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HomeMy WebLinkAboutCC Resolution 11231 (SRCC Lobby & Reception Remodel)RESOLUTION NO. 11231
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL
AWARDING CONTRACT FOR SAN RAFAEL COMMUNITY CENTER LOBBY AND
RECEPTION REMODEL - REBID TO ROSE CONSTRUCTION IN THE AMOUNT OF
$97,692.00 AND ALLOCATE AN ADDITIONAL $20,000.00 TO THE PROJECT
BUDGET FROM THE GENERAL FUND ADA ACCOUNT.
WHEREAS, on the 5`h day of December 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:
"SAN RAFAEL COMMUNITY CENTER LOBBY AND RECEPTION REMODEL
REBID"
PROJECT NO. 10718
in accordance with the plans and specifications therefor on file in the office of said City
Clerk; and
WHEREAS, the bid of Rose Construction 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, IT IS HEREBY ORDERED AND RESOLVED
that the bid of Rose Construction and the same is hereby accepted at said Base Bid,
Alternate #1, and Alternate #2 prices and that the contract for said work and improvements
H1AL ��`
be and the same is hereby awarded to said Rose Construction at the Base Bid + Alternate
#1, and Alternate #2 prices mentioned in said bid.
IT IS FURTHER ORDERED AND RESOLVED that the Mayor and the
City Clerk of said City be authorized and directed to execute a contract with Rose
Construction for said work and to return the bidders bond upon the execution of said
contract.
BE IT FURTHER ORDERED AND RESOLVED that the City Council
of said City allocate an additional $20,000.00 to the project budget from the General Fund
ADA account.
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 16h day of December, 2002 by
the following vote, to wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Miller, Phillips and Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
A.
JEANE M. LEONCINI, City Clerk
File No.: 06.01.160
City of San Rafael
Form of Contract Agreement
For
SAN RAFAEL COMMUNITY CENTER LOBBY & RECEPTION
REMODEL -REBID
PROJECT NO. 10718
This Agreement is made and entered into this 16th day of December, 2002 by and between the City of
San Rafael (hereinafter called City) and B L & K Enterprises, Inc., dba Rose Construction
(hereinafter called Contractor). Witnesseth, that the City and the Contractor, for the considerations
hereinafter named, agree as follows:
I - 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:
SAN RAFAEL COMMUNITY CENTER LOBBY & RECEPTION REMODEL -REBID
Project No. 10718
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.
II — Contract Documents
The Contract Documents consist of the following, all of which are as fully a part hereof as if herein set
out in full and, if not attached hereto, the same as if hereto attached:
A. The accepted Proposal of the Contractor.
B. The fully executed Performance Bond and Payment Bond, if required.
C. Workers Compensation, Public Liability and Property Damage Insurance, as required
from the Contractor pursuant to the terms of the Contract.
D. This Agreement.
E. The General Conditions, if applicable.
F. The Specifications and the Drawings if applicable and all authorized modifications
thereof and Addenda thereto.
III- Time of Completion
(a) Construction on the project will begin on January 5, 2003.
(b) The work shall be completed by March 15, 2003, and including extensions of time as are provided
for in the General Conditions.
IV - Liquidated Damages
It is agreed that, if all the work required by the contract is not finished or completed by the contract time
(i.e. March 15, 2003), and inclusive of extensions of time as are provided for in the General
Conditions), 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 $ 500.00 for each and every calendar day's delay in finishing the work in
excess of the contract time 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.
V - The Contract Sum
CONTRACTOR'S COMPENSATION: The City will pay and the Contractor will accept, in full
consideration for the performance of the Contract, subject to additions and deductions as provided
therein, the sum of Ninetv Seven Thousand, Six Hundred and Ninetv Two dollars and no cents.
Lump sum price written in words
($97,692.00)9
said sum being the total of the Contractor's Base Bid and the following additive and/or deductive
Alternates.
A. Alternate No. 1:
$18,500.00
B. Alternate No. 2: $6,800.00
VI - 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 Contracton.
