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C-3460(T) - Back Bay Science Center, Bid Package #12 (Fire Sprinklers)
Recorded in Official Records, Orange County Torn Daly, Clerk -Recorder IIR1111111R1111111111111111111111111111111111111111111111 11E1111 1111 NO FEE 200700056601011:52am 09117107 103 254 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 "Exempt from recording fees pursuant to Government Code Section 27383" NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the City of Newport Beach, 3300 Newport Boulevard, Newport Beach, California, 92663, as Owner, and J.G. Tate Fire Protection Systems of Poway, California, as Contractor, entered into a Contract on March 1, 2006. Said Contract set forth certain improvements, as follows: Back Bay Science Center (C-3460) Work on said Contract was completed, and was found to be acceptable on September 11,, 2007, by the City Council. Title to said property is vested in the Owner, and the Surety for said Contract is Travelers Casualty and Surety Company of America. I: je'Works Director of Newport Beach VERIFICATION I certify, under penalty of perjury, that the foregoing is true and correct to the best of my knowledge. Executed on q D 0 Q , at Newport Beach, California. BY(70VAIPt,?�Z - )Vd44ZA�2 City Clerk RECORDING REQUESTED BY AND WHEN RECORDED RETURN TO: V City Clerk City of Newport Beach 3300 Newport Boulevard Newport Beach, CA 92663 Recorded in Official Records, Orange County Torn Daly, Clerk -Recorder IIR1111111R1111111111111111111111111111111111111111111111 11E1111 1111 NO FEE 200700056601011:52am 09117107 103 254 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 "Exempt from recording fees pursuant to Government Code Section 27383" NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the City of Newport Beach, 3300 Newport Boulevard, Newport Beach, California, 92663, as Owner, and J.G. Tate Fire Protection Systems of Poway, California, as Contractor, entered into a Contract on March 1, 2006. Said Contract set forth certain improvements, as follows: Back Bay Science Center (C-3460) Work on said Contract was completed, and was found to be acceptable on September 11,, 2007, by the City Council. Title to said property is vested in the Owner, and the Surety for said Contract is Travelers Casualty and Surety Company of America. I: je'Works Director of Newport Beach VERIFICATION I certify, under penalty of perjury, that the foregoing is true and correct to the best of my knowledge. Executed on q D 0 Q , at Newport Beach, California. BY(70VAIPt,?�Z - )Vd44ZA�2 City Clerk RECORDING REQUESTED BY AND WHEN RECORDED RETURN TO: City Clerk City of Newport Beach 3300 Newport Boulevard Newport Beach, CA 92663 "Exempt from recording fees pursuant to Government Code Section 27383" NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the City of Newport Beach, 3300 Newport Boulevard, Newport Beach, California, 92663, as Owner, and J.G. Tate Fire Protection Systems of Poway, California, as Contractor, entered into a Contract on March 1, 2006. Said Contract set forth certain improvements, as follows: Back Bay Science Center (C-3460) Work on said Contract was completed, and was found to be acceptable on September 11, 2007, by the City Council. Title to said property is vested in the Owner, and the Surety for said Contract is Travelers Casualty and Surety Company of America. Pubyc�Works Director City of Newport Beach VERIFICATION I certify, under penalty of perjury, that the foregoing is true and correct to the best of my knowledge. Executed on at Newport Beach, California. BY City Clerk September 11, 2008 Mr. James Tate J.G. Tate Fire Protection Systems 12600 Stowe Drive, Suite 11 Poway, CA 92064 OFFICE OF THE CITY CLERK LaVonne M. Harkless, MMC Subject: Back Bay Science Center (C-3460) - Bid Package #12 (Fire Sprinklers) Dear Mr. Tate: On September 11, 2007, the City Council of Newport Beach accepted the work of the subject project and authorized the City Clerk to file a Notice of Completion, to release the Labor & Materials Bond 35 days after the Notice of Completion had been recorded in accordance with applicable portions of the Civil Code, and to release the Faithful Performance Bond one year after Council acceptance. The Labor & Materials Bond was released on October 22, 2007. The Surety for the contract is Travelers Casualty and Surety Company of America and the bond number is 104584182. Enclosed is the Faithful Performance Bond. Sincerely, LaVonne M. Harkless, MMC City Clerk enclosure 3300 Newport Boulevard • Post Office Box 1768 • Newport