HomeMy WebLinkAboutPW Albert Park Restrooms & Wheelchair LiftCITY OF SAN RAFAEL
Department of Public Works
111 Morphew Avenue
San Rafael, CA 94901
Public Works Contract for Projects up to $175,000
This public works contract ("Contract") is entered into by and between the City of San Rafael ("City") and
Golden Empire Concrete Products, Inc. dba StructureCast ("Contractor"), a corporation authorized to do
business in Paliforni, for work on the City's Albert Park Restrooms & Wheelchair Lift ("Project"), and is
effective oo A 2W ("Effective Date").
The parties agree as follows:
1. Scope of Work. Contractor will perform and provide all labor, materials, equipment, supplies,
transportation, and any and all other items or services necessary to perform and complete the work
required for the Project ("Work"), as specified in Exhibit A, Scope of Work, and according to the terms
and conditions of this Contract, including all attachments to the Contract and any other documents and
statutes incorporated by reference. To the extent that any attachment contains provisions that conflict or
are inconsistent with the terms set forth in the body of this Contract, the Contract terms will control. This
Project requires a valid California contractor's license for the following classification (s): B
2. Contract Documents. The Contract Documents incorporated into this Contract include and are
comprised of all of the documents listed below:
2.1 Notice Inviting Bids;
2.2 Contract;
2.3 Addenda, if any;
2.4 Exhibit A — Scope of Work;
2.5 Exhibit B — Payment, Performance, and Bid Bonds;
2.6 Exhibit C — Noncollusion Declaration;
2.7 Exhibit D — Bid Schedule;
2.8 Exhibit E — Subcontractor List.
3. Contract Price. As full and complete compensation for Contractor's timely performance and
completion of the Work in strict accordance with the terms and conditions of the Contract, City will pay
Contractor $172,500 (the "Contract Price") for all of Contractor's direct and indirect costs to perform the
Work, including all labor, materials, supplies, equipment, taxes, insurance, bonds and all overhead costs,
in accordance with the payment provisions contained herein.
3.1 Payment. Contractor must submit an invoice on the first day of each month during the
Contract Time, defined in Section 3 below, and/or upon completion, for the Work performed during the
preceding month, itemizing labor, materials, equipment and any incidental costs incurred. Contractor
warrants that title to all work, materials and equipment incorporated into the Work will pass to City free of
any claims, liens, or encumbrances upon payment to Contractor.
3.2 Payment and Performance Bonds. If the Contract Price is over $25,000, then Contractor
must provide City with a payment bond and a performance bond using the bond forms included in this
Contract as Exhibit B, Bond Forms, and submit the bonds with the executed Contract. Each bond must
be issued by a surety admitted in California. If an issuing surety cancels a bond or becomes insolvent,
Contractor must provide a substitute bond from a surety acceptable to City within seven days after written
notice from City. If Contractor fails to substitute an acceptable surety within the specified time, City may,
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Page 1
Approved by City Attorney, dated 02/27/2020
in its sole discretion and without prior notice to Contractor, purchase such bond(s) at Contractor's
expense and deduct the cost from payments otherwise due to Contractor, or terminate the Contract.
4. Time for Completion. Contractor will fully complete the Work within six months from the date
the City authorizes Contractor to proceed with the Work ("Contract Time").
5. Liquidated Damages. If Contractor fails to complete the Work within the Contract Time,
Contractor must pay liquidated damages in the amount of $500 per day for each day of unexcused delay
in completion.
6. Standard of Care. All Work must be provided in a manner that meets or exceeds the standard of
care applicable to the same type of work in the City of San Rafael. Contractor must promptly correct, at
Contractor's sole expense, any Work that the City determines is deficient or defective.
7. Permits and Licenses. Contractor, at its sole expense, must obtain and maintain during the
term of this Contract, all appropriate permits, certificates and licenses including, but not limited to, the
required California contractor's license and a City business license.
8. Indemnification. Contractor will indemnify, defend with counsel acceptable to City, and hold
harmless to the full extent permitted by law, City, its governing body, officers, agents, employees, and
volunteers from and against any and all liability, demands, loss, damage, claims, settlements, expenses,
and costs (including, without limitation, attorney fees, expert witness fees, and costs and fees of litigation)
(collectively, "Liability") of every nature arising out of or in connection with Contractor's acts or omissions
with respect to this Contract, except such Liability caused by the active negligence, sole negligence, or
willful misconduct of the City. This indemnification obligation is not limited by any limitation on the amount
or type of damages or compensation payable under Workers' Compensation or other employee benefit
acts, or by insurance coverage limits, and will survive the expiration or early termination of this Contract.
City will notify Contractor of any third -party claim pursuant to Public Contract Code section 9201.
9. Insurance. Contractor will, at all times under this Contract, maintain the insurance coverage
required in this section to cover the activities of Contractor and any subcontractors relating to or arising
from performance of the Work. Each policy must be issued by a company licensed to do business in
California, and with a strength and size rating from A.M. Best Company of A -VIII or better. Contractor
must provide City with certificates of insurance and required endorsements as evidence of coverage with
the executed Contract, or through the PINSAdvantage website httr)s://www.pinsadvantacie.com/ upon
request by the City, and before the City authorizes Contractor to proceed with the Work.
9.1 Workers' Compensation. Statutory coverage is required by the California Workers'
Compensation Insurance and Safety Act. If Contractor is self-insured, it must provide its duly authorized
Certificate of Permission to Self -Insure. In addition, Contractor must provide employer's liability insurance
with limits of no less than one million dollars ($1,000,000) per accident for bodily injury or disease.
9.2 Liability. Commercial General Liability ("CGL") insurance issued on an occurrence basis,
including coverage for liability arising from Contractor's or its subcontractor's acts or omissions in
performing the Work, including Contractor's protected coverage, blanket contractual, products and
completed operations, broad form property damage, vehicular coverage, and employer's non -ownership
liability coverage, with limits of at least $1,000,000 per occurrence and $2,000,000 general aggregate.
9.3 Automotive. Commercial automotive liability coverage for owned, non -owned and hired
vehicles must provide coverage of at least $1,000,000 combined single limit per accident for bodily injury,
death, or property damage.
9.4 Subrogation Waiver. Each required policy must include an endorsement that the insurer
waives any right of subrogation it may have against the City or the City's insurers.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
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9.5 Required Endorsements. The CGL policy and the automotive liability policy must include
the following specific endorsements:
(1) The City, including its Council, officials, officers, employees, agents, volunteers and
consultants (collectively, "Additional Insured") must be named as an additional insured for
all liability arising out of the operations by or on behalf of the named insured, and the policy
must protect the Additional Insured against any and all liability for personal injury, death or
property damage or destruction arising directly or indirectly in the performance of the
Contract.
(2) The inclusion of more than one insured will not operate to impair the rights of one
insured against another, and the coverages afforded will apply as though separate policies
have been issued to each insured.
(3) The insurance provided is primary and no insurance held or owned by City may be
called upon to contribute to a loss ("primary and non-contributory").
(4) Any umbrella or excess insurance must contain or be endorsed to contain a provision
that such coverage will also apply on a primary or non-contributory basis for the benefit of
City before the City's own insurance or self-insurance will be called upon to protect it as a
named insured.
(5) This policy does not exclude explosion, collapse, underground excavation hazard, or
removal of lateral support.
10. Labor Code Compliance. Unless the Contract Price is $1,000 or less, the Contract is subject to
all applicable requirements of Chapter 1 of Part 7 of Division 2 of the Labor Code, beginning at section
1720, and the related regulations, including but not limited to requirements pertaining to wages, working
hours and workers' compensation insurance. Contractor must also post all job site notices required by
laws or regulations pursuant to Labor Code section 1771.4.
