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HomeMy WebLinkAboutCC Resolution 12264 (Slurry Seal)RESOLUTION NO. 12264 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL AWARDING THE CONTRACT FOR SLURRY SEAL 2006/2007, PROJECT NO. 11071, TO GRAHAM CONTRACTORS INC., IN THE AMOUNT OF $69,728.00. WHEREAS, on the 17th day of May, 2007, 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: "SLURRY SEAL 2006/2007" PROJECT NO. 11071 in accordance with the plans and specifications therefore on file in the office of said City Clerk; and WHEREAS, the bid of $69,728.00 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, IT IS HEREBY ORDERED AND RESOLVED that the bid of $69,728.00 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 Graham Contractors Inc. at the unit prices mentioned in said bid. RESOLVED FURTHER, that the Mayor of said City be authorized and directed to execute a contract with Graham Contractors Inc. for said work and to return the bidders bond upon the execution of said contract. °�� rr�' n , I t ;j LL Al , I as 6(�- RESOLVED FURTHER, 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 4th day of June, 2007, by the following vote, to wit: AYES: COUNCIL MEMBERS: Heller, Miller, Phillips and Vice -Mayor Cohen NOES: COUNCIL MEMBERS: None ABSENT: COUNCIL MEMBERS: Mayor Boro Z5 qttCa G ,g, &L.,c c FZR JEANNE M. LEONCINI, City Clerk File No. 16.06.62 STREETS TO BE SLURRY SEALED Note: Streets are listed alphabetically and are not in the order in which they will be resurfaced. Street From Alderwood Way Knight Drive To End of street End of street Bret Avenue Alderwood Way �Du Bois Street Irwin Street Brentwood Drive (S)I Brentwood Drive (N) Bret Avenue Woodland Avenue End of street Redding Way End of street End of street End of street IDu Bois Street Robinhood Drive Bret Avenue Woodland Avenue End of street End of street Brentwood Drive Redding Way End of street Blossom Drive Maplewood Drive End of street Maplewood Drive Robinhood Drive End of street �1 12 Beechwood Court Rollingwood Drive 13 Billou Street Du Bois Street 14 Brentwood Drive Robinhood Drive 15 Bret Avenue 16 IBriarwood Drive 7 Dolores Street IDu Bois Street 8 IDu Bois Street lGlenaire Drive 19 lFriar Tuck Lane Robinhood Drive 1101Harte Avenue Irwin Street 111IHazel Court Irwin Street 1121Hazelwood Lane Robinhood Drive 1131Heartwood Court Beechwood Court 1141Hillview Avenue Irwin Street 1151Ironwood Drive Rollingwood Drive 1161Irwin Street IBaywood Street 1711rwin Street Bret Avenue 181Lindenwood CourtlRollingwood Drive 1191Lockwood Drive Robinhood Drive 1201Maplewood Drive Rollingwood Drive 121 Meadow Avenue Irwin Street 122 Millwood Court Rollingwood Drive Way Hillview Avenue �231Redding 24JRobinhood Drive Knight Drive Drive Maplewood Drive �251Robinhood 261Rollingwood DrivelKnight Drive 1271Rollingwood Drivelmaplewood Drive I28ISolar Court Redding Way Street From Alderwood Way Knight Drive To End of street End of street Bret Avenue Alderwood Way �Du Bois Street Irwin Street Brentwood Drive (S)I Brentwood Drive (N) Bret Avenue Woodland Avenue End of street Redding Way End of street End of street End of street IDu Bois Street Robinhood Drive Bret Avenue Woodland Avenue End of street End of street Brentwood Drive Redding Way End of street Blossom Drive Maplewood Drive End of street Maplewood Drive Robinhood Drive End of street City of San Rafael ♦ California Form of Contract Agreement For Slurry Seal 2006/2007 Project No. 11071 This Agreement is made and entered into this 4th day of June, 2007 by and between the City of San Rafael (hereinafter called City) and Graham Contractors 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: Slurry Seal 2006/2007, Project No. 11071, 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 five (5) calendar days after the date of written notice by the City to the Contractor to proceed. (b) The work shall be completed within fifteen (15) working days after the date of such notice and with such 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 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 $500.00 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. V - 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 INO. UNIT ST UNIT ITEM I ITEM I QTY I PRICE, $ I TOTAL, $ 1 Mobilization LS 1 3,500.00 3,500.00 2 Slurry Seal SY 42,400 1.22 51,728.00 3 Painted Traffic Stripes & LS 1 7,000.00 7,000.00 Pavement Markings 4 Traffic Control LS 1 7,500.00 7,500.00 Grand Total o'),718.00 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 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. 