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HomeMy WebLinkAboutC-6012 - Contract for the Improvement of Public Works Multiple Buildings Carpet Replacement � AMENDMENT NO. ONE TO CONTRACT FOR IMPROVEMENT OF PUBLIC WORK MULTIPLE BUILDINGS CARPET REPLACEMENT WITH HM FLOORING GROUP, INC. THIS AMENDMENT NO. ONE TO CONTRACT FOR THE IMPROVEMENT OF PUBLIC WORK ("Amendment No. One") is made and entered into as of this 30th day of November, 2015 ("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("City"), and HM FLOORING GROUP, INC., a California corporation ("Contractor"), whose address is 146 E. Alondra Blvd, Gardena, California 90248, and is made with reference to the following: RECITALS A. On May 13, 2015, City and Contractor entered into a Contract for the Improvement of Public Work ("Contract") to engage Contractor to: Lift/remove all existing interfering furniture, chairs, etc. items off the floors to another area of the buildings to make space for the work; remove and dispose of all existing carpeting and rubber base from the work areas; install new carpet tiles; install new rubber and/or carpet base; put back furniture, chairs, etc. that were moved. The work locations where work is to be performed are: 1. Fire Station No.1 (110 E. Balboa Boulevard); 2. Fire Station No.3 (868 Santa Barbara Drive); 3. Fire Station No.4 (124 Marine Avenue); 4. Fire Station No.6 (1348 Irvine Avenue); 5. Fire Station No.7 (20401 Acacia Street); 6. Fire Station No.8 (6502 Ridge Park Road); and 7. Mariners Library (1300 Irvine Avenue), as more fully described in the Contract Documents ("Project'). B. City desires to enter into this Amendment No. One to reflect additional Work not included in the Agreement and to increase the total compensation. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. SERVICES TO BE PERFORMED Exhibit A to the Agreement shall be supplemented to include the Scope of Work, attached hereto as Exhibit A and incorporated herein by reference ("Services' or "Work"). Exhibit A to the Agreement and Exhibit A to this Amendment No. One shall collectively be known as "Exhibit A." The City may elect to delete certain Services within the Scope of Services at its sole discretion. 2. COMPENSATION TO CONTRACTOR Section 4.1 of the Agreement is amended in its entirety and replaced with the following: "As full compensation for the performance and completion of the Project as required by the Contract Documents, City shall pay to Contractor and Contractor accepts as full payment the sum of Sixty Eight Thousand Four Hundred Forty One Dollars and 00/100 ($68,441.00), less any money deducted pursuant to Section 3.2. Contractor shall not receive any additional compensation unless approved in writing in advance by City's Project Administrator as defined herein. City shall make full payment to Contractor no later than thirty (30) calendar days after acceptance of the Work by City." The total amended compensation reflects Contractor's additional compensation for additional Work to be performed in accordance with this Amendment No. One, including all reimbursable items and subcontractor fees, in an amount not to exceed Six Thousand Eight Hundred Seventeen Dollars and 00/100 ($6,817.00). 3. INTEGRATED CONTRACT Except as expressly modified herein, all other provisions, terms, and covenants set forth in the Agreement shall remain unchanged and shall be in full force and effect. [SIGNATURES ON NEXT PAGE] HM Flooring Group, Inc. Page 2 IN WITNESS WHEREOF, the parties have caused this Amendment No. One to be executed on the dates written below. APPROVED AS TO FORM: CITY ATT R TrY'SOFFICE Date: B aN AL -- Aaron C. Harp (n, �A City Attorney ATTEST: Date: By: �G Leilani I. Brown City Clerk Attachments CITY OF NEWPORT BEACH, a California municipal corporation Date: Lz� f By: px7 i�tj David A. Webb Public Works Director CONTRACTOR: Multiple Buildings Carpet Replacement, a California corporation Date: 41iz5 {Zeas By: Oscar Monealegre Vice President/Secretary OF SIGNATURES] Exhibit A — Scope of Work HM Flooring Group, Inc. Page 3 EXHIBIT A SCOPE OF WORK HM Flooring Group, Inc. Page A-1 Exhibit A Scope of Work/Fee Amendment No. 1: Additional Scope of Work for C-6012 Multiple Buildings Carpet Replacement Project • Fire Department: Additional work at Stations 1, 3, 6, and 8 totaling $5,080.00. • Library Services: Replace 1,500 Square Feet (SF) of existing Mariners Library carpet using both existing attic stock and new materials for an amount of$6,776.00. This cost includes the lifting and repositioning of furniture, books, and shelves. The areas proposed for the new carpeting are either worn or torn beyond repairs from nine (9) years of heavy usage since the Library first opened to the public. • Recreation/Senior Services: Replace all of the existing carpeting (1,720 SF) in the Mariners Library Community Room for an amount of$8,086.00. The existing carpeting has been similarly used at the Library. Additional Work Total: $ 19,942.00 Available Contingency: - $ 13.125.00 Amendment No. 1 Increase: $ 6,817.00 CONTRACT FOR THE IMPROVEMENT OF PUBLIC WORK t MULTIPLE BUILDINGS CARPET REPLACEMENT WITH U HM FLOORING GROUP, INC. THIS CONTRACT FOR THE IMPROVEMENT OF PUBLIC WORK ("Contract") is made and entered into as of this 13th day of May, 2015 ("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("City"), and HM FLOORING GROUP, INC., a California corporation ("Contractor'), whose principal place of business is 146 East Alondra Boulevard, Gardena, California 90248, and is made with reference to the following: RECITALS A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of City. B. City desires to engage Contractor to: Lift/remove all existing interfering furniture, chairs, etc. items off the floors to another area of the buildings to make space for the work; remove and dispose of all existing carpeting and rubber base from the work areas; install new carpet tiles; install new rubber and/or carpet base; put back furniture, chairs, etc. that were moved. C. Work Locations: the buildings where work is to be performed are: a. Fire Station No. 1 (110 E. Balboa Boulevard); b. Fire Station No. 3 (868 Santa Barbara Drive); c. Fire Station No. 4 (124 Marine Avenue); d. Fire Station No. 6 (1348 Irvine Avenue); e. Fire Station No. 7 (20401 Acacia Street); f. Fire Station No. 8 (6502 Ridge Park Road); and g. Mariners Library (1300 Irvine Avenue), as more fully described in the Contract Documents ("Project"). D. City has solicited and received a proposal from Contractor and desires to retain Contractor to render services under the terms and conditions set forth in this Contract. E. Contractor has examined the location of all proposed work, carefully reviewed and evaluated the specifications set forth by City for the Project, and is familiar with all conditions relevant to the performance of services and has committed to perform all work required for the price specified in this Contract over a period of 40 calendar days commencing upon issuance of the "Notice to Proceed". NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. TERM The term of this Contract shall commence on the Effective Date and shall terminate on June 30, 2016, unless terminated earlier as provided for herein. 2. SCOPE OF WORK 2.1. Contract Documents. The complete Contract for the Project includes all of the following documents: Request for Proposals/Bids, attached hereto as Exhibit A; Proposal, attached hereto as Exhibit B; Insurance Requirements, attached hereto as Exhibit C; Labor and Materials Payment Bond attached hereto as Exhibit D; Faithful Performance Bond, attached hereto as Exhibit E; all Project Permits; the Standard Special Provisions and Standard Drawings; Plans and Special Provisions for Contract No. 6012; Standard Specifications for Public Works Construction (current adopted edition and all supplements); and this Contract, and all modifications and amendments thereto (collectively the "Contract Documents'). Exhibits A, B, C, D and E, and all other named Contract Documents, are incorporated herein by reference. The Contract Documents comprise the sole agreement between the parties as to the subject matter therein. Any representations or agreements not specifically contained in the Contract Documents are null and void. Any amendments must be made in writing, and signed by both parties in the manner specified in the Contract Documents. 2.2. Scope of Work. Contractor shall perform everything required to be performed, and shall provide and furnish all the labor, materials, necessary tools, expendable equipment and all utility and transportation services required for the Project as identified in the Contract Documents ("Work" or "Services"). 2.3. All of the Work to be performed and materials to be furnished shall be in strict accordance with the provisions of the Contract Documents. Contractor is required to perform all activities, at no extra cost to City, which are reasonably inferable from the Contract Documents as being necessary to produce the intended results. 3. TIME OF PERFORMANCE 3.1. Time is of the essence in the performance of Work under this Contract and Contractor shall complete the Work within forty (40) calendar days from the date of issuance of the "Notice to Proceed." Failure to complete the Work in the time allotted may result in termination of the Contract by City and assessment of damages as outlined in Section 3.2. 3.2. The parties agree that it is extremely difficult and impractical to determine and fix the actual damages that City will sustain should Contractor fail to complete the Project within the time allowed. Should Contractor fail to complete the Work called for in this Contract within forty (40) calendar days from the date of issuance of the Notice to Proceed, Contractor agrees to the deduction of liquidated damages in the sum of One HM Flooring Group, Inc. Page 2 Thousand Five Hundred Dollars and 001/00 ($1,500.00) for each calendar day beyond the date scheduled for completion. 4. COMPENSATION 4.1. As full compensation for the performance and completion of the Project as required by the Contract Documents, City shall pay to Contractor and Contractor accepts as full payment the sum of Sixty One Thousand Six Hundred Twenty Four Dollars and 00/100 ($61,624.00), less any money deducted pursuant to Section 3.2. Contractor shall not receive any additional compensation unless approved in writing in advance by City's Project Administrator as defined herein. City shall make full payment to Contractor no later than thirty (30) calendar days after acceptance of the Work by City. 4.2. This compensation includes: 4.2.1. Any loss or damage arising from the nature of the Work; 4.2.2. Any loss or damage arising from any unforeseen difficulties or obstructions in the performance of the Work; and 4.2.3. Any expense incurred as a result of any suspension or discontinuance of the Work, but excludes any loss resulting from earthquakes of a magnitude in excess of 3.5 on the Richter Scale and tidal waves, including tsunamis, and which loss or expense occurs prior to acceptance of the Work by City. 5. PROJECT MANAGER Contractor shall designate a Project Manager, who shall coordinate all phases of the Project. This Project Manager shall be available to City at all reasonable times during the term of the Contract. Contractor has designated Juan Yusti to be its Project Manager. Contractor shall not remove or reassign the Project Manager without the prior written consent of City. City's approval shall not be unreasonably withheld. 6. ADMINISTRATION This Contract shall be administered by the Public Works Department. City's Public Works Director, or designee, shall be the Project Administrator and shall have the authority to act for City under this Contract. The Project Administrator or designee shall represent City in all matters pertaining to the Services to be rendered pursuant to this Contract. 7. TYPE AND INSTALLATION OF MATERIALS/STANDARD OF CARE 7.1. Contractor shall use only the standard materials and equipment as described in the Contract Documents in performing Work under this Contract. Any deviation from the materials or equipment described in the Contract Documents shall not be utilized unless approved in advance by the Project Administrator. HM Flooring Group, Inc. Page 3 7.3. All of the Work shall be performed by Contractor or under Contractor's supervision. Contractor represents that it possesses the personnel required to perform the Services required by this Contract, and that it will perform all Work in a manner commensurate with the highest professional standards. For purposes of this Contract, the phrase "highest professional standards" shall mean those standards of practice recognized by one or more first-class firms performing similar work under similar circumstances. 7.4. All Services shall be performed by qualified and experienced personnel who are not employed by City, nor have any contractual relationship with City. By delivery of completed Work, Contractor certifies that the Work conforms to the requirements of this Contract, all applicable federal, state and local laws, and the highest professional standard. 7.5. Contractor represents and warrants to City that it has, shall obtain, and shall keep in full force and effect during the term hereof, at its sole cost and expense, all licenses, permits, qualifications, insurance and approvals of whatsoever nature that is legally required of Contractor to practice its profession. Contractor shall maintain a City of Newport Beach business license during the term of this Contract. 7.6. Contractor shall not be responsible for delay, nor shall Contractor be responsible for damages or be in default or deemed to be in default by reason of strikes, lockouts, accidents, acts of God, or the failure of City to furnish timely information or to approve or disapprove Contractor's Work promptly, or delay or faulty performance by City, contractors, or governmental agencies. 8. CHANGE ORDERS 8.1. This Contract may be amended or modified only by mutual written agreement of the parties. 8.2. The Contractor shall only commence work covered by a change order after the change order is executed and notification to proceed has been provided by the City. 8.3. There shall be no change in the Contractor's members of the project team, as listed in the approved proposal, which is a part of this contract without prior written approval by the City. 9. RESPONSIBILITY FOR DAMAGES OR INJURY 9.1. City and its elected or appointed officers, agents, officials, employees and volunteers shall not be responsible in any manner for any loss or damage to any of the materials or other things used or employed in performing the Project, or for injury to or death of any person as a result of Contractor's performance of the Work required hereunder; or for damage to property from any cause arising from the performance of the Project by Contractor, or its subcontractors, or its workers, or anyone employed by either of them. HM Flooring Group, Inc. Page 4 9.2. Contractor shall be responsible for any liability imposed by law and for injuries to or death of any person or damage to property resulting from defects, obstructions or from any cause arising from Contractor's Work on the Project, or the Work of any subcontractor or supplier selected by Contractor. 