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HomeMy WebLinkAboutC-2123 - Construction of Ensign View Park Storm DrainUI ( �;;l .f) rir.�..r. {1 Cti I 1. 9 1979 December 10, 1979 CITY COUNCIL AGENDA ITEM NO. H -13 TO: CITY COUNCIL By the CITY COUNCIL CITY OF i SWP0P,T BEACH FROM: Public Works Department SUBJECT: ACCEPTANCE OF ENSIGN VIEW PARK STORM DRAIN -2123) ) RECOMMENDATIONS: 1. Accept the work. 2. Authorize the City Clerk to file a Notice of Completion. 3. Authorize the City Clerk to release the bonds 35 days after Notice of Completion has been filed. DISCUSSION: The contract for the construction of the Ensign View Park storm drain has been completed to the satisfaction of the Public Works Department. The bid price was $24,490.00 Amount of unit price items constructed 24,490.00 Amount of change orders None Total contract cost 24,490.00 Funds were budgeted in the General Fund, (Account No. 02- 3497 -053). The design engineering was performed by the Public Works Department. The contractor is Hondo Company, Inc. of Santa Ana, California. The work was completed by November 9, 1979. Benjamin B. Nolan Public Works Director GPD:em RECORDING REQUESTED (�l �t463 � 18111 E XPOPT C2 M NOTICE. OF COMPLETION PUBLIC WORKS BK 13432 Pa 1 304 RECWYDED IN OFFICIAL RECORDS OF ORANGE COUNTY, CALIFORNIA 30 MIn. p.0 2 P.M. DEC 13 1979 LEE A. BRANCH, ., •q Rs ,da, 'I 'o All Laborers and Material Men and to Every Other Person Interested: YOU WILL, PLEASE TAKE NOTICE that on Nnvamher 91979 the Public Works project consisting of Ensign View Park Storm Drain on which Ho was the contractor, and was the surety, was completed. VERIFICATION I, the undersigned, say: CITY OF NEWPORT BEACH c 'Qgizi Public Works Director I am the Public Works Director of the City of Newport Beach; the foregoing Notice of Completion is true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct. Executed on December 11, 1979 at Newport Beach, California. J. )U-31 - public' Works Director VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Newport Beach; the City Council of said City on DPremhar 10, 1979 accepted the above described work as completed and ordered that a Notice of Completion be filed. I declare under penalty of perjury that the foregoing is true and correct. Executed on December 11 , 1979 at Newport Beach, California. City Clerk 6e .a r n 0 k CITY OF NEWPORT BEACH Date November 19, 1979 TO: Public Works Department FROM: City Clerk SUBJECT: Contract No. 2123 Project Ensign View Park Stonn Drain Attached is signed copy of subject contract for transmittal to the contractor. Contractor: Hondo Company, Inc. Address: 18392 East 17th Street , Santa Ana, Ca. 92705 Amount: $ 24,490.00 Effective Date: Noveniber 19, 1979 Resolution No. None Doris Geo e Att. cc: Finance Department" City Ilall 3300 Newport Boulevard. Newport Beach, California 02663 0 CITY OF NEWPORT BEACH PUBLIC WORKS DEPARTMENT CONTRACT DOCUMENTS FOR 0 CONSTRUCTION OF ENSIGN VIEW PARK STORM DRAIN Approved by the City Council October 9, 1979 oris George, City Cler CONTRACT NO. 2123 SUBMITTED BY: HONDO COMPANY, INC. Contractor 18392 East 17th Street Address Santa Ana, California 92705 City State Zip Code (714) 730 -0373 Telephone No. $24,490.00 Total Bid Price CITY CLERK 0 • Page 1 C O N T R A C T THIS AGREEMENT, made and entered into this lc�Zk, ay of ,,�_� I_,, , , 19 ? 51� , by and between the CITY OF NEWPORT BEACH, California, hereinafter designated as the City, party of the first part, and HONDO COMPANY, INC. hereinafter designated as the Contractor, party of the second part. WITNESSETH: That the parties hereto do mutually agree as follows: 1. For and in consideration of the payments and agreements hereinafter mentioned to be made and performed by the City, the Contractor agrees with the City to furnish all materials and labor for the construction of ENSIGN VIEW PARK STORM DRAIN - CONTRACT NO. 2123 and to perform and complete in a good and workmanlike manner all the work pertaining thereto shown on the Plans and Specifications therefor; to furnish at his own proper cost and expense all tools, equipment, labor, and materials necessary therefor, (except such materials, if any, as in the said Specifications are stipulated to be furnished by the City), and to do everything required by this Agreement and the said Plans and Specifications. 