HomeMy WebLinkAboutPW Freitas & Las Gallinas Resurfacing 2010 ProjectAgenda Item No: 18
Meeting Date:
l /)I'D
SAN RAFAEL CITY COUNCIL AGENDA REPORT
Department: Public
Works
Prepared b : /`�sz`
p y City Manager Approval: �
Director of Public Works (LB)
File No. 16.06.71
SUBJECT: A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL AWARDING
A CONTRACT FOR THE FREITAS PARKWAY AND LAS GALLINAS AVENUE
RESURFACING 2010 REBID, PROJECT NO. 11152, TO GHILOTTI BROTHERS, INC.
IN THE AMOUNT OF $497,018.00
RECOMMENDATION: Staff recommends that the City Council adopt the resolution awarding the contract
to Ghilotti Brothers, Inc. in the amount of $479,018.00.
BACKGROUND: Staff identified that portions of the pavement of Manuel T. Freitas Parkway and Las
Gallinas Avenue have deteriorated in such a manner that an overlay project is necessary to prevent
complete street reconstruction. The Freitas Parkway and Las Gallinas Avenue Resurfacing 2010 project
includes the following roadway segments to be resurfaced: 1) Freitas Parkway from Redwood
Highway/Civic Center Drive to 300 feet west of Los Gamos Road, and 2) Las Gallinas Avenue from
Freitas Parkway to Las Colindas Road.
Roadway resurfacing also requires the replacement of traffic signal detection at the intersection of Manual
T. Freitas Parkway and Northgate Drive. After a cost alternative was completed by staff, it was
determined that installation of video detection cameras is the best option for replacement of the signal
detection at this intersection. The City standard equipment was purchased by the City, and an informal
bid was solicited for installation of the equipment. The equipment will be installed and working prior to the
removal of the old system in order to maintain the current operating conditions at this intersection.
On July 6, 2010, the City Council adopted the plans and specifications for this project and authorized the
City clerk to call for bids. The project was originally advertised on July 23, 2010 and a bid opening was
held on August 10, 2010. Staff determined that there are discrepancies between the plans and
specifications on the original bid. Under the San Rafael Municipal Code Section 11.50.100, the City
rejected all bids.
The rebid of the project was advertised in accordance with San Rafael's Municipal code and policies on
August 20th, 2010 and bids were publicly opened on September 1, 2010 at 10:00 AM and read aloud. The
engineer's estimate was $564,250.00. The following six bids were received:
NAME OF BIDDER
AMOUNT
Ghilotti Brothers, Inc.
$497,018.00
Argonaut Constructors
$524,496.05
FOR CITY CLERK ONLY
File No.: 4-1-b/9
Council Meeting: -71 :� /a 0 c0
Disposition: (e—sol-U'yA) F - 13�Z
SAN RAFAEL CITY COUNCIL AGENDA REPORT / Page: 2
NAME OF BIDDER (continued) AMOUNT
Ghilotti Construction Co $530,058.39
Team Ghilotti, Inc. $539,839.80
John Benward Company, Inc. $559,577.30
Maggiora & Ghilotti, Inc. $632,632.00
ANALYSIS: The bid from Ghilotti Brothers, Inc. was $497,018.00 and falls within the allocated project
budget.
FISCAL IMPACT: On July 6, 2010, City Council approved the 5 year Capital Improvement Project list
allocating $795,620.00 for this project.
To date, a total of $24,712.23 has been charged to this project for reproduction of the plans and
specifications and purchase of the video detection equipment. The design was completed in house. The
remaining project costs include construction work to be performed by Ghilotti Brothers, Inc. and a 15%
construction contingency, resulting in a remaining project cost of $571,478.21 and a total project cost of
$575,000.00. The following table summarizes the costs which are associated with this project:
Category -Eden Expense Code
Amount
Note(s)
Already Charged Expenses
$415,620.00
One-time allocation
Proposition 113
$3,521.79
plan/specification reproduction
Proposition 42
$21,190.44
Purchase of traffic signal detection equipment
Remaining Expenses
$613,000.00
Construction -02
$497,018.00
Contract Amount
$16,900.00
Informal bid for Traffic Signal Camera Installs
$74,369.77
Contingency (approximately 15%
Remaining Expenses Sub Total
1 $588,287.77
Total Project Cost
1 $613,000.00
We therefore request that the Council approve a total project cost of $613,000.00 from the following
funding sources:
Source
Amount
Note(s)
Local Measure A
$415,620.00
One-time allocation
Proposition 113
$150,000.00
Accumulated previously; already assigned to project
Proposition 42
$47,380.00
Accumulated previously; transfer from Fund 225
Total Available Funds
$613,000.00
OPTIONS:
The Council can choose not to award the contract and direct Staff to rebid the project.
ACTION REQUIRED:
Adopt Resolution awarding the contract to Ghilotti Brothers, Inc. in the amount of $497,018.00
Enclosures
1. Resolution
2. Agreement
RESOLUTION NO. 13052
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL
AWARDING THE CONTRACT FOR FREITAS PARKWAY AND LAS GALLINAS
AVENUE RESURFACING 2010 REBID, PROJECT NO. 11152, TO GRILOTTI
BROTHERS, INC., IN THE AMOUNT OF $497,018.00.
WHEREAS, on the I` day of September, 2010, 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:
"FREITAS PARKWAY AND LAS GALLINAS AVENUE RESURFACING 2010 REBID"
PROJECT NO. 11152
in accordance with the plans and specifications therefore on file in the office of said City Clerk; and
WHEREAS, the project is included in the five-year Capital Improvement Program (CIP); and
WHEREAS, the bid of Ghilotti Brothers, 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.
NOW, THEREFORE, BE IT RESOLVED by the Council of the City of San Rafael, that the
bid of Ghilotti, Brothers, Inc. is hereby accepted at said unit prices and that the contract for said work and
improvements is hereby awarded to Ghilotti Brothers, Inc. at the unit prices mentioned in said bid.
IT IS FURTHER ORDERED AND RESOLVED that the City Manager and the City Clerk of
said City be authorized and directed to execute a contract with Ghilotti Brothers, Inc. in a form
approved by the City Attorney, for said work and to return the bidder's bond upon the execution of said
contract.