9.3. To the fullest extent permitted by law, Contractor shall indemnify, defend and hold harmless City, its elected or appointed officers, agents, officials, employees and volunteers (collectively, the "Indemnified Parties"), from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorneys' fees, disbursements and court costs) of every kind and nature whatsoever (individually, a Claim; collectively, "Claims"), which may arise from or in any manner relate (directly or indirectly) to any breach of the terms and conditions of this Contract, any Work performed or Services provided under this Contract including, without limitation, defects in workmanship or materials or Contractor's presence or activities conducted on the Project (including the negligent, reckless, and/or willful acts, errors and/or omissions of Contractor, its principals, officers, agents, employees, vendors, suppliers, subconsultants, subcontractors, anyone employed directly or indirectly by any of them, or for whose acts they may be liable for any or all of them. 9.4. Notwithstanding the foregoing, nothing herein shall be construed to require Contractor to indemnify the Indemnified Parties from any Claim arising from the sole negligence or willful misconduct of the Indemnified Parties. Nothing in this indemnity shall be construed as authorizing any award of attorneys' fees in any action on or to enforce the terms of this Contract. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by Contractor. 9.5. Contractor shall perform all Work in a manner to minimize public inconvenience and possible hazard, to restore other work areas to their original condition and former usefulness as soon as possible, and to protect public and private property. Contractor shall be liable for any private or public property damaged during the performance of the Project Work. 9.6. To the extent authorized by law, as much of the money due Contractor under and by virtue of the Contract as shall be considered necessary by City may be retained by it until disposition has been made of such suits or claims for damages as aforesaid. 9.7. Nothing in this Section or any other portion of the Contract Documents shall be construed as authorizing any award of attorneys' fees in any action to enforce the terms of this Contract, except to the extent provided for above. 9.8. The rights and obligations set forth in this Section shall survive the termination of this Contract. HM Flooring Group, Inc. Page 5 10. INDEPENDENT CONTRACTOR City has retained Contractor as an independent contractor and neither Contractor nor its employees are to be considered employees of City. The manner and means of conducting the Work are under the control of Contractor, except to the extent they are limited by statute, rule or regulation and the express terms of this Contract. No civil service status or other right of employment shall accrue to Contractor or its employees. Contractor shall have the responsibility for and control over the means of performing the Work, provided that Contractor is in compliance with the terms of this Contract. Anything in this Contract that may appear to give City the right to direct Contractor as to the details of the performance or to exercise a measure of control over Contractor shall mean only that Contractor shall follow the desires of City with respect to the results of the Work. 11. COOPERATION Contractor agrees to work closely and cooperate fully with City's designated Project Administrator and any other agencies that may have jurisdiction or interest in the Work to be performed. City agrees to cooperate with Contractor on the Project. 12. CITY POLICY Contractor shall discuss and review all matters relating to policy and Project direction with City's Project Administrator in advance of all critical decision points in order to ensure the Project proceeds in a manner consistent with City goals and policies. 13. PROGRESS Contractor is responsible for keeping the Project Administrator and/or designee informed on a regular basis regarding the status and progress of the Project, activities performed and planned, and any meetings have been scheduled or are desired. 14. BONDING 14.1. Contractor shall obtain, provide and maintain at its own expense during the term of this Contract both of the following: (1) a Faithful Performance Bond in the amount of one hundred percent (100%) of the total amount to be paid Contractor as set forth in this Contract in the form attached as Exhibit E and incorporated herein by reference; and (2) a Labor and Materials Payment Bond in the amount of one hundred percent (100%) of the total amount to be paid Contractor as set forth in this Contract and in the form attached as Exhibit D and incorporated herein by reference. 14.2. The Faithful Performance Bond and Labor and Materials Payment Bond shall be issued by an insurance organization or surety (1) currently authorized by the Insurance Commissioner to transact business of insurance in the State of California, (2) listed as an acceptable surety in the latest revision of the Federal Register Circular 570, and (3) assigned a Policyholders' Rating A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide: Property-Casualty. HM Flooring Group, Inc. Page 6 14.3. Contractor shall deliver, concurrently with execution of this Contract, the Faithful Performance Bond and Labor and Materials Payment Bond, and a certified copy of the "Certificate of Authority" of the Insurer or Surety issued by the Insurance Commissioner, which authorizes the Insurer or Surety to transact surety insurance in the State of California. 15. INSURANCE Without limiting Contractor's indemnification of City, and prior to commencement of Work, Contractor shall obtain, provide and maintain at its own expense during the term of this Contract or for other periods as specified in this Contract, policies of insurance of the type, amounts, terms and conditions described in the Insurance Requirements attached hereto as Exhibit C and incorporated herein by reference. 16. PREVAILING WAGES Pursuant to the applicable provisions of the Labor Code of the State of California, not less than the general prevailing rate of per diem wages including legal holidays and overtime Work for each craft or type of workman needed to execute the Work contemplated under the Agreement shall be paid to all workmen employed on the Work to be done according to the Agreement by the Contractor and any subcontractor. In accordance with the California Labor Code (Sections 1770 et seq.), the Director of Industrial Relations has ascertained the general prevailing rate of per diem wages in the locality in which the Work is to be performed for each craft, classification, or type of workman or mechanic needed to execute the Agreement. A copy of said determination is available by calling the prevailing wage hotline number (415) 703-4774, and requesting one from the Department of Industrial Relations. The Contractor is required to obtain the wage determinations from the Department of Industrial Relations and post at the job site the prevailing rate or per diem wages. It shall be the obligation of the Contractor or any subcontractor under him/her to comply with all State of California labor laws, rules and regulations and the parties agree that the City shall not be liable for any violation thereof. 17. PROHIBITION AGAINST ASSIGNMENTS AND TRANSFERS Except as specifically authorized under this Contract, the Work to be performed under this Contract shall not be assigned, transferred contracted or subcontracted out without the prior written approval of City. Any of the following shall be construed as an assignment: The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate member or co-tenant if Contractor is a partnership or joint-venture or syndicate or co-tenancy, which shall result in changing the control of Contractor. Control means fifty percent (50%) or more of the voting power or twenty-five percent (25%) or more of the assets of the corporation, partnership or joint-venture. 18. SUBCONTRACTING The subcontractors authorized by City, if any, to perform the Work on this Project are identified in the Proposal attached as Exhibit B. Contractor shall be fully responsible to HM Flooring Group, Inc. Page 7 City for all acts and omissions of any subcontractors. Nothing in this Contract shall create any contractual relationship between City and subcontractor, nor shall it create any obligation on the part of City to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise required by law. City is an intended beneficiary of any Work performed by the subcontractor for purposes of establishing a duty of care between the subcontractor and City. Except as specifically authorized herein, the Work to be performed under this Contract shall not be otherwise assigned, transferred, contracted or subcontracted out without the prior written approval of City. 19. OWNERSHIP OF DOCUMENTS 19.1. Each and every report, draft, map, record, plan, document and other writing produced (hereinafter "Documents"), prepared or caused to be prepared by Contractor, its officers, employees, agents and subcontractors, in the course of implementing this Contract, shall become the exclusive property of City, and City shall have the sole right to use such materials in its discretion without further compensation to Contractor or any other party. Contractor shall, at Contractor's expense, provide such Documents to City upon prior written request. 19.2. Documents, including drawings and specifications, prepared by Contractor pursuant to this Contract, are not intended or represented to be suitable for reuse by City or others on any other project. Any use of completed Documents for other projects and any use of incomplete Documents without specific written authorization from Contractor will be at City's sole risk and without liability to Contractor. Further, any and all liability arising out of changes made to Contractor's deliverables under this Contract by City or persons other than Contractor is waived against Contractor and City assumes full responsibility for such changes unless City has given Contractor prior notice and has received from Contractor written consent for such changes. 20. RECORDS Contractor shall keep records and invoices in connection with the Work to be performed under this Contract. Contractor shall maintain complete and accurate records with respect to the costs incurred under this Contract and any Services, expenditures and disbursements charged to City, for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor under this Contract. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of City to examine, audit and make transcripts or copies of such records and invoices during regular business hours. Contractor shall allow inspection of all Work, documents, proceedings and activities related to the Contract for a period of three (3) years from the date of final payment to Contractor under this Contract. 21. WITHHOLDINGS City may withhold payment to Contractor of any disputed sums until satisfaction of the dispute with respect to such payment. Such withholding shall not be deemed to constitute a failure to pay according to the terms of this Contract. Contractor shall not discontinue Work as a result of such withholding. Contractor shall have an immediate right HM Flooring Group, Inc. Page 8 to appeal to the City Manager or designee with respect to such disputed sums. Contractor shall be entitled to receive interest on any withheld sums at the rate of return that City earned on its investments during the time period, from the date of withholding of any amounts found to have been improperly withheld. 22. CONFLICTS OF INTEREST 22.1. Contractor or its employees may be subject to the provisions of the California Political Reform Act of 1974 (the "Act'), which (1) requires such persons to disclose any financial interest that may foreseeably be materially affected by the Work performed under this Contract, and (2) prohibits such persons from making, or participating in making, decisions that will foreseeably financially affect such interest. 22.2. If subject to the Act, Contractor shall conform to all requirements of the Act. Failure to do so constitutes a material breach and is grounds for immediate termination of this Contract by City. Contractor shall indemnify and hold harmless City for any and all claims for damages resulting from Contractor's violation of this Section. 23. NOTICES 23.1. All notices, demands, requests or approvals to be given under the terms of this Contract shall be given in writing, to City by Contractor and conclusively shall be deemed served when delivered personally, or on the third business day after the deposit thereof in the United States mail, postage prepaid, first-class mail, addressed as hereinafter provided. 23.2. All notices, demands, requests or approvals from Contractor to City shall be addressed to City at: Attn: Public Works Director Public Works Department City of Newport Beach 100 Civic Center Drive PO Box 1768 Newport Beach, CA 92658 23.3. All notices, demands, requests or approvals from City to Contractor shall be addressed to Contractor at: Attn: Oscar Montealegre HM Flooring Group, Inc. 146 E. Alondra Blvd Gardena, CA 90248 24. NOTICE OF CLAIMS Unless a shorter time is specified elsewhere in this Contract, before making its final request for payment under the Contract Documents, Contractor shall submit to City, in HM Flooring Group, Inc. Page 9 writing, all claims for compensation under or arising out of this Contract. Contractor's acceptance of the final payment shall constitute a waiver of all claims for compensation under or arising out of this Contract, except those previously made in writing and identified by Contractor in writing as unsettled at the time of its final request for payment. Contractor and City expressly agree that in addition to all claims filing requirements set forth in the Contract and Contract Documents, Contractor shall be required to file any claim Contractor may have against City in strict conformance with the Government Claims Act (Govt. Code §§ 900 et seq.). 25. TERMINATION 25.1. In the event that either party fails or refuses to perform any of the provisions of this Contract at the time and in the manner required, that party shall be deemed in default in the performance of this Contract. If such default is not cured within a period of two (2) calendar days, or if more than two (2) calendar days are reasonably required to cure the default and the defaulting party fails to give adequate assurance of due performance within two (2) calendar days after receipt of written notice of default, specifying the nature of such default and the steps necessary to cure such default, the non-defaulting party may terminate the Contract forthwith by giving to the defaulting party written notice thereof. 25.2. Notwithstanding the above provisions, City shall have the right, at its sole discretion and without cause, of terminating this Contract at any time by giving seven (7) calendar days prior written notice to Contractor. In the event of termination under this Section, City shall pay Contractor for Services satisfactorily performed and costs incurred up to the effective date of termination for which Contractor has not been previously paid. On the effective date of termination, Contractor shall deliver to City all materials purchased in performance of this Contract. 26. EFFECT OF CONTRACTOR'S EXECUTION Execution of this Contract and all other Contract Documents by Contractor is a representation that Contractor has visited the Project Site as defined by the Contract Documents, has become familiar with the local conditions under which the Work is to be performed, and has correlated all relevant observations with the requirements of the Contract Documents. 