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HomeMy WebLinkAboutPW Jessup Street & East Street Storm Drain ImprovementsCity of San Rafael * California Form of Contract Agreement for Informal Bids Jessup Street at East Street Storm Drain Improvements This Agreement is made and entered into this 47N day of 061016tQE 9 . 2015 by and between the City of San Rafael (hereinafter called City) and W.R. Forde Associates, a general partnership (hereinafter called Contractor). Witnesseth, that the City and the Contractor, for the considerations hereinafter named, agree as follows: 1. Scope of the Work. The Contractor hereby agrees to furnish all of the materials and all of the equipment and labor necessary to perform the work for the project entitled "Jessup Street at East Street Storm Drain Improvements," all in accordance with the requirements and provisions of the Construction Plan attached hereto asAttachment A. 2. Time of Completion. (a) The work to be performed under this Contract shall be commenced within FIVE (5) WORKING DAYS after the date of written notice by the City to the Contractor to proceed. (b) All work, including punchlist items, shall be completed within 10 WORKING DAYS, and with such reasonable extensions of time as may be requested by Contractor and approved by City. 3. Liquidated Damages. It is agreed that, if all the work required by the contract is not finished or completed within the number of working days as set forth in the contract, damage will be sustained by the City, and that it is and will be impracticable and extremely difficult to ascertain and determine the actual damage which the City will sustain in the event of and by reason of such delay; and it is therefore agreed that the Contractor will pay to the City, the sum of $1,200 for each and every working day's delay in finishing the work in excess of the number of working days prescribed above; and the Contractor agrees to pay said liquidated damages herein provided for, and further agrees that the City may deduct the amount thereof from any moneys due or that may become due the Contractor under the contract. 4. The Contract Sum. The City shall pay to the Contractor for the performance of the Contract the amounts determined for the total number of each of the untis for work in the following scheduled completed at the unit price stated. The number of units contained in this schedule is approximately only, and the final payment shall be made for the actual number of units that are incorporated in or made necessary by the work covered by the Contract. BID ITEMS ITEM DESCRIPTION ESTIMATED UNIT UNIT TOTAL PRICE QUANTITY PRICE Jessup Street at East Street Storm Drain 1 LS ri Improvements $22,145.00 $..22,..1..45....0.0.. GRAND TOTAL BID $22.145.00 5. Progress Payments. (a) On not later than the 6th day of every month the Public Works Department shall prepare and submit an estimate covering the total quantities under each item of work that have been completed from the start of the job up to and including the 25th day of the preceding month, and the value of the work so completed determined in accordance with the schedule of unit prices for such items together with such supporting evidence as may be required by the City and/'or Contractor . (b) As soon as possible after the preparation of the estimate, the City shall, after deducting previous payments made, pay to the Contractor 95% of the amount of the estimate as approved by the Public Works Department. (c) The Contractor may elect to receive 1000o of payments due under the contract from time to time, without retention of any portion of the payment by the public agency, by depositing securities of equivalent value with the public agency in accordance with the provisions of Section 4590 of the Government Code. Such securities, if deposited by the Contractor, shall be valued by the City's Finance Director, whose decision on valuation of the securities shall be final. Agreement • 1 6. Acceptance and Final Payment. (a) Upon receipt of written notice that the work is ready for final inspection and acceptance, the Engineer shall within 5 days make such inspection, and when he finds the work acceptable under the Contract and the Contract fully performed, he will promptly issue a Notice of Completion, over