(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 City, by depositing securities of
equivalent value with the public City in accordance with the provisions of Section 4590 of the
Government Code. Such securities, if deposited by the Contractor, shall be valued by the Director
of Public Works, whose decision on valuation of the securities shall be final.
VII - 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.
IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to
execute this Agreement the day and year first written above.
ATTEST:
Jeanne M. Leoncini
City Clerk
CITY OF SAN RAFAEL
ZJV`A' 1b t B
Mayor
APPROVED AS TO FORM: CONTRACTOR:
Gary T. Ragghianti 0 x1/1
City Attorney for ROSE CONSTRUCTION
39 Belmont Ave.
Fairfax, CA 94930
(415) 454-9994 Fax 454-9587
-rreRSU'e-y^ % PA"1111 IUY�1O'1
PREMIUM IS BASED ON THE FINAL CONTRACT AMOUNT.
PERFIQRA C!E BOND
PUBLIC WORK
Premium S1.g 54 _ nn Bond No. 61 n 134
KNOW ALL -MEN BY .THESE PRESENTS:
THAT, WHEREAS, THE City of San Rafael, as Obligee (hereinafler called the Owner), has awarded to_
BL & K Enterer. ises*, as Principal (hereinafter called the Contractor), a Contract for the .
SAN RAFAEL COMMUNTIY CENTER LOBBY.& RECEPTION REMODEL -REBID
PROJECT NO. 10719 and
WHEREAS the said Contractor is required under the terms of the said Contract to famish a Bond for the'
faithful performance of said Contract,
NOW, THEREFORE, THESE PRESENTS WITNESSETH:
that we, the Contractor, and, Fi rqt National Tncuan a Company of Am?ri r.a a
corporation duly organized and existing under the laws of the State ofwa ch i n bt`n ,
and authorized under the laws of the State of Califnmia to become surety on bonds and undertakings, as
Surety (hereinafter called the Surety), are held and firmly bound unto the said Owner in the Penal Sum
of ninety-seven thousand, six hundred ninety-two dollarG and 00/100 Dollars
(S 97,692.00------------------------------------------ . ) lawful money of the United
States, said sum being an amount of not less than one hundred percent (1001%) of the total amount
payable by the teens of said Contract, for the payment of which sum well and truly to be made the said
Contractor and the said Surety bind ourselves, our heirs, executors, administrators, successors and
assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION is such that, if the above bounden Contractor, his or its
heirs, executors, administrators, successors or assigns shall in all things stand to and abide by, and well
and truly keep and perform the covenants, conditions and agreements in the said Contract and any
alteration thereof made as therein provided, on his or their part, to be kept and perfoni►ed at the time and
in the manner therein specified, including guarantees, and in all respects according to their true intent
turd meaning, and shall indemnify and save harmless the said Owner and its officers and agents, as
therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in
full force and effect.
The said Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the
Drawings or the Specifications accompanying same, shall in any manner affect its obligations on this
Bond, and it does hereby waive notice of any such change, extension, alteration or addition.
*, Inc. dba Rose Construction Company.
CONTRACT FORMS AND AGREEMENT
00040-3
Page 3 of 13
PERFORMANCE BQND
(continued)
Whenever the Contractor shall be, and be declared by the Owner to be in default under the Contract, the
Owner having performed; its obligations thereunder, the Surety shall promptly remedy the default, or
shall promptly complete the Contract in accordance with its tens and conditions, or shall promptly
obtain Bids for completing the Contract according to its terms and conditions, and upon determination
by the Owner and the Surety, jointly, of the lowest responsible Bidder, arrange for a Contract between
such Bidder. and the Qwner, and make available as the Work progresses sufficient funds to pay the cost
of completion, less the total amount payable. by the Owner 4o the Contractor under the Contract and any
amendgients thereto (less the amount already properly paid by the Owner to the Contractor); but not
exceeding, including other costs and damages for which the Surety may be liable hereunder, the
aggregate surn specified in this Bond.
No right of action shall accrue under this Bond to or for thg use of any person or organization other than
the Owner named herein or its heirs, executors, administrators or successors.