2. For furnishing all said materials and labor, tools and equipment, and doing all the work contemplated and embraced in this Agreement, also for all loss and damage arising out of the nature of the work aforesaid, or from the action of the elements, or from any unforeseen difficulties which may arise or be encountered in the prosecu- tion of the work until its acceptance by the City, and for all risks of every description connected with the work; also, for all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as in said Specifications are expressly stipulated to be borne by the City; and for well and faithfully completing the work and the whole thereof, in the manner shown and described in the said Plans and Specifications, the City will pay and the Contractor shall receive in full compensation therefor the lump sum price, or if the bid is on the unit price basis, the total price for the several items furnished pursuant to the Specifications, named in the bidding sheet of the Proposal, as the case may be. 3. The City hereby promises and agrees with the said Contractor to employ, and does hereby employ the said Contractor to provide the materials and to do the work according to the terms and conditions herein contained and referred to for the price aforesaid, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the Specifications; and the said parties -for themselves, their heirs, executors, administrators, successors and assigns, do hereby agree to the full performance of the covenants herein contained. 4. The Special Provisions, Contractor's Proposal, and the Plans and Specifications, and all amendments thereof, when approved by the parties hereto, or when required by the City in accordance with the provisions of the Plans and Specifications, are hereby incorporated in and made part of this Agreement. • . Page 2 The City has adopted the Standard Specifications for Public Works Construction (1976 Edition) as prepared by the Southern California Chapters of the American Public Works Association and the Associated General Contractors of America. Copies may be obtained from Building News,Inc., 3055 Overland Avenue, Los Angeles, California 90034, (213) 870 -9871. The City has adopted Standard Special Provisions and Standard Drawings. Copies of these are available at the Public Works Department. 5. In accordance with the provisions of Article 2, Chapter 1, Part 7 of the California Labor Code (Sections 1770 et seq.), the Director of Industrial Relations has ascer- tained 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 contract. A copy of said determination is available in the office of the City Clerk. All parties to the contract shall be governed by all provisions of the California Labor Code relating to prevailing wage rates (Sections 1770 -7981 in- clusive). The contractor shall be responsible for compliance with Section 1777.5 of the California Labor Code for all apprenticeable occupations. • . Page 3 6. The Contractor shall assume the defense of and indemnify and save harmless the City, the Director of Public Works, and their officers and employees, from all claims, loss, damage, injury, and liability-of every kind, nature, and description, directly or indirectly arising from the performance of the contract or work, regardless of responsi- bility for negligence; and from any and all claims, loss, damage, injury, and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the contract, regardless of responsibility for negligence. IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed the day and year first above written. CITY OF NEWPORT BEACH, CALIFORNIA By: Mayor ATTEST: /L City Clerk 14'u")6 io�*,o�� Contractor (SEAL) By -- Title By: X71^ •-�' �+��� -��i3 �fi� Title CONTRACT NO. 2123 CITY OF NEWPORT BEACH PUBLIC WORKS DEPARTMENT PROPOSAL FOR STORM DRAIN CONSTRUCTION ENSIGN VIEW PARK To the Purchasing Agent City of Newport Beach 3300 West Newport Boulevard Newport Beach, California 92663 Gentlemen: PR 1 of 2 The undersigned declares that he has carefully examined the location of the work, has read the Notice Inviting Bids, has examined the Plans and Special Provisions, and hereby proposes to furnish all materials and do all the work required to complete the project in accordance with the Plans and Specifications, and will take in full payment therefor the following unit prices for each item, complete in place, to -wit: ITEM NO. QUANTITY AND UNIT ITEM DES RIPTI N UNIT PRICE WRITTEN IN WORDS UNIT TOTAL PRICE PRICE 1. L.S. Clear and grub for the lump sum price of: One thousand nine hundred sixty Dollars and No Cents $1.960.00 2. L.S. Construct 15" A.C.P.