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 AGREEMENT • 2 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. IN WITNESS WHEREOF, City and Contractor have caused their authorized representatives to execute this Agreement the day and year first written above. ATTEST: CITY OF SAN RAFAEL: Jeanne M. Leoncini Paul M. Cohen City Clerk Vice -Mayor r GRAHAM CONTRACTORS INC. for David Graham, Vice President AGREEMENT* 3 PERFORMANCE BOND Bond 104940015; Prem: $523.00 KNOW ALL BY THESE PRESENTS, That we, Graham Contractors, Inc. (hereinafter called the Principal), as Principal, and Travelers Casualtv and Suretv Companv of America , a corporation duly organized under the laws of the State of Connecticut (hereinafter called the Surety), as Surety, are held and firmly bound unto City of San Rafael , (hereinafter called the Obligee), in the sum of Sixty Nine Thousand Seven Hundred Twenty Eight and 00/100 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ($ 69,728.00 ) Dollars, for the payment of which sum well and truly to be made, we, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Signed and sealed this 4th day of June , 2007 WHEREAS, said Principal has entered into a written Contract with said Obligee, dated 06/04/2007 for Slurry Seal 2006/2007 in accordance with the terms and conditions of said Contract, which is hereby referred to and made a part hereof as if fully set forth herein: NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That if the abovt bounden Principal shall well and truly keep, do and perform each and every, all and singular, the matters and things in said contract set forth and specified to be by said Principal kept, done and performed, at the times and in the manner in said contract specified, or shall pay over, make good and reimburse to the above named Obligee, all loss and damage which said Obligee may sustain by reason of failure or default on the part of said Principal so to do, then this obligation shall be null and void; otherwise shall remain in full force and effect. NO SUIT, ACTION OR PROCEEDING by the Obligee to recover on this bond shall be sustained unless the same be commenced within two (2) years following the date on which Principal ceased work on said Contract. Graham Contractors, Inc. Principal B ��/y David Graham, Vice President Travelers Casualty and Surety Company of By``'r Bryan D. Martin, Attorney -in -Fact S-0757/GEEF 10/99 California All Purpose Acknowledgment State of California County of San Mateo On June 4, 2007 , before me, Jean L. Neu, Notary Public Date Name & Title of Officer/Notary personally appeared Bryan D. Martin Names(s) of Signers(s) personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the some in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal.,.,_.. �.. . JEAN L. NEU Commission # 1626526 Notary Public -California > Z ,tt San Mateo County rAy comm. Expires Dec 21,20091" /�� ' G�. e�•,m.�,��s-aye•,�,--•.:,�--a,�--�.f-�.s--.�-ti: Notary Public --_---------------------------------OPT/ONAL--=--------------------------------------- (The information below is not required by law) Description of Attached Document Title/type of Document Date of Document Other Signer(s) h:\docs\surely\forms\notary.doc No. of Pages BOND 104940015 CONTRACT BOND - CALIFORNIA PAYMENT BOND KNOW ALL BY THESE PRESENTS, That we, Graham Contractors, Inc. and the Travelers Casualty and Surety Company of America , a corporation organized and existing under the laws of the State of Connecticut and authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto City of San Rafael , as Obligee, in the sum of Sixty Nine Thousand Seven Hundred Twenty Eight and 00/100 --------------------------------- ---------------------------------------------------------- Dollars ($ 69,728.00 )� for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That WHEREAS, the above -bounden Principal has entered into a contract, dated 4rh day of June 2007 , with the Obligee to do and perform the following work, to -wit: Slurry Seal 2006/2007 NOW, THEREFORE, if the above -bounden Principal or his/her subcontractors fail to pay any of the persons named in Section 3181 of the Civil Code of the State of California, or amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or any amounts required to be deducted, withheld and paid over to the Franchise Tax Board from the wages of employees of the Principal or his/her subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such work and labor, Surety will pay for the same, in an amount not exceeding the amount specified in this bond, and also, in case suit is brought upon this bond, a reasonable attorney's fee, to be fixed by the court. This bond shall inure to the benefit of any and all persons, companies or corporations entitled to file claims under 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. Signed, sealed and dated this 4th No premium is charged for this bond. It is executed in connection with a bond for the performance of the contract. S-4449/GEEF 7/98 day of June 2007 Graham Contractors, Inc. Principal �� % i tea"��sr'f � - -- David Graham, Vice President Travelers Casualty and Surety Company of America Surety By G - Bryan D. Martin Attorney -in -Fact California All Purpose Acknowledgment State of County of California San Mateo On June 4, 2007 Date before me, Jean L. Neu, Notary Public Name & Title of Officer/Notary personally appeared Bryan D. Martin Names(s) of Signers(s) personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. Notary Public JEAN L. NEU - :1 / " 'i'�ja• Commission # 7626528 Notary Public - California z San Mateo County�> My Comm. Expires Dec 2, 20094' :�•�-�:�-:��'�..