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Home My WebLink AboutPW 237 Upper Toyon Drive Emergency Slide Repair ProjectCITY OF SAN RAFAEL Department of Public Works 111 Morphew Street San Rafael, CA 94901 Public Works Contract for Projects up to $200,000 This public works contract ("Contract") is entered into by and between the City of San Rafael ("City") and Team Ghilotti, Inc. ("Contractor") a corporation, for work on the City's 237 Upper Toyon Dr. Emergency Slide Repair ("Project") and is effective o�M. , (� 2'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): A 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 Documents, City will pay Contractor $48,834.39 (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 4 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, in its sole discretion and without prior notice to Contractor, purchase such bond(s) at Contractors expense and deduct the cost from payments otherwise due to Contractor, or terminate the Contract. 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Page 1 Approved by City Attorney, dated 03/28/2022 4. Time for Completion. Contractor will fully complete the Work within 18 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 (the "Indemnitees") 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 the acts or omissions of Contractor, its employees, subcontractors, representatives, or agents in performing the Work of failing to comply with any obligation of Contractor under this Contract, except such Liability caused by the active negligence, sole negligence, or willful misconduct of an Indemnitee. 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-Vill 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 https://www.pinsadvantage.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. 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Page 2 Approved by City Attorney, dated 03/28/2022 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 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Page 3 Approved by City Attorney, dated 03/28/2022 is under $25,000, Contractor must electronically submit certified payroll records to the Labor Commissioner as required under California law and regulations. 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 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Page 4 Approved by City Attorney, dated 03/28/2022 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. 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. 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Page 5 Approved by City Attorney, dated 03/28/2022 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 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)458-5347 Attn: Philip Buckley, Senior Civil Engineer Email: Philip.Buckley@cityofsanrafael.org Contractor: Name: Team Ghilotti, Inc. Address: 2531 Petaluma Blvd S City/State/Zip: Petaluma, CA 94952 Phone: (707)763-8700 Attn: Joe Moreira Email: JoeM@teamghilotti.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 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Page 6 Approved by City Attorney, dated 03/28/2022 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.] 237 Upper Toyon Dr. Emergency Slide Repair Approved by City Attomey, dated 03/28/2022 Up to $200,000 Contract Page 7 The parties agree to this Contract as witnessed by the signatures below: CITY: Approv,*d to form: s/ s/ JI CHU Z, City Manage ROB PSTEINity7attorney Date: Date: -- l Attest: s/ LINDSAY LARA, City Clerk Date 427Jal- CONTRACTOR: Team Ghilotti, Inc. Business Name Kevin Ghilotti, CEO/ President Name/Title Date: May 2, 2023 Jennifer Ghilotti, Vice President / Secretary Name/Title Date: May 2, 2023 895384, A & Haz Exp 04/30/2025 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 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Page 8 Approved by City Attorney, dated 03/28/2022 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California l County of Sonoma J} On _ MAY 0 % 7Q23 before me, Gabriel William Duran, Notary Public Date Here Insert Name and Title of the Officer personally appeared Name(s) of Signer(s) Jennifer Ghilotti. Vice President. Smtaw who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. '> GABRIEL WILLIAM DURAN Notary Public - California Z Sonoma County Commission # 2338747 My Comm. Expires Nov 27, 2024 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand,and official seal. Signature OPTIONAL ' Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 02019 National Notary Association Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: RESOLUTIONS ADOPTED BY UNANIMOUS CONSENT OF THE BOARD OF DIRECTORS of Team Ghilotti, Inc. The undersigned, in a meeting of all of the Board of Directors of Team Ghilotti, Inc. (herein TGI), a California Corporation, hereby adopt the following resolution by unanimous written consent pursuant to the By Laws of the corporation: ELECTION OF OFFICERS RESOLVED that the following persons are elected by the Directors of TGI, Inc. for the term and as authorized by the By Laws: President: Kevin Ghilotti Chief Financial Officer: Kevin Ghilotti Treasurer: Kevin Ghilotti Secretary: Jennifer Ghilotti Assistant Secretary: Joe Moreira Vice President: Jennifer Ghilotti 2"a Vice President: Robert E Lee ACTION ON RESOLUTION RESOLVED that any officer of the Corporation is authorized to take any action and execute any documents necessary to carry out any or all of the foregoing resolutions. DATED: October 5, 2021 Kevin Ghilotti Jose i Moreira ennis Gilardi Ap idgIfifer Gh%ki — ., Re pert E Lee Cecil Isaac iur Ccstamagna Home` CONTRACTORS STATE LICENSE BOARD OContractor's License Detail for License # 895384 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. C5LB complaint disclosure is restricted bylaw(B&P7124.6) If this entity is subject to public complaint disclosure click on link that will a pp ear below for more information. Click here for a definition of disclosable actions. Only construction related civil judgments reported to CSLB are disclosed (B&P 7071.17). r Arbitrations are not listed unless the contractor fails to comply with the terms. I Due to