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, ESTHER C. BEIRNE, 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 7°i day of September, 2010, by the following vote, to wit:
AYES: COUNCIL MEMBERS: Brockbank, Heller, Levine & Mayor Boro
NOES: COUNCIL MEMBERS: None
ABSENT: COUNCIL MEMBERS: Connolly
'--
ESTHER C. BEIRNE, City Clerk
City of San Rafael ♦ California
Form of Contract Agreement
for
Freitas Parkway and Las Gallinas Avenue Resurfacing 2010 Rebid
Proiect No. 11152
This Agreement is made and entered into this 7°i day of September, 2010 by and between the City of San
Rafael (hereinafter called City) and Ghilotti Brothers, Inc. (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: Freitas Parkway and Las Gallinas Avenue Resurfacing 2010 Rebid, Project No. 11152, 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. The liability insurance provided to City by
Contractor under this contract shall be primary and excess of any other insurance available to the City.
II - Time of Completion
(a) The work to be performed under this Contract shall be commenced within Five (5) Working Days
after the date of written notice by the City to the Contractor to proceed.
(b) All work shall be completed within 25 Working Days after the date of such notice to proceed and
With such extensions of time as are provided for in the General Conditions.
III - Liquidated Damages
It is agreed that, if all the work required by the contract is not finished or completed within the number of
calendar 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 $1,000 for each and every calendar day's delay in finishing the work in excess of
the number of calendar 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.
ITEM
NO.
ITEM
QTY
UNIT
UNIT
PRICE
ITEM
TOTAL
1
Mobilization (Not to exceed 3%)
1
LS
$7,000.00
$7,000.00
2
Traffic Control
1
LS
$30,860.16
$30,860.16
3
Deep Lift Patching
53,600
SF
$2.75
$147,400.00
4
Full Width Grinding
39,461
SF
$0.50
$19,730.50
Page 1
ITEM
UNIT
ITEM
NO.
ITEM
QTY
UNIT
PRICE
TOTAL
5
Cold Planing
a. Edge Grind 6'
10,250
LF
$2.00
$20,500.00
b. Conform Grind 10'
1,000
LF
$3.00
$3,000.00
6
Asphalt Concrete Overlay (Type A)
2,800
TON
$85.00
$238,000.00
7
Adjust Manhole Castings to Grade
9
EA
$500.00
$4,500.00
8
Adjust Water Valves to Grade
13
EA
$60.00
$780.00
9
Adjust Monuments/Boxes to Grade
1
EA
$340.00
$340.00
10
Traffic Loop Installation
EA
a. Type A
30
$222.00
$6,660.00
b. Type D
9
$225.00
$2,025.00
11
Traffic Striping
a. Install 4" White Striping
250
LF
$0.50
$125.00
b. Install 8" White Striping
79
LF
$1.00
$79.00
c. Install Detail 9 Striping
4,032
LF
$0.40
$1,612.80
d. Install Detail 22 Striping
192
LF
$1.50
$288.00
e. Install Detail 25 Striping
2,036
LF
$0.50
$1,018.00
f. Install Detail 27B Striping
2,825
LF
$0.40
$1,130.00
g. Install Detail 38 Striping
1,088
LF
$1.15
$1,251.20
h. Install Detail 39 Striping
1,658
LF
$0.68
$1,127.44
i. Install Detail 39A Striping
343
LF
$0.68
$233.24
j. Install Detail 40A Striping
1,503
LF
$0.10
$150.30
k. Pavement Markings
3,197 1
LF
$2.88
$9,207.36
Grand Total $497,018.00
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°,0 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 Contracor, shall be valued by the City's
Finance Director, whose decision on valuation of the securities shall be final.
Page 2
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 Contractor shall provide a "Defective Material and Workmanship Bond" for 50°x'0 of the Contract
Price, before the final payment will be made.
(d) The making and acceptance of the final payment shall constitute a waiver of all claims by the City,
other than those arising from any of the following: (1) unsettled liens; (2) faulty work appearing
within 12 months after final payment; (3) requirements of the specifications; or (4) manufacturers'
guarantees. It shall also constitute a waiver of all claims by the Contractor, except those previously
made and still unsettled.
(e) If after the work has been substantially completed, full completion thereof is materially delayed
through no fault of the Contractor, and the Engineer so certifies, the City shall, upon certificate of the
Engineer, and without terminating the Contract, make payment of the balance due for that portion of
the work frilly 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:
Esther C. Beirne
City Clerk
APPROVED AS TO FORM:
J
Robert F. Epstein
City Attorney
File No.: 16.06.71
qry
CITY OF SAN RAFAkL:
1 v
Jenlroff
City "Manager
CONTRACTOR:
MICMEt M-. MOM
For: Ghilotti Brothers, Inc® PRESIDENMEMURER
Page 3
Bond Executed in Triplicate
FAITHFUL PERFORMANCE BOND Bond No 09018576
PUBLIC WORK
(The premium charged on this bond is $ 3,479.00 , being at
the rate of %I 00,OOD @ 8.75/M per thousand of the contract price)
$397,018 @ 6.56/M
KNOW ALL MEN BY THESE PRESENTS:
THAT, WHEREAS the City of San Rafael
State of California, entered into a contract dated September 7th 2010 with
Ghilotti Bros., Inc.
hereinafter designated as the "Principal,"
for the work described as follows: Freitas Parkway and Las Gallinas Avenue Resurfacing 2010 Rebid,
No. 11152
; and
WHEREAS, the said Principal is required under the terms of said contract to furnish a bond for the faithful
performance of said contract.
NOW, THEREFORE, We, the Principal, and Fidelity and Deposit Company of Maryland a
corporation organized and existing under the laws of the State of Maryland , and duly authorized to transact
business under the laws of the State of California, as Surety, are held and firmly bound unto
City of San Rafael in the penal sum of
four hundred ninety seven thousand eighteen & 00/100--- Dollars ($ 497,018.00 ),
lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our
heirs, executors, administrators, and successors, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH, That, if the above bounden Principal, 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 performed at the time and in the manner therein specified, and in all
respects according, to their true intent and meaning, and shall indemnify and save harmless the
City of San Rafael 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 virtue.