Beach, California 92658-8915 Telephone: (949) 644-3005 • Fax: (949) 644-3039 • www. city. newport-beach. ca. us EXECUTED ' TVE (5) ORIGINAL COUNTERPARTS PREMIUM: $1204.00 CITY OF NEWPORT BEACH PUBLIC WORKS DEPARTMENT MASTER FORMAL CONTRACT CONTRACT NO. 3460 BOND NO. 104584182 FAITHFUL PERFORMANCE BOND The premium charges on this Bond is $ 1204.00— being at the rate of $15.40--------- thousand of the Contract price. WHEREAS, the City Council of the City of Newport Beach, State of California, by motion adopted, awarded to J G Tate Fire Protection Systems, Inc., hereinafter designated as the "Principal", a contract for construction of MASTER FORMAL CONTRACT, Contract No. 3460 in the City of Newport Beach, in strict conformity with the plans, drawings, specificabons, and other Contract Documents maintained in the Public Works Department of the City of Newport Beach, all of which are incorporated herein by this reference. PROJECT: BACK BAY SCIENCE CENTER - CONTRACT# 3460, BID PACKAGE 112 -FIRE SPRINFa.ERS WHEREAS, Principal has executed or is about to execute Contract No. 3460 and the terms thereof require the furnishing of a Bond for the faithful performance of the Contract; NOW, THEREFORE, we, the Principal, and TRAVELERS cASUALTy AND SURETY COMPANY OF AMERICA , duly authorized to transact business under the laws of the State of Califomia as Surety (hereinafter "Surety"), are held and firmly bound unto the City of Newport Beach, in the sum of*($78,220.00) 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. *SEVENTY EIGHT THOUSAND Two HUNDRED TWENTY AND N0/100 --- THE CONDITION OF THIS OBLIGATION IS SUCH, that 9 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 exceeding the sum specified in this Bond; otherwise this null and void. obligation shall become E 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 or to the specifications accompanying the same 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 ha been duly executed by the Principal and Surety above named, on the 30TH day ofMAR CH , 2006. J.G. TATE FIRE PROTECTION SYSTEMS, INC. James G. Tate, President Name of Contractor (Principal) Aftorized Signature/Title TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Name of Surety A orized Agent Signature 9325 SKY PARK CT 1220 SAN DIEGO, CA 92123 JEANETTE SEIDL, ATTORNEY-IN-FACT Address of Surety Print Name and Title 858-616-6253 Telephone/Fax NOTARY ACKNOWLEDGMENTS OF CONTRACTOR AND SURETY MUST BE ATTACHED 10 CALIFORNIA ' •ACKNOWLEDGMENT S>.alc�. �.C;cyya•,saC�S��G vw�,�C�k �� nd�CTv�4,_ _ � �S!c�.%.�C C�v��C�C,.� a. �S,.sv.� = �. .�S,r�aS s7.C.c�SC.�S,�� ,_. c��n3..�C State of California County of SAN DIEGO On 30 MARCH 2006 Date personally appeared ss. before me, GLADYS D. ROGERS, NOTARY PUBLIC Name and Title of Officer (e.g., "Jane Doe, Notary Public") JEANETTE SEIDL GLAD YS D. ROGERS Commission # 1537880 Notary Public - �'. Sa California n Diego County ?.J_"'4 t - 4, yn Name(s) of Signer(s) N personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand offi I s al. Place Notary Seal Above ignat of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General Iii Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: SURETY RIGHT THUMBPRINT OF SIGNER of thumb Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNER CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California I ss. County of San Diego On April 7, 2006 before me, Tana Borjeson, Notary Public Date Name and Title of Officer (e.g., "Jane Doe, Notary Public") personally appeared James G. Tate Name(s) of Signer(s) M personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the TANA BORJESON entity upon behalf of which the person(s) acted, emyCommission # 1551197 executed the instrument. Notary Public - California DSan Diego County Comm. Expires Mar 5,2009 WITNESS my hand an fficial seal. Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual • Corporate Officer — Title(s): • Partner — ❑ Limited '_1 General U Attorney in Fact Top of thumb here C Trustee Guardian or Conservator ❑ Other: Signer Is Representing: © 2004 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 - Chatswortl Signer's Name: Individual Corporate Officer — Title(s): C Partner — Limited I_ General C; Attorney in Fact Top of thumb here L Trustee E. Guardian or Conservator E1 Other: Signer Is Representing: i, CA 91313-2402 Item No. 5907 Reorder: Call Toll -Free 1-800-876-6827 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAM IS CASUALTY AND SURETY COMPANY . _ _,iAMGTON CASUALTY COMPANY Hartford, Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Brooke