workload, there maybe relevant information that has not yet been entered into the board's license database. Data cu rrent as of 5/2/2023 10:48:14 AM Business Information TEAM GHILOTTI INC 2531 PETALUMA BLVD S PETALUMA, CA 94952 Business Phone Number:(707) 763-8700 This license is current and active. All information below should be reviewed. A- GENERAL ENGINEERING o HAZ -HAZARDOUS SUBSTANCES REMOVAL Entity Corporation Issue Date 04/27/2007 Expire Date 04/30/2025 Certifications Bonding Information Contractor's Bond This license filed a Contractor's Bond with BERKLEY INSURANCE COMPANY. Bond Number: 0165536 Bond Amount: $25,000 Effective Date: 01/01/2023 Contractor's Bond History Bond of Qualifying Individual The qualifying individual KEVIN CHRISTOPHER GHILOTTI certified that he/she owns 10 percent or more of the voting stock/membership interest ofthis company; therefore, the Bond of Qualifying Individual is not required, EffectiveDate: 12/31/2018 BQI's Bond History JfKelS "Umpen5aut: This license has workers compensation insurance with the FEDERAL INSURANCE COMPANY Policy Number:54309509 Effective Date: 10/01/2018 Expire Date: 10/01/2023 Workers' Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses. Copyright © 2023 State of California 5/2/23, 11:04 AM https://cadinsecure.force.com/ContractorSearch/PrintReg Details Contractor Information Legal Entity Name TEAM GHILOTTI, INC. Legal Entity Type Corporation Status Active Registration Number 1000002085 Registration effective date 7/1/2022 Registration expiration date 6/30/2025 Mailing Address 2531 PETALUMA BLVD. SO. PETALUMA 94952 CA ... Physical Address 2531 PETALUMA BLVD. SO. PETALUMA 94952 CA ... Email Address Trade Name/DBA License Number(s) CSLB:895384 CSLB:895384 Legal Entity Information Corporation Number: Federal Employment Identification Number: President Name: Kevin Ghilotti Vice President Name: Jennifer Ghilotti Treasurer Name: Kevin Ghilotti Secretary Name: Jennifer Ghilotti, Joe Moreira CEO Name: Kevin Ghilotti Agent of Service Name: Jennifer Lorraine Ghilotti Agent of Service Mailing Address: 2531 Petaluma Blvd So. Petaluma 94952 CA United States of America Registration History Effective Date Expiration Date 5/9/2018 6/30/2019 5/5/2017 6/30/2018 5/31/2016 6/30/2017 6/9/2015 6/30/2016 10/20/2014 6/30/2015 7/1/2019 6/30/2022 7/1/2022 6/30/2025 https://cadir.secure.force.com/ContractorSearch/PrintRegDetails 1/2 5/2/23, 11:04 AM https://cadir.secure.force.com/ContractorSearch/PrintRegDetails Workers Compensation Do you lease employees No through Professional Employer Organization (PEO)?: Please provide your current workers compensation insurance information below: PEO PEO PEO PEO InformationName Phone Email Insured by Carrier Policy Holder Name:TEAM GHILOTTI, INC.Insurance Carrieffederal Insurance Company Policy Number:54309509Inception date:10/1/2021Expiration Date:10/1/2022 https://cadinsecure.force.com/ContractorSearch/PrintRegDetails 2/2 Exhibit A SCOPE OF WORK 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Scope of Work Approved by City Attorney, dated 03/28/2022 Exhibit A 4/06/2023 Team Ghilotti, Inc. Page 1 of i 4:07PM Item Cost Detail 237 Upper Toyon Dr. Slide Repair Bid -Item Description 04 Pick Up K-Rail After 6 Mo Description Area Quantity UNI 1.00 L5 Quantity/Days UM Unit Cost 5,938.2000 Unit Cost Total Cost 5,938.20 Total Cost E Foreman's Truck STD 1.OD / 1.00 DAY 435.6000 435.60 L Operator Foreman OE1 LA 1.00 / 1.00 DAY 850.9600 850.96 E Lowboy Truck STD 1.001 1.00 DAY 932.4800 932.48 L Teamster 0E1LA 1.00/ 1.00 DAY 624.7200 624.72 E Cat 314 Ex STD 1.00 / 1.00 DAY 552.0800 552.08 L Operator, Group 2 (Excavator) 0E1 LA 1.00 / 1.00 DAY 842.2400 842.24 E F-450 Flatbed STD 1.001 1.00 DAY 457.6800 457.68 L Lead Laborer 0E1LA 2.00/ 1 00 DAY 558.7200 1,117.44 O Portable Toilet OPLA 0.50 MO 250.0000 125.00 Prod per Day: 1.00 Day Lgth: 8 00 Hrs Req: 8.00 LbrTyp: Standard Man. Hrs.: 40.00 Work Comp.: 622D-1 6.00% Days Req: 1.00 Man Hrs Per LS 40 000000 Work Type: Material Labor Equipment Other Subcontractor Plua Truck Unit Cost: 3,43536 2.37784 12500 Total Cost: 3,435.36 2,37784 125.00 r� �s -/, 31 1cY-1,AL LA-�5 4, (a3-�.g3I L••l vi1 tf``♦ '+_J I '5I Z5- rnv IS% ` fu-fir 5. 34 A0/ k55..S7 Estimator: Joe Moreira (Zero Total Cost Warning) For Job: 27-23 - 237 Upper Toyon Dr. Slide Repair Generated by a SharpeSoH Product r pMM CO O M O O n 10 00O m M O r 0 0 (0 0 0D O le 0 0 Q) Rr O� O f- f0 �V N O c1 � L6 CO O O n 10 I N O) N G U) �D a cD N N M 1� CDDI o(D N Q) m �t Rr MM oN N M N M a I t G` a4 d 0 S S m gg s IS c Z $ r YI w !- I W 0 rn� r€ V V o -N o f O U 4) w In w l to g m 0-a:O 00o (D o0o�a0o cp O 000 00 T aND M 000 000 v, 000 O ! O i, v It N. 00 C'N NU'j c0 m 00)IN I (n � 1 i ml I � pl 1 i I oI ppppS ppop Iv' sr i 1 0 j V �I I p ml co c) 1 0 CC.I 0) �c? 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N%§.o.§ $22$ -GOcc �C')' Co 2 - I cm � &\.� k� §�)« L | ■ @ \ E |� o }k22 I ' »#,5l� v0/A.j■ �§� ( Exhibit B BONDFORMS Required for contracts over $25, 000. 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Bond Forms Approved by City Attomey, dated 03/28/2022 Bond #0249862 Premium: Incl. in Performance Bond Payment Bond City of San Rafael ("City") and Team Ghilotti, Inc. ("Contractors') have entered into a contract, dated , 20 23 ("Contract") for work on the 237 Upper Toyon Dr. Emergency Slide Repair ("Project"). The Contract is incorporated by reference into this Payment Bond ("Bond"). 1. General. Under this Bond, Contractor as principal and Berkley Insurance Company its surety ("Surety"), are bound to City as obligee in an amount not less than $ 48,834.39 , 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. 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: Berkley Surety Group Address. 412 Mount Kemble Avenue, Suite 31ON City/State/Zip: Morristown. NJ 07960 Phone: 866-768-3534 Fax: N/A Email: BSGClaim@berkleysurety.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. 