his own signature, stating that the work required by this Contract has been completed and is accepted by him under the terns and conditions thereof, and the entire balance found to be due the Contractor, shall be paid to the Contractor by the City as soon as possible, (b) Before final payment is due the Contractor shall submit evidence satisfactory to the Engineer that all payrolls, material bills, and other indebtedness connected with work have been paid, except that in case of disputed indebtedness or liens the Contractor may submit in lieu of evidence of payment a surety bond satisfactory to the City guaranteeing payment of all such disputed amounts when adjudicated in cases where such payment has not already been guaranteed by surety bond. (c) The making and acceptance of the final payment shall constitute a waiver of all claims by the City, other than those arising from any of the following: (1) unsettled liens; (2) faulty work appearing within 12 months after final payment; (3) requirements of the specifications; or (4) manufacturers' guarantees. It shall also constitute a waiver of all claims by the Contractor, except those previously made and still unsettled. Such payment shall be made under the terms and conditions governing final payment, except that it shall not constitute a waiver of claims. 7. Insurance. (a). Scope of Coverage. During the term of this Agreement, Contractor shall maintain, at no expense to City, the following insurance policies: 1. A commercial general liability insurance policy in the minimum amount of one million dollars ($1,000,000) per occurrence%'two million dollars ($2,000,000) aggregate, for death, bodily injury, personal injury, or property damage. 2. An automobile liability (owned, non -owned, and hired vehicles) insurance policy in the minimum amount of one million dollars ($1,000,000) dollars per occurrence. 3. If it employs any person, Contractor shall maintain worker's compensation and employer's liability insurance, as required by the State Labor Code and other applicable laws and regulations, and as necessary to protect both Contractor and City against all liability for injuries to Contractor's officers and employees. Contractor's worker's compensation insurance shall be specifically endorsed to waive any right of subrogation against City. (b) Other Insurance Requirements. The insurance coverage required of the Contractor in subparagraph (a) of this section above shall also meet the following requirements: 1. The insurance policies shall be specifically endorsed to include the City, its officers, agents, employees, and volunteers, as additionally named insureds tinder the policies. 2. The additional insured coverage under Contractor's insurance policies shall be primary with respect to any insurance or coverage maintained by City and shall not call upon City insurance or self-insurance coverage for any contribution. The "primary and noncontributory" coverage in Contractor's policies shall be at least as broad as ISO form CG20 0104 13. 3. The insurance policies shall include, in their text or by endorsement, coverage for contractual liability and personal injury. 4. Tile insurance policies shall be specifically endorsed to provide that the insurance carrier shall not cancel, terminate or otherwise modify the terms and conditions of said insurance policies except upon ten (10) days written notice to City. Agreement • 2 5. If the insurance is written on a Claims Made Form, then, following tennination of this Agreement, said insurance coverage shall survive for a period of not less than five years. 6. The insurance policies shall provide for a retroactive date of placement coinciding with the effective date of this Agreement. 