(3000 -D) storm drain. Class "C" trench bedding per CNB Std. 316 -L for the lump sum price of: Sixteen thousand two hundred Dollars and No Cents $16,200.00 3. 1 Each Construct Junction Structure No. 1 per Detail '.'A" for the unit price of One thousand four hundred eighty Dollars and No Cents $ 1,480.00 $ 1,480.00 Each 4. 2 Each Construct Manhole No. 2 per CNB Std. 307 -L for the unit price of: One thousand five hundred Dollars and No Cents $ 1,500.00 $ 3,000.00 Each 0 • PR2of2 I I tM LIUA14111Y 11tm UtbUK1Y11UN UNIT IUTAL NO. AND UNIT UNIT PRICE WRITTEN IN WORDS PRICE PRICE 5. 1 Each Construct Junction Structure No. 2 per CNB Std. 311 -L for the unit price of: Seven hundred Dollars and No Cents $ 700.00 $ 700.00 Each 6. 2 Each Construct Concrete Pipe Collar per CNB Std. 313 -L for the unit price of: Three hundred Dollars and No Cents $ 300.00 $ 600.00 Each 7. 1 Each Construct Concrete Pipe Slope Anchor per CNB Std. 314 -L for'the unit price of: Five hundred fifty " Dollars and No Cents $ 550.00 $ 550.00 Each TOTAL PRICE WRITTEN IN WORDS Twenty -four thousand four hundred ninety Dollars and No Cents TOTAL $ 24,490.00 CONTRACTOR'S LICENSE NO. 373104 DATE 10 -19 -79 TELEPHONE NO. (714) 730 -0373 HONDO COMPANY INC. (Bidder's Name Authorized Signature CONTRACTOR'S ADDRESS 18392 E. 17th St., Santa Ana, California 92705 II. III • • SP 1 of 2 CITY OF NEWPORT BEACH PUBLIC WORKS DEPARTMENT SPECIAL PROVISIONS FOR CONSTRUCTION OF ENSIGN VIEW PARK STORM DRAIN CONTRACT NO. 2123 SCOPE OF WORK The work to be done under this contract consists of furnishing all labor, transportation, and equipment required to construct a storm Ensign View Park and connecting to an existing storm drain running Drive to Newport Bay. materials, drain serving from Cliff Items of work consist of clearing and grubbing; constructing a 15 -inch diameter asbestos cement pipe drain; two junction structures; two manholes; one pipe collar; one slope anchor; connecting to the existing drain; restoration of the site; and appurtenant work necessary for the construction of the storm drain. All work shall be done in compliance with these special provisions, the Plan (Drawing No. D- 5116 -S), the City's Standard Special Provisions and Standard Draw- ings, and the City's Standard Specifications (Standard Specifications for Public Works Construction, 1976 Edition with supplement 7. BONDS AND INSURANCE The bidder's bond, the performance bond, and the labor and materials bond will not be required. The contractor shall provide the insurance as required in Section 7 -4 of the Standard Specifications and Section 7 -3 of the City's Standard Special Provisions. A standard insurance form has been adopted by the City. The successful low bidder will be required to complete this form. TIME OF COMPLETION The contractor shall complete all work on the contract within forty five (45) calendar days after issuance of the purchase order by the Purchasing Agent and as specified in Section 6 of the Standard Specifications. The construction schedule submitted by the contractor shall be approved by the engineer prior to the start of any work. Liquidated damages of $100 per calendar days will be assessed as provided in Section 6 -9 of the standard specifications. IV. PAYMENT Theunit or lump sum price bid for each item of work shown on the proposal shall be considered as full compensation for all labor, equipment, materials, and all other things necessary to complete the work in.place, and no additional allowance will be made therefor: Payment for incidental items of work, not separately