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HomeMy WebLinkAboutCC Resolution 11104 (Lincoln Ave. Rehabilitation)RESOLUTION NO. 11104
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN
RAFAEL AWARDING CONTRACT FOR LINCOLN AVENUE
REHABILITATION TO GHILOTTI BROS., INC. IN THE
AMOUNT OF $911,911.25
WHEREAS, on the 14th day of May, 2002, pursuant to due and legal
notice published in the manner provided by law, inviting sealed bids or 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:
"LINCOLN AVENUE REHABILITATION"
CITY PROJECT NO. 10741
FEDERAL AID PROJECT NO. STPL 5043-(009)
in accordance with the plans and specifications therefor on file in the office of said City
Clerk; and
WHEREAS, the bid of Ghilotti Bros., 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 therefor;
NOW, THEREFORE, BE IT RESOLVED that the bid of Ghilotti Bros.,
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 Ghilotti Bros., Inc. at the
unit prices mentioned in said bid.
BE IT FURTHER RESOLVED that the Mayor and the City Clerk of said
City be authorized and directed to execute a contract with Ghilotti Bros., 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, 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 on Monday, the 201h day of May, 2002, by the
following vote, to wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Miller, Phillips & Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
i
JEANNE M. LEONCINI, City Clerk
File No.: 16.01.199 Ftqe
City of San Rafael • California
Form of Contract Agreement
for
Lincoln Avenue Rehabilitation
This Agreement is made and entered into this 20th day of May, 2002 by and between
the City of San Rafael (hereinafter called City) and Ghilotti Bros., 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: Lincoln Avenue Rehabilitation, 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. However, no field construction shall occur until all traffic signal
hardware, including poles, mast arms, signal heads, and controller are within the
possession of the contractor.
(b) The work shall be completed within 60 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 0 2
ITEM
EST
UNIT
UNIT
ITEM
NO. ITEM
QTY
PRICE, $
TOTAL, $
I N IN �7j p NIP Ewa
1 Mobilization
1
LS
72,023.00
72,023.00
2 Asphalt Concrete Overlay
7,315
TON
50.00
365,750.00
3 Asphalt Concrete Deeplift
261
TON
90.00
23,490.00
4 Cold Planing
0.00
a. Full Width Cold Planing
34,130
SY
2.80
95,564.00
b. Edge Cold Planing
1,905
SY
4.90
9,334.50
5 Fabric Reinforcement
4,175
SY
1.10
4,592.50
6 Minor Concrete
0.00
a. Sidewalk (4" Min.)
23,200
SF
3.55
82,360.00
b. Residential Sidewalk (6" Min.)
965
SF
6.00
5,790.00
c. Commercial Sidewalk (8" Min.)
1,675
SF
7.40
12,395.00
d. Special Case Sidewalk
1,500
SF
4.60
6,900.00
e. Curb & Gutter
550
LF
27.00
14,850.00
f Reinforced Curb & Gutter
42
LF
41.00
1,722.00
g. Standing Curb
330
LF
20.00
6,600.00
h. Curb Ramp
4
EA
1,255.00
5,020.00
i. Residential Driveway Approach
160
SF
10.05
1,608.00
j. Commercial Driveway Approach
88
SF
12.25
1,078.00
k. Adjust Catch Basin to Grade
I
EA
1,380.00
1,380.00
1. Curb Inlet
I
EA
2,860.00
2,860.00
in. Install Root Barrier
300
LF
1.40
420.00
7 Adjust Manhole Casting to Grade
46
EA
385.00
17,710.00
8 Adjust Rodhole & Monument
10
EA
228.00
2,280.00
Casting to Grade
9 Adjust Pacific Bell Manhole Casting
11
EA
407.00
4,477.00
to Grade
10 GGBHTD Bus Stop Improvements
a. Asphalt Concrete Deep Lift
719
TON
86.00
61,834.00
b. Reinforced Curb & Gutter
628
LF
31.00
19,468.00
c. Standing Curb
121
LF
16.25
1,966.25
d. Sidewalk
135
SF
6.00
810.00
11 Thermoplastic Traffic Stripes &
1
LS
34,998.00
34,998.00
Pavement Markings
12 Traffic Loops
4
EA
750.00
3,000.00
13 Traffic Control
1
LS
15,606.00
15,606.00
Sub Total A
875,886.25
SCHEDULE B: PROVISIONAL ITEMS
ITEM
EST
UNIT
UNIT
ITEM
NO. ITEM
QTY
PRICE, $
TOTAL, $
ORMUMA-1 41-41
1-1 Residential Driveway Approach
1,000
SF
10.25
10,250.00
1-2 Commercial Driveway Approach
650
SF
13.50
8,775.00
1-3 Asphalt Concrete Trench Plugging
100
TON
170.00
17,000.00
Sub Total B
36,025.00
GRAND TOTAL BID
$911,911.251
AGREEMENT 0 2
V - 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). 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.