7. The limits of insurance required in this Agreement may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and noncontributory basis for the benefit of City (if agreed to in a written contract or agreement) before City's own insurance or self-insurance shall be called upon to protect it as a named insured. S. It shall be a requirement under this Agreement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be available to City or any other additional insured party. Furthermore, the requirements for coverage and limits shall be: (1) the minimum coverage and limits specified in this Agreement; or (2) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the named insured; whichever is greater. (c ) Deductibles and SIR'S. Any deductibles or self-insured retentions in Contractor's insurance policies must be declared to and approved by the City, and shall not reduce the limits of liability. Policies containing any self-insured retention (SIR) provision shall provide or be endorsed to provide that the SIR may be satisfied by either the named insured or City or other additional insured party. At City's option, the deductibles or self-insured retentions with respect to City shall be reduced or eliminated to City's satisfaction, or Contractor shall procure a bond guaranteeing payment of losses and related investigations, claims administration, attorney's fees and defense expenses. (d) Proof of Insurance. Contractor shall provide to the City all of the following: (1) Certificates of Insurance evidencing the insurance coverage required in this Agreement; (2) a copy of the policy declaration page andr'or endorsement page listing all policy endorsements for the commercial general liability policy, and (3) excerpts of policy language or specific endorsements evidencing the other insurance requirements set forth in this Agreement. City reserves the right to obtain a full certified copy of any insurance policy and endorsements from Contractor. Failure to exercise this right shall not constitute a waiver of the right to exercise it later. The insurance shall be approved as to form and sufficiency by City. S. Indemnifcation (a) Contractor shall, to the fullest extent permitted by law, indemnify, release, defend with counsel approved by City, and hold harmless City, its officers, agents, employees and volunteers (collectively, the "City Indemnitees"), from and against any claim, demand, suit, judgment, loss, liability or expense of any kind, including but not limited to attorney's fees, expert fees and all other costs and fees of litigation, (collectively "CLAIMS"), arising out of Contractor's performance of its obligations or conduct of its operations under this Agreement. The Contractor's obligations apply regardless of whether or not a liability is caused or contributed to by the active or passive negligence of the City Indemnitees. However, to the extent that liability is caused by the active negligence or willful misconduct of the City Indemnitees, the Contractor's indemnification obligation shall be reduced in proportion to the City Indemnitees' share of liability for the active negligence or willful misconduct. In addition, the acceptance or approval of the Contractor's work or work product by the City or any of its directors, officers or employees shall not relieve or reduce the Contractor's indemnification obligations. In the event the City Indemnitees are made a party to any action, lawsuit, or other adversarial proceeding arising from Contractor's performance of or operations under this Agreement, Contractor shall provide a defense to the City Indemnitees or at City's option reimburse the City Indemnitees their costs of defense, including reasonable attorneys' fees, incurred in defense of such claims. (b) The defense and indemnification obligations of this Agreement are undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this Agreement, and shall survive the termination or completion of this Agreement for the full period of time allowed by law. 9. Nondiscrimination Contractor shall not discriminate, in any way, against any person on the basis of age, sex, race, color, religion, ancestry, national origin or disability in connection with or related to the performance of its duties and obligations under this Agreement. Agreement • 3 10. Compliance with All Laws Contractor shall observe and comply with all applicable federal, state and local laws, ordinances, codes and regulations, in the performance of its duties and obligations under this Agreement. Contractor shall perform all services under this Agreement in accordance with these laws, ordinances, codes and regulations. Contractor shall release, defend, indemnify and hold harmless City, its officers, agents and employees from any and all damages, liabilities, penalties, fines and all other consequences from any noncompliance or violation of any laws, ordinances, codes or regulations. 