And 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 the specifications accompanying
the same shall in any wise affect its obligations on this bond, and it does hereby waive notice of any such change,
extension of time, alteration or addition to the terms of the contract or to the work or to the specifications.
IN WITNESS WHEREOF, We have hereunto set our hands and seals this 7th day of September 2010
PRF71001 CA0201 f
Ghilotti Bros., Inc.
By Principal
Michael M. Ghilotti, President/Treasurer
Fidelity and Deposit Company of Maryland
By
Kelly Holtemann Attorney -in -Fact
State of California
County of Marin
On September 15, 2010 before me, Kathleen J Frew-Eckhaus, Notary Public
(insert name and title of the officer)
personally appeared Michael M. Ghilotti, President/ Treasurer_
who proved to me on the basis of satisfactory evidence to be the person(, whose name(pr) is/
subscribed to the within instrument and acknowledged to me that hefs-hafthey executed the same in
his/h-OW4heir authorized capacity(' , and that by his1htTft4ie4r signatureW on the instrument the
personW,, or the entity upon behalf of which the personal acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
.��
WITNESS my hand and official sea10
l Fc�THL i t u F REE E16F'FU4 AUS
jr i tJcstcary PUJ)lja - California
� MorFn County d
Signature _., (Seal)
ACKNOWLEDGMENT
State of California
County of Marin
On ___September 7th, 2010 before me, ___ J_ DeLuca. Notary_Public _________
(insert name and title of the officer)
personally appeared ...... ...... _____Kelly_ Holtemann_ _
who proved to me on the basis of satisfactory evidence to be the person(-&) whose_ name_(s� is/_tee _
subscribed to the within instrument and acknowledged to me that.#re/she/" executed the same in
i't�her/thek authorized capacity(iee� and that by Ips/her/trek signature( on the instrument the
person(*, or the entity upon behalf of which the person(,&) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature 9 fe _... ___......._..-Q-
..........
J. Pik; MACA
R
2012
(Seal)
Bond Executed in Triplicate
PAYMENT BOND
PUBLIC WORK
Section 3247-3252 inclusive, Civil code)
(Premium included in Faithful Performance Bond)
KNOW ALL MEN BY THESE PRESENT:
That, Whereas
of San Rafael
has awarded to
Ghilotti Bros., Inc.
Bond No. 09018576
Premium: Included
as Principal, a contract for the work described as follows: Freitas Parkway and Las Gallinas Avenue
Resurfacing 2010 Rebid, Project No. 11152
AND WHEREAS, said Principal is required ad 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 Principal and Surety are held and firmly bound unto the
City of San Rafael
in the amount required by law, the sum of
four hundred ninety seven thousand eighteen & 00/100 --
Dollars (S 497,018.00 ) for which payment well and truly 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 Principal, his or its heirs, executors,
administrators, successors or assigns, or subcontractors, shall fail to pay any of the persons named in Civil Code
Section 3181, or amounts due under the Unemployment's Insurance Act with respect to work or labor performed
by any such claimant, or for any amounts required to be deducted, withheld, and paid over the Employment
Development Department from the wages of employees of the principals and his subcontractors pursuant to
section 13020 of the Unemployment Insurance Code, with respect to such work and labor, that the Surety or
Sureties herein will pay for the same in the amount not exceeding the sum specified in this bond, otherwise the
above obligation shall be void. In case suit is brought upon this bond, the said surety will pay a reasonable
attorney's fee to be fixed by the court.
PAY71001 CA0202f
In witness Whereof, We have hereunto set our hand and seals this 7th
day of September 2010
Ghilotti Bros., Inc.
Principal
By:
Michael M. dhildltti, President/Treasurer
Fidelity and Deposit Company of Maryland
m
Kelly Holtemann , Attorney -In -Fact
State of California
County of Marin
On September 15, 2010_ before me, Kathleen J Frew®Eckhaus, Notary Public
(insert name and title of the officer)
personally appeared Michael M. Ghilofti, President/ Treasurer ,
who proved to me on the basis of satisfactory evidence to be the person( whose name(pr) is/
subscribed to the within instrument and acknowledged to me that hel y executed the same in
his/h- it authorized capacity(' , and that by his 'r signature(oon the instrument the
personX, or the entity upon behalf of which the person(,;) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seals KATHLELN j Notary km
O� # 1704 10
'rnla
aOin Curly
Signature: - _ (Seal)
ACKNOWLEDGMENT
State of California
County of Marin
On ___September 7th,_2210 before me, ___ J. DeLuca, _-No tary_-Pub lic
(insert name name and title of the officer)
personally appeared ------ — --- —-----------
Kelly_ Holtemann------___-__---
who proved to me on the basis of satisfactory evidence to be the person(&) whose name(q is/a%
subscribed to the within instrument and acknowledged to me that #re/she/" executed the same in
-1 heiher/t*eir authorized capacity(ieej and that by 4ie/her/ter signature( on the instrument the
person(, or the entity upon behalf of which the person(.&) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature _....------------...
"� dd' ti'6 fdN E��elIm LNf"�'s6�tlA
... 4 -w rn � 2012
,oma°.,�,w,
(Seal) :,1n 1.4k
Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland, by THEODORE G. MARTINEZ, Vice President, and GREGORY E. MURRAY,
Assistant Secretary, in pursuance of authority granted by Article Vl, Section 2, of the By -Law id Company, which are
set forth on the reverse side hereof and are hereby certified to be in full force and effi t id a roof, does hereby
nominate, constitute and appoint Kelly HOLTEMANN and Joan DE�Wtqo
o161 r , California, EACH
its true and lawful agent and Attorney -in -Fact, to make, execu as surety, and as its
act and deed: any and all bonds and undertakino °� n o ertakings in pursuance of these
presents, shall be as binding upon said Co y d a 1 A n nd purposes, as if they had been duly
executed and acknowledged b l cted pany at its office in Baltimore, Md., in their own
proper persons. This-flpatt rk�ehalf of Kelly HOLTEMANN, dated August 30, 2007.
The said Assistant
Section 2, of the By-:
LOlffy'lhat the extract set forth on the reverse side hereof is a true copy of Article VI,
, and is now in force.