IN WITNESS WHEREOF, this instrument has been duly executed by the Contractor
and the Surety this-2.3xd day of December
(To, be signed by Contnmor and Surety, and
ac$nowledgnnent and Notarial, $eat attac4ed)
Witness
20012
BL & K Enterprises, Inc. dba
�RnGe_Construction Comnanv
{ Cpntmc.. _ (Seal)
{
i l
Wrst National Insurance•Company of America
(Seal)
witness i HY
{ Attor[i - -Fac ohn J/� ey
MA.ILIN ADD1tES$ Oi; 5UTY 400 Taylor Blvd., Pleasant Hill, CA 94523
CONTRACT FORMS AND AGREEMENT
0004D - 4
Page 4 of 13
STATE OF California
COUNTY OF Contra Costa
On DpepTnhar 91 _ 9aD9
PERSONALLY APPEARED John J. Daley
SS.
before me, Tanya Chinchilla, Notary Public
personally known to me (tp�px ratatnvxc#�Cs?ix;tavx
x4gLwxc j to he the person(X) whose name( is/kms subscribed to the
Within instrument and acknowledged to me that he/,4xa6a executed
the same in hi c%LrA&1 {r authorized capacity(tk.j and that by x�(t i his4&
signature( on the instrument tate person(4d, or the entity upon behalf
of which the person( acted, executed the instrument.
WITNESS my hand and official seal.
Signature
OPTIONAL
This urea for ficial Notarial Seat
Though the data below is not required by law, it may prove valuable to persons relying on the document and could
prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
0 ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
DESCRIPTION OF ATTACHED DOCUMENT
Performance Bond# 6103134
TITLE OF TYPE OF DOCUMENT
two (02)
NUMBER OF PAGES
December 23, 2002
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERSONIS) OR ENTITY(IES)
First NatinnaI Tnciiranrp Com an nv of America
N/A
SIGNER(S) OTHER THAN NAMED ABOVE
ID -1232 (REV. 5/01) ALL-PURPOSE ACKNOWLEDGEMENT
"'''
TANYA CHINCHILLA
'
Commisston # 1375153
z-,�
0�.V.
Notary Public - California
Contra Costa County
My Comm. Expires Sep 16,2D06
4
This urea for ficial Notarial Seat
Though the data below is not required by law, it may prove valuable to persons relying on the document and could
prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
0 ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
DESCRIPTION OF ATTACHED DOCUMENT
Performance Bond# 6103134
TITLE OF TYPE OF DOCUMENT
two (02)
NUMBER OF PAGES
December 23, 2002
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERSONIS) OR ENTITY(IES)
First NatinnaI Tnciiranrp Com an nv of America
N/A
SIGNER(S) OTHER THAN NAMED ABOVE
ID -1232 (REV. 5/01) ALL-PURPOSE ACKNOWLEDGEMENT
I PREMIUM IS BASED ON THE FINAL CONTRACT AMOUNT.
pvadc. "WokK
. Borid'N 4oLLj_Qi 114
Premium:' is included in the performance bond.
KNOW ALL MEN BY THESE PRESENTS`
THAT, WHEREAS. City of San Rafael. as Oblig-ee (hereinafter called the Owner), has awarded to
BL &'K Enterprises, Inc. dba Rose Constructionas Prin6val "(hereinifter called the
Contractor), a Cofitiit for"
SAN RAFAEL COMMUNITY CENTER LOBBY-& RECEPTION REMODEL -REBID
PROJECT NO. 10719 and
WHEREAS, pursuant to law, the said ton6ict6r ig required before entering upon*the perforniance ofthe '
Work to file a good and sufficient Bond with the body by whom the Contract is awarded to Secure the
payment of claims of laborers, mechanics, material suppliers and other persons to whom reference is
made in Section 3181 of the Civil Code of th6 Stite'of California,
NOW, THEREFORE, THESE PRESENTS WITNESSETH:
that we, the Contractor, andFirst National Insurance ComDanya corporation duly organized and
existing under the laws of the State of wash ington , and authorized under the laws of the State of
California to become surety on bonds and undertakings, as Surety (hereinafter called the Surety), are
held and firmly bound unto the said Owner* inthePeYWSUMC)fninety-seven thousand, six
hundred ninety-two dollars an 'i 00 / 100 Dollars ($ q7.6q2. n lawful
money of the United States, said sum being an amount of not less than one hundred percent (100%) of
the total amount for the payment of which sum well and truly to be made the said Contractor and the said
Surety bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally,
firmly by these presents.