11. No Third Party Beneficiaries City and Contractor do not intend, by any provision of this Agreement, to create in any third party, any benefit or right owed by one party, under the terms and conditions of this Agreement, to the other party. 12. Notices All notices and other communications required or pennitted to be given under this Agreement, including any notice of change of address, shall be in writing and given by personal delivery, or deposited with the United States Postal Service, postage prepaid, addressed to the parties intended to be notified. Notice shall be deemed given as of the date of personal delivery, or if mailed, upon the date of deposit with the United States Postal Service. Notice shall be given as follows: To City: Public Works Director City of San Rafael 1400 Fifth Avenue P.O. Box 151560 San Rafael, CA 94915-1560 To Contractor: W.R. Forde Associates 984 Hensley Street Richmond, CA 94801 13. Independent Contractor For the purposes, and for the duration, of this Agreement, Contractor, its officers, agents and employees shall act in the capacity of an Independent Contractor, and not as employees of the City. Contractor and City expressly intend and agree that the status of Contractor, its officers, agents and employees be that of an Independent Contractor and not that of an employee of City. 14. Entire Agreement; Amendments (a) The terms and conditions of this Agreement, all exhibits attached, and all documents expressly incorporated by reference, represent the entire Agreement of the parties with respect to the subject matter of this Agreement. (b) This written Agreement shall supersede any and all prior agreements, oral or written, regarding the subject matter between the Contractor and the City. (c) No other agreement, promise or statement, written or oral, relating to the subject matter of this Agreement, shall be valid or binding, except by way of a written amendment to this Agreement. (d) The terns and conditions of this Agreement shall not be altered or modified except by a written amendment to this Agreement signed by the Contractor and the City. (e) If any conflicts arise between the terms and conditions of this Agreement, and the terms and conditions of the attached exhibits or the documents expressly incorporated by reference, the terms and conditions of this Agreement shall control. 15. Waivers The waiver by either party of any breach or violation of any term, covenant or condition of this Agreement, or of any ordinance, law or regulation, shall not be deemed to be a waiver of any other term, covenant, condition, ordinance, law or regulation, or of any subsequent breach or violation of the same or other term, covenant, condition, ordinance, law or regulation. The subsequent acceptance by either party of any fee, performance, or other consideration which may become due or owing under this Agreement. shall not be deemed to be a waiver of any preceding breach or violation by the other party of any tern, condition, covenant of this Agreement or any applicable law, ordinance or regulation. Agreement • 4 16. City Business License; Other Taxes Contractor shall obtain and maintain during the duration of this Agreement, a City business license as required by the San Rafael Municipal Code Contractor shall pay any and all state and federal taxes and any other applicable taxes. City shall not be required to pay for any work performed under this Agreement, until Contractor has provided City with a completed Internal Revenue Service Form W-9 (Request for Taxpayer Identification Number and Certification). 17. Prevailing Wages Contractor shall pay prevailing wages to all of its employees perfonning work under this Agreement in accordance with the California Labor Code Section 1771 and San Rafael Municipal Code Section 11.50.180(C). 