27. STANDARD PROVISIONS 27.1. Recitals. City and Contractor acknowledge that the above Recitals are true and correct and are hereby incorporated by reference into this Contract. 27.2. Compliance with all Laws. Contractor shall at its own cost and expense comply with all statutes, ordinances, regulations and requirements of all governmental entities, including federal, state, county or municipal, whether now in force or hereinafter enacted. In addition, all Work prepared by Contractor shall conform to applicable City, county, state and federal laws, rules, regulations and permit requirements and be subject to approval of the Project Administrator and City. HM Flooring Group, Inc. Page 10 27.3. Waiver. A waiver by either party of any breach, of any term, covenant or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant or condition contained herein, whether of the same or a different character. 27.4. Integrated Contract. This Contract represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions herein. 27.5. Conflicts or Inconsistencies. In the event there are any conflicts or inconsistencies between this Contract and any other attachments attached hereto, the terms of this Contract shall govern. 27.6. Interpretation. The terms of this Contract shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of the Contract or any other rule of construction which might otherwise apply. 27.7. Amendments. This Contract may be modified or amended only by a written document executed by both Contractor and City and approved as to form by the City Attorney. 27.8. Severability. If any term or portion of this Contract is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Contract shall continue in full force and effect. 27.9. Controlling Law and Venue. The laws of the State of California shall govern this Contract and all matters relating to it and any action brought relating to this Contract shall be adjudicated in a court of competent jurisdiction in the County of Orange, State of California. 27.10. Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex, age or any other impermissible basis under law. 27.11. No Attorney's Fees. In the event of any dispute or legal action arising under this Contractor, the prevailing party shall not be entitled to attorneys' fees. 27.12. Counterparts. This Contract may be executed in two (2) or more counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. [SIGNATURES ON NEXT PAGE] HM Flooring Group, Inc. Page 11 IN WITNESS WHEREOF, the parties have caused this Contract to be executed on the dates written below. APPROVED AS TO FORM: CITY ATTORN Y'S OFFICE Date: By: Wl Aaron C. Harp (JFM ds/aip-x City Attorney ATTEST: Date: q. 4 15- By: 5 By: Leilani I. Brown City Clerk �z CITY OF NEWPORT BEACH, a Californi municipal, corporation Date:' ) By: /� 0, il_x David A. Webb Public Works Director CONTRACTOR: HM Flooring Group, Inc. a California corporation Date: 'Thewls By: (�4101�� Camilo Montealegre Vice President/Secretary Date: GJ Z 6 /-6 l • _ r!'c'riit�l Chief Financial Officer [END OF SIGNATURES] Attachments: Exhibit A — Request for Proposals/Bids, Exhibit B — Proposal Exhibit C — Insurance Requirements Exhibit D — Labor and Materials Payment Bond Exhibit E — Faithful Performance Bond -1R e�iNQ HM Flooring Group, Inc. Page 12 ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of '49s ,��.e%S } On �Z�� ZG, Za/5 before me, Phillip Andrew Fahrnkopf, Notary Public ere insert name and title of the officer) personally appeared (scar ,>//fox�cat e- a#td ff eL/op �%�t'fcq/kyr who proved to me on the basis of satisfactory evidence to be the personQ whose name&) is4gubscribed to the within instrument and acknowledged to me that he/she executed the same in his/her/feiDauthorized capacity and that by his/her/t!De Osignature(o on the instrument the person6) or the entity upon behalf of which the persoroy 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. pHILLIPANDREW FAHRNKOPF COMM. #2113456 W v Notary Public - California 9 ca LOS ANGELES COUNTY A %My Comm. Ex . Jun 26, 2019 ota' � blic Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT itle or description of attached docu nt) pub/�'c Gvbr�C,f� (Title or description of attach1d document continued) Number of Pages 12 Document Date G -1/ZU/ CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) P Corporate Officer amillr CW (Title) e) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 2015 Version vvwn•:.NotatyClasses.cotn 800873 9865 INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding nota?), wading and, if needed, should be completed and attached to the document. Acknolrvedgents j onr other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notaty larv. • State and County infor cation must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public nntst print his or her name as it appears within his or her con mission followed by a comma and then your title (notary public). • Print the names) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect I'omns (i.e. he/she/they; is /afe ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lutes. if seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. EXHIBIT A REQUEST FOR PROPOSALS/BIDS HM Flooring Group, Inc. Page A-1 CITY OF NEWPORT BEACH NOTICE INVITING BIDS Sealed bids may be received at the office of the City Clerk, 100 Civic Center Drive, Newport Beach, CA 92660 until 10:00 AM on the 21st day of April , 2015, at which time such bids shall be opened and read for MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 $ 105,000 Engineer's Estimate P0 o � u C'9tl F01% P Approved by All ark Vukojevic bl City Engineer Prospective bidders may obtain Bid Documents and Project Specifications from Mouse Graphics at (949) 548-5571 Located at 659 W. 19`" Street, Costa Mesa, CA 92627 Contractor License Classification(s) required for this project: "B" or"C-15" For further information, call Fong Tse, Project Manager at(949) 644-3321 BID INFORMATION IS AVAILABLE ON THE CITY WEBSITE: http://www.NewportBeachCA.gov CLICK: Online Services/Bidding &Bid Results CITY OF NEWPORT BEACH _ T PUBLIC WORKS DEPARTMENT SPECIAL PROVISIONS MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT CONTRACT NO. C-6012 INTRODUCTION All work necessary for the completion of this contract shall be done in accordance with (1) these Special Provisions; (2) the Exhibits; (3) the City's Standard Special Provisions and Standard Drawings for Public Works Construction, (2004 Edition), including Supplements; and (4) Standard Specifications for Public Works Construction (2009 Edition), including supplements. Copies of the Standard Specifications for Public Works Construction may be purchased at Building News, Inc., 990 Park Center Drive, Suite-E, Vista, CA 92081, 760-734-1113. The following Special Provisions supplement or modify the Standard Specifications for Public Works Construction as referenced and stated hereinafter; PART 1 - GENERAL PROVISIONS SECTION 2 - SCOPE AND CONTROL OF THE WORK 2-6 WORK TO BE DONE Add to this Section, "The majority of the work necessary for the completion of this contract includes: • Lift/remove all existing interfering furniture, chairs, etc. items off the floors to another area of the buildings to make space for the work; • Remove and dispose of all existing carpeting and rubber base from the work areas; • Install new carpet tiles; • Install new rubber and/or carpet base; • Put back furniture, chairs, etc. that were moved. 2-6.1 Work Locations Add this Section, "The buildings where work is to be performed are: 1. Fire Station No. 1 (110 E. Balboa Boulevard) 2. Fire Station No. 3 (868 Santa Barbara Drive) SP 1 of 9 3. Fire Station No. 4 (124 Marine Avenue) 4. Fire Station No. 6 (1348 Irvine Avenue) 5. Fire Station No. 7 (20401 Acacia Street) 6. Fire Station No. 8 (6502 Ridge Park Road) 7. Mariners Library(1300 Irvine Avenue) SECTION 3 - CHANGES IN WORK 3-3 EXTRA WORK 3-3.2 Payment 3-3.2.3 Markup Replace this section with the following: "(a) Work by Contractor. The following percentages shall be added to the Contractor's costs and shall constitute the markup for all overhead and profits: 1) Labor ............................................ 15 2) Materials ....................................... 15 3) Equipment Rental ........................... 15 4) Other Items and Expenditures ........... 15 To the sum of the costs and markups provided for in this subsection, one (1) percent shall be added for compensation for bonding. (b) Work by Subcontractor. When all or any part of the extra work is performed by a Subcontractor, the markup established in 3-3.2.3(a) shall be applied to the Subcontractor's actual cost(prior to any markups)of such work. A markup of 10 percent on the first$5,000 of the subcontracted portion of the extra work and a markup of 5 percent on work added in excess of $5,000 of the subcontracted portion of the extra work may be added by the Contractor. SECTION 4-CONTROL OF MATERIALS 4-1 MATERIALS AND WORKMANSHIP 4-1.3 Inspection Requirements 4-1.3.4 Inspection and Testing All material and articles furnished by the Contractor shall be subject to rigid inspection, and no material or article shall be used in the work until it has been inspected and accepted by the Engineer. The Contractor shall furnish the Engineer full information as to the progress of the work in its various parts and shall give the Engineer timely(48- hours minimum) notice of the Contractor's readiness for inspection. Submittals are required for all construction material." SP2of9 SECTION 6- PROSECUTION. PROGRESS AND ACCEPTANCE OF THE WORK 6-1 CONSTRUCTION SCHEDULE AND COMMENCEMENT OF WORK Add to this Section: The time of completion as specified in Section 6-7, shall commence on the date of the Notice to Proceed. 6-1.1 Construction Schedule No work shall begin until a Notice To Proceed has been issued, a pre-construction meeting has been conducted, and a schedule of work has been approved by the Engineer. The Contractor shall submit a construction schedule to the Engineer for approval a minimum of five working days prior to the pre-construction meeting. Schedule may be bar chart or CPM style. The Engineer will review the schedule and may require the Contractor to modify the schedule to conform to the requirements of the Contract Documents. If work falls behind the approved schedule, the Contractor shall be prohibited from starting additional work until Contractor has exerted extra effort to meet the original schedule and has demonstrated that the ability to maintain the approved schedule in the future. Such stoppages of work shall in no way relieve the Contractor from the overall time of completion requirement, nor shall it be construed as the basis for payment of extra work because additional personnel and equipment were required on the job." 6-7 TIME OF COMPLETION 6-7.1 General Add to this Section: 'The Contractor shall complete all work under Contract within 40 consecutive working days after the date on the Notice to Proceed. The Contractor shall complete all work at one building before starting work at the next location. 6-7.2 Working Days Revise 3)to read: "any City holiday, defined as January I" (New Year's Day), the third Monday in January(Martin Luther King Day), the third Monday in February(President's Day), the last Monday in May(Memorial Day), July 4t', the first Monday in September (Labor Day), November 11th (Veterans Day), the fourth Thursday and Friday in November(Thanksgiving and Friday after), December 24th, (Christmas Eve), December 25th (Christmas), and December 31't(New Year's Eve). If the holiday falls on a Sunday, the following Monday will be considered the holiday. If the holiday falls on a Saturday, the Friday before will be considered the holiday." 6-7.4 Working Hours Normal working hours are limited to 7:00 a.m. to 3:30 p.m., Monday through Friday. SP3of9 Should the Contractor elect to work outside normal working hours, Contractor must first obtain special permission from the Engineer. The request may be for 3:30 p.m. to 6:30 p.m. on weekdays or 8:00 a.m. to 6 p.m. on Saturday only. A request for working outside the normal working hours must be made at least 72 hours in advance of the desired time period. A separate request must be made for each work shift. The Engineer reserves the right to deny any or all such requests. Additionally, the Contractor may be required to pay for supplemental inspection costs of $146 per hour when such time periods are approved. 6-9 LIQUIDATED DAMAGES Revise sentence three to read: "For each consecutive calendar day after the time specified in Section 6-7-1 for completion of the work, the Contractor shall pay to the City or have withheld from moneys due it, the daily sum of$1,500.00. Revise paragraph two, sentence one, to read: "Execution of the Contract shall constitute agreement by the Agency and Contractor that the above liquidated damages per day is the minimum value of the costs and actual damage caused by the failure of the Contractor to complete the Work within the allotted time. The intent of this section is to emphasize to the Contractor the Importance of prosecuting the work in an orderly, preplanned, and continuous sequence so as to minimize inconvenience to residences, businesses, vehicular and pedestrian traffic, and the public as a result of construction operations." SECTION 7- RESPONSIBILITIES OF THE CONTRACTOR 7-1 THE CONTRACTOR'S EQUIPMENT AND FACILIITIES 7-5 PERMITS Replace this section with "Although a City Building Permit is not required, the Contractor shall have a valid City of Newport Beach business license for the work duration." 7-7 COOPERATION AND COLLATERAL WORK Add to this section: "Fire personnel are on continuous duty and will require continuous access to their facilities. Their operations shall not be disturbed. To minimize the construction impacts, the Contractor shall: 1. Make every effort to conduct his work in a manner that will not interfere with City operations. 2. Provide barriers to control construction dust and debris at all times. 3. Remove construction debris from the work site at the end of each work day. SP4of9 4. Provide trash service for construction personnel. 5. Maintain City vehicle access to the facilities at all times. 6. Park construction and personal vehicles off site. Special no-cost on-street parking permits will be provided by the City as needed. 7-8.4 Storage of Equipment and Materials 7-8.4.3 Storage of Equipment and Materials in Public Streets Delete the first paragraph and add the following: The Contractors work areas will be restricted because of ongoing activities at the site. The City will make every attempt to accommodate the contractor's access to various areas around the facility for onloading and offloading construction materials and equipment. If desired, the Contractor may enclose his work area(s) with a 6-foot minimum high chain link fence. The work area(s) shall contain all of the contractors materials, supplies, equipment, machinery, toilets, workbenches, etc. The contractors and workers vehicles shall be located outside of this work area(s). Prior to move-in, the Contractor shall take photos of the laydown area. The Contractor shall restore the laydown area to its pre-construction condition. The Engineer may require new base and pavement If the pavement condition has been compromised during construction. 7-8.5 Temporary Light, Power and Water. Add to this section: 'The Contractor will have gratis use of the City's water and power at the sites." 