THE CONDITION OF THIS OBLIGATION is such that, if the above bounden Contractor, his or its
heirs, executors, administrators, successors or assigns, or Subcontractors, shall fail to pay any claimant
named in Civil Code Section 3181, or amounts due under the Unemployment Insurance Act with respect
to work or labor performed by any such claimant, or any amounts required to be deducted, withheld and
paid over to the Franchise Tax Board from the wages of employees of the Contractor or his
Subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such work
and labor, that the Surety on this Bond will pay the same in an amount not exceeding the aggregate sum
herein above set forth, and also, in case suit is brought upon this Bond, will pay a reasonable attorney's
fee to be fixed by the Court, taxed as costs and awarded to the prevailing party in said suit.
*Company.
**of America.
CONTRACT FORMS AND AGREEMENT
00040-5
Page 5 of 13
PAYMENT BOND
(continued)
It is hereby expressly stipulated and agreed that this Bond shall inure to the benefit of any of the persons
named in Section 3181 of the Civil Code of the State of California so as to give a right of action to them
or their assigns in any suit brought upon this Bond. Should the conditions of this Bond be fully
performed, then the obligation hereunder shall become null and void; otherwise it shall be and remain in
frill force and effect.
The said Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the
Drawings or the Specifications accompanying same, shall in any manner affect its obligations on this
Bond, and it does hereby waive notice of any such change, extension, alteration or addition.
This Bond is executed and filed to comply with the provisions of an act of the Legislature of the State of
California as designated in the Civil Code, Sections 3247 to 3252, inclusive, and all amendments
thereto.
IN WITNESS WHEREOF, this instrument has been duly executed by the Contractor and the Surety this23rd
dayof December 20012
(To be signed by Contractor and Surety, and
acknowledgment and Notarial Seal attached)
BL & R Enterprsies Inc. dba
Rose Construction.eomp.any
{
` { Contract (Seal)
Witness {
{ Titl(e��
�i {Eiret I
National nsi`r.ance Company of America
{ Surety - (Seal)
Witness { By. �A.
{ Attorney n Fact n ley
MAILING ADDRESS OF SUREr Riva .. Al Pasant T 71 .. CA 94523
CONTRACT FORMS AND AGREEMENT
00040-6
Page 6 of 13
STATE OF California
COUNTY OF Contra Costa
On December 23. 2QU
PERSONALLYAPPEARED John J. Daley
SS.
before me, Tanya Chinchilla, Notary Public
personally known to me (�pxa? � tat�vx taco# x> xot
xC iolk=o� to be the person(jtj whose nanre(g� is/g>x subscribed to the
within instrument and acknowledged to me that heJ4r &I" executed
the same in his,4AffAk* authorized capacity(&.1i arul dart by hL4D& jdk
sigrulture(�j on the instrument the person(. or the entity upon behalf
of which the person(.yd acted, executed the instrument.
WITNESS uty hand and official seal.