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Payment Bond Approved by City Attomey, dated 03/28/2022 7. Effective Date; Execution. This Bond is entered into and is effective on May 1 20 23. Three identical counterparts of this Bond, each of which is deemed an original for all purposes, are hereby executed and submitted. SURETY: Berkley Insurance Company Business Name s Jean L. Neu, Attomey-in-Fact Name/Title (Attach Acknowledgment with Notary Seal and Power of Attorney) CONTRACTOR Team Ghilotti, Inc. Business Name sl E(e* Ghilotti, President Name/Title sl Jen ' er Ghilotti, ce Pres t, Secretary Name/Title APPR ED BY CITY: s/ i � �a � ROB i S E -,City Attorney END OF PAYMENT BOND 237 Upper Toyon Dr. Emergency Slide Repair Approved by City Attomey, dated 03/28/2022 Q, lt'hz� Date Up to $200,000 Contract Payment Bond CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of _ Sonoma On MAY 0 2 2023 before me, Date personally appeared Kevin Gabriel William Duran, Notary Public Here Insert Name and Title of the Officer President, CFO, Treasurer Name(s) of Signer(s) Jemft Qhilotti, Vice President. bcr& who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. GABRIEL WILLIAM DURAN Notary Public - California i Sonoma County Commission # 2338747 My Comm, Expires Nov 27, 2024 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. I Signature� ' Signature of OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 02019 National Notary Association Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Santa Clara ) �*Tf MAY -1 2023 before me, Erin Bautista, Notary Public (insert name and title of the officer) personally appeared Jean L. Neu who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/am subscribed to the within instrument and acknowledged to me that Ise/she/#Wexecuted the same in hWher/t#eiRauthorized capacity(", and that by # /her/tom signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. emy ERIN BAUTISTA d Notary Public - California San;a Clara CountyCommission = 24CO176 Comm. Expires Apr 25, 2026 Signature ��,% l-� LI,LI, t- Seal i No. BI-10192d-el POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON, DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted and appointed, and does by these presents make, constitute and appoint: Bryan D. Martin; Erin Bautista; Jean L. Neu; Stephen E. Leveroni, Angelina A. Campano; Gordon Scott Gaddy, or Jennifer Marie Hyland of ABD Insurance & Financial Services, Inc. of San Mateo, CA its true and lawful Attomey-in-Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25, 2010: RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney -in -fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such attorney -in -fact and revoke any power of attorney previously granted; and further RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney -in -fact named; and further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued. IN WITNESS WHEREOF, the Company has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this ZW day of _April 2020 ��soa^^ICF Attest: Berk] :Insurance Company By i By l�• Sl? �I. : Ir ederman Je ynce fter co IExecutive Vice President & Secretary ,Se resident STATE OF CONNECTICUT ) ) ss: COUNTY OF FAIRFIELD ) Sworn to before me, a Notary Public in the State of Connecticut, this 21st day of A ril 2020 > by Ira S. Lederman and Jeffrey M. Ha$er who are sworn to me to be the Executive Vice President. Secrct�n. and o Senior Vice President, respectively, of Berkley Insurance Company. �NOTARv�PUa81 Icy CONNECTICUT /, IAN COMMISSION EXPIRES APNIL 30, 2024 �� . oT Public, State of Connecticut CERTIFICATE I, the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and*-t authority of the Attorney -in -Fact set forth therein, who executed the bond or undertaking to which this Power of AN ched, is in full force and effect as of this date. '" der my hand and seal of the Company, this 1 St day of Ma 2023 W SEAI. � E Vincent P. Forte Please verify the authenticity of the instrument attached to this power by: Toll -Free Telephone: (866) 768-3534; or Electronic Mail: BSGinguiry@berkleysurety.com Any written notices, inquiries, claims or demands to the Surety on the bond attached to this power should be directed to: Berkley Surety Group 412 Mount Kemble Ave. Suite 31ON Morristown, NJ 07960 Attention: Surety Claims Department �Om Email: BSGClaim@berkleysuretv.com Please include with all communications the bond number and the name of the principal on the bond. Where a claim is being asserted, please set forth generally the basis of the claim. In the case of a payment or performance bond please also identify the project to which the bond pertains. Berkley Surety Group is an operating unit of W. R. Berkley Corporation that underwrites surety business on behalf of Berkley Insurance Company and Berkley Regional Insurance Company Bond #0249862 Premium: $488.00 Performance Bond City of San Rafael ("City") and Team Ghilotti, Inc. ("Contractor") have entered into a contract, dated 20 ("Contract") for work on the 237 Upper Toyon Dr. Emergency Slide Repair ("Project"). The Contract is incorporated by reference into this Performance Bond ("Bond"). General. Under this Bond, Contractor as Principal and Berkley Insurance Company its surety ("Surety"), are bound to City as obligee for an amount not less than $ 48,834.39 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: 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Performance Bond Approved by City Attomey, dated 03/28/2022 Attn: Berkley Surety Group Address: 412 Mount Kemble Avenue, Suite 31 ON City/State/Zip: Morristown, NJ 07960 Phone: 866-768-3534 Fax: N/A Email: BSGClaim@berkleysurety.