HomeMy WebLinkAboutC-4550 - Contract for 28th Street Street-end Catch Basin and Pavement RepairslQ CONTRACT WITH ASSOCIATED PACIFIC CONSTRUCTORS, INC.
l {� FOR 28T" STREET STREET -END CATCH BASIN AND PAVEMENT REPAIRS
THIS CONTRACT is made and entered into as of this gg d, ay of 2010, by and
between the CITY OF NEWPORT BEACH, a Municipal Corporation and C arter City ( "City"),
and Associated Pacific Constructors, Inc., a California corporation, ( "Contractor") whose
principal place of business is 495 Embarcadero, Morro Bay, CA, 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 is planning to repair the sunken catch basin and the damaged asphalt concrete
pavement at the 28"' Street street -end.
C. City desires to engage Contractor to repair the sunken catch basin and the damaged
asphalt concrete pavement at the 28'" Street street -end ( "Project"). Contractor has
agreed to perform the Project over ten (10) consecutive working days period,
commencing on June 14, 2010, or upon issuance of the notice to proceed.
D. Contractor has examined the location of all proposed work, carefully reviewed and
evaluated the specifications set forth by the 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 Agreement.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows:
SCOPE OF WORK
City and Contractor acknowledge that the above Recitals are true and correct and are
hereby incorporated by reference. As such, Contractor shall perform all the services
described in the Scope of Work attached hereto as Exhibit A and incorporated herein by
this reference. As a material inducement to the City entering into this Agreement,
Contractor represents and warrants that Contractor is a provider of first class work and
services and Contractor is experienced in performing the work and services
contemplated herein and, in light of such status and experience, Contractor covenants
that it shall follow the highest professional standards in performing the work and
services required hereunder and that all materials will be of good quality. For purposes
of this Agreement, 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.
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 necessary for the Project.
2. TIME OF PERFORMANCE
Time is of the essence in the performance of services under this Agreement and
Contractor shall complete the Work within the time set forth in this Section. The failure
3.
H
5.
by Contractor to complete all work within10 consecutive working days from the date of
the "notice to proceed," may result in termination of this Agreement by City and
assessment of damages as outlined in Section 2.1. The term of this contract shall
extend to July 30, 2010 unless terminated earlier as provided for herein.
2.1 The parties agree that it is extremely difficult and impractical to determine and fix
the actual damages that City will sustain should the Contractor fail to complete
the Project within the time allowed. Should Contractor fail to complete the work
called for in this Agreement on the date outlined above, Contractor agrees to the
deduction of liquidated damages in the sum of Two Hundred Fifty Dollars
($250.00) for each calendar day beyond the date scheduled for completion
provided in Section 2 of this Agreement assuming that the Contractor has
access to the space on June 14, 2010, 200 as described herein.
COMPENSATION
As full compensation for the performance and completion of the Project as required by
the Scope of Work, City shall pay to Contractor and Contractor accepts as full payment
the sum of Nineteen Thousand, Four Hundred Thirty-Seven and 96/100 Dollars
($19,437.96). Contractor shall not receive any additional compensation unless
approved in advance by the City in writing. The City shall make progress payments as
the Project work proceeds based on the percentage of Project work completed. The
cost of materials and equipment delivered and suitably stored off -site for subsequent
incorporation in the Project work shall be included in progress payments. City shall pay
Contractor no later than thirty (30) days after approval of the final invoice by City staff.
ADMINISTRATION
This Agreement will be administered by the Public Works Department. Fong Tse shall
be the Project Administrator and shall have the authority to act for City under this
Agreement. The Project Administrator or his /her authorized representative shall
represent City in all matters pertaining to the services to be rendered pursuant to this
Agreement.
TYPE AND INSTALLATION OF MATERIALS /STANDARD OF CARE
5.1 Contractor shall use only the standard materials described in Exhibit A in
performing services under this Agreement. Any deviation from the materials
described in Exhibit A shall not be installed unless approved in advance by the
City Administrator.
