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CC Resolution 11531 (Valley View Ave. Drainage Impr.)
RESOLUTION NO. 11531 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL AWARDING THE CONTRACT FOR VALLEY VIEW AVENUE DRAINAGE IMPROVEMENTS, CITY PROJECT NO. 15001, TO MAGGIORA & GHILOTTI, INC., IN THE AMOUNT OF $59,280.00. WHEREAS, on the 6th day of April, 2004, pursuant to due and legal notice published in the manner provided by law, inviting sealed bids for proposals for the work hereinafter mentioned, as more fully appears from the Affidavit of Publication thereof on file in the office of the City Clerk of the City of San Rafael, California, the City Clerk of said City did publicly open, examine, and declare all sealed bids or proposals for doing the following work in said City, to wit: "VALLEY VIEW AVENUE DRAINAGE IMPROVEMENTS" CITY PROJECT NO. 15001 in accordance with the plans and specifications therefore on file in the office of said City Clerk; and WHEREAS, the bid of Maggiora & Ghilotti, Inc. at the unit prices stated in its Bid was and is the lowest and best bid for said work and said bidder is the lowest responsible bidder therefore; NOW, THEREFORE, BE IT RESOLVED that the Bid of Maggiora & Ghilotti, Inc. and the same is hereby accepted at said unit prices and that the contract for said work and improvements be and the same is hereby awarded to said Maggiora & Ghilotti, Inc. at the unit prices mentioned in said Bid. ORIGINAL /3**\ \\11 BE IT FURTHER RESOLVED, that the Mayor and City Clerk of said City be authorized and directed to execute a contract with Maggiora & Ghilotti, Inc. for said work and to return the bidders bond upon the execution of said contract. BE IT FURTHER RESOLVED, that the Director of Public Works is hereby authorized to take any and all such actions and make changes as may be necessary to accomplish the purpose of this resolution. I, JEANNE M. LEONCINI, City Clerk of the City of San Rafael, hereby certify that the foregoing resolution was duly and regularly introduced and adopted at a regular meeting of the Council of said City held on the 19`h day of April, 2004, by the following vote, to wit: AYES: COUNCIL MEMBERS: Cohen, Heller, 1.1i l l er, Phillips & Ma /or Boro NOES: COUNCIL MEMBERS: None ABSENT: COUNCIL MEMBERS: None JEANA M. LEONCINI, City Clerk File No. 08.02.219 City of San Rafael . California APR 20M Form of Contract Agreement h/IAGGIORA .oc For GHILATTI, INC. Valley View Avenue Drainage Improvements Project No: 15001 This Agreement is made and entered into this 19th day of April 2004 by and between the City of San Rafael (hereinafter called City) and Maggiora & Ghilotti, Inc. (hereinafter called Contractor). Witnesseth, that the City and the Contractor, for the considerations hereinafter named, agree as follows: II - Scope of the Work The Contractor hereby agrees to furnish all of the materials and all of the equipment and labor necessary, and to perform all of the work shown on the plans and described in the specifications for the project entitled: Valley View Drainage Improvements, Project No: 15001, all in accordance with the requirements and provisions of the Contract Documents as defined in the General Conditions which are hereby made a part of this Agreement. III- Time of Completion (a) The work to be performed under this Contract shall be commenced within 5 calendar days after the date of written notice by the City to the Contractor to proceed. (b) The work shall be completed within 15 DAYS working days after the date of such notice and with such extensions of time as are provided for in the General Conditions. IIII - Liquidated Damages It is agreed that, if all the work required by the contract is not finished or completed within the number of working days as set forth in the contract, damage will be sustained by the City, and that it is and will be impracticable and extremely difficult to ascertain and determine the actual damage which the City will sustain in the event of and by reason of such delay; and it is therefore agreed that the Contractor will pay to the City, the sum of $500 for each and every calendar day's delay in finishing the work in excess of the number of working days prescribed above; and the Contractor agrees to pay said liquidated damages herein provided for, and further agrees that the City may deduct the amount thereof from any moneys due