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 May 1 20 23 . Three identical counterparts of this Bond, each of which is deemed an original for all purposes, are hereby executed and submitted. SURETY: Berkley Insurance Company usiness Rame s/ Jean L. u, Attorney -in -Fact Name/Title [print] (Attach Acknowledgment with Notary Seal and Power of Attorney) CONTRACTOR: Team Ghilotti, Inc. Business Name s/ L05!r:V ?7'1 Kevin Ghilotti, President Name/Title s/ Name/Title APPROVED BY CITY: r s/ (- �)ql , U, �, C=/u' ROBER 1, EPSTEIN; ity Attorney END OF PERFORMANCE BOND 237 Upper Toyon Dr. Emergency Slide Repair Approved by City Attomey, dated 03/28/2022 Date Up to $200,000 Contract Performance Bond CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Sonoma On MAY 0 2 2023 before me, Date personally appeared Gabriel William Duran, Notary Public Here Insert Name and Title of the Officer Nome(s) of Signer(s) Jennifer Qhilotti, Vice President, Seem" who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. GABRIEL WILLIAM DURAN 1 = Notary Public - California Sonoma County Commission # 2338747 L My Comm. Expires Nov 27, 2024 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my Signature OPTIONAL d official seal. Signature f Not ry Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: _ ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: ©2019 National Notary Association Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Santa Clara MAY -1 7023 Nl1 before me, Erin Bautista, Notary Public (insert name and title of the officer) personally appeared Jean L. Neu who proved to me on the basis of satisfactory evidence to be the person(g) whose name(s) is/am subscribed to the within instrument and acknowledged to me that lae/she/thw executed the same in hWher/t#T&i:Fauthorized capacity(t", and that by# Wher/t signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ERIN BAUTISTA r '- Notary Public - California < Santa Clara County Commission # 2400176 r My Comm. Expires Apr 25, 2026 f Signature �� `- (Seal) No. BI-10192d-el POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON, DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted and appointed, and does by these presents make, constitute and appoint: Bryan D. Martin; Erin Bautista, Jean L. Neu; Stephen E. Leveroni, Angelina A. Campano; Gordon Scott Gaddy; or Jennifer Marie Hyland of ABD Insurance & Financial Services, Inc. of San Mateo, CA its true and lawful Attorney -in -Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25, 2010: RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney -in -fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such attorney -in -fact and revoke any power of attorney previously granted; and further RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney -in -fact named; and further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued. IN WITNESS WHEREOF, the Company has caused these presents to. be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 2t day of April 2020 u rcF Attest: BeTid Insurance Company r � Sl•:AI. Z By By � 39n ` Ir . LdtiTnan Je n fter °�tnwn.: Executive Vice President &Secretary Se resident STATE OF CONNECTICUT ) ) ss: COUNTY OF F_&IRIULD ) Sworn to before me, a Notary Public in the State of Connecticut, this 21st day of ril y 2020 , by Ira S. Lederman and Jeffrey M. Hafter who are sworn to me to be the Executive Vice President Secretary, and t Senior Vice President, respectively, of Berkley Insurance Company. M�oT av PUB! CONNECTICUT MY COMMISSION APHIL 30, 2024PIRp . otary Public, State of Connecticut CERTIFICATE I, the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded ant8raauthority of the Attorney -in -Fact set forth therein, who executed the bond or undertaking to which this Power of P.ched, is in full force and effect as of this date. der my hand and seal of the Company, this 1 St day of Ma 2023 � Q'�` Vincent P. Forte N Le, Bid Bond ("Bi /derC")hasbmitted a bid, dated _, 20 ("Bid"), to the City of San Rafael ("City") for work on the ("Project"). Under this duly executed bid bond ("Bid ond ,. Bidder as Principal and its surety ("Surety"), are bound to ity as obligee in the penal sum of ten percent of the maximum amount of the Bid (the "Bond Sum"). B der and Surety bind themselves and their respective heirs, executors, administrators, successors an assigns, jointly and severally, as follows: 1. General. If Bidder is awarded the Contract for th/thotice Bidder will enter into the Contract with City in accordance with the terms of the Bid. 2. Submittals. Within ten days following issuance oof Award to Bidder, Bidder must submit to City the following: 2.1 Contract. The executed Contract, using ttivided by City in the Project contract documents ("Contract Documents"); / 2.2 Payment Bond. A payment bond for 1 % of the maximum Contract Price, executed by a surety licensed to do business in the S ate of California using the Payment Bond form included with the Contract Documen ; 2.3 Performance Bond. A performa a bond for 100% of the maximum Contract Price, executed by a surety licensed to o business in the State of California using the Performance Bond form included with the Co tract Documents; and 2.4 Insurance. The insurance c rtificate(s) and endorsement(s) required by the Contract Documents, and any other ocuments required by the Instructions to Bidders or Notice of Award. 3. Enforcement. If Bidder fails execute the Contract and to submit the bonds and insurance certificates as required by t Contract Documents, Surety guarantees that Bidder forfeits the Bond Sum to City. Any notice toSurety may be given in the manner specified in the Contract and delivered or transmitted t Surety as follows: Attn Address: City/State/Zip: Phone: Fax: Email: 4. Duration an Waiver. If Bidder fulfills its obligations under Section 2, above, then this obligation will be null d void; otherwise it will remain in full force and effect for 60 days following the bid opening o until this Bid Bond is returned to Bidder, whichever occurs first. Surety waives the provisio of Civil Code §§ 2819 and 2845. [Signatures are on the following page.] 2�I Upper Toyon Dr. Emergency Slide Repair Approved by City Attorney, dated 3/28/2020 Up to $200,000 Contract Bid Bond This Bid Bond is entered into and effective on . 20 SURETY: Business Name s/ Name, Title Date (Attach Acknowledgment with Notary Seal and Power of Attorney) BIDDER: Business Name s/ Name, Title Date END OF BID BOND 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Bid Bond Approved by City Attorney, dated 3/28/2020 Exhibit C NONCOLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID The undersigned declares: I am the CEO/President [title] of T [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 bid, 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 Mav 2. 