Lafrenz, Ingrid Erika Crosby, Larry D. Cogdill, Michael W. Thomas, Jeanette Seidl, of San Diego, California, their true and lawful Attomey(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her Ole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature ofa bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attomey(s)-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (05-04) Unlimited October 22, 2007 CITY OF NEWPORT BEACH Mr. James Tate J.G. Tate Fire Protection Systems 12600 Stowe Drive, Suite 11 Poway, CA 92064 OFFICE OF THE CITY CLERK LaVonne M. Harkless, MMC Subject: Back Bay Science Center (C-3460) - Bid Package #12 (Fire Sprinklers) Dear Mr. Tate: On September 11, 2007, the City Council of Newport Beach accepted the work of the subject project and authorized the City Clerk to file a Notice of Completion, to release the Labor & Materials Bond 35 days after the Notice of Completion had been recorded in accordance with applicable portions of the Civil Code, and to release the Faithful Performance Bond one year after Council acceptance. The Notice of Completion was recorded by the Orange County Recorder on September 17, 2007, Reference No. 2007000566010. The Surety for the contract is Travelers Casualty and Surety Company of America, and the bond number is 104584182. Enclosed is the Labor & Materials Payment Bond. Sincerely, LaVonne M. Harkless, MMC City Clerk cc: Public Works Department encl. 3300 Newport Boulevard • Post Office Box 1768 • Newport Beach, California 92658-8915 Telephone: (949) 644-3005 • Fax: (949) 644-3039 • www. city. newport-beach.ca.us EXECUTED IN FI (5) ORIGINAL COUNTERPARTS PREMIUM INCLUDED IN THE CITY OF NEWPORT BEACH PERFORMANCE BOND. PUBLIC WORKS DEPARTMENT MASTER FORMAL CONTRACT CONTRACT N0.3460 BOND NO. 104584182 LABOR ANI? MATERIALS PAYMENT BONIa WHEREAS, the City Council of the City of Newport Beach, State of California, by motion adopted, has awarded to J G Tate Fire Protection Systems, Inc., hereinafter designated as the "Principal," a contract for construction of MASTER FORMAL CONTRACT, Contract No. 3460 in the City of Newport Beach, in strict conformity with the plans, drawings, specifications and other Contract Documents in the office of the Public Works Department of the City of Newport Beach, all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute Contract No. 3460 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 perfo►mance 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: PROJECT: BACK BAY SCIENCE CENTER - CONTRACT# 3460, BID PACKAGE 112 -FIRE SPRINKLERS NOW, THEREFORE, We the undersigned Principal, and, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA duly authorized to transact business under the laws of the State of California, as Surety, (referred to herein as "Surety's are held firmly bound unto the City of Newport Beach, in the sum ofil($78,220.00) 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. *SEVENTY EIGHT THOUSAND Two HUNDRED TWENTY AND NO/100 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 obligations of this Bond, a reasonable attorney's fee, to be fixed by the Court as required by the provisions of Section 3250 of the Civil Code of the State of California. 7 The Bond shall inure to the benefit of any and all persons, companies, and corporations entitled to file claims under Section 3181 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 3247 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 or the specifications accompanying the same shall in any wise affect its obligations on this Bond, and it does hereby waive notice of any such change, extension of time, 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 30TH day of M CH 2006 J.G. TATE FIRE PROTECTION SYSTEM, INC. James CL Tate, Presiders( Name of Contractor (Principal)L4!& A horized Signature/Title TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICANameofSurety gent Signature 9325 SKY PARK CT. 1220 SAN DIEGO, CA 92123 JEANETTE SEIDL, ATTORNEY-IN-FACT Address of Surety Print Name and Titie 858-616-6253 Telephone/Fax NOTARY ACKNOWLEDGMENTS OF CONTRACTOR. AND SURETY MUST BE ATTACHED [3 CALIFORNIA ` •ACKNOWLEDGMENT State of California County of SAN DIEGO On 30 MARCH 2006 Date personally appeared SS. before me, GLADYS D. ROGERS, NOTARY PUBLIC Name and Title of Officer (e.g., "Jane Doe, Notary Public's JEANETTE SEIDL GLADYS D. ROGERS COrnmisslon # 1537880 "d Notary public - tor niaSan Diego CountyYCommMmoc24,200 Name(s) of Signer(s) IJ personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand off eal. Place