(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.
(d) 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.
AGREEMENT • 3
IN WITNESS WHEREOF, City and Contractor have caused their authorized
representatives to execute this Agreement the day and year first written above.
ATTESJ} � UL _ CITY A E /
S _ - /
Jea a M. lieoncini Albe BOro %
City Clerk _ Mayor
AP ? T RM: CONTRACTOR:
ary T. R t ianti.
City Aft ey for
AGREEMENT • 4
CONTRACTOR'S BOND
FOR FAITHFUL PERFORMANCE
KNOW ALL MEN BY THESE PRESENTS
That we GHILOTTI BROS., INC.
TRAVELERS CASUA AND SURETY COMPANY OF AMERICA
Hartford, Connecticut 06183
BOND NO. 103822940
PREMIUM: $5,836.00
'BOND ISSUED IN DUPLICATE'
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
1400 FIFTH AVENUE
SAN RAFAEL, CA. 94915-1560
as Obligee,
in the full and just sum of NINE HUNDRED ELEVEN THOUSAND NINE HUNDRED ELEVEN AND 25/100THS----
Dollars, ($911,911.25), 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 day of 28TH , MAY
, 2002
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 for
LINCOLN AVENUE REHABILITATION
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.
GHILOTTI BROS., INC.
BY:
MICHAEL M.j6HILOTTI, PRESIDENT/TREASURER
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
By
{ KELLY HOLTEMANN, ATTORNEY-IN-FACT
S-2359-1 (07-97)
CALIFORNIA ALL-PURPOSI .'01KNOWLEDGMENT No. 5907
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iOn 5-28-02 before me, BONNIE K. FRYMIRE, NOTARY PUBLIC
DATE NAME, TITLE OF OFFICER - E.G., -JANE DOE, NOTARY PUBLIC -
i\ personally appearedi=Y HOLTEMANN----�M- ------------------- L
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NAME(S) OF SIGNER(S) L
© personally known to me - OR - ❑ proved to me on the basis of satisfactory evidence
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knowledged. to me that)bulshe/ W -executed
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•; BONNIEK.FRYMIRE Z L
1) NOTARY PUBLIC - CALIF.
Z COUNTYOFSONOMA :+ _
L MYCOmm.EV A028, 2003, SIGNATURE OF NOTgpiY
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1 Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
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i CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT i
j ❑ INDIVIDUAL
❑ CORPORATE OFFICER PERFORMANCE BOND
TITLE OR TYPE OF DOCUMENT
TITLE(S) ;
1 ❑ PARTNER(S) ❑ LIMITED 1
l ❑ GENERAL ONE L
1
D ATTORNEY-IN-FACT NUMBER OF PAGES
❑ TRUSTEE(S) L
❑ GUARDIAN/CONSERVATOR
L ❑ OTHER: MAY .28th, 2002 L
DATE OF DOCUMENT
1
SIGNER IS REPRESENTING:
1 NAME OF PERSON(S) OR ENTITY(IES) NIS L
1 TRAVELERS CASUALTY AND SURETY COMPANY SIGNER(S) OTHER THAN NAMED ABOVE L
OF AMERICA
©1993 NATIONAL NOTARY ASSOCIATION - 8235 Remmel Ave., P.O. Box 7184 - Canoga Paris, CA 91309-71 B4
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of SONOMA
ss.
On 5-28-02 before me, BONNIE K. F'RYMWE, NOTARY PUHLIC
Date Name and Title of Officer (e.g., "Jane Doe, Notary Public")
personally appeared MICHAEL M. GHILOTTI
Name(s) of Signer(s)
OFRCIALSEAL -1217287 I
BONNIEK.FRYMIRE Z
NOTARYPUBLIC-CALIF Sj
Z COUNTYOFSONOMA
My Comm. Exp, 128, 2003
Mf II
Place Notary Seal Above
J personally known to me
❑ proved to me on the basis of satisfactory
evidence
to be the person(j) whose named isiow
subscribed to the within instrument and
acknowledged to me that hem executed
the same in hisbmmt%xnax authorized
capacity(, and that by his)ffionkjbc4b-,
signature* on the instrument the personal, or
the entity upon behalf of which the person(i)
acted, executed the instrument.
AE S S my hand and official seal.
WXj
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Signature of Notary Pubfrc
OPTIONAL
Though the information below is not required by law, it may 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: PERFORMANCE BOND
Document Date: MAY 28th, 2002
Signer(s) Other Than Named Above: NIS
Capacity(les) Claimed by Signer
Signer's Name: MICHAEL, M. GHILOTTI
❑ Individual
Ud Corporate Officer — Title(s): PRESIDENT/TREASURER
❑ Partner — ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing: GHILOTTI BROS. , INC.