2023 [date], at Petaluma [city], CA [state]. Kevin Ghilotti, CEO / President Name [print] END OF NONCOLLUSION DECLARATION 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Noncollusion Declaration Approved by City Attorney, dated 3/28/2022 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Sonoma On MAY 0 2 2023 Date Here Insert Name and Title of the Officer personally appeared Kevin Ghllotti, President, CFO, Treasurer Nome(s) of Signer(s) , before me Gabriel William Duran, Notary Public who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. GABRIEL WILLIAM DURAN ■ Notary Public - California s Sonoma County Commission 2338747 'a ��"'� My Comm. Expires Nov 27, 2024 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand 19nd official seal. Signature Signature of No taPublic - OPTIONAL — Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ElCorporate Officer - Title(s): ❑ Partner - ❑ Limited ElGeneral ❑ Individual ElAttorney in Fact ElTrustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 02019 National Notary Association Number of Pages: Signer's Name: ElCorporate Officer - Title(s): ❑ Partner - ❑ Limited ElGeneral ElIndividual ElAttorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 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 UNIT EXTENDED NO. ITEM DESCRIPTION EST. QTY. UNIT COST TOTAL AMOUNT *See Exhibit A* TOTAL BASE BID: Items 1 through inclusive: $ 48,834.39 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. 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Bid Schedule Approved by City Attorney, dated 3/28/2022 This Bid Proposal is hereby submitted on May 2 s/ Team Ghilotti, Inc. Company Name 2531 Petaluma Blvd So. Address Petaluma, CA 94952 City, State, Zip Jennifer Ghilotti Contact Name 2023 Kevin Ghilotti, CEO / President Name and Title Jennifer Ghilotti, Vice President / Secretary Name and Title 895384, A& Haz, Exp 04/30/2025 License #, Expiration Date, and Classification 1000002085 DIR Registration # (707) 763-8700 Phone Jenniferg@teamghilotti.com Contact Email 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 237 Upper Toyon Dr. Emergency Slide Repair Approved by City Attorney, dated 3/28/2022 Up to $200,000 Contract Bid Schedule 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 SUBCONTRACTOR i CALIFORNIA LOCATION OF DIR REG. NO. PERCENT OF WORK NAME CONTRACTOR BUSINESS OF LICENSE NO. I WORK None END OF SUBCONTRACTOR LIST ' For street or highway construction this requirement applies to any subcontract of $10,000 or more. 237 Upper Toyon Dr. Emergency Slide Repair Up to $200,000 Contract Subcontractor List Approved by City Attorney, dated 3/28/2022 R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCGUNTAGI ER Newfront Insurance Services (Construction) NAME! Construction Team 777 Mariner Island Blvd, Suite 250 1 PHONAX E 415-754-3635 No: San Mateo, CA 94404 1 9AI 1L-_ 1:......e./.e .,.nofrllJn uf..,nt r..n, Nww.Newfront.com INSURER A: Executive Risk Indemnity Inc 35181 INSURED INSURER B: Federal Insurance Company 20281 Team Ghilotti, Inc. 2531 Petaluma Blvd., South INSURER C : Navigators Specialty Insurance Company I 36056 1 Petaluma CA 94952 INSURER D INSURER E : INSURER F : T11CV^AT0 wworo. RFVISIAM MIIMR9=l2• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUDLZUKIPOLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/VYYY M' MMIDDYY A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR �/ �/ 54309508 10/1/2022 10/1/2023 EACH OCCURRENCE $1.000.000 $ 100 000 DAMA�E To RENT 'L' PREMISES Me occurrence MED EXP (Any one person) $ 5,000 _ X C. U Included PERSONAL & ADV INJURY $ 1 ,000.000 S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRODUCTS -COMP/OP AGG $ 2 OOO OOO POLICY � jE LOC Deductible $10 000 OTHER: B AUTOMOBILE LIABILITY ✓ ✓ 54309507 10/1/2022 10/1/2023 COMBINED SINGLE LIMIT acciderill $1 000 000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLYHAUTOS I✓ HIRED NON -OWNED ✓ AUTOS ONLY AUTOS ONLY3 PPROPERTYDAMAGE $ Is 000 Corn/Deductible I C UMBRELLA LIAB �/ OCCUR SF22EXC8852791C 10/1/2022 10/1/2023 EACH OCCURRENCE $3 000 000 AGGREGATE S3,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED7 a (Mandatory in NH) NIA ✓ 54309509 10/1/2022 10/1/2023 / STATUTE ER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: TGI Job #1388 Emergency Slide Repair Upper Toyon Drive. The City of San Rafael, its council, officials, officers, employees, agents volunteers and consultants (collectively) are named as additional insureds as respect to general liability & auto liability on a primary and non-contributory basis, as required by written contract. Excess Liability is Following Form. Waivers of subrogation apply to general & auto liability & workers compensation as required by written contract. Endorsements attached. GtK I II-IGA I It MULUtK VAI\VLL 1v1% RE: TGI Job #1388 Emergency Slide Repair Upper Toyon Drive SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of San Rafael THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 111 Morphew Street San Rafael CA 94901 AUTHORIZED REPRESENTATIVE Scott Gaddy V 18SS-LUI b AGUKU GUKYUKA I IUPI. All rlgnis reserveo. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD *13445059 122-23 GL-AL(Phys Dam)-XS-*aC-PROF-POLL INST FLTR I Jes:,i Flores I !-. 