Notary Seal Above ign re of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer— Title(s): ❑ Partner — ❑ Limited ❑ General EK Attorney in Fact Top of thumb here El Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: SURETY Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General OR", 11 Rofill ❑ Attorney in Fact E) Trustee Top of thumb here ❑ Guardian or Conservator ❑ Other: Signer Is Representing: CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of San Diego On April 7, 2006 , Date personally appeared u TANA BORASON Commission # 1551197 Notary Public - California San Diego County 01MY Comm. Expires Mar 5, 2009 Place Notary Seal Above before me, ss. Tana Borjeson, Notary Public Name and Title of Officer (e.g., "Jane Doe, Notary Public") James G. Tate Name(s) of Signer(s) W personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose names) 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. WITNESS hand and "/LA Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: 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: RIGHT THUMBPRINT OF SIGNER Number of Pages: Signer's Name: D. Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑. Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNER Top of thumb here © 2004 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 Item No. 5907 Reorder: Call Toll -Free 1-800-876-6827 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAY RS CASUALTY AND SURETY COMPANY i. .it GTON CASUALTY COMPANY . Hartford, Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Brooke Lafrenz, Ingrid Erika Crosby, Larry D. Cogdill, Michael W. Thomas, Jeanette Seidl, of San Diego, California, their true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/hef0le signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature W a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attomey(s)-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority_ This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards 4 Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached - (05 -04) Unlimited IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President and their corporate seals to be hereto affixed this 12th day of August, 2004. STATE OF CONNECTICUT }SS. Hartford COUNTY OF HARTFORD r AVp 9 GASt�;r� o n 1 f 3 2 o cow c �Q, • � Di 6 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY George W. Thompson Senior Vice President On this 12th day of August, 2004 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument, that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. CERTIFICATE `(Ylorv�� C My commission expires June 30, 2006 Notary Public Marie C. Tetreault I, the undersigned, Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, stock corporations of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and finthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate of Authority, are now in force. Signed and Sealed at the Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this 30TH day of MARCH , 20 06 J*t1Y App C✓`SUhi 5 l e 3•' W HARTFORD. ` 0 1932 o ARMFO.coft�CONK� �b L �D� f !r By Peter Schwartz Senior Vice President CITY OF NEWPORT BEACH CITY CLERK PUBLIC WORKS DEPARTMENT MASTER FORMAL CONTRACT CONTRACT NO. 3460 CONTRACT THIS AGREEMENT, entered into this 1St day of March, 2006, by and between the CITY OF NEWPORT BEACH, hereinafter "City," and J G Tate Fire Protection Systems, Inc., hereinafter "Contractor," is made with reference to the following facts: WHEREAS, City has advertised for bids for the following described public work: MASTER FORMAL CONTRACT BACK BAY SCIENCE CENTER, BID PACKAGE #12 — (FIRE SPRINKLERS Contract No. 3460 WHEREAS, Contractor has been determined by City to be the lowest responsible bidder and Contractor's bid, and the compensation set forth in this Contract, is based upon Contractor's careful examination of all Contract documents, plans and specifications. NOW, THEREFORE, City and Contractor agree as follows: A. CONTRACT DOCUMENTS The complete Contract for the Project includes all of the following documents: Notice Inviting Bids, Instructions to Bidders, Proposal, Bidder's Bond, Non -Collusion Affidavit, Faithful Performance Bond, Labor and Materials Payment Bond, Permits, General Conditions, Standard Special Provisions and Standard Drawings, Plans and Special Provisions for Contract No. 3460, Standard Specifications for Public Works Construction (current adopted edition and all supplements) and this Agreement, and all modifications and amendments thereto (collectively the "Contract Documents"). 