10.1 Prevailing Wages. Each worker performing Work under this Contract that is covered under
Labor Code section 1720 or 1720.9, must be paid at a rate not less than the prevailing wage as defined in
sections 1771 and 1774 of the Labor Code. The prevailing wage rates are on file with the City Engineer's
office and are available online at http://www.dir.ca.gov/DLSR. Pursuant to Labor Code section 1775,
Contractor and any subcontractor will forfeit to City as a penalty up to $200 for each calendar day, or
portion of a day, for each worker paid less than the applicable prevailing wage rate, in addition to paying
each worker the difference between the applicable wage rate and the amount actually paid.
10.2 Working Day. Pursuant to Labor Code section 1810, eight hours of labor consists of a
legal day's work. Pursuant to Labor Code section 1813, Contractor will forfeit to City as a penalty the sum
of $25 for each day during which a worker employed by Contractor or any subcontractor is required or
permitted to work more than eight hours during any one calendar day, or more than 40 hours per
calendar week, unless such workers are paid overtime wages under Labor Code section 1815. All Work
must be carried out during regular City working days and hours unless otherwise specified in Exhibit A or
authorized in writing by City.
10.3 Payroll Records. Contractor and its subcontractors must maintain certified payroll records
in compliance with Labor Code sections 1776 and 1812, and all implementing regulations promulgated by
the Department of Industrial Relations ("DIR"). For each payroll record, Contractor and its subcontractors
must certify under penalty of perjury that the information in the record is true and correct, and that it has
complied with the requirements of Labor Code sections 1771, 1811, and 1815. Unless the Contract Price
is under $25,000, Contractor must electronically submit certified payroll records to the Labor
Commissioner as required under California law and regulations.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Page 3
Approved by City Attorney, dated 02/27/2020
10.4 Apprentices. If the Contract Price is $30,000 or more, Contractor must comply with the
apprenticeship requirements in Labor Code section 1777.5.
10.5 DIR Monitoring, Enforcement, and Registration. This Project is subject to compliance
monitoring and enforcement by the DIR pursuant to Labor Code section 1725.5, and, subject to the
exception set forth below, Contractor and any subcontractors must be registered with the DIR to perform
public works projects. The registration requirements of Labor Code section 1725.5 do not apply if the
Contract Price is for under $25,000.
11. Workers' Compensation Certification. Under Labor Code section 1861, by signing this
Contract, Contractor certifies as follows: "I am aware of the provisions of Labor Code section 3700 which
require every employer to be insured against liability for workers' compensation or to undertake self-
insurance in accordance with the provisions of that code, and I will comply with such provisions before
commencing the performance of the Work on this Contract."
12. Termination.
12.1 Termination for Convenience. City reserves the right to terminate all or part of the
Contract for convenience upon written notice to Contractor. Upon receipt of such notice, Contractor must:
immediately stop the Work, including under any terms or conditions that may be specified in the notice;
comply with City's instructions to protect the completed Work and materials; and use its best efforts to
minimize further costs. In the event of City's termination for convenience, Contractor waives any claim for
damages, including for loss of anticipated profits from the Project. If City terminates the Contract for
convenience, City will only owe Contractor payment for the Work satisfactorily performed before Contract
termination, as well as five percent of the total value of the Work performed as of the date of notice of
termination or five percent of the value of the Work yet to be completed, whichever is less, which is
deemed to cover all overhead and profit to date.
12.2 Termination for Default. The City may terminate this Contract for cause for any material
default. Contractor may be deemed in default for a material breach of or inability to perform the Contract,
including Contractor's refusal or failure to supply sufficient skilled workers, proper materials, or equipment
to perform the Work within the Contract Time; refusal or failure to make prompt payment to its employees,
subcontractors, or suppliers or to correct rejected work; disregard of laws, regulations, ordinances, rules,
or orders of any public agency with jurisdiction over the Project; lack of financial capacity to complete the
Work within the Contract Time; or responsibility for any other material breach of the Contract
requirements. If City terminates the Contract for cause, City will only owe Contractor payment for the
Work satisfactorily performed before Contract termination.
13. Dispute Resolution. Any dispute arising under or related to this Contract is subject to the
dispute resolution procedures of Public Contract Code sections 9401 and 20104 et. seq., which are
incorporated by reference.
14. Waiver. A waiver by City of any breach of any term, covenant, or condition in this Contract will
not be deemed a waiver of any subsequent breach of the same or any other term, covenant, or condition
contained herein, regardless of the character of any such breach.
15. Warranty. Contractor guarantees and warrants the Work and the materials used or provided for
the Project for a period of one year, beginning upon City's acceptance of the Work for the Project as
complete ("Warranty Period"). During the Warranty Period, upon notice from the City of any defect in the
Work or the materials, Contractor must, at its sole expense, promptly repair or replace the defective Work
or materials, including repair or replacement of any other Work or materials that is or are displaced or
damaged during the warranty work, excepting any damage resulting from ordinary wear and tear.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Page 4
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16. Worksite Conditions.
16.1 Clean and Safe. Contractor must maintain the Work site and staging and storage areas in
a clean and neat condition and must ensure it is safe and secure. On a daily basis the Contractor must
remove and properly dispose of debris and waste materials from the Work site.
16.2 Inspection. Contractor will make the Work accessible at all times for inspection by the City
16.3 Hazardous Materials. Unless otherwise specified in the Contract documents, this Contract
does not include the removal, handling, or disturbance of any asbestos or other hazardous materials, as
identified by any federal, state, or local law or regulation. If Contractor encounters materials on the
Project site that Contractor reasonably believes to be asbestos or other hazardous materials, and the
asbestos or other hazardous materials have not been rendered harmless, Contractor may continue Work
in unaffected areas reasonably believed to be safe, but must immediately cease Work on the area
affected and report the condition to City. No asbestos, asbestos -containing products or other hazardous
materials may be used in performance of the Work.
16.4 Utilities, Trenching and Excavation. As required by Government Code section 4215, if,
during the performance of the Work, Contractor discovers utility facilities not identified by City in the
Contract documents, Contractor must immediately provide written notice to City and the utility. In
performing any excavations or trenching work, Contractor must comply with all applicable operator
requirements in Government Code sections 4216 through 4216.5. If the trenching or excavation extends
deeper than four feet below the surface, then it must also comply with Public Contract Code section 7104.
17. Records. Unless otherwise specified in Exhibit A, Contractor must maintain and update a
separate set of as -built drawings while the Work is being performed, showing changes from the Work as
planned in Exhibit A, or any drawings incorporated into this Contract. The as -built drawings must be
updated as changes occur, on a daily basis if necessary.
18. Conflicts of Interest. Contractor, its employees, subcontractors and agents, may not have,
maintain or acquire a conflict of interest in relation to this Contract in violation of any City ordinance or
policy or in violation of any California law, including under Government Code section 1090 et seq. and
under the Political Reform Act as set forth in Government Code section 81000 et seq. and its
accompanying regulations. Any violation of this Section constitutes a material breach of the Contract.
19. Non -Discrimination. No discrimination will be made in the employment of persons under this
Contract because of the race, color, national origin, ancestry, religion, gender or sexual orientation of
such person.
20. Independent Contractor. City and Contractor intend that Contractor will perform the Work under
this Contract as an independent contractor. Contractor is solely responsible for its means and methods in
performing the Work. Contractor is not an employee of City and is not entitled to participate in health,
retirement or any other employee benefits from City.
21. Assignment of Unfair Business Practice Claims. Under Public Contract Code section 7103.5,
Contractor and its subcontractors agree to assign to City all rights, title, and interest in and to all causes
of action it may have under section 4 of the Clayton Act (15 U.S.C. section 15) or under the Cartwright
Act (Chapter 2 (commencing with section 16700) of Part 2 of Division 7 of the Business and Professions
Code), arising from purchases of goods, services, or materials pursuant to the Contract or any
subcontract. This assignment will be effective at the time City tenders final payment to Contractor,
without further acknowledgement by the parties.