�..�..--�.---k�--,.�--.� te=a (The information below is not required by law) Description of Attached Document Title/type of Document Date of Document Other Signer(s) h Adocs\surety\forms\notary.doc No. of Pages A Nt�' -: t IS PO ER OF TTORNEY IS INVALID WM OUT THE BORDER TRAVELERS POWER OF ATTORNEY Farmington Casualty Company St. Paul Guardian Insurance Company Fidelity and Guaranty Insurance Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company Seaboard Surety Company Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company Attorney -In Fact No. 218559 Certificate No. 001632033 KNOW ALL MEN BY THESE PRESENTS: That Seaboard Surety Company is a corporation duly organized under the laws of the State of New York, that St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company and St. Paul Mercury Insurance Company are corporations duly organized under the laws of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc. is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Bryan D. Martin, Erin Bautista, Jean L. Neu, Nancy L. Wallis, and B. A. Poitevin of the City of Redwood City , State of California , their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. 1 IN WITNEU WHEREOF, the Compatu�e tt7ve caused this instrument to be signed and their corporate seals to be hereto affixed, this day of MM y ' L uu �� Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. Seaboard Surety Company St. Paul Fire and Marine Insurance Company 11th St. Paul Guardian Insurance Company St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company •i(00 5�:SEAL:'aF� ' State of Connecticut City of Hartford ss. By: )' ,��-- Georg6Thompson, enior ice President 11th May 2007 On this the day of before me personally appeared George W. Thompson, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., Seaboard Surety Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof, I hereunto set my hand and official seal. �A My Commission expires the 30th day of June, 2011. p�"G 58440-8-06 Printed in U.S.A. Marie C. Teireault, Notary Public WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER Client#: 44517 GRAHACONT GERTIFICA' _®F LIABILITY INSUE-NCE DATE YY)ACQPDM $ — / PRODUCER _ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Construction Unit (F) (650) 839-6964 GEN'L AGGREGATE LIMIT APPLIES PER: ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ABD Insurance &Financial Services POLICY ] JECOT- n LOC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR C AUTOMOBILE LIABILITY DPA5500001 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 305 Walnut Street X ANY AUTO (Ea accident) ($1,000,000 Redwood City, CA 94063 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER Lexington Insurance Co. I$ Graham Contractors Inc. INSURER B Arch Specialty Insurance Group P.O. Box 26770 I INSURER C Delos Insurance San Jose, CA 95159 INSURER D I 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. INSR'ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE IMM/DD/YY) DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY 7353688 05/01/07 05/0, EACH OCCURRENCE $1,000000 X COMMERCIAL GENERAL LIABILITY I DAMAGE TO RENTED PREMISES fEa occurrences $100.000 1 CLAIMS MADE 51OCCUR I MED EXP (Any one person) $ — I PERSONAL & ADV INJURY 1$1,000,000 _ I GENERAL AGGREGATE I $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS -COMP/OP AGG 1$2,000,000 POLICY ] JECOT- n LOC C AUTOMOBILE LIABILITY DPA5500001 05/01/07 05/01/08 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) ($1,000,000 ALL OWNED AUTOS BODILY INJURY _ SCHEDULED AUTOS (Per person) I$ X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) — IPROPERTY DAMAGEI $ (Per accident) GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT I $ ANY AUTO I OTHER THAN EA ACC AUTO ONLY: l+ $ AGG $ B EXCESS/UMBRELLA LIABILITY ULP000608902 05/01/07 05/01/08 EACH OCCURRENCE $10,000,000 X1 OCCUR FICLAIMS MADE I AGGREGATE 1$10,000,000 I$ DEDUCTIBLE I I $ RETENTION $ I I $ WORKERS COMPENSATION AND WC STATU- TORY LIMITS I I OFR EMPLOYERS' LIABILITY I E.L EACH ACCIDENT I $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? I E.L DISEASE - EA EMPLOYE $ If yes, describe under I I SPECIAL PROVISIONS below E.L DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Re: Project No. 11071; Slurry Seal 2006/2007. The City of San Rafael, its elective and appointive Boards, Commissions, Officers, Agents and Employees are named as additional