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. B. 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. 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. C. COMPENSATION 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 ($78,220.00). This compensation includes: (1) Any loss or damage arising from the nature of the work, (2) Any loss or damage arising from any unforeseen difficulties or obstructions in the performance of the work, (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, and which loss or expense occurs prior to acceptance of the work by City. D. 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 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. E. WRITTEN NOTICE Any written notice required to be given under the Contract Documents shall be performed by depositing the same in the U.S. Mail, postage prepaid, directed to the address of Contractor and to City, addressed as follows: CITY City of Newport Beach Public Works Department 3300 Newport Boulevard Newport Beach, CA 92663 Attention: Stephen G. Badum (949) 644-0000 CONTRACTOR JG Tate Fire Protection Systems, Inc. 12600 Stowe Drive Ste# 11 Poway, CA. 92064 Attention: James Tate (858) 486-0900 F. LABOR CODE 3700 LIABILITY INSURANCEContractor, by executing this Contract, hereby certifies: "I am aware of the provisions of Section 3700 of the Labor Code which requires every employer to be insured against liability for Workers' Compensation or undertake self- insurance in accordance with the provisions of the Code, and I will comply with such provisions before commencing the performance of the work of this Contract." G. INSURANCE Insurance is to be placed with insurers with a Best's rating of no less than A:VII and insurers must be a California Admitted Insurance Company. Contractor shall furnish City with original certificates of insurance and with original endorsements effecting coverage required by this Contract. The certificates and endorsements for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. All certificates and endorsements are to be received and approved by City before work commences. City reserves the right to require complete, certified copies of all required insurance policies, at any time. Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property, which may arise from or in connection with the performance of the work hereunder by Contractor, his agents, representatives, employees or subcontractors. The cost of such insurance shall be included in Contractor's bid. 1. Minimum Scope of Insurance Coverage shall be at least as broad as: a) Insurance Services Office Commercial General Liability coverage "occurrence" form number CG 0002 (Edition 11/85) or Insurance Services Office form number GL 0002 (Edition 1/73) covering Comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. b) Insurance Services Office Business Auto Coverage form number CA 0002 0287 covering Automobile Liability, code 1 "any auto" and endorsement CA 0029 1288 Changes in Business Auto and Truckers Coverage forms - Insured Contract. c) Workers' Compensation insurance as required by the Labor Code of the State of California and Employers Liability insurance. 2. Minimum Limits of Insurance Coverage limits shall be no less than: a) General Liability: $1,000,000.00 combined single limit per occurrence for bodily injury, personal injury and property damage. If Commercial Liability Insurance or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. b) Automobile Liability: $1,000,000.00 combined single limit per accident for bodily injury and property damage. c) Workers' Compensation and Employers Liability: Workers' compensation limits as required by the Labor Code of the State of California and Employers Liability. 3. Deductibles and Self -Insured Retentions Any deductibles or self-insured retentions must be declared to and approved by City. At the option of City, either: the insurer shall reduce or eliminate such deductibles or self-insured retentions as respects City, its officers, officials, employees and volunteers; or Contractor shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. 