22. Notice. Any notice, billing, or payment required by or pursuant to the Contract documents must
be made in writing, signed, dated and sent to the other party by personal delivery, U.S. Mail, a reliable
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Page 5
Approved by City Attorney, dated 02/27/2020
overnight delivery service, or by email as a PDF (or comparable) file. Notice is deemed effective upon
delivery unless otherwise specified. Notice for each party must be given as follows:
City:
Address:
111 Morphew Street
City/State/Zip:
San Rafael, CA 94901
Phone:
(415) 485-3373
Attn:
Fabiola Guillen-Urfer. Sr. Project Manager
Email:
Fabiola.GuillenUrfer cit ofsanrafael.or
Contractor:
Name:
Golden Empire Concrete Products, Inc. dba StructureCast
Address:
8261 McCutchen Road
City/State/Zip:
Bakersfield, CA 93311
Phone:
(661) 833-4490
Attn:
Anna M. Dezember
Email:
annaCdstructurecast.com
23. General Provisions.
23.1 Compliance with All Laws. Contractor will comply with all applicable federal, state, and
local laws and regulations including, but not limited to, unemployment insurance benefits, FICA laws,
conflict of interest laws, and local ordinances. Work may only be performed by qualified and experienced
workers who are not employed by the City and who do not have any contractual relationship with City,
with the exception of this Contract.
23.2 Provisions Deemed Inserted. Every provision of law required to be inserted in the
Contract is deemed to be inserted, and the Contract will be construed and enforced as though such
provision has been included. If it is discovered that through mistake or otherwise that any required
provision was not inserted, or not correctly inserted, the Contract will be deemed amended accordingly.
23.3 Assignment and Successors. Contractor may not assign its rights or obligations under
this Contract, in part or in whole, without City's written consent. This Contract is binding on Contractor's
and City's lawful heirs, successors and permitted assigns.
23.4 Third Party Beneficiaries. There are no intended third -party beneficiaries to this Contract.
23.5 Governing Law and Venue. This Contract will be governed by California law and venue
will be in the Superior Court of Marin County, and no other place.
23.6 Amendment. No amendment or modification of this Contract will be binding unless it is in a
writing duly authorized and signed by the parties to this Contract.
23.7 Integration; Severability. This Contract and the Contract documents incorporated herein,
including authorized amendments or change orders thereto, constitute the final, complete, and exclusive
terms of the agreement between City and Contractor. If any provision of the Contract documents, or
portion of a provision, is determined to be illegal, invalid, or unenforceable, the remaining provisions of
the Contract documents will remain in full force and effect.
23.8 Authorization. Each individual signing below warrants that he or she is authorized to do so
by the party that he or she represents, and that this Contract is legally binding on that party. If Contractor
is a corporation, signatures from two officers of the corporation are required pursuant to California
Corporation Code section 313.
[Signatures are on the following page.]
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Page 6
Approved by City Attorney, dated 02/27/2020
The parties agree to this Contract as witnessed by the signatures below:
CITY:
s/ ^-
Jim ch City Man /r
Date: '� — L1
Attest:
s/
k. &V.A41n:i
firLindsay Lara, City Clerk
Date: b -A
Approv d as to for
s/ \
Robert F. Epstein, City Attorney
Date:—V-2
CONTRACTOR: Golden Empire Concrete Products Inc dba StructureCast
Business Name
s/ .cY rltu� �� a�YGf�oit
Anna M. Dezember, President
Name/Title
Date: 08/17/2021
s/ l3NPyLt (7
Brent M. Dezember, Corporate Secretary
Name/Title
Date: 08/17/2021
774870 06/30/2022
Seal:
Contractor's California License Number(s) and Expiration Date(s)
Exhibit A: Scope of Work
Exhibit B: Bond Forms
Exhibit C: Noncollusion Declaration
Exhibit D: Bid Schedule
Exhibit E: Subcontractor List
END OF CONTRACT
Albert Park Restrooms & Wheelchair Lift
City Project #: 11372
Approved by City Attorney, dated 02/27/2020
Up to $175,000 Contract
Page 7
Exhibit A
SCOPE OF WORK
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Scope of Work
Approved by City Attorney, dated 02/27/2020
Exhibit A
STRUCTURE CAST
001
...High Performance Precast
'ING PRECAST SOLUTIONS SINCE 1974 CALIFORNIA LICENSE # 774870
EN OWNED SMALL BUSINESS - WOSB 160389 DIR #100000000308
EN BUSINESS ENTERPRISE - WBE 1600356 CA CERTIFIED SBE #42811
To: Aida Fabiola Guillen — Sr Project Manager — City of San Rafael
Subject: Precast Restroom — Four room — Four Toilet Gender Neutral Restroom
Item Qty. Description Price
1 1 2 ADA & 2 Regular Single Occupant Gender Neutral Restrooms $172,500.00
Four units in a row 11' X 28'
Delivery included add appropriate sales tax if required
Inclusions, Exclusions and Clarifications: Please review carefully
— Submittals, shop drawings and engineering included based on the design loads and the geotechnical report
provided. Design and engineering by a licensed California PE.
— Delivery to jobsite included; unloading and setting included.
— Building pad design included, pad graded and compacted by others.
— Building complete with precast concrete walls, floor and roof. Floor and Roof are post -tensioned with the
patented Easi Set System. Exterior walls are a texture and color to be determined.
— 5000 psi concrete and ASTM A615 with Zypex waterproofing admixture, grade 60 reinforcement steel.
Joint caulking inside and out with Sikaflex-1A and all panel connections are welded using stainless steel
connections.
— Floors are coved and painted with two-part epoxy. Interior walls are stained with a color to be determined.
— All restroom mirror, toilet roll holder, ADA grab Bars and soap dispenser are stainless steel.
— Toilets and sinks are porcelain. Electric hand dryer and GFI outlet in each room. Toilet paper holders, seat
cover paper holders, soap dish and mirror in each restroom.
— Doors are vented galvanized steel doors with stainless pull handles and deadbolts. Doors have closers, drip
caps and kick plates.
— LED dusk to dawn lighting above each door and motion activated LED lighting in each room. Each room is
vented with a motion activated fan in each room.
CJ
STRUCTURE CAST
...High Performance Precast
CREATING PRECAST SOLUTIONS SINCE 1974 CALIFORNIA LICENSE # 774870
WOMEN OWNED SMALL BUSINESS — WOSB 160389 DIR #100000000308
WOMEN BUSINESS ENTERPRISE — WBE 1600356 CA CERTIFIED SBE #42811
Subject: Precast Restroom — Four room — Four Toilet Gender Neutral Restroom
Inclusions, Exclusions and Clarifications (continued):
— Access required for tractor and a 40' lowboy trailer and 120 -ton crane.
— Monthly progress payments shall be made for completed products stored at StructureCast.
— Setting is done with 120 -ton hydraulic crane. Crane and delivery scheduling require a 5 -day lead time.
— This is a four-page proposal, our terms are a part of this proposal and cannot be severed.
— Each restroom has a sink, faucet, mirror, soap dispenser, hand dryer, drain and vent.
Exclusions:
— Barricades, flagmen, traffic control, if required, site preparation and compaction, site grading or setting
lines and grades, site plans drawings, permits.
— Site foundation and grading. Site repair, prep and re -grading from delivery is by others.
— All underground conduits, plumbing electrical or water.
— StructureCast is a PCI and NPCA Certified Plant, outside testing by others if required.
— If Performance and Payment Bond is required, cost to be paid by the Customer.
Delivery Schedule:
— Drawings and submittals will be delivered for approval by Owner within 20 calendar days of receipt and
acceptance of purchase order.
— Any resubmittal will be returned to Owner with corrections within 10 calendar days.
— Buildings will be procured and manufactured for delivery to project site 30 calendar days from complete
approval of submittals and a notice to proceed.
— Building will be installed in one day at site when ready. 5 days are required to coordinate crane and delivery
permits. Installation is continuous.
— All warranty and As -build documentation will be delivered to Owner within two weeks of completion of the
building.
