HomeMy WebLinkAboutCC Resolution 11814 (Street Resurfacing)RESOLUTION NO. 11814
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL
AWARDING THE CONTRACT FOR STREET RESURFACING 2004/2005,
PROJECT NO. 11037, TO GHILOTTI BROS., INC., IN THE AMOUNT OF
$1,115,554.68.
WHEREAS, on the 26`h day of July, 2005, 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:
"STREET RESURFACING 2004/2005"
PROJECT NO. 11037
in accordance with the plans and specifications therefore on file in the office of said City
Clerk; and
WHEREAS, the bid of Ghilotti Bros., Inc. at the unit prices stated in its bid was
and is the lowest and best bid for said work and said bidder is the lowest responsible
bidder therefore;
NOW, THEREFORE, IT IS HEREBY ORDERED AND RESOLVED that the
bid of Ghilotti Bros., Inc. and the same is hereby accepted at said unit prices and that
the contract for said work and improvements be and the same is hereby awarded to said
Ghilotti Bros., Inc. at the unit prices mentioned in said bid.
I'M
RESOLVED FURTHER, that the Mayor of said City be authorized and
directed to execute a contract with Ghilotti Bros., Inc. for said work and to return
the bidders bond upon the execution of said contract.
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 1st day of August,
2005, by the following vote, to wit:
AYES: COUNCIL MEMBERS: Cohen, Heller, Miller, Phillips & Mayor Boro
NOES: COUNCIL MEMBERS: None
ABSENT: COUNCIL MEMBERS:None
JEANNI. LEONCINI, City Clerk
File No. 16.06.57
STREETS TO BE RESURFACED
Note: Streets are listed in alphabetical order and not in the order in which they
would be resurfaced.
IID Street
11 Beechnut Court
2 Calafia Court
13 Chula Vista Drive
14 Coleman Drive
15 Convent Court
6 Cortes Court
17 Grand Avenue
18 Grand Avenue
9 Grand Avenue
110 Hillcrest Drive
I11 Joseph Court
12 Los Gamos Road
113 Manuel Freitas Pkwy
114 Maple Street
15 Marin Center Drive
16 Mountain View Avenue
117 Nye Street
118 Oakdale Avenue
119 Orange Blossom Ln.
120 Orris Terrace
121 Paloma Avenue
22 Sandalwood Court
123 Serra Way
24 Vineyard Drive
From
Las Ovejas Ave.
Sierra Way
City Limit
Graceland Drive
David Court
Duran Drive
Fourth Street
Mission Avenue
Jewell Street
Nye Street
Redwood Hwy.
Manuel Freitas Pkwy
Montecillo Road
Lincoln Avenue
Redwood Hwy.
Grand Avenue
Mission Avenue
Mountain View Ave.
Los Gamos Rd.
Orange Blossom
Plum Tree Lane
Manuel Freitas Pkwy
Del Ganado Road
Coleman Drive
To
End of street
End of street
end of street
Chula Vista
End of street
End of street
Mission Avenue
Belle Avenue
Acacia Avenue
Maple Street
End of street
End of street
End of street
Nye Street
End of street
Sienna Way
Maple Street
End of street
Oleander Drive
Oleander Drive
End of street
End of street
Montecillo Road
Prospect Avenue
City of San Rafael • California
Form of Contract Agreement
For
Street Resurfacing 2004/2005
This Agreement is made and entered into this 1st day of August, 2005 by and between
the City of San Rafael (hereinafter called City) and Ghilotti Bros., Inc. (hereinafter
called Contractor). Witnesseth, that the City and the Contractor, for the considerations
hereinafter named, agree as follows:
II - Scope of the Work
The Contractor hereby agrees to furnish all of the materials and all of the equipment
and labor necessary, and to perform all of the work shown on the plans and
described in the specifications for the project entitled: Street Resurfacing
2004/2005, 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 forty-five (45) 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 9 1
(ITEM
UNIT
EST
UNIT
ITEM 1
NO. ITEM
QTY
PRICE, $
TOTAL, $ 1
1 1 Mobilization
LS
1
110,000.00
110,000.001
1 2 Asphalt Concrete Overlay (Type A)
I TON
10,339
60.501
625,509.501
3 Cold Planing
SY
127,957 1
3.251
90,860.251
1 4117abric Reinforcement
I SY
127,819 1
1.071
29,766.331
1 51Deep Lift Pavement Patching
I SY
1 838
36.001
30,168.001
1 61Thermoplastic Traffic Stripes & Pavement
I LS
I 1
20,575.001
20,575.001
1 IMarkings
I
I I
I
I
I 71A.C. Berm/Dike
LF
1 2,556 I
4.101
10,479.601
1 81Adjust Manhole Castings to Grade
EA
1 99 1
300.001
29,700.001
1 91Adiust Rodholes and Monument Castings
EA
1 83 1
275.00
22,825.001
1 Ito Grade
1
I
I
I 10ITraffic Control
,
LS
1
14,568.001
14,568.001
1 111Curb Ramp Installation
1 EA
64 I
,
1,800.00
115,200.001
121Concrete Sidewalk
I SF
493 1
11.00
5,423.001
131Concrete Curb and Gutter
I LS
1 262 1
40.00
10,480.001
1 1
1
(Grand Total
1,115,554.681
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
AGREEMENT 0 2
the City within 15 days after the expiration of 35 days following the date of
recordation of said Notice of Completion.