IN WITNESS WF�tRVOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 3rd day of December,
A.D. 2007.
ATTEST:
�p DEPpsr
r �
o c
W
✓ im
State of Marylandi ss:
City of Baltimore J
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
Gregmy E. Murray Assistant Secretan
1.2
Theodore G. Martinez
P
On this 3rd day of December, A.D. 2007, before the subscriber, a Notary Public of the State of Maryland, duly
commissioned and qualified, came THEODORE G. MARTINEZ, Vice President, and GREGORY E. MURRAY, Assistant
Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals
and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same,
and being by me duly sworn, severally and each for himself' deposeth and saith, that they are the said officers of the Company
aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said
Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority
and direction of the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
Constance A. Dunn Notary Public
My Commission Expires: July 14, 2011
power,"Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice -President, or any of the Senior
Vice -Presidents or Vice -Presidents specially authorized so to do by the Board of Directors or by the Executive Committee,
shall have + with the concurrenceof anyone of + appoint+
authorizeVice-Presidents, Assistant Vice -Presidents and Attorneys -in -Fact as the business of the Company may require, or two.
person or persons to execute on behalf of + 1 bonds, undertaking,+. 1 +
policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in
the nature of mortgages,...1 to of + 1 +
1, the undersioned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,hereby certify
speciallythat the foregoing Power of Attorney is still in full force and effect on the date ofthis certificate-, and I do further certify that
the Vice -President who executed the said Power of Attorney was one ofthe additional Vice -Presidents
by the Board of Directors to appoint any Attorney -in -Fact as provided in Article VI, Section 2, of the By -Laws of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the
Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on
the 10th day of May, 1990,
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically
reproduced signature of any Vice -President, Secretary, or Assistant Secretary of' the Company, whether made heretofore or
hereafter, wherever appearing upon a certified copy of' any power of attorney issued b) [he Company, shall be valid and
binding upon the Company with the same force and effect as though manually af'fixed."
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and all -i xed the corporate seal of the said Company,
this .. day cof.tw,
r
{ ®tA®BaeeAP .�[°t'9"C'IC9P"6'
CITY OF SAN RAFAEL
MAYOR
Albert J. Boro
Department of
COUNCIL MEMBERS
Greg Brockbank
10 Public Works
Damon Connolly
Barbara Heller
Marc Leuine
INSURANCE REQUIREMENTS SHEET
SUBJECT: WORKERS' COMPENSATION AND PUBLIC LIABILITY PROPERTY
DAMAGE INSURANCE (PUBLIC WORKS CONTRACTS)
The City of San Rafael requires that all Contractors and Subcontractors performing work under a
Public Works contract with the City, carry workers' compensation insurance, public liability
insurance and property damage insurance. The public liability insurance and property damage
insurance shall insure the City, its elective and appointive Boards, Commissions, Officers,
Agents and Employees, as follows:
Public Liability: Not less than $1,000,000 per person and
$5,000,000 for one occurrence.
Property Damage: Not less than $1,000,000 for one occurrence.
The required insurance may be provided by a separate policy insuring the City and County, its
elective and appointive Boards, Commissions, Officers, Agents and Employees or, if the
contractor already has insurance, he may provide the City with the required insurance by
submitting a certificate of insurance and a standard form of additional insured endorsement. For
this latter purpose, the City will accept the following:
"IT IS HEREBY UNDERSTOOD AND AGREED THAT THE CITY OF SAN
RAFAEL AND COUNTY OF MARIN, its officers, agents and employees, are
additional insureds hereunder but only as respects liability arising out of the land
and/or property and/or work described in the Public Works contract for the project
entitled, Freitas Parkway and Las Gallinas Avenue Resurfacing 2010 Rebid,
Proiect No. 11152, between the City of San Rafael and Ghilotti Brothers, Inc. for
the work and the improvements described therein."
The contractor shall provide satisfactory evidence to the City that the required liability insurance
is primary and excess of any other insurance available to the City.
Evidence of satisfactory insurance must be furnished to the City at the time of the execution of
the Public Works contract together with evidence that the insurance carrier will not cancel or
reduce the coverage of the policy without first giving the City at least thirty (30) days prior
notice. Such notice shall be sent to:
CITY OF SAN RAFAEL
DEPARTMENT OF PUBLIC WORKS
111 Morphew Street
SAN RAFAEL, CA 94901
JE�!R" CERTIFICATE OF LIABILITY INSURANCE OP ID SP DATE(MMIDD/YYYY)
1
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
GHILO-1 09/14/10
PRODUCER
LTRINSRE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
TYPE OF INSURANCE
POLICY NUMBER
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Don Ramatici Insurance, Inc.
P.O. Box 151560
San Rafael, CA 94915
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 551
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Petaluma CA 94953
-DRWXO-RE1,11 ED
PREMISES TO'E.occurence) p $ 100,000
A
Phone: 707-782-9200 Fax: 707-782-9300
X COMMERCIAL GENERAL LIABILITY
INSURERS AFFORDING COVERAGE NAIC #
_............ _....... ____._....._._. ........................
INSURED
INSURER Natl Fire Ina. Co. of Hartford 20478
CLAIMS MADE X� OCCUR
INSURER B. Transportation Ins. Co. 20494
Ghi.lotti Bros., Inc.
PERSONAL SADV INJURY
INSURER Continental Casualty company 20443
525 Jacob Street
San Rafael CA 94901
INSURER D Zurich Amarican Insurance Co. 16535
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 CLAIMS1N5M
LTRINSRE
AWL
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXP'PON.
DATE MMIDD/YYYY DATE MM/DD/YNY)
LIMITS
P.O. Box 151560
San Rafael, CA 94915
YES.
GENERAL LIABILITYEACH
OCCURRENCE $2,000,000
-DRWXO-RE1,11 ED
PREMISES TO'E.occurence) p $ 100,000
A
X
X COMMERCIAL GENERAL LIABILITY
GL2098131032
10/01/09 10/01/10
CLAIMS MADE X� OCCUR
MED EXP (Any one person) $5,000
PERSONAL SADV INJURY
s2,000,000
X Brd Form PD
$10,000 PD DED - PER OCC
• nt.