pro- vided for in the proposal, shall be included in the price bid for other related items of work. SP2of2 V. WATER The contractor shall make his own provisions for obtaining and applying water necessary to perform his work. If the contractor desires, he may use City water. VI. CONSTRUCTION DETAILS A. Clearing and Grubbing All material removed during clearing and grubbing that is not suitable for use on this project shall be disposed of away from the job site in a manner and at a location acceptable to the City. B. Pipe Construction 1. Exposure of the existing storm drain is required in order to verify alignment and elevation prior to laying of the new pipe. 2. Bedding and backfill shall be Class "C" with granular foundation per CNB Std- 316 -L. The City of Newport Beach has acquired a 25- foot -wide construction easement for this job immediately south of the storm drain easement. In addition, access to the site will be permitted over private property lying between the new storm drain and the Coast Highway. 10 SAMPLE CITY OF NEWPORT BEACH Contract No. Special Endorsement No. In consideration of the premium charged, this endorsement is attached to and made a part of all policies insuring the liability of any person, firm or corporation performing services under contract for the City of Newport Beach. Notwithstanding any inconsistent expression in the policy to which this endorsement is attached, or in any other endorsement now or hereafter attached thereto, or made a part thereof, the protection afforded by said policies shall: 1. Include the City of Newport Beach, its officers and employees as additional insureds in the policies described below for injuries, death or damage to property arising out of or in connection with the contract executed by the named insured and the City. It is further agreed that this policy shall be primary and non - contributing with any other insurance available to the City of Newport Beach, and includes a severability of interest clause. 2. Include contractual liability coverage applicable to the contract referred to above, including the obligation to defend the City. 3. Delete all exclusions relating to property damage arising out of explosion, collapse, or underground damage (commonly referred to as "xcu" hazards). 4. Indemnify and save harmless the City of Newport Beach against any and all claims, excluding sole negligence of the City, resulting from the undertaking of the contract. This hold harmless assumption on thepart of the underwriters shall include all costs of investigation and defense, until reasonable determination is made that the City is solely negligent. 5. Provides limits of liability and coverages as follows COVERAGES TO WHICH THIS EFFECTIVE ENDORSEMENT DATE OF POLICY POLICY LIMITS OF INSURANCE ATTACHES ENDORSEMENT NUMBER PERIOD LIABILITY COMPANY This endorsement is effective , 19 , when signed by an Authorized Representative of the companies affording coverages and when issued to City shall be valid and form a part of policies herein described. Should any of the above described policies be cancelled before the expiration date thereof, the issuing company shall mail 30 days' prior written notice by registered mail to: City of Newport Beach clo City Clerk 3300 Newport Boulevard Newport Beach, California 92663. NAME OF AGENT OR BROKER Address By Authorized Representative IMPORTANT: This is the only evidence of insurance acceptable to the City. The person executing this Endorsement is cautioned to make certain that he has authority to do same on behalf of the Insurance Company or Companies. C.I.E. - 3/79 .' • 0 HONDO COMPANY INC. CITY OF NEWPORT BEACH Contract No. 2123 & P.O. 14375 Special Endorsement No. In consideration of the premium charged, this endorsement is attached to and made a part of all policies insuring the liability of any person, firm or corporation performing services under contract for the City of Newport Beach. Notwithstanding any inconsistent expression in the policy to which this endorsement is attached, or in any other endorsement now or hereafter attached thereto, or made a part thereof, the protection afforded by said policies shall: 1. Include the City of Newport Beach, its officers and employees as additional insureds in the policies described below for injuries, death or damage to property arising out of or in connection with the contract executed by the named insured and the City. It is further agreed that this policy shall be primary and non - contributing with any other insurance available to the City of Newport Beach, and includes a severability of interest clause. 