or that may become due the Contractor under the contract. IV - The Contract Sum The City shall pay to the Contractor for the performance of the Contract the amounts determined for the total number of each of the units of work in the following schedule completed at the unit price stated. The number of units contained in this schedule is approximate only, and the final payment shall be made for the actual number of units that are incorporated in or made necessary by the work covered by the Contract. AGREEMENT • 1 (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). On not later than the 15th day of the month, the City shall, after deducting previous payments made, pay to the Contractor 90% of the amount of the estimate as approved by the Public Works Department. (c). Final payment of all moneys due shall be made within 15 days after the expiration of 35 days following the filing of the notice of completion and acceptance of the work by the Public Works Department. (d). The Contractor may elect to receive 100% of payments due under the contract from time to time, without retention of any portion of the payment by the public agency, by depositing securities of equivalent value with the public agency in accordance with the provisions of Section 4590 of the Government Code. Such securities, if deposited by the Contractr, shall be valued by the City's Finance Director, whose decision on valuation of the securities shall be final. VI - Acceptance and Final Payment (a) Upon receipt of written notice that the work is ready for final inspection and acceptance, the Engineer shall within 5 days make such inspection, and when he finds the work acceptable under the Contract and the Contract fully performed, he will promptly issue a Notice of Completion, over his own signature, stating that the work required by this Contract has been completed and is accepted by him under the terms and conditions thereof, and the entire balance found to be due the Contractor, including the retained percentage, shall be paid to the Contractor by the City within 15 days after the expiration of 35 days following the date of recordation of said Notice of Completion. AGREEMENT 9 2 (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 Contractor shall provide a "Defective Material and Workmanship Bond" for 50% of the Contract Price, before the final payment will be made. (d) The making and acceptance of the final payment shall constitute a waiver of all claims by the City, other than those arising from any of the following: (1) unsettled liens; (2) faulty work appearing within 12 months after final payment; (3) requirements of the specifications; or (4) manufacturers' guarantees. It shall also constitute a waiver of all claims by the Contractor, except those previously made and still unsettled. (e) If after the work has been substantially completed, full completion thereof is materially delayed through no fault of the Contractor, and the Engineer so certifies, the City shall, upon certificate of the Engineer, and without terminating the Contract, make payment of the balance due for that portion of the work fully completed and accepted. Such payment shall be made under the terms and conditions governing final payment, except that it shall not constitute a waiver of claims. IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute this Agreement the day and year first written above. ATTEST: � . lZe M. Leoncini Citv Clerk Vl ly NILVI IICy CWert. RAFAEL: ro Mayor _ 11 CO for L AGREEMENT • 3 CONTRACTOR'S BOND FOR FAITHFUL PERFORMANCE (BOND ISSUED IN DUPLICATE) KNOW ALL MEN BY THESE PRESENTS: TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hartford, Connecticut 06183 BOND NO. 104181896 PREMIUM: $311.00 That we, MAGGIORA AND GHILOTTI, INC. as Principal, and TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, a corporation organized under the laws of the State of Connecticut and duly authorized under the laws of the State of California to become sole surety on bonds and undertakings, as Surety, are held and firmly bound unto CITY OF SAN RAFAEL as Obligee, in the full and just sum of FIFTY-NINE THOUSAND TWO HUNDRED EIGHTY AND NO/100THS Dollars, ($ 59,280.00) lawful money of the United States of America, to be paid to the said Obligee, successors or assigns; for which payment, well and truly to be made, we bind ourselves, our heirs, executors, successors, administrators