Signature
OPTIONAL
TANYA CHINCHILLA
Commission if 1375153 Z
Z .,� Notary Public - California ;
Z ' Contra Costa County
My Comm Expires Sep 16, 2006E
This area for Oficial Notarial Seal
Though the data below is not required by law, it may prove valuable to persons relying on the document and could
prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
DESCRIPTION OF ATTACHED DOCUMENT
Pa3 mgllt Rnnd# Al (1I `'ALL
TITLE OF TYPE OF DOCUMENT
two (02)
NUMBER OF PAGES
December 23, 2002
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
First National Insurance- Company of America
N/A
SIGNER(S) OTHER THAN NAMED ABOVE
ID -1232 (REV. 5/01) ALL-PURPOSE ACKNOWLEDGEMENT
S A F EC 0' POWER
OF ATTORNEY
FIRST NATIONAL SURETY
PO BOX 34526
SEATTLE, WA 98124-1526
KNOW ALL BY THESE PRESENTS:
FIRST NATIONAL INSURANCE COMPANY OF AMERICA
PO BOX 34526
SEATTLE, WA 98124-1526
No. 10889
That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint
B. BARNE.TT; M. R. PRENGFR, C. SMITH; JOHN J DALEY; Walnut Creek,
its true and lawful attorney(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar
character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such
instruments had been duly executed by its regularly elected officers at its home office.
IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents
this 3rd
day of June
2002
t -e- P CHRISTINE MEAD, SECRETARY MIKE MCGAVICKK,,JPfR E'S'IDECNJT
CERTIFICATE
Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA:
"Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that
purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to
execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any
instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or
undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not
be necessary to the validity of any such instrument or undertaking."
Extract from a Resolution of the Board of Directors of
FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28. 1970.
"On any certificate executed by the Secretary or an assistant secretary of the Company setting out,
(i) The provisions of Article V, Section 13 of the By -Laws, and
(ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and
(iii) Certifying that said power-of-attomey appointment is in full force and effect,
the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof."
I, Christine Mead, Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a
Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the
Resolution and the Power of Attorney are still in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation
SEAI.
1928 y
f 0 WAl ,4
S-1049/FNEF 7/98
this 23rd
dayof ]jprpmhpr ; 2QQ2
CHRISTINE MEAD, SECRETARY
® A registered trademark of SAFECO Corporation
06/04/2002 PDF
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DEDUCT BLE I s
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MAOiCOMPEN3 AND �[ I TORY lIAI NEW1
8 ENrru7f6nYLsRSLuaLITy 713-007271-02 10/01/02 10/01/03 Et.E/1CHACCIDSUT 31,000,000
fi.LM&EA"-EAENPL 31,000,000 _
I F.L,OW-AX-POUCYLIIMT I s 1, 0001 000
MIA
a Builder's Iti.sk I QT6603525AI73TI 11/01/02 11/01/03 Basic 11500,000
FrlvTI 50011000
DEESi1PTI0N OF OFEItATpNIsfLGCATIONSNEHICLESIEIEC W Si01CS ADDEO BYENDORSENE ffMPECNL PRDY6t�.Fa
per 0020101165 City of San Rafael, its officers, agents, & eMploye►ee are
named as Additional Insureds as respects General Liability, SCEs San Rafael
Comounity Center Lobby & Reception Remodel -Rebid / Job 430718.
CERTIFICATE HOLDER I y I ADDITIONAL INSURM IMMAXA LETTER. _
CITXSRI
City of San Rafael
Departzmat of P%zblic Vorka
P.O. Ik= 151560
San Rafel z CA 94915-1560
ACORD 35.9 (7/971
CANCELLATION
SHOULD ANY OF THE AMWE O SCH090 POLMaaS as CAM MUED EEFORE THE 11"ATIOM
DATE THEREOF- TNEa39UM INSURER V LL ENDEAVOR TO MAL -Q_ DAVI VA TTEN
NOTICE TO THE CERTIFICAM MOLDER NAMED TOTHE LEFT, ALLURE TO 00 BO MULL
IMPOSE NO OSLOAOF ANY IONO
P"REJElITATN �
IALTTITORLM RC r r�ra1 TF �t+nl.l�m�.tb
®ACORD CORPORATION ISM
JAN -02-2003 09.39 99% P_ e?