PRECAST BUILDINGS
- npr-u
CJ
STRUCTURE CAST
...High Performance Precast
'ING PRECAST SOLUTIONS SINCE 1974 CALIFORNIA LICENSE # 774870
EN OWNED SMALL BUSINESS — WOSB 160389 DIR #100000000308
EN BUSINESS ENTERPRISE — WBE 1600356 CA CERTIFIED SBE #42811
Subject: Precast Restroom — Four room — Four Toilet Gender Neutral Restroom
Terms: Net 30 for product produced and stored in the StructureCast yard. A 2% prompt payment discount is allowed for
invoices paid within 10 days. Payments on billing are to be current before delivery commences. No Retention. If it
becomes necessary to enforce the provisions of this agreement or to obtain redress for the breach or violation of any of
its provisions, StructureCast shall be entitled to recover from the other party all costs and expenses associated with such
proceedings, including reasonable attorney's fees and interest. If liquidated damage clauses are to be a part of
StructureCast's contract, add 5 times their daily amount to the total of this proposal.
Scheduling of delivery: StructureCast will send a shipping confirmation for acceptance by the owner to be signed and
returned three days prior to delivery. The shipping confirmation indicates that the site is prepared and compacted for
acceptance of the building and that the crane and truck and trailer have proper and safe access to the site for unloading
and setting the building.
Delivery Standby Time: One installation set up is included in this proposal. Should StructureCast be delayed because of
corrections needed due to misplaced utilities, improper site preparation, site obstructions, or extra work not in our
scope, the crew will be charged at $400. per hour. The crane will be charged at $500 per hour and trucking standby is
charged at $175. per hour.
Proposal: Proposal is valid for 90 days from the first date mentioned. By accepting this proposal and, or awarding a
contract to StructureCast, you agree that this proposal document will be a part of your formal contract whether such
contract so provides or contains an integration clause.
Service Charge: Service Charge of 1.5% monthly will be assessed on all past due accounts.
Proposal submitted by: Brent Dezember 661-301-2624 brent@structurecast.com
This proposal document must accompany all orders with the proper acknowledgement and acceptance of the above terms
and conditions and are verified by the signature below. All precast products will be produced as per the approved
StructureCast shop drawings. It is the sole responsibility of the contractor to confirm that the StructureCast shop drawings
meet or exceed all plan and specification requirements. Should any terms of this proposal be changed in the customers
proposed purchase order StructureCast reserves the right to rescind the proposal.
gwor
Signature Date
r� PRECAST BUILDINGS 1
PCI Easi-Set - Easi-Span n Pr. "
Cj
STRUCTURE CAST
...High Performance Precast
ING PRECAST SOLUTIONS SINCE 1974
:N OWNED SMALL BUSINESS — WOSB 160389
:N BUSINESS ENTERPRISE — WBE 1600356
Outfitting Features
Porcelain Toilets
Porcelain Sinks
Chrome Faucets
Steel Toilet Seat Dispenser
Electric Hand Dryers
Soap Dispenser
Floor Drain
Mirror
Inline Filters
Concealed Flush Valve
Water Hammer Arrestor
PVC vent Pipe
Copper Pipe
D box
trap primer
Main shut off valve
Exterior Light — dusk to dawn
Interior Lights
Exhaust Fan
GFI Outlets
Motion Sensor lighting switch
Panel
Exterior penetrating Stain & Sealer
Interior Penetrating Stain & Sealer
Two-part Epoxy Floor Paint
Stainless steel wall connections
Coved flooring
Blok Guard Anti -Graffiti Coating
CALIFORNIA LICENSE # 774870
DIR #100000000308
CA CERTIFIED SBE #42811
FA PRECAST BUMBINGS
PCI Easi-Set -Easi-Span A
Exhibit B
BONDFORMS
Required for contracts over $25, 000.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Bond Forms
Approved by City Attorney, dated 02/27/2020
Payment Bond
City of San Rafael ("City") and ("Contractor") have entered into a
contract, dated 20_ ("Contract") for work on the
("Project"). The Contract is incorporated by reference into this Payment Bond ("Bond").
1. General. Under this Bond, Contractor as principal and
its surety ("Surety"), are bound to City as obligee in an amount not less than
S under California Civil Code sections 9550, et seq.
2. Surety's Obligation. If Contractor or any of its subcontractors fails to pay any of the
persons named in California Civil Code section 9100 amounts due under the
Unemployment Insurance Code with respect to work or labor performed under the
Contract, or for any amounts required to be deducted, withheld, and paid over to the
Employment Development Department from the wages of employees of Contractor and its
subcontractors, under California Unemployment Insurance Code section 13020, with
respect to the work and labor, then Surety will pay for the same.
3. Beneficiaries. This Bond inures to the benefit of any of the persons named in California
Civil Code section 9100, so as to give a right of action to those persons or their assigns in
any suit brought upon this Bond. Contractor must promptly provide a copy of this Bond
upon request by any person with legal rights under this Bond.
4. Duration. If Contractor promptly makes payment of all sums for all labor, materials, and
equipment furnished for use in the performance of the Work required by the Contract, in
conformance with the time requirements set forth in the Contract and as required by
California law, Surety's obligations under this Bond will be null and void. Otherwise,
Surety's obligations will remain in full force and effect.
5. Waivers. Surety waives any requirement to be notified of alterations to the Contract or
extensions of time for performance of the Work under the Contract. Surety waives the
provisions of Civil Code sections 2819 and 2845. City waives requirement of a new bond
for any supplemental contract under Civil Code section 9550. Any notice to Surety may be
given in the manner specified in the Contract and delivered or transmitted to Surety as
follows:
Attn:
Address:
City/State/Zip:
Phone:
Fax:
Email:
6. Law and Venue. This Bond will be governed by California law, and any dispute pursuant
to this Bond will be venued in the Superior Court of Marin County, and no other place.
Surety will be responsible for City's attorneys' fees and costs in any action to enforce the
provisions of this Bond.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Payment Bond
Approved by City Attorney, dated 02/27/2020
7. Effective Date; Execution. This Bond is entered into and is effective on _
20_. Three identical counterparts of this Bond, each of which is deemed an original for all
purposes, are hereby executed and submitted.
SURETY:
Business Name
s/
Name/Title
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR:
Business Name
s/
Name/Title
s/
Name/Title
APPROVED BY CITY:
s/
Name/ Fltle
END OF PAYMENT BOND
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Payment Bond
Approved by City Attorney, dated 02/27/2020
Performance Bond
City of San Rafael ("City") and ("Contractor") have entered into a
contract, dated , 20 ("Contract") for work on the
("Project"). The Contract is incorporated by reference into this Performance Bond ("Bond").
General. Under this Bond, Contractor as Principal and , its
surety ("Surety"), are bound to City as obligee for an amount not less than $
By executing this Bond, Contractor and Surety bind themselves and their respective heirs,
executors, administrators, successors and assigns, jointly and severally, to the provisions of this
Bond.
2. Surety's Obligations; Waiver. If Contractor fully performs its obligations under the Contract,
including its warranty obligations under the Contract, Surety's obligations under this Bond will
become null and void upon City's acceptance of the Project, provided Contractor has timely
provided a warranty bond as required under the Contract. Otherwise Surety's obligations will
remain in full force and effect until expiration of the one year warranty period under the Contract.
Surety waives any requirement to be notified of and further consents to any alterations to the
Contract made under the applicable provisions of the Contract documents, including changes to the
scope of Work or extensions of time for performance of Work under the Contract. Surety waives
the provisions of Civil Code sections 2819 and 2845.
3. Application of Contract Balance. Upon making a demand on this Bond for completion of the
Work prior to acceptance of the Project, City will make the Contract Balance available to Surety for
completion of the Work under the Contract. For purposes of this provision, the Contract Balance is
defined as the total amount payable by City to Contractor as the Compensation minus amounts
already paid to Contractor, and minus any liquidated damages, credits, or backcharges to which
City is entitled under the terms of the Contract.