7-8.6 Water Pollution Control Add to this Section, "All water used during the work containing mud, silt or other deleterious material due to the construction of this project shall be treated by filtration or retention in settling basin(s) sufficient to prevent such material from migrating into any catch basin, Newport Harbor, the beach, or the ocean. The Contractor shall also comply with the Construction Runoff Guidance Manual which is available for review at the Public Works Department or can be found on the City's website at www.newportbeachca.gov/publicworks and clicking on permits, then selecting the link Construction Runoff Guidance Manual. Additional information can be found at www.cleanwatemewport.com" 7-8.6.2 Best Management Practices (BMPs) Add to this Section: The Contractor shall be responsible for containing any wastewater or storm water runoff from the project site including, but not limited to the following: a. No placement of construction materials where they could enter storm drain system, which includes gutters that lead to catch basins. SP5of9 b. Checking construction vehicles for fluid leaks. c. Providing a controlled area for cleaning or rinse-down activities. d. Monitoring construction activities. e. Minimizing usage of water when saw-cutting and vacuum the residue. f. Providing measures to capture or vacuum-up water contaminated with construction debris. g. Removing any construction related debris on a daily basis. h. Protecting work areas from erosion. The City of Newport Beach will monitor the adjacent storm drains and streets for compliance. Failure of the Contractor to follow BMP will result in immediate cleanup by City and back-charging the Contractor for all costs plus 15 percent. The Contractor may also receive a separate Administrative Citation per Section 14.36.030A23 of the City's Municipal Code. 7-10 PUBLIC CONVENIENCE AND SAFETY 7-10.1 Traffic and Access Add to this Section: "Although not expected on this Project, whenever any portion of the public sidewalk or roadway adjacent to the work location is impacted by the staging of materials or equipment, the Contractor shall provide traffic control and access in accordance with Section 7-10 of the Standard Specifications and the Work Area Traffic Control Handbook(WATCH), also published by Building News, Inc. Pedestrian access shall be maintained to the extent possible. The Contractor shall furnish and install signage, barricades, construction fencing, delineators, yellow safety ribbon, and any other measures deemed necessary by the Engineer to safely direct the public around areas of construction. Such measures shall be shown on the Detailed Traffic Control Plans (see Section 7-10.3)." 7-10.4 Safety 7-10.4.1 Safety Orders Add to this Section: The Contractor shall be solely and completely responsible for conditions of the job-site, including safety of all persons and property during performance of the work, and the Contractor shall fully comply with all State, Federal and other laws, rules, regulations, and orders relating to the safety of the public and workers. The right of the Engineer or the City's Representative to conduct construction review or observation of the Contractor's performance shall not include review or observation of the adequacy of the Contractor's safety measures in, on, or near the construction site." 7-10.5 "No Parking" Signs SP6of9 The Contractor shall install, maintain in place, and notify the City's Police Department at (949) 644-3717 for verification of posting at least forty-eight hours in advance of the need for enforcement of the posted "NO PARKING-TOW AWAY" signs. The signs will be provided by the City at no cost to the Contractor. However, the City reserves the right to charge $2.00 per sign following any excessive abuse or wastage of the signs by the Contractor. The City of Newport Beach "Temporary Tow-Away, No Parking" signs are available from the Public Works Department. The Contractor shall print the hours and dates of parking restriction on the "NO PARKING -TOW AWAY" sign in 2-inch high non-erase letters and numbers. A sample of the completed sign shall be reviewed and approved by the Engineer prior to posting. 7-15 CONTRACTOR'S LICENSES At the time of City Council contract award and until completion of work, the General Contractor shall possess a valid a General Building Contractor "B" or a Flooring and Floor Covering "C-15" License issued by the State of California. At the start of work and until completion of work, the Contractor and all Sub-contractors shall possess a valid Business License issued by the City of Newport Beach. SECTION 9 - MEASUREMENT AND PAYMENT 9-3 PAYMENT 9-3.1 General Revise paragraph two to read: The unit and lump sum prices bid for each item of work shown on the Proposal shall include full compensation for furnishing the labor, materials, tools, and equipment and doing all the work, including restoring all existing improvements, to complete the item of work in place and no other compensation will be allowed thereafter. Payment for incidental items of work not separately listed shall be included in the prices shown for the other related items of work. The following items of work pertain to the bid items included within the Proposal: Item No. 1 Mobilization and Demobilization: Work under this item shall include providing bonds, insurance and financing, preparing BMPs and construction schedule, distributing Construction Notices to the residents and businesses within 500' of each work site, site cleanup, and all other related work as required by the Contract Documents and these Special Provisions Item No. 2 Fire Stations: This bid item shall include all of the equipment, materials, supplies, and labor necessary to relocate all interfering furniture, remove and dispose of the existing flooring and sub-layers to the bare floor, prepare the bare floor, install new carpet tiles, install new carpet and/or rubber bases along all of the new carpet perimeters, and return the furniture to their original locations. Payment is made for the square footage of carpet tiles and carpet base installed. SP7of9 The cost of concrete slab moisture testing, slab moisture reduction work, rubber base installation, and carpet base installation hardware shall be made a part of the price bid and no additional compensation shall be made by the City. Item No. 3 Mariners Library: This bid item shall include all of the equipment, materials, supplies, and labor necessary to relocate all interfering furniture and equipment, remove and dispose of the existing flooring to the bare floor, prepare the bare floor, install city- supplied new carpet tiles and contractor-supplied rubber bases along all of the new carpet perimeters, and return the furniture and equipment to their original locations. Payment is made for the square footage of carpet tiles installed. The scope of work in the Mariners Library is limited to the areas in front of the public restrooms and around the entrance check-out detection pedestals. The cost of rubber base installation shall be made a part of the price bid and no additional compensation shall be made by the City. 9-3.2 Partial and Final Payment. Delete the third paragraph and replace with the following: "From each progress estimate, five (5) percent will be retained by the Agency, and the remainder less the amount of all previous payments will be paid." Add to this section: "Partial payments for mobilization and traffic control shall be made in accordance with Section 10264 of the California Public Contract Code." PART 2 CONSTRUCTION MATERIALS SECTION 215---BUILDING CONSTRUCTION MATERIALS 215-1 BUILDING MATERIALS 215-1.1 Carpet 215.1.1.1 Fire Stations Carpet Tiles shall be manufactured by BOYLU Contract as follows. No substitution will be accepted. • Style: ENTERPRISE • Color. ENT12 PARTNERSHIP • Yard Content: AVALAR RE • Size: 24" X 24" Additional information can be obtained by contacting the BOYLU Account Manager most familiar with this project, Mr. Frank Owen, via telephone at (714)425-9008 or u.com through email at frank.owen bol g Cc:1 v 215-1.1.2 Carpet Wall Base Carpet for carpet wall base shall match the new carpet tiles and be%2" taller than the existing base. 215-1.1.3 Mariners Library The new carpet tiles needed for the work will be provided to the Contractor at no cost. SP8of9 215-1.2 Rubber Wall Base Rubber wall base shall be 'W taller than the existing and as manufactured by Mercer or equal. Color shall be as close to the existing as possible. PART 3 CONSTRUCTION METHODS SECTION 313—CONCRETE SLAB MOISTURE PROTECTIONITESTING 313-1 GENERAL The Contractor shall ascertain that concrete slab surfaces upon which new carpeting is to be placed is sufficiently dry to receive the new carpet tiles. Therefore, the Contractor may want to consider only removing the section of existing flooring that can be covered by the end of the same work day. In the event that the concrete slab is too "wet" for the new installation, the contractor shall deploy acceptable drying techniques to reduce the concrete slab moisture to a level acceptable to the product manufacturer. SECTION 314—FLOOR PREPARATION 314-1 GENERAL The Contractor shall: • Clean away debris and scrape up cementitious deposits from surfaces to receive flooring. • Fill cracks, depressions, and rough areas using materials recommended by the flooring manufacturer. • Verify substrate surfaces are smooth and flat with maximum variation of 1/8" in 10'. • Vacuum clean immediately before installation. SECTION 315—CARPET TILES INSTALLATION 315-1 GENERAL The Contractor shall: • Strictly follow the flooring manufacturer's installation instructions. • Only use manufacturer's approved ahesives and seam sealers so as to maintain the factory product warranty. • Provide cutouts when: needed. • Install edge guard where edge of flooring is exposed. • Another edge guard to substrate. • Apply seaming adhesive on edge of flooring at seams. All exposed adhesives shall be removed. • Fit the flooring material into each space for fitness prior to applying adhesive. • Trim edges and butter cuts with seaming cement. • Apply adhesive in a preplanned and uniform pattern. • Roll the flooring material tightly to avoid air pockets. SP9of9 DINING DAY ROOM BEDROOM KITCHEN HALL LOCKER OFFICE ROOM DOWN STAIRS OFFICE BALBOA BLVD E LEGEND CARPETING TO BE REPLACED N.Qg FIRE STATION NO. 1 C-6012 STAIRS #2 BATH COMM ROOM DORM WEIGHT � ROOM m J PHONE LOCKER ROOM [WH STAIRS#1 MEDIC BATHROOM DORM SANTA BARBARA DRIVE LEGEND cq ® CARPETING TO BE REPLACED FIRE STATION NO. 3 UPSTAIRS EXHIBIT C-6012 HOSE LIQUIDS TOWER $TOR. GENERAL HOSE STOR. STORAGE SHOP KITCHEN PANTRY roR R DINING ROOM TOILE DAY ROOM APPARATUS BAY W CO.COMM ORI a DORMRORY c LAV, y 0 U) ~ XYGE AIR BATT.CHIEF OFFICE CO.COMM OFFICE SANTA BARBARA DRIVE LEGEND CARPETING TO BE REPLACED FIRE STATION NO. 3 DOWNSTAIRS EXHIBIT C-6012 PARK AVE 77 DORM DORM BATH DORM HALL BATH DAY ROOM KITCHEN TRAINING LEGEND A CARPETING TO BE REPLACED N.T.S. FIRE STATION NO. 4 UPSTAIRS C-6012 SHOP BATH DORM LAUNDR BATH APPARATUS TURN BAY OUT WEIGHT DAY OFFICE ROOM KIT ROOM IRVINE AVENUE LEGEND d�ti CARPETING TO BE REPLACED FIRE STATION NO. 6 C-6012 HALL TRAINING STORAGE DORM LOC RR APPARATUS ELEC BAYS TRAINING AN E &ALT EOC RR LOCK HIEN RR 7-7 WOMEN DINING COMM JAN. LOBBY RR WORKOUT KRCHEN STATION DAYROOM OFFICE ACACIA STREET LEGEND �y CARPETING TO BE REPLACED FIRE STATION NO. 7 C-6012 RIDGE PARK ROAD LOBBY DINING KITCHEN OFFICESTO PHYSICAL TRAINING DAYROOM 0 v OFFICE /�// HALHALL L STORAGE WATCH OFFICE WOMEN WORK OUTDOOR STORAGE APPARATUS fPE PATIO BAY MEN TURN OUT HALL HVAC pEN RM LEGEND }� CARPETING TO BE REPLACED FIRE STATION NO. 8 C-6012 EXHIBIT B PROPOSAL HM Flooring Group, Inc. Page B-1 i City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 it it► INSTRUCTIONS TO BIDDERS A 1. The following documents shall be completed, executed and received by the City Clerk In socordance with NOTICE INVITING BIDS. INSTRUCTIONS TO BIDDERS BIDDER'S BOND DESIGNATION OF SUBCONTRACTORS CONTRACTOR'S INDUSTRIAL SAFETY RECORD INFORMATION REQUIRED OF BIDDER ALL ADDENDA TO PLANS AND SPECIFICATIONS AS ISSUED BY AGENCY PRIOR TO BID OPENING DATE(if any) TEChWCAL ABILITY AND EXPERIENCE REFERENCES NON-COLLUSION AFFIDAVIT ill DESIGNATION OF SURETIES PROPOSAL i� 2. Cash, certified check or cashier's check(sum not less than 10 percent of the total bid price) may be received in lieu of the BIDDER'S BOND. The title of the project and the words'Saeted Bid'shall be dearly marked on the outside of the envelope containing the documents. 3. The City of Newport Beach will not permit a substitute format for the Contract Documents listed above. Bidders are advised to review their content with bonding and legal agents prier to submission of bid. 4. BIDDER'S BOND stall be issued by an insurance organization or surety (1) patently authorized by the Insurance Commissioner to transact business of insurance in the State of California, and(2) Iced as an acceptable surety in the latest revision of the Federal Register Circular 570. The successful bidder's security shall be held until the Contract Is executed. 5. The estimated quantities Indicated In the PROPOSAL are approximate,and are given solely to A allow the comparison of total bid prices. e. Bids are to be computed upon the estimated quantities indicated in the PROPOSAL multiplied by unit price submitted by the bidder. in the event of discrepancy between wording and figures, bid wording shall prevall carer bid figures. In the event of error In to multiplication of estimated A quantity by unit price, the correct multiplication will be computed and the bids will be compared it with Correctly multiplied totals. The City stall riot be held responsible for bidder errors and omissions In the PROPOSAL 7. The City of Newport Beach reserves the right to reject any or all bids and to waive any mirror Irregularity or Informality In such bids. Pursuant to Public Contract Code Section 22300, at A the request and expense of the Contractor, securities shall be permitted In substitution of A money withheld by the City to enure performance under the oontracL The securities shall A be deposited in a state or federal chartered bank in Califomia, as the escrow agent a 3 A A i 8. In accordance with the Califomla Labor Code(Sections 1770 et seq.), the Director of Industrial Relations has ascertained the general prevailing rate of per diem wages In the locality in which the work Is to be performed for each waft, classification, or We of workman or mechanic i needed to execute the contract. A copy of said determination Is avdiabie by calling the prevailing wage hotline number(415) 703.4774, and requesting one from the Department of Industrial Relations. All parties to the contract shall be governed by all provisions of the California Labor Code– Including, but not limited to, the requirement to pay prevailing wage rates(Sections 1770-7881 inclusWe). A copy of the prevailing wage rates shall be posted by the Contractor at the job site. i g. The Contrector shall be responsible for Insuring compliance with provisions of Section 1777.5 of the Labor Code Apprenticeship requirements and Section 4100 at seq. of the Public Contracts Code,`Subletting and Subcontracting Fair Practices Acr. 10.No contractor or subcontractor may be listed on a bid proposal for a public works project (submitted on or after March 1, 2015) unless registered with the Department of Industrial Relations pursuant to Labor Code section 1725.8(vvfth limited exceptions from this requirement for bid purposes only under Labor Cada section 1771.1(a)j. 11.No contractor or subcontractor may be awarded a contract for public work on a public works i project(awarded on or after April 1, 20157 unless registered with the Department of indu*W Relations pursuant to Labor Code section 1725.5. 