(b) Before final payment is due the Contractor shall submit evidence satisfactory to the
Engineer that all payrolls, material bills, and other indebtedness connected with
work have been paid, except that in case of disputed indebtedness or liens the
Contractor may submit in lieu of evidence of payment a surety bond satisfactory to
the City guaranteeing payment of all such disputed amounts when adjudicated in
cases ,where such payment has not already been guaranteed by surety bond.
(c) The making and acceptance of the final payment shall constitute a waiver of all
claims by the City, other than those arising from any of the following: (1) unsettled
liens; (2) faulty work appearing within 12 months after final payment; (3)
requirements of the specifications; or (4) manufacturers' guarantees. It shall also
constitute a waiver of all claims by the Contractor, except those previously made
and still unsettled.
(d) If after the work has been substantially completed, full completion thereof is
materially delayed through no fault of the Contractor, and the Engineer so certifies,
the City shall, upon certificate of the Engineer, and without terminating the
Contract, make payment of the balance due for that portion of the work fully
completed and accepted.
Such payment shall be made under the terms and conditions governing final payment,
except that it shall not constitute a waiver of claims.
IN WITNESS WHEREOF, City and Contractor have caused their authorized
representatives to execute this Agreement the day and year first written above.
ATTEST:
anne M. Leoncini
City Clerk .,'i
119,14-
N
CITY OF SA RAFAEL:
Albert oro
Mayor
GHILOTTI BROS., INC.:
for
AGREEMENT • 3
MSURARCE PROM
CNA
BOND EXECUTED IN DUPLICATE
PERFORMANCE BOND
CALIFORNIA PUBLIC WORK
BOND NO. 929337064
PREMIUM: $ 8,193.00
KNOW ALL MEN BY THESE PRESENTS: That we GHILOTTI BROS., INC.
Principal,
and WESTERN SURETY COMPANY , Surety,
a corporation organized and existing under the laws of the State of SOUTH DAKOTA and
authorized to transact surety business in the State of California, are held and firmly bound unto
CTTY OF SAN RAFA.FL
_ .._ .- Obligee,
in the sum of ONE MILLION ONE HUNDRED kItTh&aN THOUSAND FIVE HUNDRED FIF'T'Y—FOUR AND 68/100THS
--------------------------------
---------------------------------- -Dollars ($ 1,115,554.68 )
for the payment of which we bind ourselves, our legal representatives, succeessors and assigns, jointly and
severally, firmly by these presents.
WHEREAS, Principal has entered into a contract with Obligee, dated AUGUST 1, 2005
for
STREET RESURFACING 2004 / 2005 PROJECT NO. 11037
copy of which contract is by reference made a part hereof.
NOW, THEREFORE, if Principal shall faithfully perform such contract or shall indemnify and save
harmless the Obligee from all cost and damage by reason of Principal's failure so to do, then this obligation
shall be null and void; otherwise it shall remain in full force and effect. No right of action shall accrue under
this bond to or for the use of any person other than the said Obligee.
Signed, sealed and dated
G -23260-A
AUGUST 5, 2005
GHILOTTI BROS., INC.
BY: (Seal)
MlGIIPHEL M. uA4 'Iti, Principal
PRESIDENT/TREASURER
WESTERN SURETY COMPANY
By
LAWRENCE J. "COYNE Attorney -in -Fact
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
ss.
County of 10\ a cz;
On 1 1- v i, 1—- i before me, /Yi,4T WrL 1 >-�t x -=.l �.�ry, MI, Lj ()_J61
Date Name and Title of Officer ,e:g., "Jane Doe, Nota Public")
personally appeared f C-1 l r!,N-i to f, ,
Names) • f S gner(s)
�10monally known to me
proved to me on the basis of satisfactory
evidence
QMyMATTHEW PETRAY
COMM. #1425111
NOTARY PUBLIC - CALIFORNIA
MARIN COUNTY
Comm. Expires July 15, 2007
V V
L V V V V V V
to be the person(s) whose name(s) is/are
subscribed to the within instrument and
acknowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s)
acted, executed the instrument.
my hand an�.l, l seal.