2. Include contractual liability coverage applicable to the contract referred to above, including the obligation to defend the City. 3. Delete all exclusions relating to property damage arising out of 6K, or underground damage (commonly referred to as "xcu" hazards). See note 4. Indemnify and save harmless the City of Newport Beach against any and all claims, excluding sole negligence of the City, resulting from the undertaking of the contract. This hold harmless assumption on the part of the underwriters shall include all costs of investigation and defense, until reasonable determination is made that the City is solely negligent. 5. Provides limits of liability and coverages as follows: COVERAGES TO WHICH THIS EFFECTIVE ENDORSEMENT DATE OF POLICY POLICY LIMITS OF INSURANCE ATTACHES ENDORSEMENT NUMBER PERIOD LIABILITY COMPANY 10/31/79 72CAB6315 5/10/79 $500,000 CSL Hartford 5/10/80 This endorsement is effective October 31, 19 79 , when signed by an Authorized Representative of the companies affording coverages and when issued to City shall be valid and form a part of policies herein described. Should any of the above described policies be cancelled before the expiration date thereof, the issuing company shall mail 30 days' prior written notice by registered mail to: City of Newport Beach c/o City Clerk 3300 Newport Boulevard Newport Beach, California 92663. NOTE: NAME OF AGENT OR BROKER Insured does note carry explosion or underground Reae�keof, Rapp & Schmidt Insurance Agency on this policy. Address 1275 _E. Lss Tunas Drive San Gabriel, CA 91778 By Authorized Re e (entative) G. W. Hosskopf, Vice President IMPORTANT: This is the only evidence of insurance acceptable to the City. The person executing this Endorsement is cautioned to make certain that he has authority to do same on behalf of the Insurance Company or Companies. C.I.E. - 3/79 NAME AND ADDRESS OF AGENCY ¢ J� COMPANIES AFFORDING COVERAGES sm ft "10 ca 91763 - COMPA LETTERNY At Yoiillwa ZWU "L M COMPANY LETTER B AGGREGATE NAME AND ADDRESS OF INSURED - COMPANY LETTER /� ■ _ V wilt +may, uk, 1=2 & Ifth $t* COMPANY LETTER W Unto An* 0% UM • COMPANY LETTER GENERAL LIABILITY any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies •ms, exclusions and conditions of such policies. herein is subject to all the Limits o Liability in Thousan E COMPANY LETTER TYPE OF INSURANCE POLICY NUMBER - POLICY EXPIRATION DATE EACH AGGREGATE OCCURRENCE GENERAL LIABILITY BODILY INJURY E E ' ® COMPREHENSIVE FORM ® PREMISES —OPERATIONS PROPERTY DAMAGE E E ❑ EXPLOSION AND COLLAPSE HAZARD ® UNDERGROUND HAZARD ® PRODUCTS /COMPLETED OPERATIONS HAZARD ® BODILY INJURY AND CONTRACTUAL INSURANCE PROPERTY DAMAGE E E 3= BROAD FORM PROPERTY COMBINED DAMAGE ® INDEPENDENT CONTRACTORS E ® PERSONAL INJURY PERSONAL INJURY AUTOMOBILE LIABILITY BODILY INJURY E r• (EACH PERSON) 3 ❑ CC,,,PREHENSIVE FORM BODILY INJURY E A, El (EACH ACCIDENT) PROPERTYDAMAG[ E ❑ HIRED .•_i BODILY INJURY AND E] NON -OWNED - PROPERTY DAMAGE E COMBINED EXCESS LIABILITY BODILY INJURY AND ❑ UMBRELLA FORM - PROPERTY DAMAGE E 5 ❑ OTHER THAN UMBRELLA COMBINED FORM WORXERS'COMPENSATION S rATUIORY - '.r•:= and EMPLOYERS' LIABILITY s rt.2M o-CCIW Nip i OTHER 0 HONDO COMPANY INC. E CITY OF NEWPORT BEACH Contract No. 2128 & P.O. 14375 Special Endorsement No. In consideration of the premium charged, this endorsement is attached to and made a part of all policies insuring the liability of any person, firm or corporation performing services under contract for the City of Newport Beach. Notwithstanding any inconsistent expression in the policy to which this endorsement is attached, or in any other endorsement now or hereafter attached thereto, or made a part thereof, the protection afforded by said policies shall: 1. Include the City of Newport Beach, its officers and employees as additional insureds in the policies described below for injuries, death or damage to property arising out of or in connection with the contract executed by the named insured and the City. It is further agreed that this policy shall be primary and non - contributing with any other insurance available to the City of Newport Beach, and includes a severability of interest clause. 