and assigns, jointly and severally, firmly by these presents. Sealed with our seals and dated this 19TH day of APRIL 12004 THE CONDITION OF THE ABOVE OBLIGATION is such that whereas the said Principal has entered into a contract or is about to enter into a contract with the said Obligee VALLEY VIEW AVENUE DRAINAGE IMPROVEMENTS PROJECT NO. 15001 as is more specifically set forth in said contract, to which contract reference is hereby made. NOW, THEREFORE, if the said Principal shall well and truly do the said work, and fulfill each and every of the covenants, conditions and requirements of the said contract in accordance with the plans and specifications, then the above obligation to be void, otherwise to remain in full force and virtue. I l MAGGIO GH O ary Ghilow President TRAVELERS CASUALTY A DS COMPANY OF AMERICA By V— KELLY HOLTEMANN, Attorney -in -Fact CALIFORNIA ALL. -PURPOSE ACKNOWLEDGMENT State of California County of SONOMA ss. On 4/19/04 before me, LAWRENCE J. COYNE, NOTARY PUBLIC Date Name and Title of Officer (e.g., "Jane Doe, Notary Public") personally appeared -------KELLY HOLTEMANN------------------------------ r Name(s) of Signers) .: LAWRENCE J. COYNE -,-C. Commission # 1281143 z Notary Publir: - Carifomia Sonoma Courtly My Comm. B�p*nm Oct M, 2M4 Place Notary Seal Above M personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(x) whose name(s) is/m�ar, subscribed to the within instrument and acknowledged to me thattxdshe executed the same in ±PbYher/x authorized capacity, and that by kk;kher1kxAK signature(x) on the instrument the person(%), or the entity upon behalf of which the personf;s� acted, executed the instrument. WITNESS my hand and official seal. Sigrq re of Nota Public OPTIONAL Though the information below is not required by law, ifmay prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: APRIL 19, 2004 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General IN Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: IialC .1� CIU d 1 N� C ►1� N/A SLY HOLTEMANN Number of Pages: ONE Top of thumb here Signer Is Representing: TRAVELERS CASUALTY AND SURETY COMPANY OF tiMKRICA41 ��:�%iJU�.r'�.�'-':7GC:t%(:Y'*S��.S`_..�'��%��.Jr=ir�.'�-/�.^�C:����>�%S`M v`-G'�.:�rc=�%tG✓:.'v.:�=_;:�.��:.`%i��:.`%o`��=L"�%�:=%3���C..�%C%_.:%C-,v_':' 01999 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313.2402 • www.nationalnotary.org Prod. No. 5907 Asorder. Call Toll -Frees 1 -BOO -976.6827 PAYMENT BOND - PUBLIC WO SECTIONS 3247 - 3252, CIVIL C"JE (CALIFORNIA) (BOND ISSUED IN DUPLICATE) KNOW ALL MEN BY THESE PRESENTS: TRAVELERS CASUAL 4ND SURETY COMPANY OF AMERICA f urtford, Connecticut 06183 Bond No.104181896 Premium $(INCLUDED) THAT WHEREAS, The State of California, acting by and through the CITY OF SAN RAFAEL has awarded to MAGGIORA AND GHILOTTI, INC. as Contractor, a contract for the work described as follows: VALLEY VIEW AVENUE DRAINAGE IMPROVEMENTS PROJECT NO. 15001 AND WHEREAS, Said Contractor is required to furnish a bond in connection with said contract, to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW, THEREFORE, We the undersigned Contractor and Surety are held and firmly bound unto the State of California in the amount required by law, the sum of FIFTY-NINE THOUSAND TWO HUNDRED EIGHTY AND NO/100THS - ($ 59,280.00 ) Dollars, for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, That if said Contractors shall fail to pay (1) Any of the persons named in Civil Code Section 3181, (2) amounts due under the Unemployment Insurance Code for work or labor performed in connection with said contract by any such claimant, or (3) any amounts required to be deducted, withheld and paid over to the Employment Development Department from wages of the employees of Contractor and his sub -contractors with respect to such work and labor, pursuant to Section 13020 of the Unemployment Insurance Code, then the Surety or Sureties herein will pay for the same in an aggregate amount not exceeding the sum specified in this bond, and also in case suit is brought upon the bond, a reasonable attorney's fee, to be fixed by the court, otherwise the above obligation shall be void. This bond shall inure to the benefit of any of the persons named in Civil Code Section 3181 so as to give a right of action to such persons or their assigns in any suit brought upon this bond. This bond is executed and