L
rESS
Signature of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document: P,'c..4?_ ig%
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:
❑ Individual
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Attorney -in -Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
0 1999 National Notary Association - 9350 De Solo Ave., P.O. Box 2402 - Chatsworth, CA 91313.2402 - wvrcv.nationalnotary.wj
Number of Pages:
Top of thumb here
Prod. No. 5907 Reorder: Call Toll -Free 1-600.676.6827
CALIFORNIA ALL-PURPOSE ACET'OV�TEDGMENT
State of CALIFORNIA
County of SONONIA
On 8/5/05 before me, J. DE LUCA, NOTARY PUBLIC,
personally appeared LAWRENCE J. COYNE,
❑ personally known to me -OR- ® proved to me on the basis of satisfactory evidence to be the person(s)
whose name* is/are- subscribed to the within instrument and
aclrnowledged to me that he/sheAhep executed the same in his eir
authorized capacity(4es), and that by his&ef/ signature(s) on the
instrument the person(, or the entity upon behalf of which the person(s)
acted, executed the instrument.
J. DE LUCA
~ COMM. #1521691
V NOTARY PUBLIC -CALIFORNIA n
SONOMA COUNTY -"
My Comm. ExpirmOct.24, 2008
WITNESS my hand and official seal.
C�L4_..o
Signature of Notary
�-:'t"{fh:-,�j"�.fi3�'•'.i:�.:•iL"R.,°A,�a...5*>��&!. ,",n5't'F.4�__+��v� ��.t C�`c�!,, �t rt riSt,aS .-v ' ... L�cit��.c�a_. sJr .,s;�t"�'..�.J .o_, ;u:� •s...�iF.,,.� x c�� -
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
WESTERN SURETY COMPANY
CA-ICW 24 (7/00)
DESCRIPTION OF ATTACHED DOCUMENT
PERFORMANCE BOND
i)ocument;
ONE
Number of Pages
AUGUST 5, 2005
Date
CNA
For All the Commitments You Make'
BOND EXECUTED IN DUPLICATE PAYMENT BOND BOND NO. 929337064 CALIFORNIA PUBLIC WORK PREMIUM: (INCLUDED)
KNOWN ALL MEN BY THESE PRESENTS, That we, GHILOTTI BROS.. INC.
, as Principal,
and WESTERN SURETY COMPANY
a corporation organized and existing under the laws of the State of SOUTFI DAKOTA 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 ONE MILLION ONE HUNDRED r lr rr v THOUSAND FTVF; RTDFTFTY—FOUR AND r)Rlin THq-
----------------------------------------------------------------- nollars($ 1.11H.FFd.h£� 1,
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.
WHEREAS, the above -bounded Principal has entered into a contract, a copy of which contract is by reference made a
part hereof, dated AUGUST 1. 2005 with the obligee for
STREET RESURFACING 2004 /2005 PROJECT NO. 11037
NOW, THEREFORE, if the above -bounded Principal or his subcontractors shall 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 by any such claimant, or any amounts required to be deducted, withheld and
paid over to the Franchise Tax Board from the wages of employees of the Principal or his sub -contractors 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 agreeable 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
G-23261 -A
5TH day of AUGUST , 19=5
GHILOTTI BROS., INC.
Principal
B
MIYCHAEL M. GHAOTTI, PRESIDENT/TREASURER
WESTERN SURETY COMPANY Surety
LAYWRIIJCE J. COYNE ' Attorney -in -Fact
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
A ss.
County of IN\ fhN1,a.J
On L_ before me PJoIYNM tP ,-I'( ,
Date Name and Ttle of Offic�g., `Jane Doe, Notary Public')
personally appeared r') c (*:w I [ f -t, U -rr--t ,
4 MATTHEW PETRAY
COMM. #1425111
CD 1 NOTARY PUBLIC - CALIFORNIA;
MARIN COUNTY
My Comm. Expires July 15, 2007
V V V V V V V V V V V V V
Name s I ner(s)
IXpefsonally known to me
proved to me on the basis of satisfactory
evidence
to be the person(s) whose name(s) is/are
subscribed to the within instrument and
acknowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s)
acted, executed the instrument.
LESS my hand and ial seal.