_.. _......................
s4,000,000
PRODUCTS - COMP/OP AGG
S 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
POLICY X jE,0j LOC
Em 1 Liab
1,000,000
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
s 1,000,000
B
X
ANY AUTO
BUA2087746336
10/01/09
(Ea accident)
10/01/10
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 LIABIUTY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
S
ANY AUTO
S
AUTO ONLY AGG
EXCESS I UMBRELLA LIABIUTY
EACH OCCURRENCE
S 10 , 0 00 , O OO
C
X OCCUR CLAIMSMADE
CUP2098041315
10/01/09
10/01/10
$10,000 0,00
AGGREGATE
S
$
DEDUCTIBLE
$
X � RETENTION $10,000
WORKERS COMPENSATION
X TORY LIMITS I ER
AND EMPLOYERS' LIABILITY
EL EACHACCIDENT
$ 1,000,000
D
ANY ECUTIVF�
WC427761403
10/01/09
10/01/10
OFFICER/MEMBEREXCLNER/E
(Mandatory In NH) LN !
E L DISEASE • EA EMPLOYEE
S 1,000,000
If yes, describe under
SPECIAL PROVISIONS below
E L. DISEASE - POLICY OMIT
1 $ l , 000 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Operations of the Named Insured for the Certificate Holder.
JOB: Freitas Parkway and Las Gallinas Avenue Resurfacing, 2010 Rebid,
Project No. 11152, GBI #10432
*Ten day notice would be sent on non payment **officers, agents & employees
30*XG140331A99(LF)/SPECIAL
CERTIFICATE HOLDER CANCELLATION
ACURD 25 (2009/01) U 1958-2009 AGVKU UURPUKA I IUN. AH ngnls reservea.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
SANRAF4
DATE THEREOF, THE ISSUING INSURER WILL6,11106ALGRT.O MAIL 30* DAYS WRITTEN
City of San Rafael
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURET8 Be 08 BE 1A 1.
& County of Marin, its**
0 BF ANY 11101119 WP8N;R AG
SEE ADDENDUM ATTACHED
P.O. Box 151560
San Rafael, CA 94915
YES.
A ZED NTATNE
0.un txiC�'
ACURD 25 (2009/01) U 1958-2009 AGVKU UURPUKA I IUN. AH ngnls reservea.
The ACORD name and logo are registered marks of ACORD
NOTEPAD. MOLDERSDA{S
ANAAF4 ����-1
NM
Ghilotti Bros., Inc. OP ID SP
"IT IS HEREBY UNDERSTOOD AND AGREED THAT THE CITY OF SAN RAFAEL AND
COUNTY OF MARIN, its officers, agents and employees, are additional
insureds hereunder but only as respects liability arising out of the land
and/or property and/or work described in the Public Works contact for the
project entitled, Freitas Parkway and Las Gallinas Avenue Resurfacing 2010
Rebid, Project No: 11152 between the City of San Rafael and Ghilotti
Bros., Inc. for the work and the improvements therein."
PAGE 2
DATE 09/14/10
G -140331-A99
(Ed. 1011)
CNA
For All Commitments You Make* Named Insured: Ghilotti Bros., Inc. Policy No. GL2098131032
IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE
ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT.
SEE PARAGRAPH C.1. OF THIS ENDORSEMENT FOR THESE DUTIES.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED
ENDORSEMENT WITH PRODUCTS - COMPLETED OPERATIONS COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Oreanization:
As Required by written contract/agreement
per Paragraph A. below.
Desienated Project:
As per the written contractlagreement,
provided the location is within the
"coverage territory" of this Coverage
Part.
(Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.)
A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization, including
any person or organization shown in the schedule above, (called additional insured) whom you are required to add as
an additional insured on this policy under a written contract or written agreement; but the written contract or written
agreement must be:
L Currently in effect or becoming effective during the term of this policy; and
2. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury."
B. The insurance provided to the additional insured is limited as follows:
I. That person or organization is an additional insured solely for liability due to your negligence and
specifically resulting from "your work" for the additional insured which is the subject of the written contract
or written agreement. No coverage applies to liability resulting from the sole negligence of the additional
insured.
2. The Limits of Insurance applicable to the additional insured are those specified in the written contract or
written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are
inclusive of, and not in addition to, the Limits of Insurance shown in the Declarations.
3. The coverage provided to the additional insured by this endorsement and paragraph f. of the definition of
"insured contract" under DEFINITIONS (Section V) do not apply to "bodily injury" or "property damage"
arising out of the "products -completed operations hazard" unless required by the written contract or written
agreement.
4. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or
"personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or
failure to render any professional services including:
G -140331-A99
(Ed. 10/1)
a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions,
reports, surveys, field orders, change orders or drawings and specifications; and
b. Supervisory, or inspection activities performed as part of any related architectural or engineering
activities.
C. As respects the coverage provided under this endorsement, SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS are amended as follows:
1. The following is added to the Duties In The Event of Occurrence, Offense, Claim or Suit Condition:
e. An additional insured under this endorsement will as soon as practicable:
(1) Give written notice of an occurrence or an offense to us which may result in a claim or
"suit" under this insurance;
(2) Tender the defense and indemnity of any claim or "suit" to us for a loss we cover under
this Coverage Part;
(3) Tender the defense and indemnity of any claim or "suit" to any other insurer which also
has insurance for a loss we cover under this Coverage Part; and
(4) Agree to make available any other insurance which the additional insured has for a loss
we cover under this Coverage Part.
f. We have no duty to defend or indemnify an additional insured under this endorsement until we
receive written notice of a claim or "suit" from the additional insured.
I. Paragraph 4.b. of the Other Insurance Condition is deleted and replaced with the following:
4. Other Insurance
b. Excess Insurance
This insurance is excess over any other insurance naming the additional insured as an
insured whether primary, excess, contingent or on any other basis unless a written contract
or written agreement specifically requires that this insurance be either primary or primary
and noncontributing to the additional insured's own coverage. This insurance is excess
over any other insurance to which the additional insured has been added as an additional
insured by endorsement.