insured as respects general liability and automobile liability per endorsements attached. CERTIFICATE HOLDER City of San Rafael Public Works - Admin/Engineering 111 Morphew Street, P.O. Box 151560 San Rafael, CA 94915-1560 ACORD 25 (2001/08)1 of 2 #S994086/M982448 CANCELLATION Ten Dav Notice for Non-Pavment of Premium SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENjQj *9)WMWIL in DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B1jMjt)(pigQi7(=R9 JWA (XX 4fIRDi;iWCOl0C9i:007tOFl�QCCQEiWt,.:...w�,..:�, vr;�!Itl'lit(tl�,/F.0�0JOXl(�fORii9E7E06)f9C,�EkR9NItiCxxx t 1XIMMSIRMXxxxx -;-I AUTHORIZED REPRESENTATIVE G 1 C�a,vre— GRAHACONT JTH © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001/08) 2 of 2 #S994086/M982448 POLICYNUMBER: 7353688 ENDORSEMENT COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II • Who Is An Insured 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 ongoing operations performed for that insured. S. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily in- jury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 ©ISO Properties, Inc., 2000 Page 1 of 1 O LX9605 POLICYNUMBER: 7353688 ENDORSEMENT COMMERCIAL GENERAL LIABILITY CO 20 37 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. F1,411111 W I'' •' �• • •'1 a • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract for commercial operations only. Residential work Is excluded. Residential Is defined In the Non -Commercial Dwelling & Residential Exclusion endorsement. Location And Description of Completed Operations: Additional Premium: (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) Section II - Who Is An Insured is amended to include as an insured the person or organization shov�,n in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule of this endorsement performed for that insured and included in the "products -completed operations hazard". CG 20 37 10 01 ©ISO Properties, Inc., 2000 Page 1 of 1 ❑ LX9604 POLICY NUMBER: DPA5500001 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. SCHEDULE Name of Person or Organization: City of San Rafael Public Works - Admin/Engineering 111 Morphew Street, P.O. Box 151560 San Rafael, CA 94915-1560 A. WHO IS AN INSURED is amended to include as an "Insured" the person or organization shown in the Schedule as an Additional Insured. The cov- erage afforded to the Additional Insured is solely limited to liability specifically resulting from the conduct of the Named Insured which may be imputed to the Additional Insured. However, the naming of the person or organization shown in the Schedule as an Additional Insured does not increase or alter the Limit of Insurance nor the scope of coverage of this policy. B. EXCLUSIONS This insurance does not apply to: 1. "Bodily injury" or "property damage" for which the Additional Insured is obligated to pa , damages by reason of the assumption of liability in a contract or agreement. But this exclusion does not apply to liability for damages that the Additional Insured would have in the absence of the contract or agreement. 2. "Bodily injury" or "property damage" arising out of the use of your "products" or work you performed for the Additional Insured. 3. "Property damage" to: a. Property owned, used or occupied by or rented to the Additional Insured. b. Property in the care, custody or control of the Additional Insured for any purpose of exercising physical control. C. Any coverage provided by this policy shall be excess only, over any other valid and collectible insurance which would apply in the absence of this policy. However, this policy shall not be ex- cess over any policy written as specific excess. Re: Project No. 11071; Slurry Seal 2006/2007. The City of San Rafael, its elective and appointive Boards, Commissions, Officers, Agents and Employees are named as additional insured as respects automobile liability. CL/CA 99 09 08 95 CERTHOLDER COPY NA STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 05-04-2007 GROUP: 000467 POLICY NUMBER: 0000488-2007 CERTIFICATE ID: 2200 CERTIFICATE EXPIRES: 04-01-2008 04-01-2007/04-01-2008 CITY OF SAN RAFAEL NA JOB:PROJECT NO. 11071; SLURRY SEAL 2006-2007 PUBLIC WORKS - ADMIN ENGINEERING 111 MORPHEW ST SAN RAFAEL SAN RAFAEL CA 94901-5508 CA This is to certify that we have issued a valid Workers' 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 30days 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 policy 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 to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. tTHORIZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - GERALD GRAHAM PRE - EXCLUDED. ENDORSEMENT #1600 - STEVE GRAHAM VICE PRESIDENT - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04-01-2001 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER GRAHAM CONTRACTORS, INC NA PO BOX 25770 SAN JOSE CA 95159 [B18,NAI (REV.2-05I PRINTED : 06-04-2007