2. Include contractual liability coverage applicable to the contract referred to above, including the obligation to defend the City. 3. Delete all exclusions relating to property damage arising out of 1pn ObOMVLV� or underground damage (commonly referred to as "xcu" hazards). 4. Indemnify and save harmless the City of Newport Beach against any and all claims, excluding sole negligence of the City, resulting from the undertaking of the contract. This hold harmless assumption on the part of the underwriters shall include all costs of investigation and defense, until reasonable determination is made that the City is solely negligent. 5. Provides limits of liability and coverages as follows: COVERAGES TO WHICH THIS EFFECTIVE ENDORSEMENT DATE OF POLICY POLICY LIMITS OF INSURANCE ATTACHES ENDORSEMENT NUMBER PERIOD LIABILITY COMPANY 10/31/79 72CAB6315 5/10/79 $500,000 CSL Hartford 5/10/80 This endorsement is effective October 31, 19 79, when signed by an Authorized Representative of the companies affording coverages and when issued to City shall be valid and form a part of policies herein described. Should any of the above described policies be cancelled before the expiration date thereof, the issuing company shall mail 30 days' prior written notice by registered mail to: NOTE: Insured does note carry explosion or underground on this policy. City of Newport Beach c/o City Clerk 3300 Newport Boulevard Newport Beach, California 92663. NAME OF AGENT OR BROKER .tosakopt, Rapp & Schmidt Insurance lgency Address 1275 E. Las Tunas San Gabriel, GA 93778 By f G. W.'Stb'sH OWVttRrAq"T'�Yle) IMPORTANT: This is the only evidence of insurance acceptable to the City. The person executing this Endorsement is cautioned to make certain that he has authority to do same on behalf of the Insurance Company or Companies. C.I.E. - 3/79 a NAME AND ADDRESS OF AGENCY :naw zwmu= A51111i COMPANIES AFFORDING COVERAGES • � W R*�,.. /X1111111111� aa•ft�� it . 4NfitiiW� 91M COMPANY LETTER A COMPANY A LETTER a NAME AND ADDRESS OF INSURED COMPANY C LETTER Ar�1 V two ISM12 fyh S/r I�f332 lE. 1� •F'�l COMPANY LETTER D 'p. C& 9270 • COMPANY E .� LETTER This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstandingg 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. Limits of Liability In Thousan ss (000) COMPANY LETTER TYPEOF INSURANCE POLICY NUMBER POLICY EXPIRATION DATE EACH AGGREGATE ' OCCURRENCE GENERAL LIABILITY BODILY INJURY b E i� &J COMPREHENSIVE FORM ♦KrfFlal{ii L�ST� �? ® PREMISES – OPERATIONS PROPERTY DAMAGE § § _ ❑ EXPLOSION AND COLLAPSE HAZARD UNDERGROUND HAZARD ® PRODUCTS /COMPLETED I7 OPERATIONS HAZARD ® BODILY INJURY AND �l CONTRACTUAL INSURANCE PROPERTY DAMAGE § l $20 Eli BROAD FORM PROPERTY COMBINED DAMAGE q 16J INDEPENDENT CONTRACTORS PERSONAL INJURY § ® PERSONAL INJURY j� AUTOMOBILE LIABILITY J BODILY IN TRY (EACH PCRSONI jf ❑ COMPREHENSIVE FORM BODILY INJURY § rc "` j ❑ OWNED (EACH ACCIDENT) PROPERTY DAMAGE § ❑ HIRED INJURY AND ElBODILY 4yj9 NON-OWNED PROPERTY DAMAGE § COMBINED EXCESS LIABILITY BODILY INJURY AND ❑ UMBRELLA FORM § § ❑ THAN UMBRELLA PROPERTY DAMAGE OTHER COMBINED FORM WORKERS'COM1SPENSATIOIV — SrATHTORY and . EMPLOYERS' LIABILITY IexH Acuorn* I i9 OTHER STATE COMPENSATION I N S U R A N C E FUND 0 P.O. BOX 807, SAN FRANCISCO, CALIFORNIA 94101 November 6, 1979 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE City of Newport Beach Public Works Department 3300 Newport Boulevard Newport Beach, California 92663 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. 494854 -79 6 -20- 7916 -20 -80 EMPLOYER PRESIDENT Hondo Company 10747 Crawford Canyon Road Santa Ana, California 92705 SCIF FORM 262A (REV. 8 -78) JOB: Ensign View Park Storm Drain (Contract No. 2123)