When this insurance is excess, we will have no duty under Coverages A or B to defend the
additional insured against any "suit" if any other insurer has a duty to defend the additional
insured against that "suit." if no other insurer defends, we will undertake to do so, but we
will be entitled to the additional insured's rights against all those other insurers.
When this insurance is excess over other insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the sum of:
(1) The total amount that all such other insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-insured amounts under all that other
insurance.
We will share the remaining loss, if any, with any other insurance that is not described in
this Excess Insurance provision and was not bought specifically to apply in excess of the
Limits of Insurance shown in the Declarations of this Coverage Part.
CNA
Commercial Umbrella
Renewal Declaration
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POLICY NUMBER COVERAGE PROVIDED BY
QlIP2098041315 CONTINENTAL CASUALTY COMPANY FROM - POLICY PERIOD - TO
333 S. WABASH 10/01/09 10/01/10
CHICAGO, IL. 60604
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This policy becomes effective and expires at 12:01 A.M. standard time at your mailing
address on the dates shown above.
The Named Insured is a Corporation.
Your policy is composed of this Declarations, with the attached Coverage Forms, and
Endorsements if any. The Policy Forms and Endorsement Schedule shows all foims
applicable to this policy at the time of policy issuance.
Premium Basis
WE
Flat Charge
Minimum Premium: $0
Audit Period is Not Auditable
■
Estimated ?-Es
Exposure Rate Advance
Premium
Annual Total Advance Premium:
AGENT Page 1 of 3
INSURED NAME AND ADDRESS
GHILOTTI BROS, INC.
525 Jacoby Street
SAN RAFAEL, CA 94901
AGENCY NUMBER
AGENCY NAME AND ADDRESS
070990
DON RAMATICI INS INC
731 A SOUTHPOINT BLV
P.O. BOX 551
PETALUPA, CA 94954
.Phone Number: (707)782-9200
BRANCH NUMBER
BRANCH NAME AND ADDRESS
250
SAN FRANCISCO
P.O BOX 7430
405 HOWARD STREET SUITE 600
SAN FRANCISCO, CA 94120 .
Phone Number: (415)932-7400
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This policy becomes effective and expires at 12:01 A.M. standard time at your mailing
address on the dates shown above.
The Named Insured is a Corporation.
Your policy is composed of this Declarations, with the attached Coverage Forms, and
Endorsements if any. The Policy Forms and Endorsement Schedule shows all foims
applicable to this policy at the time of policy issuance.
Premium Basis
WE
Flat Charge
Minimum Premium: $0
Audit Period is Not Auditable
■
Estimated ?-Es
Exposure Rate Advance
Premium
Annual Total Advance Premium:
AGENT Page 1 of 3
.-- ..VW ^AJAJAZZIM 111. -1— 1-11-1,11"',
L 2098041315 ILOTTI BROS, INC
025 Jacoby street
SAN RAFAEL,, CA 94901
Form Numb r
Form Title
G56015137
11/19,911
NAMED INSURED
G133136B V
07/201015
Bridge Endorsement
G15051CV
G16375EV
06/2005
01/2004
Commercial Umbrella Plus Coverage Part
G16543AV
01/1991
Contractor Limitation Endorsement
Prof
G1813216 ✓
07/2005
Services Errors and Omissions Exclusion
Employee Benefits Liability Limitation
IL0017
11/1998
Endorsement
Common Policy Conditions
IL0270 ✓
09/200*7
California Changes - cancellation and Nonrenewal
*** PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCww3:Nr. YOUR POLICY *--
For= Number Form Title
G138BBBA wA-%/04/2000 Commercial Umbrella Plus Policyholder Notice
G144233F,/ 01/2008 Notice - Offer of Terrorism Disclosure of Premium
Countersignature
�r .an of the Board
P -43770-B (Ed- 10/89) AGENT Page 3 of 3
(2) 'Personal and advertising injury' or 'property
damage' arising in whole or in part out of the
actual, alleged or threatened presence of
'silica '
w. Named Insured vs. Named Insured
Any liability arising out of claims or 'suits, by a
named insured against another named insured.
x. Employment Related Practices
Any liability arising out of:
(1) A refusal to employ;
(2) Termination of employment;
(3) Demotion, evaluation, reassignment,
discipline;
(4) Coercion, defamation, discrimination,
harassment or humiliation; or
any other employment related practices, policies,
acts or omissions.
y. Terrorism Limitation
'Bodily Injury' or 'property damage' arising out of
any act of terrorism, unless, and then only to the
extent that coverage is provided by 'scheduled
underlying Insurance'
z. Liquor liability limitation
'Bodily Injury' or 'property damage' for which an
Insured may be held liable by reason of:
(1) Causing or contributing to the Intoxication of
any person;
(2) The furnishing of alcoholic beverages to a
person under the legal drinking age or under
the influence of alcohol; or
(3) Any statute, ordinance or regulation relating to
the sale, gift, distribution or use of alcoholic
beverages;
unless, and then only to the extent that coverage
Is provided by 'scheduled underlying Insurance.'
aa. Auto and Mobile Equipment Limitation
Any liability arising out of the:
G -15057-C
(Ed. 05/05)
To the extent that this insurance applies to an
'automobile' or 'mobile equipment' it is further
subject to the pollution exclusion, exclusion f. of
this policy.
Use includes operation or 'loading or unloading.'
bb. Do Not Call
Any liability arising directly or indirectly out of any
action or omission that violates or is alleged to
violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law; or
(2) The CAN -SPAM Act of 2003, including any
amendment of or addition to such law; or
(3) Any statute, ordinance or regulation, other
than the TCPA or the CAN -SPAM Act of 2003,
that prohibits or limits the sending,
transmitting, communicating or distribution of
material or information.
SECTION II — WHO IS AN INSURED
1. Named Insured means any Individual or organization
stated in the Declarations of this policy and If you are
designated In the Declarations of this policy as:
a. An individual, you and your spouse, but only with
respect to the conduct of a business of which you
are the sole owner.
If you are designated In the Declarations of this
policy as an individual, this policy shall not apply
to liability arising out of your domestic or non-
business activities. This does not apply to the
ownership, maintenance, use or 'loading or
unloading' of any 'automobile,' or to the Personal
Umbrella Liability Coverage Part
b. A partnership or Joint venture, you and your
members, your partners, and their spouses, but
only with respect to the conduct of your business.