3 4. Other Insurance Provisions The policies are to contain, or be endorsed to contain, the following provisions: a) General Liability and Automobile Liability Coverages City, its officers, agents, officials, employees and volunteers and Construction Manager are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor, including the insured's general supervision of Contractor; products and completed operations of Contractor; premises owned, occupied or used by Contractor; or automobiles owned, leased, hired or borrowed by Contractor. The coverage shall contain no special limitations on the scope of protection afforded to City, its officers, officials, employees or volunteers and Construction Manager. Contractor's insurance coverage shall be primary insurance and/or primary source of recovery as respects City, its officers, officials, employees and volunteers and Construction Manager. Any insurance or self-insurance maintained by City, its officers, officials, employees and volunteers and Construction Manager shall be excess of the Contractor's insurance and shall not contribute with it. iii. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to City, its officers, agents, officials, employees and volunteers and Construction Manager. iv. Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. v. The insurance afforded by the policy for contractual liability shall include liability assumed by contractor under the indemnification/hold harmless provision contained in this Contract. b) Workers' Compensation and Employers Liability Coverage The insurer shall agree to waive all rights of subrogation against City, its officers, agents, officials, employees and volunteers and Construction Manager for losses arising from work performed by Contractor for City. c) All Coverages Each insurance policy required by this clause shall be endorsed to state that coverage shall not be suspended, voided, canceled, rescinded by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to City. All of the executed documents referenced in this contract must be returned within ten (10) working days after the date on the "Notification of Award," so that the City may review and approve all insurance and bonds documentation. 5. Acts of God 4 Pursuant to Public Contract Code Section 7105, Contractor shall not be responsible for the repairing and restoring damage to Work, when damage is determined to have been proximately caused by an Act of God, in excess of 5 percent of the Contract amount provided that the Work damaged is built in accordance with the plans and specifications. 6. Right to Stop Work for Non -Compliance City shall have the right to direct the Contractor to stop work under this Agreement and/or withhold any payment(s), which become due to Contractor hereunder until Contractor demonstrates compliance with the requirements of this article. H. RESPONSIBILITY FOR DAMAGES OR INJURY 1. City and all officers, employees and representatives thereof, including Construction Manager, shall not be responsible in any manner: for any loss or damages that may happen to the Work or any part thereof; for any loss or damage to any of the materials or other things used or employed in performing the Work, for injury to or death of any person either workers or the public; or for damage to property from any cause arising from the construction of the work by Contractor, or its subcontractors, or its workers, or anyone employed by it. 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 the Contractor. 3. Contractor shall indemnify, hold harmless, and defend City, its officers and employees and Construction Manager from and against (1) any and all loss, damages, liability, claims, allegations of liability, suits, costs and expenses for damages of any nature whatsoever, including, but not limited to, bodily injury, death, personal injury, property damages, or any other claims arising from any and all acts or omissions of Contractor, its employees, agents or subcontractors in the performance of services or work conducted or performed pursuant to this Contract; (2) use of improper materials in construction of the Work; or, (3) any and all claims asserted by Contractor's subcontractors or suppliers on the project, and shall include reasonable attorneys' fees and all other costs incurred in defending any such claim. Contractor shall not be required to indemnify City or Construction Manager from the sole negligence or willful misconduct of City, its officers or employees or Construction Manager. 4. 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. 5. Nothing in this article, nor 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 in H.3, above. 6. The rights and obligations set forth in this Article shall survive the termination of this Contract. 