filed to comply with the provisions of the act of Legislature of the State of California as designated in Civil Code, Sections 3247 - 3252 inclusive, and all amendments thereto. IN WITNESS WHEREOF, We have hereunto set our hands and seals on this 19TH day of APRIL , 2004 MAGGI AND GH OT_ TI, INC. Contractor Gary Ghilatti President TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA By KELLY HOLTEMANN, Attorney -in -Fact TrKveor IMPOt k f A T DISCLOSURE NOTICIE OF T 2RRDR1SM -B Sid WCE COVERAGE On -November _26, 2002, President Hush signed into -law thq Tarrods-in -Risk Insurance Act of 2002 ' (the "Act"): -The Act . establishes a shaf term -program under - which :the -:Federal Government will share -in the. -payment of covered losses caused by certain acts or international terrorism. VV -z .are providing you Wrth this -notice to inform -you of the f ey -features -of. tine .Aot, -and to' let: you .Yn©wwha.t effect, it -any, the Activifill have :on your premium. Uhdar-the Aft, insurers arei:required -to provide coverage for cafta=n losses -caused .:by international acts -OT' terrorism .as defined in the pct. Tha Act lurther provides -that the .Fedeml-.Government will pay a share ,of -sudh losses. L ;pecirlcaliy, the rederai_ -Government -will pay _909/6 -ot t1 amount or covered iesses -caused by -certain acts Df terrorism whidh is :ill exbass :of Trav6iers' statutorily aitablishecl ,deducible forfihat-yaar. The -Act aiso Mpslhs amount-afterrorism- related fosses 1 -or which *the-Fedaral Gover-rimeeht or -an insurer carp ,be-rasponscble at $100 Poc) -000,000,00, .provided that the Insures- . -has -met its -deductible, :Fliease -note -that passage or the Act does .nof. result in any dhange in -coveisge -under-the attached :pblic}r or bond (or tha .pplicy or boric- being :quoted). :Please' a'lso note that -no separate additional Premium ~ charge --has .been rnadz ia fi_he rrorisrn coverao -required .by -the -Act. The .premium charge t.hat is .alfoceble -to suctr covarage is inseparable '-from and irnbaddad in your. o' aralfi premium, and is no more'than one, percent cif .your .prernium. - IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President and their corporate seals to be hereto affixed this 11th day of December 2000. STATE -OF CONNECTICUT ) SS. Harrriord COUNTY OF HARTFORD e01010 010y LTY ,,yO I'D01 0 sL7tfJY 5J?. s Gl.sup��. F. CONN.'�'e J H CONN. n ARMom' pl *82 0 a D _ T ' i feC11Xi11Nt'W� TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY FARIVIINGTON CASUALTY COMPANY George W. Thompson Senior Vice President On -this 11th day of December, 2000 before me personally came GEORGE W. THOMPSON to me known, who, -being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVE+ LERS CASUALTY AND SURETY COMPANY and TAIMIf+IGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument; that.he/she knows the seals of said corporations; that the seals affixed to the said. instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. My commission expires June 30, 2001 Notary Public Marie C. Tetreault CERTIFICATE I, the undersigned, Assistant Secretary of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS•CASUALTY AND SURETY COMPANY.and FARMINGTON:CASUALTY COMPANY, stock corporations of . the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate .of Authority, are now in force. Signed and Sealed at the•Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this 19TH day of APRIL, $2004- , 20o4. uoo 9l T JP�,'fY ANC 9�1a, GA OV�tA 6m tO a HAAiFdAO ¢ HARD, < 0 1982. 0 't CONN. �{ T y CONN. c oQ x IIS ' i -q13y Kori M.Johanson Assistant Secretary, Bond ,Acow_ CERTIFICATE" W LIABILITY INSURAW _ OP ID DATE (MM/DD/YYYY) MAGGI-1 04/23/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Don Ramatici Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 551 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Petaluma CA 94953 Phone:707-782-9200 Fax:707-782-9300 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Insurance INSURER B: National Union Fire Ins. of PA Ma giora & Ghilotti, Inc. INSURER C: At n: Matt Petray 555 Dubois Street INSURER D: San Rafael CA 94901 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LTR AUU'L POLICY NUMBER LTR INSRC TYPE OF INSURANCE DATE POLICY EFFECTIVE DATE (MM/DD/YY )N LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1, 0 0 0, 0 0 0 A X X COMMERCIAL GENERAL LIABILITY DTEC07975A495TIL03 