4. Contractor Default. Upon written notification from City that Contractor is in default under the
Contract, time being of the essence, Surety must act within seven calendar days of receipt of the
notice to remedy the default through one of the following courses of action:
4.1 Arrange for completion of the Work under the Contract by Contractor, with City's consent,
but only if Contractor is in default solely due to its financial inability to complete the Work;
4.2 Arrange for completion of the Work under the Contract by a qualified contractor
acceptable to City, and secured by performance and payment bonds issued by an admitted
surety as required by the Contract documents, at Surety's expense; or
4.3 Waive its right to complete the Work under the Contract and reimburse City the amount
of City's costs to have the remaining services completed.
5. Surety Default. If Surety defaults on its obligations under the Bond, City will be entitled to recover
all costs it incurs due to Surety's default, including legal, design professional, or delay costs.
6. Notice. Notice to Surety must be given or made in writing and sent to the Surety via personal
delivery, U.S. Mail, or a reliable overnight delivery service, or by email as a PDF (or comparable)
file. Notice is deemed effective upon delivery unless otherwise specified. Notice for the Surety
must be given as follows:
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Performance Bond
Approved by City Attorney, dated 02/27/2020
Attn:
Address:
City/State/Zip:
Phone:
Fax:
Email
7. Law and Venue. This Bond will be governed by California law, and any dispute pursuant to this
Bond will be venued in the Superior Court of Marin County, and no other place. Surety will be
responsible for City's attorneys' fees and costs in any action to enforce the provisions of this Bond.
8.
Effective Date; Execution. This Bond is entered into and effective on
20 . Three identical counterparts of this Bond, each of which is deemed an original for all
purposes, are hereby executed and submitted.
SURETY:
Business Name
s/
Name/Title [print]
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR: _
Business Name
s/
Name/Title
s/
Name/Title
APPROVED BY CITY:
s/
Name/Title
END OF PERFORMANCE BOND
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Performance Bond
Approved by City Attorney, dated 02/27/2020
Bid Bond
("Bidder") has submitted a bid,
dated , 20 ("Bid"), to the City of San Rafael ("City") for work on
the ("Project'). Under this duly executed bid bond ("Bid Bond"), Bidder as Principal and
its surety ("Surety"), are bound to City as obligee in the penal sum
of ten percent of the maximum amount of the Bid (the "Bond Sum"). Bidder and Surety bind themselves
and their respective heirs, executors, administrators, successors and assigns, jointly and severally, as
follows:
General. If Bidder is awarded the Contract for the Project, Bidder will enter into the Contract with
City in accordance with the terms of the Bid.
Submittals. Within ten days following issuance of the Notice of Award to Bidder, Bidder must
submit to City the following:
2.1 Contract. The executed Contract, using the form provided by City in the Project contract
documents ("Contract Documents");
2.2 Payment Bond. A payment bond for 100% of the maximum Contract Price, executed by a
surety licensed to do business in the State of California using the Payment Bond form
included with the Contract Documents;
2.3 Performance Bond. A performance bond for 100% of the maximum Contract Price,
executed by a surety licensed to do business in the State of California using the Performance
Bond form included with the Contract Documents; and
2.4 Insurance. The insurance certificate(s) and endorsement(s) required by the Contract
Documents, and any other documents required by the Instructions to Bidders or Notice of
Award.
Enforcement. If Bidder fails to execute the Contract and to submit the bonds and insurance
certificates as required by the Contract Documents, Surety guarantees that Bidder forfeits the Bond
Sum to City. Any notice to Surety may be given in the manner specified in the Contract and
delivered or transmitted to Surety as follows:
Attn:
Address:
City/State/Zip:
Phone:
Fax:
Email:
4. Duration and Waiver. If Bidder fulfills its obligations under Section 2, above, then this obligation
will be null and void; otherwise it will remain in full force and effect for 60 days following the bid
opening or until this Bid Bond is returned to Bidder, whichever occurs first. Surety waives the
provisions of Civil Code §§ 2819 and 2845.
[Signatures are on the following page.]
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Bid Bond
Approved by City Attorney, dated 2/27/2020
This Bid Bond is entered into and effective on .20
SURETY:
Business Name
s/
Name, Title
uate
(Attach Acknowledgment with Notary Seal and Power of Attorney)
BIDDER:
Business Name
s/
Name, Title
Albert Park Restrooms & Wheelchair Lift
City Project #: 11372
Date
END OF BID BOND
Approved by City Attorney, dated 2/27/2020
Up to $175,000 Contract
Bid Bond
Exhibit C
NONCOLLUSION DECLARATION
TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID
The undersigned declares:
I am the President [title] of Golden Empire Concrete Products Inc dba StructureCast
[business name], the party making the foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company,
association, organization, or corporation. The bid Is genuine and not collusive or sham. The bidder has
not directly or Indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has
not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in
a sham bid, or to refrain from bidding, The bidder has not in any manner, directly or Indirectly, sought by
agreement, communication, or conference with anyone to fix the bid price of the bidder or any other
bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All
statements contained in the bid are true. The bidder has not, directly or indirectly, submitted his or her bid
price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to
any corporation, partnership, company, association, organization, bid depository, or to any member or
agent thereof, to effectuate a collusive or sham hid, and has not paid and will not pay, any person or
entity for such purpose,
This declaration is intended to comply with California Public Contract Code § 7106 and Title 23 U.S.0 §
112.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and
correct and that this declaration is executed on November 16, 2021 [date], at
Bakersfield
[city], _ CA [state].
st
Anna M. Dezember
Name [print]
END OF NONCOLLUSION DECLARATION
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Noncollusion Declaration
Approved by City Attorney, dated 2/27/2020
Exhibit D
BID SCHEDULE
This Bid Schedule must be completed in ink and included with the sealed Bid Proposal. Pricing must be
provided for each Bid Item as indicated. Items marked "(SW)" are Specialty Work that must be performed
by a qualified Subcontractor. The lump sum or unit cost for each item must be inclusive of all costs, whether
direct or indirect, including profit and overhead. The sum of all amounts entered in the "Extended Total
Amount' column must be identical to the Base Bid price entered in Section 1 of the Bid Proposal form.
AL = Allowance CF = Cubic Feet CY = Cubic Yard EA = Each LB = Pounds
LF = Linear Foot LS = Lump Sum SF = Square Feet TON = Ton (2000 lbs.)
BID
ITEM
NO. ITEM DESCRIPTION
EST. QTY.
UNIT
UNIT
COST
EXTENDED
TOTAL AMOUNT
TOTAL BASE BID: Items 1 through inclusive: $
Note: The amount entered as the "Total Base Bid" should be identical to the Base Bid amount entered in
Section 1 of the Bid Proposal form.
Albert Park Restrooms & Wheelchair Lift
City Project #: 11372
Approved by City Attorney, dated 2/27/2020
Up to $175,000 Contract
Bid Schedule
This Bid Proposal is hereby submitted on
s/
s/
Company Name
Address
City, State, Zip
Contact Name
,20
Name and Title
Name and Title
License #, Expiration Date, and Classification
DIR Registration #
Addenda. Bidder agrees that it has confirmed receipt of or access to, and reviewed, all addenda issued
for this Bid. Bidder waives any claims it might have against the City based on its failure to receive,
access, or review any addenda for any reason. Bidder specifically acknowledges receipt of the following
addenda:
Addendum: Date Received: Addendum: Date Received:
#01 #05
#02 #06
#03 #07 _
#04 #08
END OF BID SCHEDULE
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Bid Schedule
Approved by City Attorney, dated 2/27/2020
Exhibit E
SUBCONTRACTOR LIST
For each Subcontractor that will perform a portion of the Work in an amount in excess of one-half of 1 %
of the bidder's total Contract Price,' the bidder must list a description of the Work, the name of the
Subcontractor, its California contractor license number, the location of its place of business, its DIR
registration number, and the portion of the Work that the Subcontractor is performing based on a
percentage of the Base Bid price.
DESCRIPTION
OF WORK
_
SUBCONTRACTOR
NAME
CALIFORNIA
CONTRACTOR
LICENSE NO.
LOCATION OF
BUSINESS
_
DIR REG. NO.