ACORD CERTIFIC/ -E OF LIABILITY INSU ANCk OP ID s DATE (MM/DD/YY)
OSEC-1 12/23/02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
California Insurance Center ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICKE
CA Lic . # 0423393 HOLDER. THIS CERTIFI=E DOES NOT AMEND, EXTEND OR
1340 Treat Blvd., Suite 480 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Walnut Creek CA 94597 INSURERS AFFORDING COVERAGE
Phone:925-299-1112 Fax:925-299-0328
INSURED INSURER Navigators Insurance Company
IINSURERB Calif. State Compensation Fund
Rose Construction
INSURER C: Hartford Casualty Ins. Co.
39 Belmont Ave.
INSURER D. Travelers Indemnity Co of
Ill.
Fairfax CA 94930-1737
I
I INSURER E:
$1,000,000
COVERAGES
1,500,000
Frame
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.
(NSRTYPE OF INSURANCE POLICY NUMBER
LTR
DATE MIDDIYY) EFFECTIVEICY POLICY EXPIRATION I
DATE (MWDD/YYI LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S 1,000, 000
A X COMMERCIAL GENERAL LIABILITY GL207939
11/01/02 11/01/03 IFIRE DAMAGE (Any one fire)
S 50,000
CLAIMS MADE a OCCUR
I MED EXP (Any one person)
S 5,000
X $1000 ded/BI/PD
I PERSONAL &ADV INJURY
S 1,000,000
GENERAL AGGREGATE
5 2,000,000
I PRODUCTS - COMP/OP AGG
S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X JE o n LOC
I I
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$ 1,000,000
ANY AUTO 57UECUP9929
C9_X
11/01/02 11/01/03 (Eaacodenq
ALL OWNED AUTOS
BODILY INJURY
S
(Per person)
SCHEDULED AUTOS
X HIRED AUTOS
BODILY INJURY
S
(Per accident)
X NON -OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
DOCCUR 17 CLAMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
B EMPLOYERS' LIABILITY 713-007271-02
OTHER
D Builder's Risk QT6603525A179TI
PROPERTY DAMAGE
(Per accident)
AUTO ONLY - EA ACCIDENT S
OTHER THAN EA ACC S
AUTO ONLY, AGG S
EACH OCCURRENCE $
(AGGREGATE $
I S
S
S
DESCRIPTION OF OPERATIONS/LOCATIONSN EHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Per CG20101185 City of San Rafael, its officers, agents, & employees are
named as Additional Insureds as respects General Liability, RE: San Rafael
Community Center Lobby & Reception Remodel -Rebid / Job #10718.
CERTIFICATE HOLDER I Y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITYSR1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of San Rafael
Department of Public Works
P.O. Box 151560
San Rafel CA 94915-1560
ACORD 25-S (7197)
DATE THEREOF, THE ISSUING INSURER WILL §110� MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
AU HORIZED
©ACORD CORPORATION 1988
X IWC
TORYrLIMITS I IOER
10/01/02 10/01/03 I E.L. EACH ACCIDENT
S 1,000,000
E.L. DISEASE - EA EMPLOYEE
S 1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,000
11/01/02 11/01/03 Basic
1,500,000
Frame
500,000
DESCRIPTION OF OPERATIONS/LOCATIONSN EHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Per CG20101185 City of San Rafael, its officers, agents, & employees are
named as Additional Insureds as respects General Liability, RE: San Rafael
Community Center Lobby & Reception Remodel -Rebid / Job #10718.
CERTIFICATE HOLDER I Y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITYSR1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of San Rafael
Department of Public Works
P.O. Box 151560
San Rafel CA 94915-1560
ACORD 25-S (7197)
DATE THEREOF, THE ISSUING INSURER WILL §110� MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
AU HORIZED
©ACORD CORPORATION 1988
POLICY NUMBER: GL207939 COMMERCIAL GENr_RAL 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
Name of Person or Organization:
City of San Rafael
Department of Public Works
P.O. Box 151560
San Rafael CA 94915-1560
Per CG20101185 City of San Rafael, its officers, agents, & employees are
named as Additional Insureds as respects General Liability, RE: San Rafael
Community Center Lobby & Reception Remodel -Rebid / Job #10718.
(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.
CG 20 10 11 85 Copyright, Insurance Service Office, Inc., 1984