5.2 All of the services 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 Agreement, and that it will perform all
services in a manner commensurate with community professional standards. All
services shall be performed by qualified and experienced personnel who are not
employed by City, nor have any contractual relationship with City.
6. RESPONSIBILITY FOR DAMAGES OR INJURY
6.1 City and all officers, employees and representatives thereof 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 services required
hereunder; or for damage to property from any cause arising from the
performance of the Project by Contractor, or its subconcontractors, or its
workers, or anyone employed by either of them.
6.2 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.
6.3 Contractor shall indemnify, hold harmless, and defend City, its officers and
employees 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 damage, 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 Agreement; (2) use of
improper materials in performing this Project including, without limitation, defects
in workmanship or materials and/or design defects; and/or (3) any and all claims
asserted by Contractor's subconcontractors or suppliers on the Project, and shall
include reasonable attorneys' fees and all other costs incurred in defending any
such claim. However, nothing herein shall require Contractor to indemnify City
from the sole negligence or willful misconduct of City, ifs officers or employees.
6.4 Contractor shall perform all Project 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.
6.5 To the extent authorized by law, as much of the money due Contractor under and
by virtue of the Agreement 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.
6.6 Nothing in this section shall be construed as authorizing any award of attorney's
fees in any action to enforce the terms of this Agreement, except to the extent
provided in Section 6.3 above.
6.7 The rights and obligations set forth in this Section shall survive the termination of
this Contract.
7. INDEPENDENT CONTRACTOR
City has retained Contractor as an independent contractor and neither Contractor nor its
employees are to be considered employees of the 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 Agreement. No civil
service status or other right of employment shall accrue to Contractor or its employees.
8. 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 the Contractor on the Project.
9. 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 Agreement, a policy or policies of liability insurance of the type and amounts
described below and in a form satisfactory to City.
A. Certificates of Insurance. Contractor shall provide certificates of insurance with
original endorsements to City as evidence of the insurance coverage required
herein. Insurance certificates must be approved by City's Risk Manager prior to
commencement of performance or issuance of any permit or performance of any
work. Current certification of insurance shall be kept on file with City at all times
during the term of this Agreement.
B. Signature. A person authorized by the insurer to bind coverage on its behalf
shall sign certification of all required policies.
C. 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 the City's Risk Manager.
D. Coveraoe Requirements.
Workers' Compensation Coveraoe. Contractor shall maintain Workers'
Compensation Insurance and Employer's Liability Insurance for his or her
employees in accordance with the laws of the State of California. In
addition, Contractor shall require each subcontractor to similarly maintain
Workers' Compensation Insurance and Employer's Liability Insurance in
accordance with the laws of the State of California for all of the
subcontractor's employees. Any notice of cancellation or non - renewal of
all Workers' Compensation policies must be received by City at least
thirty (30) calendar days (10 calendar days written notice of non - payment
of premium) prior to such change. The insurer shall agree to waive all
rights of subrogation against City, its officers, agents, employees and
volunteers for losses arising from work performed by Contractor for City.
ii. General Liability Coverage. Contractor shall maintain commercial
general liability insurance in an amount not less than one million dollars
($1,000,000) per occurrence for bodily injury, personal injury, and
property damage, including without limitation, contractual liability. If
commercial general liability insurance or other form with a general
aggregate limit is used, either the general aggregate limit shall apply
separately to the work to be performed under this Agreement, or the
general aggregate limit shall be at least twice the required occurrence
limit.
4
iii. Automobile Liability Coverage. Contractor shall maintain automobile
insurance covering bodily injury and property damage for all activities of
the Contractor arising out of or in connection with work to be performed
under this Agreement, 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 occurrence.