No person or organization Is an Insured with
respect to the conduct of any current or past
partnership or joint venture that Is not shown as a
Named Insured In the Declarations.
c. An organization other than a partnership or joint
(1) Ownership; venture, you and your executive officers and
(2) Maintenance; directors, but only with respect to their duties as
your officers or directors. Your stockholders are
(3) Use; or also named insureds, but only with respect to their
(4) Entrustment to others liability as stockholders.
of an 'automobile' or 'mobile equipment' owned d• A limited liability company, you and your
or operated by or rented or loaned to an Insured members, but only with respect to the conduct of
unless, and than only to the extent that coverage your business. Your managers are also named
is provided by 'scheduled underlying Insurance.' insureds but only with respect to their duties as
your managers.
G -15057-C
(Ed. 06/05)
Page 6 of 17
Named Insured: Ghilotti Bros:, Inc.
Policy Number: CUP209B041315.
COMMON POLICY CONDITIONS
All Coverage Parts Included in this policy are subject to the following conditions.
A. Cancellation
1. The first Named Insured shown in the Declarations
may cancel this policy by mailing or delivering to
us advance written notice of cancellation.
2. We may cancel this policy by mailing or delivering
to the first Named Insured written notice of
cancellation at least:
a. 10 days before the effective date of
cancellation If we cancel for nonpayment of
premium; or
(b. ] 30 days before the effective date of
cancellation if we cancel for any other reason.
3. We will mail or deliver our notice to the first Named
Insured's last mailing address known to us.
4. Notice of cancellation will state the effective data of
cancellation. The policy period will' and on that
data.
5. if this policy is cancelled, we will send the first
Named Insured any premium refund due. If we
cancel, the refund WIN be pro rata. If the first
Named Insured cancels, the refund may be less
than pro rata. The cancellation will be effective
even if we have not made or offered a refund.
S. If notice is mailed, proof of mailing will be sufficient
proof of notice.
B. Changes
This policy contains all the agreements between you
and us concerning the insurance afforded. The first
Named Insured shown in the Declarations is authorized
to make changes in the terms of this policy with our
consent. This policy's terms can be amended or waived
only by endorsement issued by us and made a part of
this policy.
C. Examination Of Your Books And Records
We may examine and audit your books and records as
they relate to this policy at any time during the policy
period and up to three years afterward.
D. Inspections And Surveys
1. We have the right to:
a. Make inspections and surveys at any time;
IL 00 17 11 98
IL DO 1I T 11 98
b. Give you reports on the conditions we find;
and
c. Recommend changes
2. We are not obligated to make any inspections,
surveys, reports or recommendations and any
such actions we do undertake relate only to
insurability and the premiums to be charged. We
do not make safety Inspections. We do not
undertake to perform the duty of any person or
organization to provide for the health or safety of
workers or the public. And we do not warrant that
conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or
standards.
3. Paragraphs 1. and 2. of this condition apply not
only to us, but also to any rating, advisory, rate
service or similar organization which makes
Insurance inspections, surveys, reports or
recommendations.
4. Paragraph 2. of this condition does not apply to
any inspections, surveys, reports or
recommendations we may make relative to
certification, under state- or municipal statutes,
ordinances or regulations, of boilers, pressure
vessels or elevators.
E Premiums
The first Named Insured shown in the Declarations:
1. Is responsible for the payment of all premiums; and
2. Will be the payee for any return premiums we pay.
F. Transfer Of Your Rights And Duties Under This
Policy
Your rights and duties under this policy may not be
transferred without our written consent except in the
case of death of an individual named Insured.
If you die, your rights and duties will be transferred to
your legal representative but only while acting within
the scope of duties as your legal representative. Until
your legal representative Is appointed, anyone having
proper temporary custody of your property will have
your rights and duties but only with respect to that
property.
Copyright, Insurance Services office, Inc., 1998
Page 1 of 1
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC040601A
CALIFORNIA CANCELATION ENDORSEMENT
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement. Effective 10/01/09
Insured GHILOTTI BROS., INC.
Policy No. WC427761403 Endorsement No.
Insurance Company ZURICH AMERICAN INSURANCE COMPANY
Premium $
This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the
information page.
The cancelation condition in Part Six (Conditions) of the policy is replaced by these conditions:
Cancelation
1. You may cancel this policy. You must mail or deliver
advance written notice to us stating when the cancelation
is to take effect
2. We may cancel this policy for one or more of the
following reasons:
a. Non-payment of premium;
b. Failure to report payroll;
c. Failure to permit us to audit payroll as required by
the terms of this policy or of a previous policy
issued by us;
d. Failure to pay any additional premium resulting 3.
from an audit of payroll required by the terms of
this policy or any previous policy issued by us;
e. Material misrepresentation made by you or your
agent;
f. Failure to cooperate with us in the inves-tigation of
a claim;
g. Failure to comply with Federal or State safety
orders;
h. Failure to comply with written recom-mendations of
our designated loss control representatives; 4•
WC 535 (12-93)
WC 04 06 01 A
1. The occurrence of a material change in the
ownership of your business;
j. The occurrence of any change in your busi-ness or
operations that materially increases the hazard for
frequency or severity of loss;
L The occurrence of any change in your business or
operation that requires additional or different
classification for premium calcu-lation;
1. The occurrence of any change in your business or
operation which contemplates an activity excluded
by our reinsurance treaties.
If we cancel your policy for any of the reasons listed in
(a) through (f) we will give you 10 days advance written
notice, stating when the cancelation is to take effect.
Mailing that notice to you at your mailing address shown
in item 1 of the Information Page will be sufficient to
prove notice. If we cancel your policy for any of the
reasons listed in items (g) through (1), we will give you
30 days advance written notice; however, we agree that
in the event of cancelation and reissuance of a policy
effective upon a material change in ownership or
operations, notice will not be provided.
The policy period will end on the day and hour stated in
the cancelation notice.
