give notice of an "occurrence" or
offense.
(3) Notice to us of such "occurrence" or of an offense
will be deemed to be given as soon as practicable if it is
given in good faith as soon as practicable to your
workers' compensation insurer. This applies only if you
subsequently give notice to us of the "occurrence" or
offense as soon as practicable after any of the persons
de -scribed in Paragraphs e. (1) or (2) above discovers
that the "occurrence" or offense may result in sums to
which the insurance provided under this Coverage Part
may apply.
However, if this Coverage Part includes an
endorsement that provides limited coverage for
"bodily injury" or "property damage" or pollution
costs arising out of a discharge, release or escape
of "pollutants" which contains a requirement that
the discharge, release or escape of "pollutants"
must be reported to us within a specific number of
days after its abrupt commencement, this
Paragraph e. does not affect that requirement.
K. UNINTENTIONAL OMISSION
The following is added to Paragraph 6.,
Representations, of SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS:
The unintentional omission of, or unintentional
error in, any information provided by you which we
relied upon in issuing this policy will not prejudice
your rights under this insurance. However, this
provision does not affect our right to collect
additional premium or to exercise our rights of
cancellation or non -renewal in accordance with
applicable insurance laws or regulations.
L. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph S., Transfer Of
Rights Of Recovery Against Others To Us, of
SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:
If the insured has agreed in a contract or
agreement to waive that insured's right of recovery
against any person or organization, we waive our
right of recovery against such person or
organization, but only for payments we make
because of:
a. "Bodily injury" or "property damage" that occurs;
or
b. "Personal injury" or "advertising injury" caused
by an offense that is committed;
subsequent to the execution of that contract or
agreement.
M. AMENDED BODILY INJURY DEFINITION
The following replaces the definition of "bodily injury" in
the DEFINITIONS Section:
3. "Bodily injury" means bodily injury, mental
anguish, mental injury, shock, fright,
disability, humiliation, sickness or disease
sustained by a person, including death
resulting from any of these at any time.
N. CONTRACTUAL LIABILITY — RAILROADS
1. The following replaces Paragraph c. of the
definition of "insured contract" in the DEFINI-
TIONS Section:
c. Any easement or license agreement;
2. Paragraph f.(1) of the definition of "insured contract"
in the DEFINITIONS Section is deleted.
Southwest Construction & Property Management, Inc.
Issue Date 05/01/2018
Policy Number: CO -2907M379
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 II) 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",
"property damage" or "personal injury"; and
b) If, and only to the extent that, the injury or
damage is caused by acts 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.
2. 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 insurance described in
Section III — Limits Of Insurance.
b) The insurance provided to the additional in-
sured does not apply to "bodily injury", "prop-
erty damage" or "personal injury" arising out
of the rendering of, or failure to render, any
professional architectural, engineering or sur-
veying services, including:
L 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 failing 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
"property 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 time 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
cover 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-
tional insured when that person or organization is
an additional insured under such 'other insur-
ance".
4. 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 St. Paul Travelers Companies, Inc. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
I. How, when and where the 'occurrence"
or offense took place;
iii. 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:
L Immediately record the specifics of the
claim or "suit' and the date received; and
ii. 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 practicable.
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
TRAVELERS J� WORKERS COMPENSATION
AND
ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY
HARTFORD CT 06183
ENDORSEMENT WC 00 03 13 (00) - 001
POLICY NUMBER: UB -9J590696 -18-26-G
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
SCHEDULE
DESIGNATED PERSON:
DESIGNATED ORGANIZATION:
ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS
WAIVER.
DATE OF ISSUE: 12-22-17 ST ASSIGN: PAGE 1 OF
RECEIAVED
SOUTHWEST CONSTRUCTION
NOV 1 3 2018 1213 San Mateo Avenue
San Bruno, CA 94066
CITY ATTORR-EY Phone #: (650) 877-0717 Fax #: (650) 877-0747
TRANSMITTAL COVER SHEET
TO: City of San Rafael - DPW
111 MorPhew Street
San Rafael. CA 94915-1560
RECEIVED
0 0 9 2019
eC B, pF SAN RAF EL
Date: 11/5/2018
DATE
Attn: Dave Nicholson
Re: Install New Walking Pads at Terra Linda
Community Center
3
11/5/18
WE ARE SENDING: ® Attached ❑ Under separate cover via
❑ Shop Drawings ❑ Prints ❑ Plans
❑ Copy of Letter ❑ Change Order ❑ Submittals
❑ Samples
® Other
❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
3
11/5/18
1
Signed Contract Agreement Signature Page
THESE ARE TRANSMITTED:
❑ For approval
® For your records
® As requested
❑ For review and comments
❑ FOR BIDS DUE:
REMARKS:
❑ Approved as submitted
❑ Approved as noted
❑ Returned for corrections
❑ Other:
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ Prints returned after loan to us
cc: SIGNED: Karen MoralesMl�%
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and aouroval in the order shown below
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department: DPW
Project Manager: Dave Nicholson
Extension: 3454
Contractor Name: Southwest Construction & Property Management, Inc.
Contractor's Contact: James Gardner
Contact's Email: james.gardner@southwestcpm.com
❑ FPPC: Check if Contractor/Consultant must file Form 700
Step
RESPONSIBLE
DESCRIPTION
COMPLETED
REVIEWER
DEPARTMENT
DATE
Check/Initial
1
Project Manager
a. Email PINS Introductory Notice to Contractor
10/1/2018
❑x
b. Email contract (in Word) & attachments to City
DN
Atty c/o Laraine.Gittens@cityofsanrafael.org
10/2/2018
❑X
2
City Attorney
a. Review, revise, and comment on draft agreement
❑X LG
and return to Project Manager
10/2/2018
❑x LG
b. Confirm insurance requirements, create Job on
PINS, send PINS insurance notice to contractor
3
Department Director
Approve content of agreement
❑x BG
4
Project Manager
Forward three (3) originals of final agreement to
❑X DN
contractor for their signature
5
Project Manager
When necessary, * contractor -signed agreement
❑X N/A
agendized for Council approval
❑x
*PSA> $20,000; or Purchase > $35,000; or
Or
DN
Public Works Contract > $125,000
Date of Council approval
PRINT
CONTINUE ROUTING PROCESS WITH HARD COPY
6
Project Manager
Forward signed original agreements to City
Attorney with printed copy of this routing form
7
City Attorney
Review and approve hard copy of signed
City Attorney
agreement
Review and approve insurance in PINS , and bonds
8
(for Public Works Contracts)
9
City Manager/ Mayor
Agreement executed by Council authorized official
CZ *1 u crv-
t e s