E. Endorsements. Each general liability and automobile liability insurance policy
shall be endorsed with the following specific language:
The City, its elected or appointed officers, officials, employees, agents
and volunteers are to be covered as additional insureds with respect to
liability arising out of work performed by or on behalf of the Contractor.
ii. This policy shall be considered primary insurance as respects to City, its
elected or appointed officers, officials, employees, agents and volunteers
as respects to all claims, losses, or liability arising directly or indirectly
from the Contractor's operations or services provided to City. Any
insurance maintained by City, including any self- insured retention City
may have, shall be considered excess insurance only and not
contributory with the insurance provided hereunder.
iii. This insurance shall act for each insured and additional insured as
though a separate policy had been written for each, except with respect
to the limits of liability of the insuring company.
iv. The insurer waives all rights of subrogation against City, its elected or
appointed officers, officials, employees, agents and volunteers.
V. Any failure to comply with reporting provisions of the policies shall not
affect coverage provided to City, its elected or appointed officers,
officials, employees, agents or volunteers.
vi. The insurance provided by this policy shall not be suspended, voided,
canceled, or reduced in coverage or in limits, by either parry except after
thirty (30) calendar days (10 calendar days written notice of non- payment
of premium) written notice has been received by City.
F. Timely Notice of Claims. Contractor shall give City prompt and timely notice of
claim made or suit instituted arising out of or resulting from Contractor's
performance under this Contract.
G. Additional Insurance. Contractor shall also procure and maintain, at its own cost
and expense, any additional kinds of insurance, which in its own judgment may
be necessary for its proper protection and prosecution of the work.
10. BONDING
Contractor shall obtain, provide and maintain at its own expense during the term of this
Contract: 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 Agreement and in
the form attached hereto as Exhibit B which is incorporated herein by this reference; and
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 Agreement in the form attached hereto
as Exhibits C which is incorporated herein by this reference.
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, (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.
The Contractor shall deliver, concurrently with execution of this Agreement, the Labor and
Materials Payment Bond and Faithful Performance Bond, 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 Sate of
California.
11. 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 at 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.
12. SUBCONTRACTING
City and Contractor agree that subcontractors may be used to complete the work
outlined in the Scope of Services provided the Contractor obtains City approval prior to
the subcontractor performing any work. Contractor shall be fully responsible to City for
all acts and omissions of the 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.
13. 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 to appeal to the City Manager or his/her 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.
14. CONFLICTS OF INTEREST
The 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.
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.
15. NOTICES
All notices, demands, requests or approvals to be given under the terms of this
Agreement 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. All notices, demands, requests or approvals from Contractor to
City shall be addressed to City at:
Attn: Fong Tse
Public Works Department
City of Newport Beach
3300 Newport Boulevard
Newport Beach, CA, 92660
Phone: 949 - 644 -3321
Fax: 949 - 6443308
All notices, demands, requests or approvals from City to Contractor shall be addressed
to Contractor at:
Attention: Cam Boyd
Associated Pacific Constructors, Inc.
495 Embarcadero
Morro Bay, CA 93442
Phone: 805 - 772 -7472
Fax: 805 - 772 -5803
16. TERMINATION
In the event that either party fails or refuses to perform any of the provisions of this
Agreement at the time and in the manner required, that party shall be deemed in default
in the performance of this Agreement. 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 Agreement forthwith by giving to the defaulting party written
notice thereof.
Notwithstanding the above provisions, City shall have the right, at its sole discretion and
without cause, of terminating this Agreement 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 Agreement.
17. 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.
18. WAIVER
A waiver by City of any term, covenant, or condition in the Agreement shall not be
deemed to be a waiver of any subsequent breach of the same or any other term,
covenant or condition.
19. INTEGRATED AGREEMENT
This Agreement 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.
20. CONFLICTS OR INCONSISTENCIES
In the event there are any conflicts or inconsistencies between this Agreement and the
Scope of Services, the terms of this Agreement shall govern.
21. AMENDMENTS
This Agreement 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.
22. EFFECT OF CONTRACTOR'S EXECUTION
Execution of this Agreement 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 performed, and has taken into consideration these factors in submitting its
Project Proposal and Scope of Work.