09/01/03 ° "IS " "`°c " 09/01/04 � PREMREMISES(Eaoccurence) S 300,000 CLAIMS MADE I X OCCUR MED EXP (Any one person) S 5, 000 X XCU Included PERSONAL & ADV INJURY S1,000,000 X PD Ded. $10,000 I GENERAL AGGREGATE S2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS - COMP/OP AGG I S 1,000,000 POLICYFX n LOC I JEDT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO DT8107975A495TIL03 09/01/03 09/01/04 (Ea accident) ALL OWNED AUTOS BODILY INJURY I SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY S NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG IS I S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE I S 5,000,000 B `• OCCUR 7 CLAIMSMADE BE3206269 09/01/03 09/01/04 AGGREGATE S 5,000,000 S DEDUCTIBLE I S X RETENTION S10,000 WORKERS COMPENSATION AND WL; 51AU-S I I TORY LIMITS I I ER EMPLOYERS' LIABILITY I E.L. EACH ACCIDENT S ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I E.L. DISEASE - EA EMPLOYEEI S If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Operations of the Named Insured for the Certificate Holder JOB: Valley View Ave. Drainage Improvements, Project no. 15001, M&G#4990 *and property owners at 248 and 250 Elizabeth Way, San Rafael, CA 30XCGD247 CERTIFICATE HOLDER City of San Rafael, its agents officers & employees* Public Works P.O. Box 151560 San Rafael, CA 94915 ACORD 25 (2001108) CANCELLATION SANRAI3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL dWa4 4W^-4MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT '7�C T!71,4N4fZd7' ;FI 1E 1148WRER, FFG AGENTS 13R AU RIZED RESEE �`-`�WyV� .�`O ,c` cAC6RD CORPORATION 1988 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY - CONTRACTORS COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): City of San Rafael, its agents, officers & employees and property owners at 248 and 250 Elizabeth Way, San Rafael PROJECTILOCATION OF COVERED OPERATIONS: Valley View Ave. Drainage Improvements, Project no. 15001, M&G#4990 1. WHO IS AN INSURED - (Section II) is amended to include the person or organization shown in the Schedule above. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The person or organization is only an additional insured with respect to liability caused by "your work" for that additional insured at the location shown in the Schedule. 2. The insurance provided to the additional insured is limited as follows: a) In the event that the limits of liability stated in the policy exceed the limits of liability required by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought, the insurance provided by this endorsement shall be limited to the limits of liability required by such contract or agreement. This endorsement shall not increase the limits stated in Section Ill - LIMITS OF INSURANCE. b) The insurance provided to the additional insured does not apply to "bodily injury", "property damage", "personal injury" or "advertising injury" arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: I. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and II. Supervisory or inspection activities performed as part of any related architectural or engineering activities. C) This insurance does not apply to "bodily injury" or "property damage" caused by "your work" included in the "products -completed operations hazard" unless you are required to provide such coverage for the additional insured by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought and then only for the period of time required by such contract or agreement and in no event beyond the expiration date of the policy. 3. Subpart (1)(a) of the Pollution exclusion under Paragraph 2., Exclusions of Bodily Injury and Property Damage Liability Coverage (Section I - Coverages) does not apply to you if the "bodily injury" or "property damage" arises out of "your work" performed on premises which are owned or rented by the additional insured at the time "your work" is performed. 4. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought specifically requires that this insurance apply on a primary or non-contributory basis. When this insurance is primary and there is other insurance available to the additional insured from any source, we will share with that other insurance by the method described in the policy. 