Signature of Notary Public
OPTIONAL
Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent
fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document: ��, �„� .,,— �3�•�.�.ta
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:
❑ Individual
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Attorney -in -Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
0 1999 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 -Chatsworth, CA 91313,2402 - www.nationalnotary.org
Number of Pages:
IMMOM ;U11111
Top of thumb here
Prod. No. 5907 Reorder: Call Toll -Free 1-600-676-6827
CALIFORNIA ALL-PURPOSE AC12I0V"1LEDGNIENT
State of CALIFORNIA
County of SONOMA
On 8/x/05 before me, J. DE LUCA, NOTARY PUBLIC,
personally appeared LAWRENCE J. COYNE,
❑ personally known to me -OR- ® proved to me on the basis of satisfactory evidence to be the personH
whose name* is/are- subscribed to the within instrument and
acknowledged to me that he/slreftke� executed the same in hisfker,�eir
authorized capacity(), and that by hisAieWlieif--signature( on the
instrument the person(s), or the entity upon behalf of which the person(
acted, executed the instrument.
ry J. DE LUCA
'- COMM. #1521691
K
QNOTARY PUBLIC -CALIFORNIA
n
SONOMA COUNTY
-�
My Comm. ExpUes Oct. 24, 2000
WITNESS my hand and official seal.
1\
Signature of Notary
'� •.' ��'n ��ta�'..��S.Y�'n,. dY+ n,'��,` �r`x,�1�"g`.�.,.`ic� rA.�.�+�:.-�'a � �L��®`�j,9��!V���'�ci3,�•�+��� .¢r „re��+s� - "g- � 'r i��-3 - �.�' � (^
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Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
WESTERN SURETY COMPANY
CA-ICW 24 (7/00)
DESCRIPTION OF ATTACHED DOCUMENT
PAY= BOND
i)ocument
ONE
Number of Pages
AUGUST 5, 2005
Date
NOTICE
In accordance with the Terrorism Risk Insurance Act of 2002, we are providing this disclosure
notice for bonds and certain insurance policies on which one or more of the Writing Companies
identified below is the surety or insurer.
To principals on bonds and insureds on certain insurance policies written by any one or more of
the following companies (collectively the "Writing Companies") as surety or insurer: Western
Surety Company, Universal Surety of America, Surety Bonding Company of America,
Continental Casualty Company, National Fire Insurance Company of Hartford, American
Casualty Company of Reading, PA, The Firemen's Insurance Company of Newark, NJ, and The
Continental Insurance Company.
DISCLOSURE OF PREMIUM
The premium attributable to coverage for terrorist acts certified under the Act was Zero Dollars
($0.00).
DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM
LOSSES
The United States will pay ninety percent (90%) of covered terrorism losses exceeding the
applicable surety/insurer deductible.
Form F7310
Vestern Surety Cor .pony
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Lawrence J Coyne, Kelly Holtemann, Goran G E Ryn, Joan Deluca, Individually
of Petaluma, CA, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds,
undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be hereto affixed on this 21st day of March, 2005.
suaEr}�� WESTERN SURETY COMPANY
►Mopµ°1
Paul. Bruflat, Senior Vice President
State of South Dakota
ss
County of Minnehaha
On this 21st day of March, 2005, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he
resides in the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and which
executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so
affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires j~`'`'~~`' ~`'`'~`'`'`'~`'"'`'`'`'`'`' r
r D. KRELL r
r
November 30, 2006 j ^NOTARY PUBLIC?
i sib SOUTH DAKOTA SF1�L r
+titihtitiYhsti444ititi4tiYtiti4�sti
4:D. Krell�N. Public
CERTIFICATE
I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my name and affixed the seal of the said corporation this 5TU day of AUGUST 2005
WESTERN SURETY COMPANY
�r°�pORa�od=
/ �els.n,Secretary
Form F4280-01-02
ACORD CERTIFICATE F LIABILITY INSURANC CSR SD
1
DATE(MM/DD/YYYY)
GHILO-1
08/09/05
P RL L� UCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Don Ramatici Insurance, Inc.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 551
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Petaluma CA 94953
Phone: 707-782-9200 Fax:707-782-9300
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A National Union Fire Ins. of PA
(INSURER B: Nationwide Mutual Insurance Co
Ghilotti Bros., Inc.
