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HomeMy WebLinkAboutCC 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
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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