Number of Pages: ONE
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0 1999 National Notary Association - 0350 De Sato Ave., P.O. Box 2402 - Chalsworth, CA 91313-2402 - w .nationalnotary.org Prod. No. 5907 Reorder. Call TaIFFreE3 1•B00.97E•6827
PAYMENT BOND -PUBLIC WOE- -
SECTIONS 3247 - 3252, CIVIL CODE
(CALIFORNIA)
KNOW ALL MEN BY THESE PRESENTS:
TRAVELERS CASUAL'i AND SURETY COMPANY OF AMERICA
Hartford, Connecticut 06183
Bond No 103822940
PREMIUM; INCLUDED
'BOND ISSUED IN DUPLICATE'
THAT WHEREAS, The State of California, acting by and through the, CITY OF SAN RAFAEL
Has awarded, GHILOTTI BROS., INC.
as Contractor, a contract for the work described as follows:
LI NCOLN AVENUE REHABILITATION
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
NINE HUNDRED ELEVEN THOUSAND NINE HUNDRED ELEVEN AND 25/100THS ---------------------------------------------
($911,911.25) 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 28TH day of MAY , 2002.
GHILOTTI BROS., INC.
BY: w b"*'
MICHAEL M. GPIL01f'TI, PRESIDENT/TREASURER
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
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KELLY HOLTEMANN ATTORNEY-IN-FACT
S-2061-8 (07-97)
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
1 State of CALIFORNIA
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1
1
1
County of SONOMA
On 5-28-02 before me,
DATE
personally appeared lulu HOLTEMANN
No. 5907
BONNIE K. FRF, NOTARY PUBLIC
NAME, TITLE OF OFFICER - E.G., "JANE DOE, NOTARY PUBLIC
NAMES) OF SIGNER(S)
© personally known to me - OR - ❑ proved to me on the basis of satisfactory evidence
to be the persons-) whose nameg ism
subscribed to the within instrument and ac-
knowledged' to me that (she&i ;.executed
the same.' in AX%Vher/== authorized
capacity j, and that by KW-her/N�W
signature(N) on the instrument the personM,-
or the entity upon behalf of which the
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MY Comm. Exp. Apd128, 20D3 �!
WI NESS my hand and official seal.
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SIGNATURE OF NOT
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OPTIONAL i
Though the data below Is not required by law, it may prove valuable to persons relying on the document and could prevent 1
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL -
❑ CORPORATE OFFICER
TfTLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
0 ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
TRAVELERS CASUALTY AND SURETY COMPANY
OF AMERICA
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DESCRIPTION OF ATTACHED DOCUMENT
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PAY= BOND — PUBLIC WORK
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TITLE OR TYPE OF DOCUMENT
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ONE
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NUMBER OF PAGES
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MAY 28th, 2002
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
ss.
County of
SONOMA
On 5-28-02 before me, BONNIE K. )1v=, NOTARY PUBLIC
Date Name and 16 of ofltcer (a.0„ "Jane Doe, Notary Public'
personally appeared MICHAEL M. CT=OTTI
Name(s) of Signer(s)
a personally known to me
❑ proved to me on the basis of satisfactory
evidence
to be the person(a) whose named is/a s
subscribed to the within instrument and
acknowledged to me that hejbhodk" executed
the same in hisbminAbindr, authorized
�I OFFICIALSEAL-1217287 capacity(:k*, and that by his,,f �
SONNIEK,FRYMIRE Z signatures on the instrument the person(*, or
NOTARY PUBLIC -CALIF the entity upon behalf of which the persc)n(a) s
Z COUNTY OFSONOMA -+ acted, executed the instrument. i
M Comm. Exo�A rtl 28, 2003
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NESS my hand and official seal.
Placa Notary Seal Above Ignature of Notary Pub[
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
i
Description of Attached Document
Title or Type of Document: LABOR AND MATERIAL PAYMENT BOND '
%s
Document Date: MAY 30th, 2002 Number of Pages: ONE
s
Signer(s) Other Than Named Above: NIS i
Capacity(ies) Claimed by Signer
Signer's Name: MICHAEL M. GHILOTTI lot-
❑ Individual Top Wthumb here
EZ Corporate Officer — Title(s): PRESIDENT/TREASURER
❑ Partner — ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing: GHIL OTTI BROS. , INC.
O 1399 National Notary Association - 9350 De Soto Ave., P.O. Box 2402- Chatsworth, CA 91313.2402 - www.nationalnotary.org Prod. No. 5907 Reorder. Cell Tall•FmEe 1-900.876.6927
IN WITNESS WEEREOF, TRAVEI S -CA.SUALTY AND SURETY COM 1Y OF AMERICA, TRAVELERS
CASUALTY AND SURETY COMPAIV .z and FARMil'iGTON CASUALTY COMrnNY 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. Hartford
COUNTY OF HARTFORD
6Jp;6 Y A,qa sG .� 0,%SU
Ge
r FfAR7FORD, �- s HARTFORD,
ODS f 01 CONN, a 2A.