I INSURER C
525 Jacoby Street
I INSURER
San Rafael CA 94901
INSURER E -
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT
TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INDK gUU'L POLICY NUMBER
LTR NSRE TYPE OF INSURANCE
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE S 1,000,000
A X X COMMERCIAL GENERAL LIABILITY GL9 3 3 3 4 3 5
UAMAUL, 1 U KtN I tU
10/01/04 10 / 0 1/ 0 5 PREMISES (Ea occurence) S 100,000
LA MS MADE X OCCUR
I MED EXP (Any one person) S 5, 000
X Contrctl/Brd Frm
I PERSONAL& ADV INJURY S 1,000,000
XJXCU Incl. SIR $25,000
I GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER"
I PRODUCTS - COMP/OP AGG Is 2, 000,000
POLICY IX I JET n LOC
I Emp. Ben. I 1,000,000
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
S 1,000,000
B X ANY AUTO ACP7840621590
10/01/04 1.0/01./05
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY S
SCHEDULED AUTOS
(Per person)
X HIRED AUTOS
BODILY INJURY $
X NON -OWNED AUTOS
(Per accident)
X Ded. $1000 APD
PROPERTY DAMAGE S
I
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT S
ANY AUTO
I OTHER THAN EA ACC S
AUTO ONLY: AGG S
LIABILITY
EACH OCCURRENCE 5 9,000,000
—EXCESS/UMBRELLA
A X I OCCUR CLAIMSMADE BE2684920
10/01/04 10/01/05
AGGREGATE I S 9,000,000
I$
DEDUCTIBLE
I S
X RETENTION 5 10 , 000
I S
WORKERS COMPENSATION AND
WG STATU-
X I TORY LIMITS I I OER
A EMPLOYERS' LIABILITY WC6436674
10/01/04 10/01/05 I E.L. EACH ACCIDENT I S1,000,000
ANY PROPRIETOR/PARTNER/EXECUTiVE
OFFICER/MEMBER EXCLUDED?
I E.L. DISEASE - EA EMPLOYEE( S 1, 000,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT I S 1, 000,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
RE: Operations of the Named Insured for the Certificate Holder.
*Ten day notice would be sent on non payment.
JOB: Street Resurfacing 2004/2005 Project #11037, GBI #05423
30*XCG2010(10/01)CG2037(10/01)
CERTIFICATE HOLDER
City of San Rafael, its
officers, agents & empl.
Dept. of Public Works
P.O. Box 151560
San Rafael, CA 94915-1560
ACORD 25 (2001/08)
CANCELLATION
SANRAF4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL PAWW W44- MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B}F FAIEH YG Gu S
IMPOSE 110 913616; ArTig? I SR 610 816':F* e F 11? Wlil? IB 1. -MR, tT^_.ieEN+&eR—
AU�HQ�ZED RESEN E
(\� c
RD CORPORATION 1988
POLICY NUMBER: GL9333435 )MMERCIAL GENERAL LIABILITY
NAMED INSURED: Ghilotti Bros., Inc. CG 20 10 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of San Rafael, its officers, agents & employees
Dept. of Public Works
JOB: Street Resurfacing 2004/2005 Project #11037, GBI #05423
(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
B. With respect to the insurance afforded to these additional insureds, the following exclusion
is added:
2. Exclusions
This insurance does not apply to "bodily injury" 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 Page 1 of 1
ISO Properties, Inc, 2000
Policy Number: GL9333435 Commercial General Liability
CG 20 37 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — OWNERS, LESSEES OR
CONTRACTORS — COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABIITY COVERAGE PART
SCHEDULE
Named of Person or Organization:
City of San Rafael, its officers, agents & employees
Dept. of Public Works
Location and Description of Completed Operations:
JOB: Street Resurfacing 2004/2005 Project #11037, GBI #05423
Additional Premium: Included
(If no Entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
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 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 Page 1 of 1
POLICY NUMBER: ACP7840621590
COMMERCIAL AUTO
CA 20 48 02 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
DESIGNATED INSURED
This endorsement modifies insurance provided under the Following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage
Form apply unless modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" under the
Who Is An Insured Provision of the Coverage Form.
This endorsement does not alter coverage provided in the Coverage Form. This
endorsement changes the policy effective on the inception date of the policy unless
another date is indicated below.
Endorsement effective: 08/09/05
Named Insured: Ghilotti Bros., Inc.
SCHEDULE
Countersigned by:
(Authorized Representative)
Name of Person(s) or Organization(s):
City of San Rafael, its officers, agents & employees
Dept. of Public Works
Job: Street Resurfacing 2004/2005 Project #11037, GBI #05423
(If no entry appears above, information required to complete this endorsement will be
shown in the Declarations as applicable to this endorsement.)
Each person or organization shown in the Schedule is an "insured" for Liability
coverage, but only to the extent that person or organization qualifies as an "insured"
under the Who Is An Insured Provision contained in Section 11 of the Coverage Form.