12.This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. 13.All documents shall bear signatures and Was of persons authorized to sign on behalf of the • bkkier. For corporations, tie signatures shall be of a corporate officer or an individual authorized by the corporation. For partnerships,the signatures shall be of a general partner. For sole ownership,the signature shall be of to owner. . The signature below represwft that the above has been reviewed. . Gc(, - —R1 077 C -(S - Contra"s License No.&Classification lot) 000 6 _30�j,— . DIR Rererenos Numbef&Exphtlon a Bidder Authorized Signature/fltle . Date 4 City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 INSTRUCTIONS TO BIDDERS 1. The following documents shall be completed, executed and received by the City Clerk in accordance with NOTICE INVITING BIDS: INSTRUCTIONS TO BIDDERS BIDDER'S BOND DESIGNATION OF SUBCONTRACTORS CONTRACTOR'S INDUSTRIAL SAFETY RECORD INFORMATION REQUIRED OF BIDDER ALL ADDENDA TO PLANS AND SPECIFICATIONS AS ISSUED BY AGENCY PRIOR TO BID OPENING DATE (if any) TECHNICAL ABILITY AND EXPERIENCE REFERENCES NON -COLLUSION AFFIDAVIT DESIGNATION OF SURETIES PROPOSAL 2. Cash, certified check or cashier's check (sum not less than 10 percent of the total bid price) may be received in lieu of the BIDDER'S BOND. The title of the project and the words "Sealed Bid" shall be clearly marked on the outside of the envelope containing the documents. 3. The City of Newport Beach will not permit a substitute format for the Contract Documents listed above. Bidders are advised to review their content with bonding and legal agents prior to submission of bid. 4. BIDDER'S BOND shall be issued by an insurance organization or surety (1) currently authorized by the Insurance Commissioner to transact business of insurance in the State of California, and (2) listed as an acceptable surety in the latest revision of the Federal Register Circular 570. The successful bidder's security shall be held until the Contract Is executed. 5. The estimated quantities indicated in the PROPOSAL are approximate, and are given solely to allow the comparison of total bid prices. 6. Bids are to be computed upon the estimated quantities indicated in the PROPOSAL multiplied by unit price submitted by the bidder. In the event of discrepancy between wording and figures, bid wording shall prevail over bid figures. In the event of error in the multiplication of estimated quantity by unit price, the correct multiplication will be computed and the bids will be compared with correctly multiplied totals. The City shall not be held responsible for bidder errors and omissions in the PROPOSAL. 7. The City of Newport Beach reserves the right to reject any or all bids and to waive any minor Irregularity or informality in such bids. Pursuant to Public Contract Code Section 22300, at A the request and expense of the Contractor, securities shall be permitted in substitution of A money withheld by the City to ensure performance under the contract. The securities shall be deposited in a state or federal chartered bank in California, as the escrow agent. A 3 City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 BIDDER'S BOND We, the undersigned Principal and Surety, our successors and assigns, executors, heirs and administrators, agree to be jointly and severally held and firmly bound to the City of Newport Beach, a charter city, in the principal sum of.10% of bid amount not to exceed thirty eight thousand five hundred & 00/100 Dollars $38,500.00 of Newport Beach if the bid proposal of the undersigned t Principo be al fo d he forfeited construction City MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT, Contract No. 6012 in the City of Newport Beach, is accepted by the City Council of the City of Newport Beach and the proposed contract is awarded to the Principal, and the Principal fails to execute the Contract Documents in the form(s) prescribed, including the required bonds, and original insurance certificates and endorsements for the construction of the project within thirty (30) calendar days after the date of the mailing of "Notification of Award", otherwise this obligation shall become null and void. If the undersigned Principal executing this Bond is executing this Bond as an individual, it is agreed that the death of any such Principal shall not exonerate the Surety from its obligations under this Bond. Witness our hands this 17th day of April 2015. H M Carpet, Inc. dba HM Flooring Group Name of Contractor (Principal) The Ohio Casualty Insurance Company Name of Surety 62 Maple Avenue, Keene, NH 03431 Address of Surety (617)357-9500 relephone Au ori d Signature/ Title 6--- P. v . w Authorized Agent Signature Shawn Blume, Attorney -in -Fact Print Name and Title (Notary acknowledgment of Principal & SUrety must be attached) 5 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached and not the truthfulness, accuracy, or validity of that document. State of California ) County of, 1O_range ) On L 1 -7 115 before me, Barbara Copeland Notary Public, personally appeared Shawn Blume Name(s) of Signer(s) who 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. �s BARBARA COPELANO " Commission # 2016348 a "F Notary Public California Z 'r� Orange County a My Comm. Expires Apr 19, 2017 Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my and and official seal. Signature:c>�--�--. Signature of 136tary Public ------------------------------------------------------------ OPTIONAL ---------------------------------------------------------- Though the information below is not required by law, it may prove valuable to persons relying on the document and could present fraudulent and reattachment of this form to another document. Description of Attached Document Type or Title of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Shawn Blume ❑ Individual ❑ Corporate Officer - Title(s): ❑ Partner: ❑Limited ❑ General © Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer - Title(s): ❑ Partner: ❑Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Rev. 1-15 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF OL On 1 1 �/ \ (�-'2015, before the Charlene Ortiz Notary Public personally appeared, 1 who proved to me on the basis of satisfactory evidence to be the person(4-whose name(Kos M bscribed to the within instrument and acknowledged to me thathe executed the same m li ker�tirelr' authorized capacity(iesj, -and that by s/ srgnature(stmi the instrument the perso , or the entity upon behalf of which the per on(�, 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)kand an MF CHARLENE ORTIZ o W4 y COMM. #1963969 z (seal) Z Notary Public - California 7J Orange County My Commission Expires: Jan. 13, 2016 t.o N' M Comm. Empires Jan. 13, 201(? Notary Name: Charlene Ortiz Notary Registration Number: 1963969 Notary Phone: 714-580-7253 County of Principal Place of Business: Orange THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 5672502 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: ThatAmerican Fire & Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and WestAmerican Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, ERIC LOWEY; MARK RICHARDSON; SHAWN BLUME; STEPHANIE HOANG........................................................................................................................... ..........................................................................................................................................................................................................................................................................I...... ................................................................................................................................................................................................................................................................................. all of the city of COSTA MESA , state of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 30th day of November 1 2012 . STATE OF WASHINGTON ss COUNTY OF KING American Fire and Casualty Company The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West American Insurance Company By: Gregory W. Davenport, Assistant Secretary On this 30th day of November , 2012 , before me personally appeared Gregory W. Davenport, who acknowledged himself to be the Assistant Secretary of American Fire and Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute 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 have hereunto subscribed my name and affixed my notarial seal at Seattle, Washington, on the day and ,,year ��first above written. By: KD Riley, Not Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV— OFFICERS — Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts — SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Gregory W. Davenport, Assistant Secretary to appoint such attomeys-in-fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, David M. Carey, the undersigned, Assistant Secretary, of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this' day of Y) I 20 LMS -12873_092012 By:^� David M. Carey,"Assistant Secretary a a City of Newport Beach ' MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No.6012 DESIGNATION OF SUBCONTRACTORfS1 ' State law reWlres the kiting of all sus who will perform work In an amount In excess of one-hat of one percent of the Contractor's total bid. If a subcontractor Is not Wed,the Contractor represents ' that he/she is fully qualified to and vA be responsible for performing that potion of the work. Substitution of subcontractors shall be made only in accordance with State law and/or the Standand SoedReatlons for Pubfic Works Consbuctlon as applicable. 1 Pursuant to Public Contract Code Section 22300 approwlate sectuldes may be substituted for any maNes to be wthheld to ensure performance under the Contract. 1 The Bidder, by signing this designation, centties that bide from the following subcontractors have ' been used In fommdating the bid for the proal and that these suboontractors will be used subject to the approval of the Engineer and In accordance with State law. No charges may be made In these subcontractors except with prior approval of the City of Newport Beach. (Use Hanel sly ti Treaded.) 1 SuboontradDes Information Bid Rom N Description of Work notal eta 1 Name: ' Address: Phone: 1 Stats I Number: 1 DR Reference: 1 Email 1 AddreaL / Phone: 1 State LIQ Number: 1 DR Reference: 1 Email Address: ' name: Address: 1 Phone: , State Lleense N , DIR Referercm , EMWIAddresq , Bldd6rT Authorized rmture/Tftle r City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 TECHNICAL ABILITY AND EXPERIENCE REFERENCES Contractor must use this WWII Please print or type. Bidder's Name M -#t sovJc 6.aau1p (+{xt cc+ 'r FAILURE OF THE BIDDER TO PROVIDE ALL REQUIRED INFORMATION IN A COMPLETE AND ACCURATE MANNER MAY BE CONSIDERED NON-RESPONSIVE. For all public agency projects you have worked on (or are currently working on) in the past 2 years in excess of$15,000, provide the following information: No.1 Project Name/Number =�F�416 Amm,0&- -914-I�� YO. cs-rrvsu. Project Descriptiono�- 2i�1(, sasrnAtiS;a3S 'Gfw �tM�alt _cl S'aaap� Approximate Construction Dates: From 2-01,3 To: 2-Q Lr Agency Name - -AS2oSLA-C.- Contact Person CMr 6 rtc6c S Telephone(.3".33G - I�5'6 Original Contract Amount$50,005� Final Contract Amount$ . If final amount is different from original, please explain(change orders, extra work,etc.) ANN,j/ S 1(L G7wYi'it/ z BIAS 3E .� FIc_r' 2t'� G'nts'-1 o h. l0.-A1'-k- 0q/ �.� NA+cam IFE -s,1 cogxs 4jL- (Ing REntsi" Did you file any claims against the Agency? Did the Agency file any claims again--st``y''ou/Contractor?If yes,briefly explain and indicate outcome of claims. 9 No,2 Project Name/Number 1 t aa,�.9 3esr L,. Int AT- oJ� ,..Ib ' Project Description vT S - Approximate Construction Dates: From 2012- To: ZOI.i Agency Name 40JSA1- � 65Oi4&L.Pi.n, ContactPerson /l(p2�c Bi6JFss Telephone(�9) ago— °b4T_ Original ContractAm�S���Final Contract Amount' T�bo•axa� If final amount is different from original,please explain(change orders, extra work, eta) +�F AA-GSg a.6,% Esc-r�JY� �.)1 ca.SrnAor , n(� is 3e 7fA. Did you file an claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. No. 3 Project Name/Number 4 Co& -J(1 Project Description tic —i2 SC4-001-4 Approximate Construction Dates: From ZO IS To: 6w-' .-,Jx 2oZo Agency Name QC- s r,-^-cx- Contact Person G(::vc Telephone(rte W6—SS 66 Original Contract Amount$3Q, Final Contract Amount$ c-,�J�Q 422cA�Ji2C0-$3,A,0e If final amount is different from original, please explain(change orders, extra work,etc.) tic qqwozj: . -0.50 .1 Co.ts.IWLZ t -7�L(-- Aa, +tea R�ca_.Sri�, wo„1 � �� a_oes%ore �3tG .�3cT.�rns,J Did you file any claims against the Agency?Did the Agency file any claims NJA-rL— 20Z,-=1 against yoWContractor? If yes,briefly explain and indicate outcome of claims. r��rs 10 No.4 Project Name/NumberProject Description Description Approximate Construction Dates: From AbV.zo13 To: • �t Agency Name Contact Person JE Telephone(611 462- 2177 Original Contract Amount$ �3B,d i nal Contract Amount$ If final amount is different from original, please explain (change orders,extra work,etc.) Did you file any claims against the Agency?Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. N jOt4 ' No.5 Project Name/Number I,)c- Project Description -�tcrsn%-w lai �w � 1� �o bi^►eW'��"l. Approximate Construction Dates: From Npj Zd i3 To: I� Agency Name UC. Contact Person 9.-owwg s.1,6 Telephone(q51) G�=g343 Original Contract Amount$ Wlow Final Contract Amount$ � If final amount is different from original, please explain(change orders, extra work,etc.) Did you file any claims against the Agency?Did the Agency file any claims against you/Contractor? If yes, briefly explain and Indicate outcome of claims. 11 1 Nag Project Name/Number Project Description Approximate Construction Dates:From To: 1 1 Agency Name 1 Contact Person Telephone( } Original Contract Amount$ Rnal Contract Amount$ 1 1 If final amount Is different from original,please explain(change orders, extra work,etc.) 1 1 Oki you file any claims against the Agency?Did the Agency file any claims 1 against you/Contractor?If yes,briefly explain and indicate outcome of claims. 1 1 1 Attach additional sheets If necessary. 1 1 Attach to this Bid the experience resume of the person who will be designated as General Construction Superintendent or on-site Construction Manager for the 1 Contractor. 1 Upon request, the Contractor shall attach a financial statement and other information 1 sufficiently comprehensive to permit an appraisal of the Contractors current financial 1 conditions. 