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, has become familiar with the local conditions under which the work is to be 5 performed, and has correlated all relevant observations with the requirements of the Contract Documents. J. CONFLICT If there is a conflict between provisions of this Contract and any other Contract Document, the provisions of this Contract shall prevail. K. WAIVER A waiver by City or any term, covenant, or condition in the Contract Documents shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant or condition. IN WITNESS WHEREOF, the parties hereto have caused this contract to be executed the day and year first written above. ATTEST: I� CITY OF NEWPORT B H ya .c A Muni ' al C p ra 'o kiln By: CITY CLERK Mayor APPROVED AS TO FORM: CITY ATTORNEY 9 CONTRACTOR By: ( orporate Officer) Title: Pres' �ttt+ Print NameJoy-s 6- o&c, By: / 0/�&. - W- /r/ (Financial Officer) Title: Print Name: jN,, DATE ACORDM CERTIFICATE OF LIABILITY INSURA BICE 03/30/2006) PRODUCER (949)261-5335 FAX _ ..0261-1911 THIS CERTIFICATE. ,SSUED AS A MATTER OF INFORMATION utton Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2913 S. Pullman St. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Ana, CA 92705 INSURED J.G. Tate Fire Protection Systems, Inc 12600 Stowe Drive Suite 11 Poway, CA 92064 IM�Iq 7!7•�N 1`I INSURERS AFFORDING COVERAGE INSURER A: Everest Indemnity Insurance Co INSURERB: Hartford Casualty Ins. Co. INSURER C: INSURER D: INSURER E: NAIC # AR THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD' N R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM DDIYY POLICY EXPIRATION DATE MM DD LIMITS GENERAL LIABILITY 51GL002878-051 12/14/2005 12/14/2006 EACH OCCURRENCE $ 1,000,0-00 X COMMERCIAL GENERAL LIABILITY x DAMAGE TO RENTED $ 50,000 CLAIMS MADE [)(] OCCUR MED EXP (Any one person) $ 5,000 A X I Errors & Omissions PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO - JECT LOC AUTOMOBILE X LIABILITY ANY AUTO 72UECTR3631 12/14/2005 12/14/2006 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY $ (Per person) B ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X X BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY X OCCUR ❑ CLAIMS MADE 51E0000280-051 12/14/2005 12/14/2006 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A $ ]DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- TORY LIMIT ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS E: Back Bay Science Center, Newport Beach, CA he City of Newport Beach, its officers, agents, officials, employees & volunteers are named as additional insured for GL per attached CG2010 (11/85). Auto additional insured applies per the attached CA2048 02/99. Primary applies per form ECG24520(04/02). 10 day notice of cancellation for non-payment of premium. 'Revised -Added A/I for Auto -06/29/06 deb, Inc. Attn: Jay Smith 14471 Chambers Road, Suite 102 Tustin, CA 92780 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ACORD 25 (2001/08) FAX: (858)486-0950 /r ©ACORD CORPORATION 1988 POLICY NUMBER: 51 GL002878-051 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: BLANKET WHERE REQUIRED BY CONTRACT. The City of Newport Beach, its officers, agents, officials, employees & volunteers RE: Back Bay Science Center, Newport Beach, CA (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work' for that insured by or for you. CG 20 101185 Copyright Insurance Services Office, Inc., 1984 01/09/06 TWARD Policy Number: 51 GL002878-051 COMMERCIAL GENERAL LIABILITY ECG 24 520 04 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT -- OTHER INSURANCE (PRIMARY NONCONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A_ Paragraph a. Primary Insurance of 4. Other Insurance of SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: a. Primary Insurance This insurance is primary except when b. be- low applies. If this insurance is primary, our ob- ligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below, except that we will not seek contribution from any party with Whom you have agreed in a written contract or agreement that this insurance will be primary and noncontributory, if the written contract or agreement was made prior to the subject "oc- currence" or offense. ECG 24 520 04 02 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 ❑ with its permission. POLICY NUMBER: 72 JET R3631 CHANGE NUMBER: 003A COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement; the provisions of the Coverage Form apply unless modified by this endorsement_ This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. .