PERCENT
OF
WORK
END OF SUBCONTRACTOR LIST
1 For street or highway construction this requirement applies to any subcontract of $10,000 or more.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Subcontractor List
Approved by City Attorney, dated 2/27/2020
AUTHORIZATION TO INSERT DATE INTO
CONTRACT BONDS
August 18, 2021
To: City of San Rafael
RE: Golden Empire Concrete Products Inc. dba StructureCast
Authority to Date Contract Bonds — Bond No: 107471410
To Whom It May Concern:
This letter gives you the authority to date the three (3) Performance and Payment Bonds
attached to match the date that you enter into Contract with Golden Empire Concrete
Products, Inc. dba StructureCast for the project named: City's Albert Park Restrooms
& Wheelchair Lift. You will also need to date the Power of Attorneys to match the
contract date. When this is completed please forward to me, at the address noted below,
a copy of the signed and dated bonds along with the Power of Attorney.
I appreciate your assistance in this matter.
Sincerely,
Vickie J. Nickel
Attorney -In -Fact
Cly. V.
ow
�Vt64e'Nickel, Account Executive
-mAel@ckcins.com Phone: 913-754-0191
Cornerstone Kansas City
4400 College Blvd., Suite 350
Overland Park, KS 66211
Travelers Casualty and Surety Company of America
AOW Travelers Casualty and Surety Company
TRAVELERS J St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Vickie J Nickel of
OVERLAND PARK , Kansas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
4*MY9Fry ea�rr• •Nn s -Ole
r 6y
TFMO l 4
•r CONN.
a
State of Connecticut
By:
City of Hartford ss. Robert L. Rane , enior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.."''
NOTARY Oi
My Commission expires the 30th day of June, 2026 r -j-
Anna P. Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it Is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this 18 day of August , 2021
1Ll4TFOH:4 � � HPATFORD, � � °0170'1
caw, Q CONN. o" #J�
r,
!�
Kevin E. Hughes, Assi tant Secretary
To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880.
Please refer to the above-named Attorney(s)-in-Fad and the details of the bond to which this Powerof Attorney is attached.
Bond No: 107471410
Performance Bond
Golden Empire Concrete Products Inc dba StructureCast
City of San Rafael ("City") and ("Contractor") have entered into a
contract, dated a -W 20A1 ("Contract") for work on the Albert Park Restrooms & Wheelchair Lift
("Project"). The Contract is incorporated by reference into this Performance Bond ("Bond").
Travelers Casualty and Surety
1. General. Under this Bond, Contractor as Principal and Companv of America its
surety ("Surety"), are bound to City as obligee for an amount not less than $ 172,500
By executing this Bond, Contractor and Surety bind themselves and their respective heirs,
executors, administrators, successors and assigns, jointly and severally, to the provisions of this
Bond.
2. Surety's Obligations; Waiver. If Contractor fully performs its obligations under the Contract,
including its warranty obligations under the Contract, Surety's obligations under this Bond will
become null and void upon City's acceptance of the Project, provided Contractor has timely
provided a warranty bond as required under the Contract. Otherwise Surety's obligations will
remain in full force and effect until expiration of the one year warranty period under the Contract.
Surety waives any requirement to be notified of and further consents to any alterations to the
Contract made under the applicable provisions of the Contract documents, including changes to the
scope of Work or extensions of time for performance of Work under the Contract. Surety waives
the provisions of Civil Code sections 2819 and 2845.
Application of Contract Balance. Upon making a demand on this Bond for completion of the
Work prior to acceptance of the Project, City will make the Contract Balance available to Surety for
completion of the Work under the Contract. For purposes of this provision, the Contract Balance is
defined as the total amount payable by City to Contractor as the Compensation minus amounts
already paid to Contractor, and minus any liquidated damages, credits, or backcharges to which
City is entitled under the terms of the Contract.
4. Contractor Default. Upon written notification from City that Contractor is in default under the
Contract, time being of the essence, Surety must act within seven calendar days of receipt of the
notice to remedy the default through one of the following courses of action:
4.1 Arrange for completion of the Work under the Contract by Contractor, with City's consent,
but only if Contractor is in default solely due to its financial inability to complete the Work;
4.2 Arrange for completion of the Work under the Contract by a qualified contractor
acceptable to City, and secured by performance and payment bonds issued by an admitted
surety as required by the Contract documents, at Surety's expense; or
4.3 Waive its right to complete the Work under the Contract and reimburse City the amount
of City's costs to have the remaining services completed.
Surety Default. If Surety defaults on its obligations under the Bond, City will be entitled to recover
all costs it incurs due to Surety's default, including legal, design professional, or delay costs.
Notice. Notice to Surety must be given or made in writing and sent to the Surety via personal
delivery, U.S. Mail, or a reliable overnight delivery service, or by email as a PDF (or comparable)
file. Notice is deemed effective upon delivery unless otherwise specified. Notice for the Surety
must be given as follows:
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Performance Bond
Approved by City Attorney, dated 02/27/2020
Attn: Surety Claim Dept.
Address: One Tower Square, 251A
City/State/Zip: Hartford, CT 06183
Phone: 1-800-842-8496
Fax: no specific fax number for bond claim
Email: BSIC]ainis@Travelers.com
Law and Venue. This Bond will be governed by California law, and any dispute pursuant to this
Bond will be venued in the Superior Court of Marin County, and no other place. Surety will be
responsible for City's attorneys' fees and costs in any action to enforce the provisions of this Bond.
8. Effective Date; Execution. This Bond is entered into and effective on SegKWU19W ozo
204. Three identical counterparts of this Bond, each of which is deemed an original for all
purposes, are hereby executed and submitted.
SURETY: Travelers Casualty and Surety Company of America
Business Name
s/
Vickie J. Nickel. Attornev-in-Fact
Name/Title [print]
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR: Golden Empire Concrete Products Inc dba StructureCast
Business a e
s/
Anna M. Dezember, Pr- t
Name/Title
s/
Name/Title
APPROVED BY CITY:
s/ LW,
_0 AV_-
Pn1�y
Name/Title
END OF PERFORMANCE BOND
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Performance Bond
Approved by City Attorney, dated 02/27/2020
TRAVELERS�J
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Vickie J Nickel of
OVERLAND PARK , Kansas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
31
t @l
M
FLARTFaf� "'Mm. AN
Li\% rAiiN. C `v
CONN. n SEbI
State of Connecticut
City of Hartford ss.
By:
Robert L. Rane enior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal." '�'-k ��
170iAAY
My Commission expires the 30th day of June, 2026 . �s 4"
PLIWO r' Anna P. Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this day of
sur,r '+a It
�e
T7 KARTFORD,
VULg
�f
Kevin E. Hughes, Assi tant Secretary
To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880.
Please refer to the above-named Attorney(s)-in-Fact and the details of the bond to which this Power ofAttorney is attached.
Bond No: 107471410
Payment Bond
Golden Empire Concrete Products Inc dba StructureCast
City of San Rafael ("City") and ("Contractor") have entered into a
contract, dated .1-0 , 20m?1 ("Contract") for work on the Albert Park Restrooms & Wheelchair Lift
("Project"). The Contract is incorporated by reference into this Payment Bond ("Bond").
General. Under this Bond, Contractor as principal and 1`ravelers Casualty and Surety Company of America
its surety ("Surety"), are bound to City as obligee in an amount not less than
S 172,500 , under California Civil Code sections 9550, et seq.
2. Surety's Obligation. If Contractor or any of its subcontractors fails to pay any of the
persons named in California Civil Code section 9100 amounts due under the
Unemployment Insurance Code with respect to work or labor performed under the
Contract, or for any amounts required to be deducted, withheld, and paid over to the
Employment Development Department from the wages of employees of Contractor and its
subcontractors, under California Unemployment Insurance Code section 13020, with
respect to the work and labor, then Surety will pay for the same.
3. Beneficiaries. This Bond inures to the benefit of any of the persons named in California
Civil Code section 9100, so as to give a right of action to those persons or their assigns in
any suit brought upon this Bond. Contractor must promptly provide a copy of this Bond
upon request by any person with legal rights under this Bond.