2023 11:07:37 AM (PST) I Page 1 of 11 This certificate cancels and supersedes ALL previously :s:_i:ed certit ^ates. POLICY NUMBER: 54309508 COMMERCIAL GENERAL LIABILITY CG20101219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations WHERE REQUIRED BY WRITTEN CONTRACT. ALL LOCATIONS WHERE REQUIRED BY WRITTEN CONTRACT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or .'property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG20101219 © Insurance Services Office, Inc., 2018 73445059 1 22-23 GL-ALIPhys Dam)-XS-HC-PROF-POLL INST FLTR I Jessica Flores 1 3/16/2023 11:07:37 AM (PST) I Page 2 of 11 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 7714S059 1 22-23 GL-AL(Phys Dam)-XS-WC-PROF-POLL INST FLTR I JessiCA Flores 11/16/2023 11:07:37 AM (PST) I Page 3 of 11 This certificate cancels and supersedes ALL previously issued certificates. CG20101219 POLICY NUMBER: 54309508 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations WHERE REQUIRED BY WRITTEN CONTRACT, BUT ONLY WHERE THE CONTRACT SPECIFIES COVERAGE FOR COMPLETED OPERATIONS. ALL LOCATIONS WHERE REQUIRED BY WRITTEN CONTRACT. Information reauired to complete this Schedule. if not shown above. will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 12 19 © Insurance Services Office, Inc., 2012 *13445059 1 22-23 GL-AL(Phys Dam)-XS-WC-PROF-POLL INST FLTR I Jessica Flores 1 3/16/2023 11:07:37 AM (PST) I Page 4 of 11 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 1 POLICY NUMBER: 54309508 COMMERCIAL GENERAL LIABILITY 10-02-2461 (Ed. 7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE FOR SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Additional Insured: WHERE REQUIRED BY WRITTEN CONTRACT SCHEDULE Location Of Covered Operations: ALL LOCATIONS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect only to the Additional Insured and at the Location Of Covered Operations shown in the Schedule, the following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Additional Insured with respect to the Location Of Covered Operations shown in the Schedule under this policy provided that: (1) The Additional Insured is a named insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. 10-02-2461 (Ed. 7-15) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 73665059 1 22-23 GL-AL(Phys Dam)-XS-WC-PROF-POLL INST FLTR I Jessica Flores 13/16/2023 11:07:37 AM (PST) I Page 5 of 11 This certificate cancels and supersedes ALL previously issued certificates. POLICY NO. 54309508 c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method al- so. Under this approach each insurer contrib- utes equal amounts until it has paid its appli- cable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable lim- it of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Cover- age Part in accordance with our rules and rates. To the extent that the insured's rights to recover all or part of any payment made under this Cover- age Part have not been waived, those rights are transferred to us. The insured must do nothing af- ter loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Coverage C. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expi- ration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS b. We may audit your books and records as they 1 relate to this insurance at any time during the term of this policy and up to three years after- wards. c. The first Named Insured must keep records of the information we need for premium computa- tion, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accu- rate and complete; b. Those statements are based upon representa- tions you made to us; and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this in- surance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Or Waiver Of Rights Of Recovery Against Others To Us We will waive the right of recovery we would oth- erwise have had against another person or organ- ization, for loss to which this insurance applies, provided the insured has waived their rights of re- covery against such person or organization in a contract or agreement that is executed before such loss. "Advertisement" means an electronic, oral, written or other notice, about goods, products or services, designed for the specific purpose of attracting the general public or a specific market segment to use such goods, products or services. "Advertisement" does not include any e-mail ad- dress, Internet domain name or other electronic address or metalanguage. 2. "Advertising injury" means injury, other than "bodi- ly injury", "property damage" or "personal injury", sustained by a person or organization and caused by an offense of infringing, in that particular part of your "advertisement" about your goods, products or services, upon their: a. Copyrighted "advertisement"; or b. Registered collective mark, registered service mark or other registered trademarked name, slogan, symbol or title. 3. "Asbestos" means asbestos in any form, including its presence or use in any alloy, by-product, com- pound or other material or "waste". 4. "Auto" means: a. A land motor vehicle, trailer or semitrailer de- signed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a com- pulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However, "auto" does not include "mobile equip- ment". 5."Bodily injury" means physical: a. Injury; b. Sickness; or c. Disease; Page 12 of 16 Includes copyrighted material of ISO Properties, Form 10-02-1800 (Rev. 6-09) Inc., with its permission '731.45059 1 22-23 GL-AL(Phylt: Dam)-XS WC -PROF -POLL INST FLTR I Jesalc.� Flores 13/16/2023 11:07:37 AM (PST) I Page 6 of 11 This certificate cances and supersedes ALL previously issued certificates. 54309507 COMMERCIAL AUTOMOBILE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEfihENT This endorsement modifies insurance provided under the following; BUSINESS AUTO COVERAGE FORM This endorsement modifies the Business Auto Coverage Form. 1. EXTENDED CANCELLATION CONDITION Paragraph A2.b. — CANCELLATION - of the COMMON POLICY CONDITIONS form IL 00 17 is deleted and replaced with the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations As Insureds The Named Insured shown in the Declarations is amended to include: 1. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form - However, the Named Insured does not include any subsidiary that is an `insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. 2. Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is an "insured" under any other automobile policy; (b) That has exhausted its Limit of Insurance under any other policy; or (c) 180 days or more after its acquisition or formation by you, unless you have given us written notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization. B. Employees as Insureds Paragraph A. 1. — WHO IS AN INSURED — of SECTION II — LIABILITY COVERAGE is amended to add the following: d. Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A.I. — WHO IS AN INSURED — of SECTION II —LIABILITY COVERAGE is amended to add the following: e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor; and (2) The "auto" is leased without a driver. Such leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by: 1. You; 2. Any of your 'employees' or agents; or 3. Any person, except the lessor or any "employee" or agent of the lessor, operating an "auto" with the permission of any of 1. and/or 2. above. D. Persons And Organizations As Insureds Under A Written Insured Contract Paragraph A 1 — WHO IS AN INSURED — of SECTION II — LIABILITY COVERAGE is amended to add the following: f. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed under an express provision in a written "insured contracts, written agreement or a written permit issued to you by a governmental or public authority to add such person or organization to this policy as an "insured". However, such person or organization is an "insured" only: Form: 16-02-0292 (Rev. 11-16) Page 1 of 3 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" !'059 122-23 GL-AL Dam)-XS :- F-POLL INST FLTR I JessiCa Flores 112023 11:07:37 AM (PST) I Page 7 of 11 ?'?t:s certificate ca:;ccls and s`.ipi scdes ALL previously issued certifica/16/tes. 54309507 3. S. (1) with respect to the operation, maintenance or use of a covered "auto"; and (2) for "bodily injury" or "property damage" caused by an "accident" which takes place after (a) You executed the "insured contract' or written agreement; or (b) The permit has been issued to you. FELLOW EMPLOYEE COVERAGE EXCLUSION B.5. - FELLOW EMPLOYEE — of SECTION II — LIABILITY COVERAGE does not apply. PHYSICAL DAMAGE — ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A_4.a. — TRANSPORTATION EXPENSES —of SECTION III —PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day for temporary transportation expense, subject to a maximum limit of $1,000. AUTO LOANILEASE GAP COVERAGE Paragraph A. 4. — COVERAGE EXTENSIONS - of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: c. Unpaid Loan or Lease Amounts In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the loan or lease for a covered "auto" minus: 1. The amount paid under the Physical Damage Coverage Section of the policy; and 2. Any: a. Overdue loan/lease payments at the time of the "loss"; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; c. Security deposits not returned by the lessor: d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or leaser and e. Carry-over balances from previous loans or leases. We will pay for any unpaid amount due on the loan or lease if caused by: 1. Other than Collision Coverage only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto'; 2. Specified Causes of Loss Coverage only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto'; or 3. Collision Coverage only if the Declarations indicate that Collision Coverage is provided for any covered "auto, S. RENTAL AGENCY EXPENSE Paragraph A- 4. — COVERAGE EXTENSIONS — of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: .d. Rental Expense We will pay the following expenses that you or any of your 'employees" are legally obligated to pay because of a written contract or agreement entered into for use of a rental vehicle in the conduct of your business: MAXIMUM WE WILL PAY FOR ANY ONE CONTRACT OR AGREEMENT: 1. $2,500 for loss of income incurred by the rental agency during the period of time that vehicle is out of use because of actual damage to, or "loss" of, that vehicle, including income lost due to absence of that vehicle for use as a replacement; 2. $2,500 for decrease in trade-in value of the rental vehicle because of actual damage to that vehicle arising out of a covered "loss'; and '3. $2,500 for administrative expenses incurred by the rental agency, as stated in the contract or agreement. 4. $7,500 maximum total amount for paragraphs 1., 2. and 3. combined, 7, EXTRA EXPENSE — BROADENED COVERAGE Paragraph A.4. — COVERAGE EXTENSIONS — of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: e. Recovery Expense We will pay for the expense of returning a stolen covered "auto" to you. 8. AIRBAG COVERAGE Paragraph 13.3.a. - EXCLUSIONS — of SECTION III — PHYSICAL DAMAGE COVERAGE does not apply to the accidental or unintended discharge of an airbag. Coverage is excess over any other collectible insurance or warranty specifically designed to provide this coverage. 9. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT - BROADENED COVERAGE Paragraph CA.b. — LIMIT OF INSURANCE - of SECTION III - PHYSICAL DAMAGE is deleted and replaced with the following: b. $2,000 is the most we will pay for "loss" in any one "accident" to all electronic equipment that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or (3) An integral part of such equipment. 10. GLASS REPAIR —WAIVER OF DEDUCTIBLE Form: 16-02-0292 (Rev. 11-16) Page 2 of 3 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" <'059 1 22-23 GL-AL Dam)-XS :. } ::LL INST FLTR I Jes- Flores 1 3/16/2023 11:07:37 AM (PST) I Page B of 11 Ti:•;:; certificate ca:...,:'a and s.:..�_::'�.-:ie: ALL previously :..:-;:ed certificates. 54309507 Under Paragraph D. - DEDUCTIBLE — of SECTION III — PHYSICAL DAMAGE COVERAGE the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 11. TWO OR MORE DEDUCTIBLES Paragraph D.- DEDUCTIBLE — of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: If this Coverage Form and any other Coverage Form or policy issued to you by us that is not an automobile policy or Coverage Form applies to the same "accident", the following applies: 1. If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; or 2. if the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Paragraph A.2.a. - DUTIES IN THE EVENT OF AN ACCIDENT, CLAIM, SUIT OR LOSS of SECTION IV - BUSINESS AUTO CONDITIONS is deleted and replaced with the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when the "accident' is known to: (1) You or your authorized representative, if you are an individual; (2) A partner, or any authorized representative, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer, insurance manager, or authorized representative, if you are an organization other than a partnership or limited liability company. Knowledge of an "accident', claim, "suit" or "loss" by other persons does not imply that the persons listed above have such knowledge. Notice to us should include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons or witnesses. 