�NncuV LC Name of Person(s) or Organization(s): (SEE FORM TH12011185 ATTACHED) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 POLICY NUMBER: 72 UEC TR3631 CHANGE NUMBER: 004 Ax'��i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: ADDITIONAL INSURED COMMERCIAL AUTO COVERAGE PART IT IS HEREBY" AGREED AND UNDERSTOOD THE FOLLOWING ADDITIONAL INSUREDS ARE ADDED EFFECTIVE 2{24%05: SOLPAC, INC DBA SOLTEK PACIFIC 2424 CONGRESS STREET SAN DIEGGO, CA 92110-2888 SAN DIEGO UNIFIED SCHOOL DISTRICT 4860 RUFFNER ST SAN DIEGO, CA 92111 CITY OF NEWPORT BEACH ITS OFFICERS, AGENTS, OFFICIALS, EMPLOYEES & VOLUNTEERS 3300 NEWPORT BLVD NEWPORT BEACH, CA 92658 TEMECULA VALLEY UNIFIED SCHOOL DISTRICT AND EDGE DEVELOPMENT INC 27368 VIA INDUSTRIA, STE 101 TEMECULA CA 92590 Form IH 12 01 11 85 SEQ.NO. 09 Printed in U.S.A. V"E-Cm i HOL,D E -R LOOPY -- - __ - - P.C. BOX 4209-07, —S—AN I FRAA vCi CLl,CA 94 42-0807 = L_ -cr?--- r-rsTE :'ic yin: iCErJc• _c=I_. 'AT_ :a_i 4-2yC M.:=�uvY3i CERTIFIC.'-c ;n. 237 CER 7 !FICA---- PMES: 4.3-01 -27m_ -ITv nF NEWPORT BEACH N ItWKL T REACH CA 9=9-63-3-916 Jt= jUB;=ACK SAY SCIENCE CENTER i*n:S is [a Certify T^8t W:P_. {SiVn IS$'ved -- V.A11:7 'v ork.ersr Cornper;satran ms.urarice policy in a farm approVea :;y tyle Cni;f,^,r^ia his -Trance Comr!:S5ioner To the emP!over namied be'ovv -Cr the p'-•iicy pee-i6U it :clicate.;A. �?piiC✓ is not a-ibject iC CE?; cliat!4n FJ'J i.,e i -u -d e,1; =r=t u lor.3% days advanCc "Yvrittan no' =G i .v emplover ar U:rp .�iil �'c, _ rd, :�aa%rt a_hra�Cc iCC shlrl tfiiL i t-8 --- to Fcrrq-ai- 'nIS- cert:'.Ca.e CI msurancp is, nw ar, IMl)ran;,a pjjicva<5 doas no 'nand9, tend ter the coverage af'arded t^c r.t%';:'.f I:Soil `eir2i, ♦ v:rtrl_--.uIR ary r2 uir-e er._ zer-r5 r ]n r: I ^. ^h :h. g a D• li tiu 1 J. ami :r Gi t Gr C: �i GIDG JrrlEnl r@SF: �. `^ a-tifin;Ise rr.f in5ur�ncF map• a igg!1:r„i G" Y'C %?7i Cl'S It nr-t::n !n9 I?':5iir-cr'C8 ef'^i ?5a }r,j :rc gni .-s:gCij_c,_I l58r6li'! IS sub,at.t tD 6i -The 40rms. BX::ius:Ot55, a^.. CDnCiit!On5, of such ppliCy. r*5 11 ,a^1:ii,i..7�.i:.LL ^CrRESENTAT,1"'.'.-..t Y"Xv`514.1kiJT _1i1_'i gi T LIMIT 114CL DING DEFENSE COSTS: $1;000, 000 PER OCCi.IRRE"CE. E&_DM_, >r_NT r_-ing- _AeTfiT2 EEt ERTIPICATE s4m t?c'e3' NOTI='c 'e�fc�TT_erE 4 r_r:_2-�� sc ,ATTACHED TO AND FORMS A 'ART rse TLII i; ufiL lC #2=70 EENITiTLE, W-pur� " �UBRC:.r_,;;T�Ci� EFFECTIVE E 21;0E..-i_�s-S i Tr ATTACHED TO .A:C FORMS r F'.AI=T i_iF TH.je .POLICY -CITY OF NFwPOu--r ftrA�.H T�IRU PARTY NAME! ilt�lX -- AUTi- 1T21E,61 ICN URE EiviPLi74LR 4 -G. -TATE FIRE PROTECTION SYSTEMS 7NE 52600 STOiWE DR STT° 111 POWAY _A SZQ$4 - - cry lB 14.SPj PRINTED . Oli-11'-26006 CERTIFICATE OF INSURANCE CHECKLIST CITY OF NEWPORT BEACH THIS CHECKLIST IS COMPRISED OF REQUIREMENTS AS OUTLINED ABY THE CITY OF NEWPORT BEACH. DATE RECEIVED: e2 6. DEPARTMENT/CONTACT RECEIVED FROM: "` r DATE COMPLETED: `y SENT TO: BY: t C J COMPANY/PERSON REQUIRED TO HAVE CERTIFICATE I. GENERAL LIABILITY. , A INSURANCE COMPANY:=tov,uEt ai of AM BEST RATING (A VII or greater}. � � �;�/" " ADMITTED COMPANY; (Must be California Admitted) Is company admitted in Califomia? Yes No I7. LIlVIITS: (Must be $1,000,000 or greater} What is limit provided? E. PRODUCTS AND COMPLETED OPERATIONS: (Must Include) Is -it included? Yes No F. ADDITIONAL INSURDED WORDING TO INCLUDE: ( The City its officers, agents, officials, employees and volunteers), Is it included? Yes No G. PRIMARY AND NON CONTRIBUTORY WORDING: (Must be included) Is it included? YeszNo H. CAUTION! ( Confirm that loss or liability of the Named insured is not);Waited solely by their negligence.) Does endorsement include "solely by negligence" wording? Yes No 1. NOTIFICATION OF CANCELLATION: Although there is a provision that requires notification of cancellation by certified mail; per Lauren Farley the City will accept the endeavor wording. Il. AUTOMOBILE LIABILITY: A. INSURANCE COMPANY:__ B. AM BEST RATING (A VII or greater): + X C. ADMITTED COMPANY: ( MUST BE CALIFORNIA ADMITTED) Is company admitted? Yes No D. LIMITS: ( Must be $1,000,000 minimum BI & PD and $500,000 UM) What is limits provided? s eE? f•a: c. 11u1Ji11vNf L IMUR D WVxlllNcFiTO INCLUDE: (The City its officers,agents, officials, employees and volunteers).; Is it included? Yes > No F. PRIMARY AND NON CONTRIBUTORY WORDING: (Must be included). Is it included? Yes No ' 'r G. NOTIFICATION OF CANCELLATION: Although there is a provision that requires notification of cancellation by certified mail; per Lauren Farley the City will accept the endeavor wording. III. WORKERS COMPENSATION: A. INSURANCE COMPANY: ISF T-0- v f -j c B. AM BEST RATING (A VII or greater)( C. LIMITS; Statutory D. WAVIER OF SUBROGATION: (To include). Is it included? Yes No HAVE ALL ABOVE REQUIREMENTS BEEN MET? Yes No IF NO, WHICH ITEMS NEED TO BE COMPLETED?