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TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
TRAVELERS CASUALTY AND SURETY COMPANY
FARMINGTON CASUALTY COMPANY
rp—
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, TRAVELERS CASUALTY AND SURETY' COMPANY and FARMIIVGTON 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 instr=ent ase such corporate seals; and -that he/she executed the said instrument on behalf of the corporations by
authority of hisfher 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 28th day of
MAY ' , 20 02,
DN
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,pP6U�O�3- �LTY AHQGpSU,���
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aHAATr4RQ 1. HARTFORD, 0 1 4.8 2 O By
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Kori M. Johanson
1 ��� dl ��y' �'� • �`� Assistant Secretary, Bond
ACOi7D CERTIFICATE OF LIABILITY INSURANCE CSR SD I DATE(MWDD/YY)
HILO-1 05/29/02
PROCUCF.l THIS CERTIFICATE SUED AS A MATTER OF INFORMATION
ONLY AND CONFERa ,.O 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
INSURED INSURER A. Evanston Insurance Co.
INSURER B. Nationwide Mutual Insurance Co
Ghilotti Bros., Inc. INSURER C: Amer.Internat'l SpecialtyLines
525 Jacoby Street INSURER D;
San Rafael CA 94901
I I INSURER E: State Comvensation Ins. Fund
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.
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR
TYPE OF INSURANCE
POLICY NUMBER
DATE IMWDD/YYI DATE IMM/DD/YYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S 1, 0 0 0, 0 0 0
A
X COMMERCIAL GENERAL LIABILITY
OIGLP1004993
10/01/01 10/01/02 FIRE DAMAGE (Any one fire)
S 50,000
= CLAIMS MADE FX] OCCUR
MED EXP (Any one person)
S 5,000
X GL Ded. $5,000
I PERSONAL&ADV INJURY
$1,000,000
X X, C, U Included
I GENERAL AGGREGATE
$2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
I PRODUCTS - COMP/OP AGG
$1,000,000
PRO -
POLICY n LOC
I I EC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$1,000,000
B
X ANY AUTO
ACP7810621590
10/01/01 10/01/02
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
X HIRED AUTOS
BODILY INJURY
$
X NON -OWNED AUTOS
(Per accident)
X Ded. $1000 APD
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
I AUTO ONLY - EA ACCIDENT
$
ANY AUTO
EA ACC
OTHER THAN
$
AUTO ONLY: AGG
$
EXCESS LIABILITY
I EACH OCCURRENCE
1$10,000,000
C
7 OCCUR FICLAIMSMADE
BE7413100
10/01/01 10/01/02 1 AGGREGATE
1$10,000,000
IS
DEDUCTIBLE
I
I $
X RETENTION $ None
I S
WORKERS COMPENSATION AND
I X I TORY LIMITS I 101
OER
E
EMPLOYERS' LIABILITY
315129301
10/01/01 10/01/02 E.L. EACH ACCIDENT
1$1,000,000
E.L. DISEASE - EAEMPLOYEEI
$ 1, 000, 000
E.L. DISEASE -POLICY LIMIT
S 1, 000, 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Operations of the Named Insured for the Certificate Holder.
JOB: Lincoln Avenue Rehabilitation, GBI #02411
30XCG2020 11/85LF
CERTIFICATE HOLDER I Y I ADDITIONAL INSURED; INSURER LETTER:
SANRAF4
City of San Rafael & County of
Marin, its officers, agents &
employees, Dept. of Pub. Works
P.O. Box 151560
San Rafael, CA 94915-1560
I
ACORD 25-S (7/97)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL L- : - . - . ,. MAIL 3_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
-
AUT PRESENT
7:
(7�
CSX WM _ZORPORATION 1988
Policy Number: 01 GLP1004993
Commercial General Liability
THIS ENDORSEMENT CHANGES THE POLICY - PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
City of San Rafael & County of Marin, its officers, agents & employees
Dept. of Public Works
JOB: Lincoln Avenue Rehabilitation, GBI #02411
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule,
but only with respect to liability arising out of "your work" for that insured by or for you.
The insurance provided herein is primary coverage to the certificate holder with respects to any insurance or self insurance
programs maintained by the certificate holder, and no insurance held or owned by the certificate holder shall be called
upon to contribute to a loss.
The inclusion of more than one insured shall not operate to impair the rights of one insured against anotther insured and
the coverage afforded shall apply as though separate policies had been issued to each insured, but the inclusion of more
than one insured shall not operate to increase the limits of the Company's Liability.
CG 20 10 11 85 Copyright Insurance Services Office, Inc. 1984