13. WAIVER OF SUBROGATION Paragraph A.5. - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US of SECTION IV— BUSINESS AUTO CONDITIONS is deleted and replaced with the following: 5. We will waive the right of recovery we would otherwise have against another person or organization for "loss" to which this insurance applies, provided the "insured" has waived their rights of recovery against such person or organization under a contract or agreement that is entered into before such "loss". To the extent that the "insured's" rights to recover damages for all or part of any payment made under this insurance has not been waived, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them_ At our request, the insured will bring suit or transfer those rights to us and help us enforce them. 14. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph B.2. —CONCEALMENT, MISREPRESENTATION or FRAUD of SECTION IV — BUSINESS AUTO CONDITIONS - is deleted and replaced with the following: If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not void coverage under this Coverage Form because of such failure. 15. AUTOS RENTED BY EMPLOYEES Paragraph B.5. - OTHER INSURANCE of SECTION IV— BUSINESS AUTO CONDITIONS - is amended to add the following: e. Any "auto" hired or rented by your -employee" on your behalf and at your direction will be considered an "auto" you hire. If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. 16. HIRED AUTO —COVERAGE TERRITORY Paragraph 13.7.b.(5). - POLICY PERIOD, COVERAGE TERRITORY of SECTION IV — BUSINESS AUTO CONDITIONS is deleted and replaced with the following: (5) A covered "auto" of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 45 days or less; and 17. RESULTANT MENTAL ANGUISH COVERAGE Paragraph C. of - SECTION V —DEFINITIONS is deleted and replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death as a result of the "bodily injury" sustained by that person. Form: 16-02-0292 (Rev. 11-16) Page 3 of 3 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" 73445059 1 22-23 GL-AL(P6ys Dam)-XS-NC-PROF-POLL INST FLTR I Jessica Flores 1 1/16/2023 11:07:37 AM (PST) I Page 9 of 11 This certificate cancels and supersedes ALL previously issued certificates. POLICY NUMBER:54309507 COMMERCIAL AUTO 16-02-0316 Ed. 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY LIABILITY INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Team Ghilotti, Inc. Endorsement Effective Date: 10/01/2022 SCHEDULE Name(s) Of Person(s) Or Organization(s): As required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Item 5. — "Other Insurance" of Item B. — "General Conditions" under Section IV — "Business Auto Conditions": e. Regardless of the provisions of Paragraph 5.a. through d. above, for any liability arising out of the ownership, maintenance, use, rental, lease, loan, hire or borrowing by an "insured" of a covered "auto" for which an "insured" is contractually obligated to provide primary insurance coverage to a client, this Coverage Form will be primary and non-contributory with respect to the Persons or Organizations in the schedule, regardless of the availability or existence of other collectible insurance under any other Coverage Form or policy that applies on a primary basis. 16-02-0316 Ed. 10 14 73445059 22-23 GL-AL:i'nye Dam)-XS-WC-PROF-POLL INST FLTR I Jessica Flores 1 3/16/2023 11:07:37 AM (PST) I Page 10 of 11 rt This ceificate cancels and supersedes ALL previously issued certificates. Page 1 of 1 Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Team Ghilotti, Inc. Policy Number 54309509 Symbol: Number: Policy Period Effective Date of Endorsement TO 10/01 /2023 10/01 /2022 Issued By (Name of Insurance Company) Federal Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (X ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: WHERE REQUIRED BY WRITTEN CONTRACT 3. Premium: n/a The premium charge for this endorsement shall be percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: n/a L"U7" Xfiia& Authoriz d Representative WC 90 03 75 (05/18) 73445059 i 22-23 GL-AL(Phys Dam)-XS-NC-PROF-POLL INST FLTR i Jessica Flores i 3/26/2023 11:07:37 AM (PST) i Page 11 of 11 This certificate cancels and supersedes ALL previously issued certificates. RAP <1 ►1, z yo /Ty WITH P'�\� CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Public Works Project Manager: Nataly Torres (for Philip Buckley) Extension: 3353 Contractor Name: Team Ghilotti Contractor's Contact: Joe Moreira Contact's Email: JoeM@teamghilotti.com ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED REVIEWER DEPARTMENT DATE Check/Initial 1 Project Manager a. Email PINS Introductory Notice to Contractor Click here to L enter a date. b. Email contract (in Word) and attachments to City 3/17/2023 Attorney c/o Laraine.Gittens@cityofsanrafael.org 3/17/2023 ❑X NT 2 City Attorney a. Review, revise, and comment on draft agreement and return to Project Manager 3/17/2023 ❑X GC b. Confirm insurance requirements, create Job on PINS, send PINS insurance notice to contractor ® GC 3 Department Director Approval of final agreement form to send to ® AM 3/17/2023 contractor Project Manager Forward three (3) originals of final agreement to 4 3/20/2023 contractor for their signature 5 Project Manager When necessary, contractor -signed agreement ❑X N/A agendized for City Council approval * *City Council approval required for Professional Services 0 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 5/4/2023 NT Attorney with printed copy of this routing form Review and approve hard copy of signed ,off 7 City Attorney I/ I27 _ agreement V� 8 City Attorney Review and approve insurance in PINS , and bonds 9 City Manager / Mayor (for Public Works Contracts) Agreement executed by City Council authorized , official (/ 10 City Clerk Attest signatures, retains original agreement and 40d Y forwards copies to Project Manager A _ / ,