18. Warranty: (a) Except as otherwise expressly provided in the Agreement, and excepting only items of routine maintenance, ordinary wear and tear and unusual abuse or neglect by City, Contractor warrants and guarantees all work executed and all supplies, materials and devices of whatsoever nature incorporated in or attached to the work, or otherwise provided as a part of the work pursuant to the Agreement, to be absolutely free of all defects of workmanship and materials for a period of one year after final acceptance of the entire work by the City. Contractor shall repair or replace all work or material, together with any other work or material that may be displaced or damaged in so doing, that may prove defective in workmanship or material within this one year warranty period without expense or charge of any nature whatsoever to City. (b) In the event that Contractor shall fail to comply with the conditions of the foregoing warranty within ten (10) days after being notified of the defect in writing, City shall have the right, but shall not be obligated, to repair, or obtain the repair of, the defect and Contractor shall pay to City on demand all costs and expense of such repair. Notwithstanding anything herein to the contrary, in the event that any defect in workmanship or material covered by the foregoing warranty results in a condition that constitutes an immediate hazard to public health or safety, or any property interest, or any person, City shall have the right to immediately repair, or cause to be repaired, such defect, and Contractor shall pay to City on demand all costs and expense of such repair. The foregoing statement relating to hazards to health, safety or property shall be deemed to include both temporary and permanent repairs that may be required as determined in the sole discretion and judgment of City. (c) In addition to the above, the Contractor shall make a written assignment of any applicable manufacturers' and other product warranties to the City, prior to completion and final acceptance of the work by City. Agreement • 5 IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute this Agreement the day and year first written above. CITY OF SAN RAFAEL: Jim C/7111:: City lanag V ATTEST: Fvher 4 '. Beirne City Clerk APPROVED AS TO FORM: j Robert F Epstein City Attorney File No.: 08.09.10 1V.12. FOIZDE ASSOCIATES By: Donald J. Russell President, Donald J. Russell Inc. General Partner of W. R. Forde Associates Agreement • 6 ATTACHMENT A (THIS SHEET ONLY) TYPE A; PG 64-16). COUNTY STD. DWG. 105 413 GUTTER PER PLAN. CONSTRUCT TYPE 'A' CURB 105 ON 4' MIN. CLASS 2 AB. 1 I PER . THE CONTRACTOR SHALL REFER TO 'PER NOT SHOWN ON THIS PLAN. INSTALL 5' TO, DWG. 255. BOX DEPTH ASSUMED TO BE 2.5't. 1627 SECOND STREET APN: 012-046-12 NECESSARY TO CONSTRUCT THE GALLERY INLET. THE ENTIRE UNDER SIDEWALK DRAIN PIPE (3' PVC) OWNSPOUT; DAYLIGHT AT FACE OF CURB (NOT IN IASINS AND CONNECTING 7' WIDE TRENCH DRAIN. APPROX.i w..w"% W • TECT ALL EXISTING UTILITIES IN EX. SIDEW N FOR REMOVAL G, d G --OWNER OF 15 JESSUPSTREET .._- ._ -.URS BY USE OF STEEL PLATES H 2 LBS LAMP BLACK PER CUBIC JESSUP STREET WCE WITH THE 2014 CA MUTCD. ......................................... ss SS TRUCTION STAKING. EX. FACE SALL THE LABOR, MATERIALS, OF CURBW NCIDENTALS, AND FOR DOING ALL W""' """"' """"'W AMOVEMENTS AS SHOWN ON THE — — — ''< WITHIN 10 WORKING DAYS. OH — — EX 9DEWALK APPROX. R/W 18.0't 16 HART STREET APN: 012-048-05 APPROX. PROPE ID LOCATE INTERSECTION HALF MOON AND SD PIPE; �12• SAWCUT IOVE EX. PIPES INSIDE OF V CATCH BASIN END OF TYPE 'A' CURB AND GUTTER 5.0• GALLERY INLET SCA: 1-600-227-26001 BEFORE ) � GO A GRAPHIC SCALE SND �- CA: 1-800 227-2600— CALL TWO BEFORE EG ( IN Fur ) I Ine6 - le R 7 TYPE C CATCH BASIN N.T.S. 2.0' s' Ij_ EX. DRIVEWAY FRAI 11•} 'T�INSTALL EXPANSION JOINT PAPER 6' 3.0' RAIN SECTION I.T.S. S z V) o H w Z H 2 Q Q w -I F Ij0 z_ wwO_Z wofa- O NM- U o I- -Z Q< Ir 0 U) W En Z of to OC a (n o vp°iw,at� YC tl C No. upt/�a /rA. dd' q Gl1f SCALE: 1' - 10• DATE: SEPTEMBER 2015 CITY PROJECT NO.: SHEET NO.: CP -01 DRAWING: 1 OF 1 WRFORDE-01 SKERR ACORN DATE (MM}DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/14/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0303587 1 CONTACT ISU Sander Jacobs Cassayre Insurance Services t PHONE (707 252.8822 PAX. (707 253-8255 3200 Villa Lane 11A/p, Ivo. Emrl; } j Napa, CA 94558 [ aooi ESS: lnfo@sanderjacobs.