Page I of l
CITY OF
Mayor
Albert J. Boro
Council Members
Greg Brockbank
Damon Connolly
Barbara Heller
Marc Levine
PUBLIC WORKS - ADMIN/ENGINEERING: (415) 485-3355 FAX: (415) 485-3334
FAXED, E-MAILED AND MAILED
August 17, 2010
P. O. No. 00449
File No: 16.06.71
Independent Journal
P.O. Box 6150
Novato, CA 94949
FAX NO: 382-1535
Attn: Donna Lazarus
Re: NOTICE INVITING SEALED PROPOSALS — FREITAS PARKWAY AND
LAS GALLINAS AVENUE RESURFACING 2010 REBID
PROJECT NO: 11152
Enclosed is one copy of Notice Inviting Sealed Proposals for Public Works entitled:
"FREITAS PARKWAY AND LAS GALLINAS AVENUE RESURFACING 2010
REBID".
Please publish the enclosed notice on August 20, 2010 and furnish us with Galley Proof
and Proof of Publication in duplicate.
Thank you for your cooperation in this matter.
Sincerely yours,
LP
L
LESLIE BLOMQUIST
Associate Civil Engineer
LB:gj
Enclosure (1)
cc: Esther C. Beirne, City Clerk (2 copies-w/encls.)
Project Engineer (w/encl.)
Secretaries (2) (w/encl.)
111 Morphew Street, P. O. Box 151560, San Rafael, CA 94915-1560
CITY OF SAN RAFAEL - DEPARTMENT OF PUBLIC WORKS
NOTICE INVITING SEALED PROPOSALS FOR PUBLIC WORKS
Notice is hereby given that the City of San Rafael Department of Public Works will receive bids
for furnishing all labor, materials, equipment and services for
FREITAS PARKWAY AND LAS GALLINAS AVENUE
RESURFACING 2010 REBID
PROJECT NO. 11152
This project consists of all the associated work described in the attached specifications and plans
and the provisions of this document for resurfacing of two roadway segments, including deep lift
patch repairs, full width grinding, traffic signal loop replacement and roadway striping, all
located in the City of San Rafael, California.
Each bid shall be in accordance with the plans and specifications adopted by the City of San
Rafael City Council on July 6, 2010, and other contract documents, now on file with the City
Clerk, City I fall, San Rafael, California; and may be examined and copies may be obtained at the
Department of Public Works, 111 Morphew Street„ P. 0. Box 151560, San Rafael, CA 94901.
Cost shall be Fifty Dollars ($50.00) per set, non-refundable. Cost of' mailing sets shall be an
additional Ten Dollars ($10.00) per set.
Bidders are hereby notified that pursuant to Section 1770 of the Labor Code of the State of
California, the City of San Rafael has ascertained the general prevailing rate of per diem wages
and rates for legal holiday and overtime work in the locality where the work is to be performed
for each craft or type of workmen or mechanics needed to execute the contract which will be
awarded the successful Bidder. The prevailing rates so determined by the City are on file in the
office of the City Clerk, copies of which are available to any interested party on request.
Each bid shall be made out on the form to be obtained at the Department of Public Works, 11 1
Morphew Street, San Rafael, California 94901 and shall be accompanied by cash, certified check
or bidder's bond ror ten percent (10%) of the amount of bid, made payable to the order of the
City of San Rafael; shall be sealed and filed with said City Clerk, Room 209, 1400 Fifth
Avenue, San Rafael, California 94901 on or before 10:00 A.M., Wednesday, September 1,
2010.
The City reserves the right to reject any or all bids or to waive any informality in a bid.
Dated: August 20, 2010 )EP -1e.,
ESTHER BEIRNE
City Clerk
PROFESSIONAL SERVICES AGREEMENT/CONTRACT
COMPLETION CHECKLIST AND ROUTING SLIP
Below is the process for getting your professional services agreements/contracts finalized and
executed. Please attach this "Completion Checklist and Routing Slip" to the front of your
contract as you circulate it for review and signatures. Please use this form for all professional
services agreements/contracts (not just those requiring City Council approval).
This process should occur in the order presented below.
Step
Responsible
Description
Completion
Department
Date
1
City Attorney
Review, revise, and comment on draft
agreement.
2
Contracting Department
Forward final agreement to contractor for
their signature. Obtain at least two signed
originals from contractor.
3
Contracting Department
Agendize contractor -signed agreement for
Council approval, if Council approval
necessary (as defined by City Attorney/City
Ordinance*).
4
City Attorney
Review and approve form of agreement;
b;L
bonds, and insurance certificates and
endorsements.
J 3f«
5
City Manager / Mayor / or
Agreement executed by Council authorized
Department Head
official.
6
City Clerk
City Clerk attests signatures, retains original
agreement and forwards copies to the
I
contracting department.
zK `
To be completed by Contracting Department:
Project Name �.
��� ��� ��n� � �y� )
Project Manager:
Agendized for City ouncil Meeting of (if necessary): �..a
P�
If you have questions on this process, please contact the City Attorney's Office at 485-3080.
* Council approval is required if contract is over $20,000 on a cumulative basis.
CITY OF SAN RAFAEL
ROUTING SLIP / APPROVAL FORM
INSTRUCTIONS: USE THIS FORM WITH EACH SUBMITTAL OF A CONTRACT, AGREEMENT,
ORDINANCE OR RESOLUTION BEFORE APPROVAL BY COUNCIL / AGENCY.
SRRA / SRCC AGENDA ITEM NO.
DATE OF MEETING: 9/7/2010
FROM:
DEPARTMENT
Parviz Mokhtari
Public Works
DATE: 9/11/2010
TITLE OF DOCUMENT:
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL AWARDING A CONTRACT
FOR THE FREITAS PARKWAY AND LAS GALLINAS REFURFACING 2010 PROJECT REBID, CITY
PROJECT #11152, TO GHILOTTI BROTHERS, INC. IN THE AMOUNT OF $497,018.00. (BID OPENING
HELD ON WEDNESDAY, SEPTEMBER 1, 2010)
Department Head (signature)
(LOWER HALF OF FORM FOR APPROVALS ONLY)
APPROVED AS COUNCIL / AGENCY
4EN
ITEMger (signature
NOT APPROVED
REMARKS:
APPROVED AS TO FORM:
City Attorney (signa ure)
File No.: 16.06.71