1 -H//M (--� X/ EWderl Aulhoize gnaluraMi e 1 1 1 1 1 1 1 1 1 12 1 1 HM Flooring Group (utcgpa,(,,,DBA) Phone: (310)516-9272 146E. Alondm Blvd Gardena,CA 90248 CL#791 o77 Fax: (310)516-2006 www.hmflooringgroup.com Experience Resume April 20,2015 City of Newport Beach 100 Civic Center Drive Newport Beach,CA 92660 Attn: Fong Tse—Project Manager Ref: Multiple Buildings Carpet Replacement Project—Contract No.6012 Dear Mr. Tse, As part of the Bid requirements,the following is a brief description of the relevant experience of our Designated Construction manager,Mr.Juan Yusti_ -He has been working with HM Flooring Group(HM Carpet,Inc. DBA)since 1991. -In Charge of our Commercial Division since 2000. -Has managed, supervised and completed thousands of Residential,Commercial and Public Works,Floor Covering Installations. -Has successfully managed jobs at UCLA,UC Santa Barbara,LAUSD,ABCUSD,City of Santa Monica,Housing Authority of LA County,Housing Authority of San Bernardino County,Monrovia USD,US Coast Guard,LA Kings,Anaheim Angels, Ventura County Housing Authority,Air Force,LA Archdiocese,The Aerospace Corp., Caltech—JPL,LAX, Social Security Administration, and many more private and public entities. -He has completed every single job under his watch within budget and anticipated completion times. Please,do not hesitate to call me if you should have any questions,my office phone is (310)516-9272 Si ly, Camilo Montealegre President HM Flooring Group City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 NON -COLLUSION AFFIDAVIT State of California ) ) ss. County of ) being first duly sworn, deposes and says that he or she is of the party making the foregoing bid; that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that party making the foregoing bid; that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. I declare under penalty of perjury of the laws of the State of is that the foregoing is true and correct. ,+/,,-t G -- C -TC--> /V Bidder Authorized Signature/Title Subscribed and sworn to (or affirmed) before me on this day of by , prow satisfactory evidence to be the person(s) who appeared before me. I certify under PENALTY OF PERJURY foregoing paragraph is true and correct � [SEAL] A notary public or other officercompleting this certificate verifies only the identity of the individual who signed the document to which this certificate Is attached, and not the truthfulness, accuracy, or validity of that document. State of California, County of b T W � Subscribed and sworn to tor affirmedbefore me on this �—� dayof .20 by br Q5 C0 -.f' proved to me on th basis of satisfactory e Idence to be the person appeared for e. Signature: 2015 me on the basis of the laws of the State of California that the Di Notary Public My Commission Expires: E 5: °`" f, CN;1RLENE ORTI7. p COMM. #1963969 z X _ Notary Public • California I 13 z Orange County o o.�' My Comm. Expires Jan. 13, 2016 City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 DESIGNATION OF SURETIES Bidder's name Provide the names, addresses, and phone numbers for all brokers and sureties from whom Bidder intends to procure insurance and bonds(list by Insurancelbond type): C� 9162b • ���G -71y�5y6- Sly �Ax `���— Sy6-3'Yy7 14 City of Newaort Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 CONTRACTOR'S INDUSTRIAL SAFETY RECORD / TO ACCOMPANY PROPOSAL Bidder's Name -ham J6 C 0-01- Record Last Five(5)Full Years Current Year of Record Current Record Record Record Record Record Year of for for for for for Record 2014 2013 2012 2011 2010 Total 2015 No. of contracts —3 /f IZ -T Total dollar Amount of Contracts(in $.?4oeL yfO-Aj Thousands of$ No. of fatalities nC rs No.of lost t� T Workday Cases E� No.of lost workday cases Involving permanent transfer to another job or termination of employment The information required for these items is the same as required for columns 3 to 6. Code 10, Occupational Injuries,Summary--Occupational Injuries and Illnesses, OSHA No. 102. 15 Legal Business Name of Bidder 41q -�--u'44 �. �� �► // Business Address: t`!4 F. ae.�a2-u, 3,.� �: lay CA gnure Business Tel. No.: 51(, -9c-7z- State C9z7LState Contractor's License No. and Classification: `-7`t / 0`7 7 Title -rzc - cn-�j u The above information was compiled from the records that are available to me at this time and I declare under penalty of perjury that the information is true and accurate within the limitations of those records. Signature of c7v Nbidder Date y Z! /S Title Signature of bidder Date Title Signature of bidder Date Title Signature of bidder Date Title C ,Tv. /v Signature Requirements: If bidder is an individual, name and signature of individual must be provided, if doing business under a fictitious name, the fictitious name must be set fort along with the County. If bidder is a partnership or joint venture, legal name of partnership/joint venture must be provided, followed by signatures of all of the partners/joint ventures or if fewer than all of the partners/joint ventures submit with evidence of authority to act on behalf of the partnership/joint venture. If bidder is a corporation, legal name of corporation must be provided, followed by signatures of the corporation President or Vice President or President and Secretary or Assistant Secretary, and the corporate seal, or submit with evidence of authority to act on behalf of the corporation. All must be acknowledged before a Notary Public, who must certify that such individuals, partners/joint ventures, or officers were proven on the basis of satisfactory evidence to be the persons whose name are subscribed to and acknowledged that they executed the same in their authorized capacities. ]NOTARY ACKNOWLEDGMENT and CORPORATE SEAL MUST BE ATTACHED] 1 )tt i[^: A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORN�I,AI\ � COUNTY OF OV V`� v/ � r On �\ �� \ `5 ,2015, before ine, Charlene Ortiz, Notary Public, personally appeared, lc . who proved to me on the basis of satisfactory evidence to be the person()—whose name( subscribed to the within instrument and acknowledged to me that XOexecuted the same in r / authorized capacity(ies�, and that by is/ ' nature(s� the instrument the person( or the entity upon behalf of which the person( -s) 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 of cial seal. d . ` CHARLENE AORTIZ p COMM. #1963969 z Notary Public - California x (seal) Z Orange County MY Comm. Expires Jan. 13, 2016 My Commission Expires: Jan. 13, 201 Notary Name: Charlene Ortiz Notary Registration Number: 1963969 Notary Phone: 714-580-7253 County of Principal Place of Business: Orange City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 ACKNOWLEDGEMENT OF ADDENI?A Biddersname 476'C 'f'i ;J6 The bidder shall signify receipt of all Addenda here, If any, and attach executed copy of addenda to bid documents: Addendum No. Date Received Signature kVA 17 City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6412 INFORMATION REQUIRED OF BIDDER Bidder certifies under penalty of perjury under the laws of the State of California that the following information is true and correct: Name of individual Contractor, Company or Corporation: A _SL, _.034 Business Address: W. yF- t L�J Telephone and Fax Number: 3t0 I G- 9L7L 3iO �6-ecu, California State Contractor's License No. and Class: '79 10-7-7 G- I Y (REQUIRED AT TIME OF AWARD) Original Date Issued: 10M5 Expiration Date: a./2b/1 b List the name and titlelposition of the person(s) who inspected for your firm the site of the work proposed in these contract documents: ��s-Z ._. E�c� - t,�[n..<c�t_�G:o�PKrrl��'s(._ %fid• Ma.(/a(�5� The following are the names, titles, addresses, and phone numbers of all individuals, firm members, partners, joint ventures, and company or corporate officers having a principal interest in this proposal: Name Title Address Telephone QSCAII u�. I,• �c+l%l-- CA,uaO +t�r_.s;�.�r G� - �.w�s-i•�.-4;' - S'�= r_� /-�3.�,s"�' Corporation organized under the laws of the State oftaEenua 18 The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this proposal are as follows: K tC)'a All company, corporate, or fictitious business names used by any principal having inteerr(e}st in this proposal are as follows: For all arbitrations, lawsuits, settlements or the like (in or out of court) you have been Involved in with public agencies in the past five years (Attach additional Sheets if necessary) provide: Provide the names, addresses and telephone numbers of the parties; K)Orj' • Briefly summarize the parties' claims and defenses; r fc r4 i Have you ever had a contract terminated by the owner/agency? If so, explain. ( JK--W'1541 Have you ever failed to complete a project? If so, explain. tJ'S;36-z-- For any projects you have been involved with in the last 5 years, did you have any claims or actions by any outside agency or individual for labor compliance(i.e. failure to pay prevailing wage,falsifying certified payrolls, etc.)?Yes/No 19 Are any claims or actions unresolved or outstanding? Yes / No If yes to any of the above, explain. (Attach additional sheets, if necessary) Failure of the bidder to provide ALL requested information in a complete and accurate manner may be considered non-responsive. �I I �rQ6vr MS L� v� Bidder lT On before me, DSCG� �O✓��'Cc�IE-S� (Print name of Owner or President of Corporation/Company) C V Authorize ignature/Title C � ( j ---�. Title Date appeared basis of satisfactory evidence to be the person(s) whose na s; instrument and acknowledged to me that he/she/they exec d the capacity(ies), and that by his/her/their signature(s) on the ' strument behalf of which the person(s) acted, executed the instru nt. I certify under PENALTY OF PERJURY paragraph is true and correct. WITNESS my hand and official seal, Notary Public in and for My Commission Notary Public, personally who proved to me on the is/are subscribed to the within same in his/her/their authorized the person(s), or the entity upon e laws of the State of California that the foregoing s _ (SEAL) 20 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA n n COUNTY OF OVN `� � On 1 \ ,2015, personally appeared, // I before me, Charlene Ortiz, Notary Public, CC who proved to me on the basis of satisfactory evidence to be the persoil4)—whose names/ Prr su ribed to the within instrument and acknowledged tc ne that (719IT&riey executed the satne to s authorized capacity(iend that by eir s , a e/1 reil—stgnature(s}tm the instrument the person , or the entity upon behalf of which the person�cted, executed the instrument. 1 certify under PENALTY OF PERJURY undcr the laws of the State of California that the foregoing paragraph is true and correct. WITNESS nxv hand My Commission Expires: Jan. 13, 20 Notary Name: Charlene Ortiz Notary Registration Number: 1963969 Notary Phone: 714-580-7253 County of Principal Place of Business: Orange CHARLENE OR I IZ (seal) 0Wy., COMM. #1963969 z ' Notary Public - California x Z' �' Orange County oar' My Comm. Expires Jan. 13, 201E City of Newport Beach MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT Contract No. 6012 NOTICE TO SUCCESSFUL BIDDER The following Contract Documents shall be executed and delivered to the Engineer within ten (10)days (not including Saturday, Sunday and Federal holidays)after the date shown on the °Notitkation of Award"to the successful bidder. • CONTRACT WITH REQUIRED INSURANCE CERTIFICATES AND ENDORSEMENTS • LABOR AND MATERIALS PAYMENT BOND • FAITHFUL PERFORMANCE BOND The City of Newport Beach will not permit a substitute format for these Contract Documents. Bidders are advised to review their content with bonding, Insuring and legal agents prior to submission of bid. Original Certfficate(s) of Insurance, General Liability Insurance Endorsement, and Automobile Liability Insurance Endorsement shall be provided as required by the Contract documents and delivered to the Public Works Department within ten (10) working days after the date shown on the Notification of Award to the successful bidder. The Labor and Materials Payment Bond and Faithful Performance Bond shall be issued by an insurance organization or surety (1) currently authorized by the Insurance Commissioner to transact business of insurance in the State of California, and (2) listed as an acceptable surety in the latest revision of the Federei Register Circular 570. Pursuant to Public Contract Code Section 22300, appropriate securities may be substituted for any monies to be withheld to ensure performance under the Contract. Insurance companies affording coverage shall be(1)currently authorized by the Insurance Commissioner to transact business of insurance in the State of California, and (2) assigned Policyholders' Rating A(or higher)and Financial Size Category Class W(or larger)in accordance with the latest edition of Bests Key Retina Guide: ProcerlwCasuaitv. Coverages shag be provided as specified in the Standard Specifications for Public Works Conshudion, except as modified by the Special Provisions. Certificates of Insurance and additional insured endorsements shag be on the insurance company's forms, fully executed and delivered with the Contract The Notice to Proceed will not be issued until all contract documents have been received and approved by the City. 21 PR 1 of 2 CITY OF NEWPORT BEACH PUBLIC WORKS'DEPARTMENT PROPOSAL MULTIPLE BUILDINGS CARPET REPLACEMENT PROJECT CONTRACT NO. 601 To the Honorable City Council City of Newport Beach 100 Civic Center Drive Newport Beach, California 92660 Gentlemen: The undersigned declares that he has carefully examined the location of the work, has read the Instructions to the Bidders, has examined the Plans and Special Provisions, and hereby proposes to furnish all materials except that material supplied by the City and shall perform all work required to complete Contract No. 6012 In accordance with the Plans and Special Provisions, and will take in full payment therefore the following unit prices for the work, complete in place,to wit: ITEM QUANTITY ITEM DESCRIPTION AND UNIT UNIT TOTAL AND UNIT PRICE WRITTEN IN WORDS PRICE PRICE 1. Lump Sum Mobilization and Demobilization @ Dollars and Oo�po ___ Cents $ -s,eco-07 Per Lump Sum 2. 10,250 S.F. Fire Stations a --i owV Dollars and 22 too .r Cents $ •22- $ 3 Z55-CO Per Square Foot 3. 200 S.F. Mariners Library @ 0-1 Dollars and 2 oo Cents $ 1•� $ _ Per Square Foot i PR2of2 TOTAL PRICE IN WRITTEN WORDS -n-jot�w Dollars and ents $ • L q9-� Total Price(Figures) iL/Go%t 41tT'&,,..16 6,.g Date IBidder f st0-s14-gL7Z- Bidder's Telephone and Fax Numbers Bidder's Authorized Signature and Title "7q 107-1 C-!S 11f 6 r-7- AkQ j92a cacao. Bidders License No(s). Bidders Address 6av�.—lid,c4crO". and Classification(s) Bidders email address: L4-4t-Co G Dsc^,L_ C-4144-411004CW4 G--A3- - t EXHIBIT C INSURANCE REQUIREMENTS — PUBLIC WORKS AND CONSTRUCTION 1. Provision of Insurance. Without limiting Contractor's indemnification of City, and priorto commencement of Work, Contractor shall obtain, provide and maintain at its own expense during the term of this Contract, policies of insurance of the type and amounts described below and in a form satisfactory to City. Contractor agrees to provide insurance in accordance with requirements set forth here. If Contractor uses existing coverage to comply and that coverage does not meet these requirements, Contractor agrees to amend, supplement or endorse the existing coverage. 2. Acceptable Insurers. All insurance policies shall be issued by an insurance company currently authorized by the Insurance Commissioner to transact business of insurance in the State of California, with an assigned policyholders' Rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide, unless otherwise approved by City's Risk Manager. 