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA.Gemini Insurance Company _ 10833 INSURED INSURER B:West American Ins. Co. 44393 W. R. Forde Associates I INSURER C. Houston Casualty Company 984 Hensley Street I INSURER o: STATE COMPENSATION INS. FUND OF CA 42374 35076 Richmond, CA 94801-2117 I INSURER E. OnIER: 1 INSURER F . _S __ _ 5,0001 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THA THE POLIC ES OF INSI.IRANCE LIS'ED BELOW HAVE BEEN SSUED TO THE NSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTAND'NG ANY REOU REMEN- TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTH N, THE INSURANCE AFFORDED BY THE ROL CIES DESCR'BED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POi CIES LIMITS SHOWN MAY HAVE BEEN REDGGED BY PAID CLA MS INSR ADDLISUSR POLICY EFF POLICY YLIMITS A X COMMERCIpLOGENEURXLNLtABILITY POLICY NUMBER - ----- ,(MMIDDIYYI'Y), jMMIDD/YYY LTR IfdSD VdVO Y) - - _-- -- - --- - , EACH OCCURRENCE 5 1,000,000 CLAIMS -MADE 0 � R X VCGP021674 04/0112015 04/0112016 PREMISES(Eaoccurrencat 5 50,000 ME[: EXP (Any one person) S 5,0001 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may bo attached If more space is required) Jessup Street at East Street Storm Drain Improvements When required by written contract the City of San Rafael, its officers, employees, agents and volunteers are included as Additional Insured per policy form CG2010 04113 attached. Coverage is Primary/Non-Contributory per policy form CG2001 04/13 attached. 30 days notice of cancellation except 10 days for non -pay. Auto 30 day cancellation endorsements attached. GL 30 day cancellation endorsement applies (forthcoming from carrier). WC 30 day cancellation applies it was issued at policy inception 2013 and per State Fund is automatically renewed each year but a new endorsement cannot be generated. CERTIFICATE HOLDER City of San Rafael P.O. Box 151560 San Rafael. CA 94915-1560 ACORD 25 (2014/01) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR ZED REPRESENTATIVE 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Elaf:iONAL 8 ADV IfJJURY -n 1,000,0001 GF.N'L +GGREOAT, LIMIT APPLE R R ''" Fl"IEHAL AGGREGATE 5 2,000,0001 PO. ICY ® PEO- ❑ LOC I PR( DUCTS - COMPIOP AGG 5 2,000,0001 OnIER: ._ eductible __ _S __ _ 5,0001 AUTOMOBILE LIABILITY _ UMHINLU b1NGLE LIMIT (Ea omdenll 1,000,000 B X AI IY Au r0 SAW1655976085 04/0112015 0410112016 Bi,'1'f LILY INJURY (Per peiscn S A' OWNED SCHEDULED Bl"li ILY NJUR'r (Per acid.'u) S All l US AUTOS NON -OWNED ' r^ROPERTY DAMAGE S H ED AUTOS AUTOS (Per acwlonn 5 X UMBRELLA LIAR X OCCUR EACH OCCURHLNCE S 5,000,000 C EXCESS LIAR CLAIMS -MADE H15XC5032701 04/01/2015 04/01/20161 AGGREGATE S 5,000,0001 DED I I RE IENTIONS 1 S WORKERS COMPENSATION 1 X 1 STATUTE I I ETH I AND EMPLOYERS' LIABILITY D ANY PROPRIECOWPARTNEP.IEXECUTiVE IYIN 1962796-2015 10/01/2015 10101120161 EL EACH ACCIDENT S 1,000,0001 OFFICEMMEMBER EXCLUDED? L - I NIA (Mandatory In NH) E L DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERA710IdS b.1— -E L DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may bo attached If more space is required) Jessup Street at East Street Storm Drain Improvements When required by written contract the City of San Rafael, its officers, employees, agents and volunteers are included as Additional Insured per policy form CG2010 04113 attached. Coverage is Primary/Non-Contributory per policy form CG2001 04/13 attached. 30 days notice of cancellation except 10 days for non -pay. Auto 30 day cancellation endorsements attached. GL 30 day cancellation endorsement applies (forthcoming from carrier). WC 30 day cancellation applies it was issued at policy inception 2013 and per State Fund is automatically renewed each year but a new endorsement cannot be generated. CERTIFICATE HOLDER City of San Rafael P.O. Box 151560 San Rafael. CA 94915-1560 ACORD 25 (2014/01) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR ZED REPRESENTATIVE 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy: VCGP021674 �Ij I as I all 1014 10-40 11A.