23. CONTROLLING LAW AND VENUE
The laws of the State of California shall govern this Agreement and all matters relating
to it and any action brought relating to this Agreement shall be adjudicated in a court of
competent jurisdiction in the County of Orange.
24. INTERPRETATION
The terms of this Agreement 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 Agreement or any other rule of construction which might otherwise
apply.
25. WARRANTY
Contractor agrees that the improvements installed pursuant to this Agreement shall be
covered by a 1 -year warranty as described in the Standard Specifications for Public
Works Construction, 2006 Edition and is incorporated in full by this reference.
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the day
and year first written above.
APPROVED AS TO FORM:
nett agcha p,
Assistant City A or ey Gllv�� j
for the City of Newport Beach
CITY OF NEWPORT BEACH,
A Municipal Corporati
aum,
ctor ublic Works
the 1tyofNewport Beach
ASSOCIATE9PACIFIC CONSTRUCTORS, INC.
By:
(Corporate Off
ic )
Title: '��I t(�fr--
Print Name:C�U
By:
(Financial Officer
Title: �7 lj le
Print Name: 6�,v'"L
Please note: Corporations must complete and sign both places above
even if each office is held by the same individual
Attachments: Exhibit A - Scope of Services
Exhibit B - Labor and Materials Payment Bond
Exhibit C - Faithful Performance Bond
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UP
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
INFORMAL BID
28eh STREET STREET -END STORM DRAIN REPAIRS
To the Public Works Director
City of Newport Beach
3300 Newport Boulevard
Newport Beach, California 92663
Gentlemen:
The undersigned declares that he has carefully examined the location of the work, has
read, and will comply with the instructions and requirements listed on the Informal Bid
Invitation Letter, has examined the Drawing Details and Payment Descriptions, and hereby
proposes to furnish all materials except that material supplied by the City and shall perform
all work required to complete this Contract in accordance with the attached requirements,
and will take in full payment the following unit prices for the worts, complete in place, to wit:
ITEM QUANTITY ITEM DESCRIPTION AND UNIT UNIT TOTAL
2.
3.
4.
Lump Sum Mobilization
kr
�ollarS
and
S;rjQe. Cents $ 779.149
Per Lump Sum
Lump Sum Traffic Control
@> :x u icP )A-43 600oilars
and
Cents $ (o38.IS
Per Lump Sum
Lump Sum Best Management Practices
@ 5c m t, Dollars
and
EsIA4= e Cents $ 713.31
Per Lump Sum
Lump Sum Removals and Site Preparation
@f>✓tt6A&j. &0"'.A4 VolV&t.
and
s ,ki-y ane Cents $ 19,32.5-0
Per Lump Sum
PR2of2
ITEM QUANTITY ITEM DESCRIPTION AND UNIT UNIT TOTAL
AND UNIT PRICE WRITTEN IN WORDS PRICE PRICE
B. 3 C Y. Place Clean Sand Compacted In Place
Dollars
and
Cents $ 30y.15 $ 91z.4s"
Per Cubic Yard
6. Lump Sum Construct New Catch Basin and
Local Depression
SCJ �
�.. 4 "J, C, a..,,, i Chars
and
eta Y n :rt Cents $ 9,'{s7. Rh
Per Lump Sum
7. 20 L.F. Construct Type -A PCC Curb and Gutter
eQ O 4 h.,,drA L-1-1 +i.r« Dollars
and
OAR- Cents $ 14 .01 $ Z'94n - ,20
Per Linear Foot
S. 130 S.F. Construct 6" Thick AC Pavement
aQ �we��Y ��� Dollars
and
Sever Cents $ 2H.0'7 $ 31124.10
Per Square Foot
9. Lump Sum Install White Striping to Join Adjacent
@s.-r (tA tw«dj a ,% ,Dollars
and
Cents $ EU,o9
Per Lump Sum
TOTAL PRICE IN WRITTEN WORDS
V r
Pti•.9o1r.- 772 - 74'72_ P-x: Sos 711, -TBo3
Bidder's Telephone and Fax Numbers
-S`14 4906(e -4
Bidders License No(s).
and %Cents $ 1114 .9 le
Total Price (Figures)
As5er:1%+eok QRtr:t �s.5iry,i9rS�Tw�.