3. Coverage Requirements. A. Workers' Compensation Insurance. Contractor shall maintain Workers' Compensation Insurance providing statutory benefits and Employer's Liability Insurance with limits of at least one million dollars ($1,000,000) each employee for bodily injury by accident and each employee for bodily injury by disease in accordance with the laws of the State of California, Section 3700 of the Labor Code. In addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance and Employer's Liability Insurance in accordance with California law for all of the subcontractor's employees. The insurer issuing the Workers' Compensation insurance shall amend its policy by endorsement to waive all rights of subrogation against City, its elected or appointed officers, agents, officials, employees and volunteers. Contractor shall submit to City, along with the certificate of insurance, a Waiver of Subrogation endorsement in favor of City, its elected or appointed officers, agents, officials, employees and volunteers. B. General Liability Insurance. Contractor shall maintain commercial general liability insurance and, if necessary, umbrella liability insurance, with coverage at least as broad as provided by Insurance Services Office form CG 00 01, in an amount not less than one million dollars ($1,000,000) per occurrence, two million dollars ($2,000,000) general aggregate and two million dollars ($2,000,000) completed operations aggregate. The policy shall cover liability arising from premises, operations, products-completed operations, personal and advertising injury, and liability assumed under an HM Flooring Group, Inc. Page C-1 insured contract (including the tort liability of another assumed in a business contract). C. Automobile Liability Insurance. Contractor shall maintain automobile insurance at least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for all activities of Contractor arising out of or in connection with Work to be performed under this Contract, including coverage for any owned, hired, non-owned or rented vehicles, in an amount not less than one million dollars ($1,000,000) combined single limit for each accident. 4. Other Insurance Requirements. The policies are to contain, or be endorsed to contain, the following provisions: A. Waiver of Subrogation. All insurance coverage maintained or procured pursuant to this Contract shall be endorsed to waive subrogation against City, its elected or appointed officers, agents, officials employees and volunteers or shall specifically allow Contractor or others providing insurance evidence in compliance with these requirements to waive their right of recovery prior to a loss. Contractor hereby waives its own right of recovery against City, and shall require similar written express waivers and insurance clauses from each of its subcontractors. B. Additional Insured Status. All liability policies including general liability, products and completed operations, excess liability, pollution liability, and automobile liability, if required, shall provide or be endorsed to provide that City, its elected or appointed officers, agents, officials employees and volunteers shall be included as additional insureds under such policies. C. Primary and Non Contributory. Contractor's insurance coverage shall be primary insurance and/or the primary source of recovery with respect to City, its elected or appointed officers, agents, officials, employees and volunteers. Any insurance or self-insurance maintained by City shall be excess of Contractor's insurance and shall not contribute with it. D. Notice of Cancellation. All policies shall provide City with thirty (30) calendar days notice of cancellation or nonrenewal of coverage (except for nonpayment for which ten (10) calendar days notice is required) for each required coverage except Builders Risk Insurance, which shall contain an endorsement with said required notices. 5. Additional Agreements Between the Parties. The parties hereby agree to the following: A. Evidence of Insurance. Contractor shall provide certificates of insurance to City as evidence of the insurance coverage required herein, along with a waiver of subrogation endorsement for workers' compensation and other HM Flooring Group, Inc. Page C-2 endorsements as specified herein for each coverage. All of the executed documents referenced in this Contract must be returned to City within ten (10) regular City business days after the date on the "Notification of Award". Insurance certificates and endorsements must be approved by City's Risk Manager prior to commencement of performance. Current certification of insurance shall be kept on file with City at all times during the term of this Contract. City reserves the right to require complete, certified copies of all required insurance policies, at any time. B. City's Right to Revise Requirements. City reserves the right at any time during the term of the Contract to change the amounts and types of insurance required by giving Contractor ninety (90) calendar days advance written notice of such change. If such change results in substantial additional cost to Contractor, City and Contractor may renegotiate Contractors compensation. C. Right to Review Subcontracts. Contractor agrees that upon request, all agreements with subcontractors or others with whom Contractor enters into contracts with on behalf of City will be submitted to City for review. Failure of City to request copies of such agreements will not impose any liability on City, or its employees. Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that City is an additional insured on all insurance required from subcontractors. For CGL coverage, subcontractors shall provide coverage with a format at least as broad as CG 20 38 04 13. D. Enforcement of Contract Provisions. Contractor acknowledges and agrees that any actual or alleged failure on the part of City to inform Contractor of non-compliance with any requirement imposes no additional obligations on City nor does it waive any rights hereunder. E. Requirements not Limiting. Requirements of specific coverage features or limits contained in this Exhibit C are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. If the Contractor maintains higher limits than the minimums shown above, the City requires and shall be entitled to coverage for higher limits maintained by the Contractor. Any available proceeds in excess of specified minimum limits of insurance and coverage shall be available to the City. F. Self-Insured Retentions. Contractor agrees not to self-insure or to use any self-insured retentions on any portion of the insurance required herein and further agrees that it will not allow any indemnifying party to self-insure its HM Flooring Group, Inc. Page C-3 obligations to City. If Contractor's existing coverage includes a self-insured retention, the self-insured retention must be declared to City. City may review options with Contractor, which may include reduction or elimination of the self-insured retention, substitution of other coverage, or other solutions. Contractor agrees to be responsible for payment of any deductibles on their policies. G. City Remedies for Non Compliance. If Contractor or any subcontractor fails to provide and maintain insurance as required herein, then City shall have the right but not the obligation, to purchase such insurance, to terminate this Contract, or to suspend Contractor's right to proceed until proper evidence of insurance is provided. Any amounts paid by City shall, at City's sole option, be deducted from amounts payable to Contractor or reimbursed by Contractor upon demand. H. Timely Notice of Claims. Contractor shall give City prompt and timely notice of claims made or suits instituted that arise out of or result from Contractor's performance under this Contract, and that involve or may involve coverage under any of the required liability policies. City assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve City. I. Coverage not Limited. All insurance coverage and limits provided by Contractor and available or applicable to this Contract are intended to apply to the full extent of the policies. Nothing contained in this Contract or any other agreement relating to City or its operations limits the application of such insurance coverage. J. Coverage Renewal. Contractor will renew the coverage required here annually as long as Contractor continues to provide any Work under this or any other Contract or agreement with City. Contractor shall provide proof that policies of insurance required herein expiring during the term of this Contract have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. A coverage binder or letter from Contractor's insur4ance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City with five (5) calendar days of the expiration of the coverages. HM Flooring Group, Inc. Page C-4 CERTIFICATE OF INSURANCE CHECKLIST City of Newport Beach This checklist is comprised of requirements as outlined by the City of Newport Beach. Date Received: 7/14/15 Dept./Contact Received From: Raymund Date Completed: 8/19/15 Sent to: Raymund By: Chris/Alicia Company/Person required to have certificate: H.M Flooring Group Type of contract: Public Works I. GENERAL LIABILITY EFFECTIVE/EXPIRATION DATE: 9/1/14-9/1/15 A. INSURANCE COMPANY: State Farm Mutual Automobile Insurance Company B. AM BEST RATING (A- :VII or greater): A++;XV C. ADMITTED Company(Must be California Admitted): Is Company admitted in California? ® Yes ❑ No D. LIMITS(Must be$1 M or greater): What is limit provided? 2,000,000/4,000,000 E. ADDITIONAL INSURED ENDORSEMENT—please attach ®Yes ❑ No F. PRODUCTS AND COMPLETED OPERATIONS(Must include): Is it included? (completed Operations status does not apply to Waste Haulers or Recreation) ® Yes ❑ No G. ADDITIONAL INSURED FOR PRODUCTS AND COMPLETED OPERATIONS ENDORSEMENT(completed Operations status does not apply to Waste Haulers) ® Yes ❑ No H. ADDITIONAL INSURED WORDING TO INCLUDE (The City its officers, officials,employees and volunteers): Is it included? ® Yes ❑ No I. PRIMARY&NON-CONTRIBUTORY WORDING(Must be included): Is it included? ® Yes ❑ No J. CAUTION! (Confirm that loss or liability of the named insured is not limited solely by their negligence) Does endorsement include"solely by negligence"wording? ❑ Yes ® No K. ELECTED SCMAF COVERAGE(RECREATION ONLY): ® N/A ❑ Yes ❑ No L. NOTICE OF CANCELLATION: ❑ N/A ®Yes ❑ No H. AUTOMOBILE LIABILITY EFFECTIVEIEXPIRATION DATE: 11/06/14— 11/06/15 A. INSURANCE COMPANY: State Farm Fire and Casualty B. AM BEST RATING (A- : VII or greater) A+;XV C. ADMITTED COMPANY(Must be California Admitted): Is Company admitted in California? ® Yes ❑ No D. LIMITS- If Employees(Must be$1 M min. BI & PD and $500,000 UM, $2M min for Waste Haulers): What is limits provided? 1,000,000 E LIMITS Waiver of Auto Insurance/ Proof of coverage(if individual) (What is limits provided?) N/A F. PRIMARY&NON-CONTRIBUTORY WORDING(For Waste Haulers only): ® N/A ❑ Yes ❑ No G. HIRED AND NON-OWNED AUTO ONLY: ❑ N/A ❑Yes ® No H. NOTICE OF CANCELLATION: ❑ N/A 0 Yes ❑ No III. WORKERS'COMPENSATION EFFECTIVE/EXPIRATION DATE: 9/1/14-9/1/15 A. INSURANCE COMPANY: State Farm General Insurance Co B. AM BEST RATING(A-: VII or greater): A;XV C. ADMITTED Company(Must be California Admitted): ®Yes ❑ No D. WORKERS' COMPENSATION LIMIT: Statutory ®Yes ❑ No E. EMPLOYERS' LIABILITY LIMIT(Must be$1M or greater) 1,000,000 F. WAIVER OF SUBROGATION (To include): Is it included? ❑Yes ® No G. SIGNED WORKERS' COMPENSATION EXEMPTION FORM: ® N/A ❑Yes ❑ No H. NOTICE OF CANCELLATION: ❑ N/A ® Yes ❑ No ADDITIONAL COVERAGE'S THAT MAYBE REQUIRED IV. PROFESSIONAL LIABILITY ® N/A ❑ Yes ❑ No V POLLUTION LIABILITY ® N/A ❑ Yes ❑ No V BUILDERS RISK ® N/A ❑ Yes ❑ No HAVE ALL ABOVE REQUIREMENTS BEEN MET? ®Yes ❑ No IF NO,WHICH ITEMS NEED TO BE COMPLETED? Approved:y a " ::5 8/19/15 Agent of Alliant Insurance Services Date Broker of record for the City of Newport Beach RISK MANAGEMENT APPROVAL REQUIRED (Non-admitted carrier rated less than_; Self Insured Retention or Deductible greater than$ ) ❑ N/A ❑ Yes ❑ No Reason for Risk Management approval/exception/waiver: Approved: Risk Management Date Subject to the terms of the contract. EXHIBIT D Premium listed on performance bond Executed in duplicate CITY OF NEWPORT BEACH BOND NO. 024060342 LABOR AND MATERIALS PAYMENT BOND WHEREAS, the City of Newport Beach, State of California, has awarded to HM Flooring Group, Inc. hereinafter designated as the "Principal," a contract for the Improvement of Multiple Buildings Carpet Replacement located at: a. Fire Station No. 1 (110 E. Balboa Boulevard); b. Fire Station No. 3 (868 Santa Barbara Drive); C. Fire Station No. 4(124 Marine Avenue); d. Fire Station No. 6(1348 Irvine Avenue); e. Fire Station No. 7 (20401 Acacia Street); f. Fire Station No. 8(6502 Ridge Park Road); and g. Mariners Library(1300 Irvine Avenue), in the City of Newport Beach, in strict conformity with the Contract on file with the office of the City Clerk of the City of Newport Beach, which is incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute the Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of Principal's subcontractors, shall fail to pay for any materials, provisions, or other supplies used in, upon, for, or about the performance of the Work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, We the undersigned Principal, and, The Ohio Casualty Insurance Company duly authorized to transact business under the laws of the State of California, as Surety, (referred to herein as "Surety')are held and firmly bound unto the City of Newport Beach, in the sum of Sixty One Thousand Six Hundred Twenty Four Dollars and 00/100 ($61,624.00) lawful money of the United States of America, said sum being equal to 100% of the estimated amount payable by the City of Newport Beach under the terms of the Contract; for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally,firmly by these present. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal or the Principal's subcontractors, fail to pay for any materials, provisions, or other supplies, implements or machinery used in, upon, for, or about the performance of the Work contracted to be done, or for any other work or labor thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work or labor, or for any amounts required to be deducted, withheld and paid over to the. Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor, then the Surety will pay for the same, in an amount not exceeding the sum specified in this Bond, and also, in case suit is brought to enforce the HM Flooring Group, Inc. obligations of this Bond, a reasonable attorneys' fee, to be fixed by the Court as required by the provisions of Section 9554 of the Civil Code of the State of California. The Bond shall inure to the benefit of any and all persons, companies, and corporations entitled to file claims under Section 9100 of the California Civil Code so as to give a right of action to them or their assigns in any suit brought upon this Bond, as required by and in accordance with the provisions of Sections 9500 et seq. of the Civil Code of the State of California. And Surety, for value received, hereby stipulates and agrees that no change, extension of time, alterations or additions to the terms of the Contract or to the Work to be performed thereunder shall in any wise affect its obligations on this Bond, and it does hereby waive notice of any such change, extension of time, alterations or additions to the terms of the Contract or to the Work or to the specifications. In the event that any principal above named executed this Bond as an individual, it is agreed that the death of any such principal shall not exonerate the Surety from its obligations under this Bond. IN WITNESS WHEREOF, this instrument has been duly executed by the above named Principal and Surety, on the 2nd day of June 20 15 . H M Carpet, Inc. dba HM Flooring Group Name of Contractor (Principal) The Ohio Casualty Insurance Company Name of Surety 62 Maple Avenue, Keene, NH 03431 Address of Surety (617)357-9500 Telephone APPROVED AS TO FORM: CITY ATTO NET'S OFFICE Date: By: Aaron C. Harp L,�M ots�3�lis City Attorney Authorized Signature/Title Authorized Agent Signature ~� Shawn Blume, Attorney -in -Fact Print Name and Title NOTARY ACKNOWLEDGMENTS OF CONTRACTOR��y,Q ;�,C, 'k!