-Allme MMIXIII " I I LISIOZ [hixendorsement modifies insurance provided under the following: Commercial General Liability Coverage Purt /he following is added to the Othei- Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Immxomnmc rhis insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (|) The additional insured isuNamed Insured under such other insurance; and (Z) You have agreed inwriting iuvcontract magreement that this insurance Would hxprimary and would not seek contribution frorn any other insurance available to the additional insured. Policy: VCGP021674 Insured Name: WR FORDE ASSOCIATES CG 20 10 04 13 Effective Date: 04/01/2015 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 SCIIEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Information required to complete this Schedule, if not shown above, wiI I 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 liab lAy 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 o, o—fissions of those act ng on your behalf n the performance of your ongoing operations for the additional insureds) at the location(s) designated above However 1. The insurance afforded to such additonal 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 add trona' ensured will not be broader than that which you are required by the contract or agreement to prov de for such additiona, insured B. With respect to the insurance afforded to these ad6t ona insureds, the following additional exclusions appy Th s insurance does not apply to "bodily injury' or "property damage" occurring after- All fter All work, ncluding materials, parts or equ'pment furnished in connection with such work, on the project o other than service maintenance or repairs) to be performed by or on behalf of the add trona insured(s) at the ocat on of the covered operations has been competed 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. 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 shown in the Declarations; whichever is less This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations CG 20 � 0 04 13 COMMERCIAL AUTO CA 88 63 09 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- ing such Conditions is amended by the following: A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or organization shown in the Schedule below. In no event will the notice to the person or organization scheduled below exceed the notice to the first named insured. B. Our obligation to send notice to the person or organization listed in the Schedule below will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person or organization to maintain insurance coverage under a policy which requires that such person or organization be notified in the event of cancellation. SCHEDULE 1. Name or Person or Organization: City of an Rafael 2. Mailing Address: PO BOX 151560 San Rafael, CA 9491�j 3. Number Days Advance Notice: All other terms and conditions of this policy remain unchanged © 20121-iberty Mutual Insurance CA 88 63 09 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ENDORSEMENT AGREEMENT CERTIFICATE HOLDERS' NOTICE HOME OFFICE SAN FRANCISCO EFFECTIVE OCTOBER 1, 2013 AT 12.01 A.M ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME W R FORDE ASSOCIATES 984 HENSLEY ST RICHMOND, CA 94801 7676258-13 NEW NA 5-54-99-80 PAGE 1 OF NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: AUTHORIZED REPRESENTA IVE N:;swiI,ORM 10217 (REV 1.2012) OCTOBER 2, 2013 Fe 1 PRES DENT AND CEO 5 OLD DP 217 Policy Number: VCGP021674 VE 0139 02 13 Insured Name: WR FORDE ASSOCIATES Number: 38 Effective Date: 0&152015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARE, FULLY. NOTICE OF CANCELLATION TO DESIGNATED ENTITIES This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Name of Person or Organization: CITY OF SAN RAFAEL Street Address: P.O. BOX 151560 City: SAN RAFAEL State: CA Zip Code: 94915--1560 In consideration of an additional premium of $0.0, it is hereby agreed that: If we cancel this policy on or before the expiration date of the policy, we will mail or deliver to the person or organization shown in the schedule above, written notice of cancellation to the address included above at least 30 days before the effective date of cancellation. Notice of cancellation will state the effective date of cancellation. The policy will end on that date. If the notice is mailed, proof of mailing shall be sufficient proof of notice This endorsement shall not apply for the following reasons: a. Cancellation for nonpayment of premium; or b. Non -renewal of the policy for any reason. All other terms and conditions of the policy shall apply and remain unchanged. VE 0139 02 13 Page I of' I 61MUN-11" 9 OKI] W 2[03 Hil Named Insured: WR FORDS ASSOCIATES POLICY NO.: VCGP021674 V464 FORM NUMBER End. # TITLE VE 06 00 06 14 Common Policy Conditions CG 00 01 12 07 Commercial General Liability Coverage