5. As a condition of coverage, each additional insured must: a.) Give us prompt written notice of any "occurrence" or offense which may result in a claim and prompt written notice of "suit". b.) Immediately forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with policy conditions. c.) Tender the defense and indemnity of any claim or "suit" to any other insurer which also insures against a loss we cover under this endorsement_ This includes, but is not limited to, any insurer which has issued a policy of insurance in which the additional insured qualifies as an insured. For purposes of this requirement, the term "insures against" refers to any self-insurance and to any insurer which issued a policy of insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer provide the additional insured with a defense and/or indemnity under that policy of insurance. d.) Agree to make available any other insurance that the additional insured has for a loss we cover under this endorsement. d� 0 0 0 0 a_ 0 0 0 004439 surer's share is based on the ratio of its appli- cable limit 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. b. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period. Audit pre- miums are due and payable on notice to the first Named Insured. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we will need for premium com- putation, 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 repre- sentations you made to us; c. We have issued this policy in reliance upon your representations; and d. You represent that you do not know of any losses, claims, or "suits" pending against you that have not already been reported to us. 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 insurance 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 of Rights of Recovery Against Others To Us transfer those rights to us and help us enforce them. We will not enforce our right of recovery against any person or organization with whom you have waived your rights of subrogation in writing before the time of loss. However, our waiver applies only to the extent required of you by such written con- tract. 9. Motor Vehicle Laws a. When this Coverage Part is certified as proof of financial responsibility for the future under the provisions of any motor vehicle financial responsibility law, the insurance provided by the Coverage Part for "bodily injury" or "prop- erty damage" liability will comply with the pro- visions of the law to the extent of the coverages and limits of insurance required by that law. b. With respect to "mobile equipment" to which this insurance applies, we will provide any li- ability, uninsured motorists, underinsured mo- torists, no-fault or other coverages required by any motor vehicle insurance law. We will pro- vide the required limits for those coverages. 10. 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 suffi- cient proof of notice. SECTION V — DEFINITIONS 1. "Advertising injury" means injury arising out of one or more of the following offenses: a. Oral or written publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; b. Oral or written publication of material that vio- lates a person's right of privacy; c. Misappropriation of advertising ideas or style of doing business; or If the insured has rights to recover all or part of d. Infringement of copyright, title or slogan. any payment we have made under this Coverage 2. "Auto" means a land motor vehicle, trailer or Part, those rights are transferred to us. The in- semitrailer designed for travel on public roads, in- sured must do nothing after loss to impair them. cluding any attached machinery or equipment. At our request, the insured will bring suit or But "auto" does not include "mobile equipment". GN CO 01 01 98 Copyright, The Travelers Indemnity Company, 1998 Page 11 of 14 CERTHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 04-23-2004 GROUP: POLICY NUMBER: 1758056-2003 CERTIFICATE ID: 67 CERTIFICATE EXPIRES: 10-01-2004 10-01-2003/10-01-2004 CITY OF SAN RAFAEL P.O. BOX 151560 SAN RAFAEL CA 94915 JOB: VALLEY VIEW DRAINAGE IMPROVEMENTS PROJECT NO. 15001, M&G#4990 This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance 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. �(A� AUTHORIZED REPRESENTATIVE Al . e. A�- PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER MAGGIORA & GHILOTTI, INC 555 DU BOIS ST SAN RAFAEL CA 94901 PNC' PRINTED: 04-23-2004 SCIF 10262E Accept this certificate only if you see a faint watermark that reads "OFFICIAL STATE FUND DOCUMENT" PAGE 1 OF 1