4. Duration. If Contractor promptly makes payment of all sums for all labor, materials, and
equipment furnished for use in the performance of the Work required by the Contract, in
conformance with the time requirements set forth in the Contract and as required by
California law, Surety's obligations under this Bond will be null and void. Otherwise,
Surety's obligations will remain in full force and effect.
5. Waivers. Surety waives any requirement to be notified of alterations to the Contract or
extensions of time for performance of the Work under the Contract. Surety waives the
provisions of Civil Code sections 2819 and 2845. City waives requirement of a new bond
for any supplemental contract under Civil Code section 9550. Any notice to Surety may be
given in the manner specified in the Contract and delivered or transmitted to Surety as
follows:
Attn: Suretv Claim Dent.
Address: One Tower Square, 251A
City/State/Zip: Hartford, CT 06183 _
Phone: 1-800-842-8496
Fax: no specific fax number for bond claim _
Email: BSIClaims@Traveters.com
Law and Venue. This Bond will be governed by California law, and any dispute pursuant
to this Bond will be venued in the Superior Court of Marin County, and no other place.
Surety will be responsible for City's attorneys' fees and costs in any action to enforce the
provisions of this Bond.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Payment Bond
Approved by City Attorney, dated 02/27/2020
Effective Date; Execution. This Bond is entered into and is effective on A
2C.L A Three identical counterparts of this Bond, each of which is deemed an original for all
purposes, are hereby executed and submitted.
SURETY: Travelers Casualty and Surety Company of America _
Business Name
11!111111 1 SEE
Vickie J. Nickel, Attorney -in -Fact
Name/Title
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR: Golden Empire Concrete Products Inc dba StructureCast
Business e
s/ G
Anna M. Dezember, President
Name/Title
s/
Name/Title
APPROVED BY CITY.
Lt Q /k f IL
ane/
Name/Title
END OF PAYMENT BOND
Albert Park Restrooms & Wheelchair Lift
City Project #: 11372
Approved by City Attorney, dated 02/27/2020
Up to $175,000 Contract
Payment Bond
s/
Lt Q /k f IL
ane/
Name/Title
END OF PAYMENT BOND
Albert Park Restrooms & Wheelchair Lift
City Project #: 11372
Approved by City Attorney, dated 02/27/2020
Up to $175,000 Contract
Payment Bond
Travelers Casualty and Surety Company of America
AG► Travelers Casualty and Surety Company
TRAVELERS J St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Vickie J Nickel of
OVERLAND PARK , Kansas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
Olt
wit7 �rsY �4C
.e` ®rtj a "aArF°A°,
State of Connecticut
By:
City of Hartford ss. Robert L. Rane , enior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
'p7 NOjy •M1
IN WITNESS WHEREOF, I hereunto set my hand and official seal. ■�' * ^i��
N01AFiY
My Commission expires the 30th day of June, 2026 C
aue�i Anna P_ Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this day of
tla �7r � gar :�o yi�E
a �
GOW6 E CGXK..`_
� � Kevin E. Hughes, Secretary
To verity the authenticity of this Power ofAttorney, p. e0.se caii us at 1-800-421-388x?.
Please refer to the above-named Attorneys) -in -Fact and the details of the bond to which this PowerofAttorney is attached.
ACKNOWLEDGEMENT OF SURETY
(Corporate Officer)
STATE OF Kansas
County of Johnson
On this 18th day of August , 2021, before me, a Notary Public in and for said
County, personally appeared Vickie J. Nickel personally known to me, who being by me
duly sworn, did say that he is a the aforesaid Attorney -in -Fact of TRAVELERS CASUALTY AND
SURETY COMPANY OF AMERICA, a corporation duly organized and existing under the laws of
the State of Connecticut, that the seal affixed to the foregoing instrument is the corporate seal
of said corporation, that the said instrument was signed, sealed and executed on behalf of said
corporation by authority of its Board of Directors, and further acknowledge that the said
instrument and the execution thereof to be the voluntary act and deed of said corporation.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal
the day and year last above written.
My commission expipL4
-2-1b ZZ
Bond No: 107471410
Performance Bond
Golden Empire Concrete Products Inc dba StructureCast
City of San Rafael ("City") and ("Contractor") have entered into a
contract, dated div , 20 AL1 ("Contract") for work on the Albert Park Restrooms & Wheelchair Lift
("Project"). The C ntract is incorporated by reference into this Performance Bond ("Bond").
Travelers Casualty and Surety
1. General. Under this Bond, Contractor as Principal and CompLmy of America its
surety ("Surety"), are bound to City as obligee for an amount not less than $ 1.72,500
By executing this Bond, Contractor and Surety bind themselves and their respective heirs,
executors, administrators, successors and assigns, jointly and severally, to the provisions of this
Bond.
2. Surety's Obligations; Waiver. If Contractor fully performs its obligations under the Contract,
including its warranty obligations under the Contract, Surety's obligations under this Bond will
become null and void upon City's acceptance of the Project, provided Contractor has timely
provided a warranty bond as required under the Contract. Otherwise Surety's obligations will
remain in full force and effect until expiration of the one year warranty period under the Contract.
Surety waives any requirement to be notified of and further consents to any alterations to the
Contract made under the applicable provisions of the Contract documents, including changes to the
scope of Work or extensions of time for performance of Work under the Contract. Surety waives
the provisions of Civil Code sections 2819 and 2845.
3. Application of Contract Balance. Upon making a demand on this Bond for completion of the
Work prior to acceptance of the Project, City will make the Contract Balance available to Surety for
completion of the Work under the Contract. For purposes of this provision, the Contract Balance is
defined as the total amount payable by City to Contractor as the Compensation minus amounts
already paid to Contractor, and minus any liquidated damages, credits, or backcharges to which
City is entitled under the terms of the Contract.
4. Contractor Default. Upon written notification from City that Contractor is in default under the
Contract, time being of the essence, Surety must act within seven calendar days of receipt of the
notice to remedy the default through one of the following courses of action:
4.1 Arrange for completion of the Work under the Contract by Contractor, with City's consent,
but only if Contractor is in default solely due to its financial inability to complete the Work;
4.2 Arrange for completion of the Work under the Contract by a qualified contractor
acceptable to City, and secured by performance and payment bonds issued by an admitted
surety as required by the Contract documents, at Surety's expense; or
4.3 Waive its right to complete the Work under the Contract and reimburse City the amount
of City's costs to have the remaining services completed.
5. Surety Default. If Surety defaults on its obligations under the Bond, City will be entitled to recover
all costs it incurs due to Surety's default, including legal, design professional, or delay costs.
6. Notice. Notice to Surety must be given or made in writing and sent to the Surety via personal
delivery, U.S. Mail, or a reliable overnight delivery service, or by email as a PDF (or comparable)
file. Notice is deemed effective upon delivery unless otherwise specified. Notice for the Surety
must be given as follows:
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Performance Bond
Approved by City Attorney, dated 02/27/2020
Attn: Surety Claim Dept.
Address: One Tower Square. 251A
City/State/Zip: Hartford. CT 06183
Phone: 1-800-842-8496
Fax: no specific fax number for bond claim
Email: BSIClaims@Travelers.com
7. Law and Venue. This Bond will be governed by California law, and any dispute pursuant to this
Bond will be venued in the Superior Court of Marin County, and no other place.
Surety will be
responsible for City's attorneys' fees and costs in any action to enforce the provisions of this Bond.
8. Effective Date; Execution. This Bond is entered into and effective on
d -O
209�. Three identical counterparts of this Bond, each of which is deemed an original for all
purposes, are hereby executed and submitted.
` 1 4, .