Form CGLDEC0514 Commercial General Liability Declarations SCHED 03 08 Schedule of Forms POLCVLTR 03 14 Vela Policy Cover Letter CMNDEC 03 08 Common Declarations VE 67 09 03 14 01 Claims Reporting IL 00 21 09 08 02 Nuclear Energy Liability Exclusion (Broad Form) VE 05 28 09 13 03 Professional Liability Exclusion VE 0525 08 11 04 California Disclosure Notice VE 05 00 09 13 05 Electromagnetic Fields Exclusion VE 04 94 09 13 06 Lead Exclusion VE 66 08 09 13 07 Asbestos Exclusion VE 06 05 04 14 08 Deductible Liability Insurance - Per Occurrence VE 0446 09 09 09 Occupational Disease Exclusion CG 21 73 01 08 10 Exclusion of Certified Acts of Terrorism VE 0106 04 08 11 Exclusion - Trade/Patent Infringement VE 0192 08 08 12 Wrap Up Exclusion VE 7902 10 11 13 Service of Suit - State of California VE 0442 07 09 14 Tainted Drywall Exclusion CG 2417 1001 15 Contractual Liability - Railroads CG 21 96 03 05 16 Silica or Silica -Related Dust Exclusion CG 21 67 12 04 17 Fungi or Bacteria Exclusion CG 20 01 04 13 18 Primary and Noncontributory - Other Insurance Condition Additional Insured - Owners, Lessees or Contractors - Completed CG 20 37 04 13 19 Operations Additional Insured - Lessor of Leased Equipment - Automatic Status VE 0586 04 13 20 When Required in Lease Agreement With You VE 05 88 04 13 21 Premium Basis Additional Insured - Owners, Lessees or Contractors - Scheduled CG 20 10 04 13 22 Person or Organization CG 21 47 12 07 23 Employment Related Practices Exclusion VE 05 72 03 14 24 New Single Family Residential Project Exclusion VE 05 73 08 13 25 Multi -Family Residential Project Exclusion SCHED 03 08 Page 1 of 2 FORM NUMBER End. # TITLE VE 05 91 08 13 26 Condominium Conversion Exclusion VE 05 92 08 13 27 New Small Format Multi -Family Residential Project Exclusion CG 24 04 05 09 28 Waiver of Transfer to Rights of Recovery Against Others To Us VE 04 95 09 13 29 Punitive Damages Exclusion VE 06 10 09 13 30 Radioactive Material or Contamination Exclusion CG 24 26 04 13 31 Amendment of Insured Contract Definition VE 01 07 10 13 32 Exclusion - Exterior Insulation and Finish Systems Designated Construction Project(s) General Aggregate Limit - Subject VE 01 84 12 13 33 To A Maximum Aggregate Subcontractor and Independent Contractor Conditional Amendment of VE 05 81 02 14 34 Deductible VE 0506 06 14 35 Amendment - Premium Audit VE 6640 09 14 36 Exclusion - Continuous or Progressive Damage Claims Additional Insured - Owners, Lessees or Contractors - Scheduled VE 0224 09 14 37 Person or Organization - Including Completed Operations - Residential Projects Only VE 0139 02 13 38 Notice of Cancellation to Designated Entities SCHED 03 08 Page 2 oft SAN i5 ..,..2 .1.1. IFO`z��� PROFESSIONAL SERVICES AGREEMENT/CONTRACT COMPLETION CHECKLIST AND ROUTING SLIP Below is the process for getting your professional services agreements/contracts finalized and executed. Please attach this "Completion Checklist and Routing Slip" to the front of your contract as you circulate it for review and signatures. Please use this form for all professional services aLyreements/contracts (not just those requiring City Council approval). This process should occur in the order presented below. Step Responsible Description Department 1 City Attorney Review, revise, and comment on draft agreement. 2 Contracting Department Forward final agreement to contractor for their signature. Obtain at least two signed originals from contractor. 3 Contracting Department Agendize contractor -signed agreement for Council approval, if Council approval necessary (as defined by City Attorney/City Ordinance*). 4 City Attorney Review and approve form of agreement; bonds, and insurance certificates and endorsements. 5 City Manager / Mayor / or Agreement executed by Council authorized Department Head official. 6 City Clerk City Clerk attests signatures, retains original agreement and forwards copies to the contracting department. Completion Date 011 WWW rrn ivlwab To be completed by Contracting Department: Project Manager: (.41,71, �f�. _. Project Name: 1 i �� . � '� Agendized for City Council Me utg of (�ff necessary): If you have questions on this process, please contact the City Attorney's Office at 485-3080. * Council approval is required if contract is over $20,000 on a cumulative basis.