� AND SURETY MUST BE ATTACHED X,,Q�iP Y� HM Flooring Group, Inc. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached and not the truthfulness, accuracy, or validity of that document. State of California ) County of Orange On LP I 'n- 5 before me, Barbara Copeland Notary Public, personally appeared Shawn Blume Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Ware subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/therr authorized capacity(ies), and that by his/1wr/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person() acted, executed the instrument. I certify under PENALTY OF PERJURY under the BARBARA COPE -AND laws of the State of California that the foregoing Commission #2018.34A paragraph is true and correct. z Notary Public - California z z `�` Orange County D WITNESS m and and official seal. My Comm. Expires Apr 19, 2017 y, Signature: Signature of tary Public Place Notary Seal Above ----------------------------------------------------------- OPTIONAL --------------- ------------------------------------ -------- Though the information below is not required by law, it may prove valuable to persons relying on the document and could present fraudulent and reattachment of this form to another document. Description of Attached Document Type or Title of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Shawn Blume ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner: ❑Limited ❑ General ® Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner: ❑Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Rev. "1-15 ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of l .S 4wele,5 } 0ni�yu�, ZV_5 before me, Phillip Andrew Fahrnkopf, Notary Public ere insert name and title of the officer) personally appeared ler �Aoy71g! who proved to me on the basis of satisfactory evidence to be the personw whose name(ta')is/ re subscribed to the within instrument and acknowledged to me that Ike she/they executed the same in ls/ er/their authorized capacity(iesg), and that by is er/their signature(,sj on the instrument the personal, 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. 01-1 Notaryblit Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT La6ar 11W�jaf�Ycr/S (Title or description of attached document) (Titler description of attached document continued) Number of Pages 1? Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) 00 Corporal e Officer co (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 2015 Version vvvn.-:.NotatyClasses.cotn 800.873 9865 / aPHILLIP ANDREW FAHRNKOPF "COMM. #2113456 w Notary Public - California LOS ANGELES COUNTY .P M Comm. Exe. Jun 26, 2019 INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notmy wording and, if needed, should be completed and attached to the document. Acknohredgents from other states nay be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notmy law • State and County information must be the State and County where the document sigrrer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which nmst also be the same date the acknowledgnneni is completed. • The notary public nmst print his or her name as it appears within his or her conmtission followed by a comma and then your title (notary public). • Print the names) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or phual fotnrs by crossing off urconect forms (i.e. he/she/they,, is /nre ) or circling the cornet forms. Failure to correctly indicate tris information may lead to rejection of document recording. • The notary sea] impression must be clear and photographically reproducible. Impression must not corer text or lines. If seal impression smudges, re -seal if a sufficient area pennits, otherwise complete a different acknowled6anent form. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not requred but could help to ensure this acknowledgment is not misused or attached to it diflerent document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this doctmtent to the signed document with a staple. tZ aD �y Y y C .O4S 2 O = 'a)= CE v tv O d > d � 7 ,3 'w O i L do o +3 C M ry Mtm d 0 C E L M v MC O` Zv THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 5672513 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire & Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and WestAmerican Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, ERIC LOWEY; MARK RICHARDSON; SHAWN BLUME; STEPHANIE HOANG........................................................................................................................... all of the city of COSTA MESA , state of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 30th day of November 2012 . 6 STATE OF WASHINGTON ss COUNTY OF KING American Fire and Casualty Company The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West American Insurance Company By: Gregory W. Davenport, Assistant Secretary On this 30th day of November 1 2012 , before me personally appeared Gregory W. Davenport, who acknowledged himself to be the Assistant Secretary of American Fire and Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute 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 have hereunto subscribed my name and affixed my notarial seal at Seattle, Washington, on the day and year first above written. By: &-4v."Ft 414= KD Riley, Not Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV — OFFICERS — Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts — SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Gregory W. Davenport, Assistant Secretary to appoint such attorneys -in -fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, David M. Carey, the undersigned, Assistant Secretary, of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power ofAttorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this day of U n� , 20 . By: David M. Carey; Assistant Secretary LMS_12873_092012 U) H at C .N .a PREMIUM IS FOR THE CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT BASED ON FINAL CONTRACT PRICE EXHIBIT E Executed in duplicate CITY OF NEWPORT BEACH BOND NO. 024060342 FAITHFUL PERFORMANCE BOND The premium charges on this Bond is $ 1,849.00 , being at the rate of $ 30.00 thousand of the Contract price. WHEREAS, the City of Newport Beach, State of California, has awarded to HM Flooring Group, Inc. hereinafter designated as the "Principal," a contract for the Improvement of Multiple Buildings Carpet Replacement located at a. Fire Station No. 1 (110 E. Balboa Boulevard); b. Fire Station No. 3 (868 Santa Barbara Drive); C. Fire Station No. 4 (124 Marine Avenue); d. Fire Station No. 6 (1348 Irvine Avenue); e. Fire Station No. 7 (20401 Acacia Street); f. Fire Station No. 8 (6502 Ridge Park Road); and g. Mariners Library (1300 Irvine Avenue), in the City of Newport Beach, in strict conformity with the Contract on file with the office of the City Clerk of the City of Newport Beach, which is incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute the Contract and the terms thereof require the furnishing of a Bond for the faithful performance of the Contract. NOW, THEREFORE, we, the Principal, and The Ohio Casualty Insurance Company duly authorized to transact business under the laws of the State of California as Surety (hereinafter "Surety"), are held and firmly bound unto the City of Newport Beach, in the sum of Sixty One Thousand Six Hundred Twenty Four Dollars and 00/100 ($61,624.00) lawful money of the United States of America, said sum being equal to 100% of the estimated amount of the Contract, to be paid to the City of Newport Beach, its successors, and assigns; for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these present. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal, or the Principal's heirs, executors, administrators, successors, or assigns, fail to abide by, and well and truly keep and perform any or all the Work, covenants, conditions, and agreements in the Contract Documents and any alteration thereof made as therein provided on its part, to be kept and performed at the time and in the manner therein specified, and in all respects according to its true intent and meaning, or fails to indemnify, defend, and save harmless the City of Newport Beach, its officers, employees and agents, as therein stipulated, then, Surety will faithfully perform the same, in an amount not HM Flooring Group, Inc. Page E-1 exceeding the sum specified in this Bond; otherwise this obligation shall become null and void. As a part of the obligation secured hereby, and in addition to the face amount specified in this Performance Bond, there shall be included costs and reasonable expenses and fees, including reasonable attorneys fees, incurred by the City, only in the event the City is required to bring an action in law or equity against Surety to enforce the obligations of this Bond. Surety, for value received, stipulates and agrees that no change, extension of time, alterations or additions to the terms of the Contract or to the Work to be performed thereunder shall in any way affect its obligations on this Bond, and it does hereby waive notice of any such change, extension of time, alterations or additions of the Contract or to the Work or to the specifications. This Faithful Performance Bond shall be extended and maintained by the Principal in full force and effect for one (1) year following the date of formal acceptance of the Project by the City. In the event that the Principal executed this bond as an individual, it is agreed that the death of any such Principal shall not exonerate the Surety from its obligations under this Bond. IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and Surety above named, on the 2nd day of June 2015 . H M Carpet, Inc. dba HM Flooring Group Oro Name of Contractor (Principal) Authorized -Signature/Title The Ohio Casualty Insurance Company /2l Name of Surety Authorized Agent Signature 62 Maple Avenue, Keene, NH 03431 Shawn Blume, Attorney -in -Fact Address of Surety Print Name and Title (617)357-9500 Telephone APPROVED AS TO FORM: CITY ATT - 'S OFFICE Date: By: . 7NWI�: Aaron C. Harp cA A cvtxvll�- City Attorney NOTARY ACKNOWLEDGMENTS OF CONTRACTOR AND �,Q�tv SURETY MUST BE ATTACHED HM Flooring Group, Inc. Page E-2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached and not the tnrthfulness, accuracy, or validity of that document. State of California ) County of Orange ) On ��I1,1� before me, Barbara Copeland , Notary Public, personally appeared Shawn Blume Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Ware subscribed to the within instrument and acknowledged to me that he/stw/they executed the same in his/her/their authorized capacity(ies), and that by his/herMTeir signature() on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. BARBARA COPELAND Commission # 2016348 a~ z.�,_�_ Notary Public -California z z "' Orange County D My Comm. Expires Apr 19, 2017 Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my and and official seal. Signature: c.J Signature of ary Public --- ---------- ---- —------------------ —-------- ----- ------- OPTIONAL ---------------------------------------------------------- Though the information below is not required by law, it may prove valuable to persons relying on the document and could present fraudulent and reattachment of this form to another document. Description of Attached Document Type or Title of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Shawn Blume ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner: ❑Limited ❑ General ® Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner: ❑Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Rev. 1-15 ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los 4weles On asf4 =/J5' before me, Phillip Andrew Fahrnkopf, Notary Public ere insert name and title of t e o icer personally appeared 004A.- who proved to me on the basis of satisfactoryevidence to be the personal whose namei�i Dare subscribed to the within instrument and acknowledged t0 me that (�e2he/they executed the same in(pi / er/their authorized capacityfies`f, and that by IS/ er/their signature on the instrument the persoe, 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. J %'LLHIPANDREWFAHRNKOCOMM. #2113456NotaryPublic-CaliforniamLOSANGELES COUNTY� Comm. Exp. Jun 26, 2019 otary P tic Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Dateawzlmes CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) N' Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 2015 Version VIVA:.NotaryCIass es.com 800.373 9865 INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary+ wording and, ifneeded, should be completed and attached to the document. Acknoltvedgents fi onu other states may be cornpleied for documents being sent to that state so long as the wording does not require the California nota,y to violate California nota,y latt,. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signet (s) personally appeared which must also be the same date the acknowledgment is completed. • T7re notary public must print his or her name as it appears withnr his or her conmtission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the conect singular or plural forms by crossing off incorrect forms (i.e. he/she/dreg,-- is litre ) or circling the correct forms. Faihue to conectly indicate this infonnation may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. impression must not cover text mlines. If seal impression smudges, re -seal if a sufficient area pennits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the oflice of the county clerk. Additional information is not required bill could help to ensure this acknowledgment is not misused or attached to it different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 5672512 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire & Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, ERIC LOWEY; MARK RICHARDSON; SHAWN BLUME; STEPHANIE HOANG........................................................................................................................... all of the city of COSTA MESA , state of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 30th day of November 2012 . STATE OF WASHINGTON ss COUNTY OF KING American Fire and Casualty Company The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West American Insurance Company By: o4�� Gregory W. Davenport, Assistant Secretary On this 30th day of November 2012 , before me personally appeared Gregory W. Davenport, who acknowledged himself to be the Assistant Secretary of American Fire and Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute 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 have hereunto subscribed my name and affixed my notarial seal at Seattle, Washington, on the day and year first above written. By: KD Riley, NotJ4 Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV– OFFICERS – Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII – Execution of Contracts – SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation – The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Gregory W. Davenport, Assistant Secretary to appoint such attorneys -in -fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization – By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, David M. Carey, the undersigned, Assistant Secretary, of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 2 day of �� , 2016— By: 01By: David M. Carey Secretary Secretary LMS -12873_092012 to d S U) 7 c O V N yW LE O C. Q M o� 4) C 3M O£ IL Q �o O C d 'a do C4 N M Cop 0o H4