SURETY: Travelers Casualty and Surety Company of America
r a •: 1
Business Name
r p
-
s/
Q
n,' -. -
ti f•�''••... .��,
Vickie J. Nickel, Attorney -inn -Fact
Name/Title [print]
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR: Golden Empire Concrete Products Inc dba StructureCast
Busine Nome
s/
Anna M. Dezember, President
Name/Title
s/
Name/Title
APPROVED BY CITY:
END OF PERFORMANCE BOND
Albert Park Restrooms & Wheelchair Lift
City Project #: 11372
Approved by City Attorney, dated 02/27/2020
a
Up to $175,000 Contract
Performance Bond
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
TRAVELERS J St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Vickie J Nickel of
OVERLAND PARK , Kansas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
.dam y ��Tr aypIt
COOK
FA HARTFORD
;+ CONN.O rS iEAI
State of Connecticut
By:.
_,;4A�6e
City of Hartford ss. Robert L. Raneyrtenior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.f�`'�A rya" gt�fl
NOTARY of-* I, - Z G
My Commission expires the 30th day of June, 2026 • LI
Fue`i Anna P. Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this day of
�nswyiy
4w
��� ! HARiiOM. ; � ..art
L Kevin E. Hughes, AssET.1ant Secretary
To verify the authenticity of this Power ofAttorney, please call us at 1-800-421-3880
Please refer to the above-named Attorneys) -in -Fact and the details of the bond to which this PowerofAttorney is attached.
Bond No: 107471410
Payment Bond
Golden Empire Concrete Products Inc dba StructureCast
City of San Rafael ("City") and ("Contractor") have entered into a
contract, dated 24fAYVW ,Z0 2041 ("Contract") for work on the Albert Park Restrooms & Wheelchair Lift
("Project'). The C ntract is incorporated by reference into this Payment Bond ("Bond").
1. General. Under this Bond, Contractor as principal and Travelers Casualty and Surety Company of America
its surety ("Surety"), are bound to City as obligee in an amount not less than
$ 172,500 , under California Civil Code sections 9550, et seq.
2. Surety's Obligation. If Contractor or any of its subcontractors fails to pay any of the
persons named in California Civil Code section 9100 amounts due under the
Unemployment Insurance Code with respect to work or labor performed under the
Contract, or for any amounts required to be deducted, withheld, and paid over to the
Employment Development Department from the wages of employees of Contractor and its
subcontractors, under California Unemployment Insurance Code section 13020, with
respect to the work and labor, then Surety will pay for the same.
3. Beneficiaries. This Bond inures to the benefit of any of the persons named in California
Civil Code section 9100, so as to give a right of action to those persons or their assigns in
any suit brought upon this Bond. Contractor must promptly provide a copy of this Bond
upon request by any person with legal rights under this Bond.
4. Duration. If Contractor promptly makes payment of all sums for all labor, materials, and
equipment furnished for use in the performance of the Work required by the Contract, in
conformance with the time requirements set forth in the Contract and as required by
California law, Surety's obligations under this Bond will be null and void. Otherwise,
Surety's obligations will remain in full force and effect.
5. Waivers. Surety waives any requirement to be notified of alterations to the Contract or
extensions of time for performance of the Work under the Contract. Surety waives the
provisions of Civil Code sections 2819 and 2845. City waives requirement of a new bond
for any supplemental contract under Civil Code section 9550. Any notice to Surety may be
given in the manner specified in the Contract and delivered or transmitted to Surety as
follows:
Attn:
Surety Claim Dept.
Address:
One Tower Square. 251A _
City/State/Zip: Hartford, CT 06183
Phone:
1-800-842-8496
Fax:
no specific fax number for bond claim
Email:
BSIClaims(r,Travelers.com
6. Law and Venue. This Bond will be governed by California law, and any dispute pursuant
to this Bond will be venued in the Superior Court of Marin County, and no other place.
Surety will be responsible for City's attorneys' fees and costs in any action to enforce the
provisions of this Bond.
Albert Park Restrooms & Wheelchair Lift Up to $175,000 Contract
City Project #: 11372 Payment Bond
Approved by City Attorney, dated 02/27/2020
Effective Date; Execution. This Bond is entered into and is effective on 020
2011 Three identical counterparts of this Bond, each of which is deemed an original for all
purposes, are hereby executed and submitted.
SURETY: Travelers Casualty and S
Business Name
s/ U�
Vickie J. Nickel, Attorney -in -Fact
Name/Title
of America
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR: Golden Empire Concrete Products Inc dba StructureCast
Busines e
s/
Anna M. Dezember, President
Name/Title
s/
Name/Title
APPROVED BY CITY:
s/
END OF PAYMENT BOND
Albert Park Restrooms & Wheelchair Lift
City Project #: 11372
Approved by City Attorney, dated 02/27/2020
y
Up to $175,000 Contract
Payment Bond
TRAVELERSJ�
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Vickie J Nickel of
OVERLAND PARK , Kansas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
S FLiR'iFO�,
ca+"ut
MAN. KA
State of Connecticut
City of Hartford ss
By:
Robert L. Rane , enier Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
..:Pa tiOif.'•
IN WITNESS WHEREOF, I hereunto set my hand and official seal. 0" -
My Commission expires the 30th day of June, 2026 Anna P. Nowik, Notary Public
,- YT''
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this day of
C9 GUX
o SIX
Kevin E. Hughes, Assi tant Secretary
To verify the authenticity of this Power of Attorney, please calf us at 1-800-421-3830.
Please refer to the above-named Attorney(s)-in-Fact and the details of the bond to which this Powerof Attorney is attached.
ACKNOWLEDGEMENT OF SURETY
(Corporate Officer)
STATE OF Kansas
County of Johnson
On this 18th day of August , 2021, before me, a Notary Public in and for said
County, personally appeared Vickie J. Nickel personally known to me, who being by me
duly sworn, did say that he is a the aforesaid Attorney -in -Fact of TRAVELERS CASUALTY AND
SURETY COMPANY OF AMERICA, a corporation duly organized and existing under the laws of
the State of Connecticut, that the seal affixed to the foregoing instrument is the corporate seal
of said corporation, that the said instrument was signed, sealed and executed on behalf of said
corporation by authority of its Board of Directors, and further acknowledge that the said
instrument and the execution thereof to be the voluntary act and deed of said corporation.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal
the day and year last above written.
My commie expires
Notary Public
�7 �Z
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4
M4i
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7
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P� WITH P'X
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: Iman Kayani for FG Extension: 3352
Contractor Name: Golden Empire Concrete Products, Inc. dba StructureCast
Contractor's Contact: Anna Dezember Contact's Email: anna@structurecast.com
❑ FPPC: Check if Contractor/Consultant must file Form 700
Step
RESPONSIBLE
DESCRIPTION
COMPLETED
REVIEWER 1
DEPARTMENT
DATE
Check/Initial
1
Project Manager
a. Email PINS Introductory Notice to Contractor
Click here to
i
enter a date.
b. Email contract (in Word) and attachments to City
7/22/2021
Attorney c/o Laraine.Gittens@cityofsanrafael.org
❑X IKK
2
City Attorney
a. Review, revise, and comment on draft agreement
7/22/2021
❑X LG
and return to Project Manager
7/22/2021
❑X LG
b. Confirm insurance requirements, create Job on
PINS, send PINS insurance notice to contractor
3
Department Director
Approval of final agreement form to send to
7/26/2021
❑X BG
contractor
4
Project Manager
Forward three (3) originals of final agreement to
8/17/2021
❑X IKK
contractor for their signature
5
Project Manager
When necessary, contractor -signed, agreement
0 N/A
agendized for City Council approval *
*City Council approval required for Professional Services
OIKK
Agreements and purchases of goods and services that exceed
Or
$75,000; and for Public Works Contracts that exceed $175,000
Click here to
Date of City Council approval
enter a date.
PRINT
CONTINUE ROUTING PROCESS WITH HARD COPY
6
Project Manager
Forward signed original agreements to City
9/7/2021
IKK
City Attorney
Attorney with printed copy of this routing form
7
Review and approve hard copy of signed
b10/&z
agreement
7
8
City Attorney
Review and approve insurance in PINS, and bonds
p/20��ZI
A�7
(for Public Works Contracts)
/
9
City Manager/ Mayor
Agreement executed by City Council authorized
1
A-
official
Attest signatures, retains original agreement and
10
City Clerk
forwards copies to Project Manager