Bidder
Pre1'ri,.1- QNa�fr
Bidders Authorized Signatu and Tide
495 E- ,bar-LJVor Norm &I Q 934�7Z
Bidder's Address
BID ITEM MEASUREMENT AND PAYMENT
Item No. 1 Mobilization: Work under this item shall include providing bonds, insurance
and financing, establishing a field office, preparing the BMP Plan and construction schedule,
attend preconstruction meeting, and all other. related work as required by the Contract
Documents.
Item No. 2 Traffic Control: Work under this item shall include delivering all required
notifications, post signs and all costs incurred notifying residents. In addition, this item
includes preparing traffic control plans, providing the traffic control required by the project
including, but not limited to signs, cones, barricades, etc. This item includes furnishing all
labor, tools, equipment and materials necessary to comply with the W.A.T.C.H. Manual, latest
edition, and City of Newport Beach Requirements.
Item No. 3 Best Manaaement Practices: Provisions should be set in place for collecting
and disposing of fallen construction debris and to protect public and private properties to
include, but not limited to, private and public docks, underground and aboveground utilities,
boats, landscaping and the waterway.
Item No. 4 Removals and Site Preparation: Work under this item shall include the cost
of all labor, equipment, and materials needed to sawcut, remove, and dispose of all interfering,
unwanted, or undesirable materials such as the existing sunken catch basin; local depression;
broken curb and gutter; asphalt concrete pavement; debris, etc. The payment for work to
prepare the site such as cleaning, subgrade compacting, tack coating, and other preparatory
work to receive the new improvements shall be made a part of this bid item and no additional
compensation shall be made.
Item No. 5 Place Clean Sand Compacted In Place: Work under this item shall include
the cost of all labor, material, and equipment to furnish, place, grade, and compact the
required amount of clean sand in place to receive the new catch basin.
item No. a construct New catch Basin and Local Depression: Work under this item
shall include the cost of all labor, equipment, and materials to construct the new catch basin
and local depression complete in place as shown in the drawing details. Grouting of the catch
basin outlet joint and the installing of epoxy coated dowels shall be paid as a part of this bid
item and no additional compensation shall be made.
Item No. 7 construct Type -A PCC Curb and Gutter: Work under this item shall include
the cost of all labor, equipment, and materials to construct the new PCC curb with 24" wide
gutter completed in place per City Standards,
Item No. 8 Construct 6" Thick AC Pavement: Work under this item shall include the
cost of all labor, equipment, and materials to construct the new AC pavement in two (2) equal
lifts. The cost of grading and tack coating shall be paid as a part of this bid item and no
additional compensation shall be made.
Item No. 9 Install White Striping to Join Adjacent: Work under this item shall include
the cost of all labor, equipment, and materials to install two (2) coats of white striping two
weeks after the AC pavement placement.
CONSTRUCTION MATERIALS
PORTLAND CEMENT CONCRETE shall be Class 560 -C -3250.
REINFORCING STEEL shall be Grade 60 steel conforming to ASTM A615 with 2 -inch
minimum cover unless otherwise indicated
DOWELS shall be No.4 epoxy coated Grade 60 reinforcing bars
QUICK SETTING GROUT to be installed at the catch basin outlet joint shall be of the quick
setting type.
ASPHALT CONCRETE PAVEMENT shall be Type III -C -3 PG 64 -10 (III- C3 -AR- 4000).
TACK COAT shall be Type SS1 H asphaltic emulsion placed at a rate not to exceed one —tenth
(1/10) of a gallon per square yard and shall be uniformly applied to existing A.C. and P.C.C.
surfaces and edges against which asphalt concrete is to be placed.
EXISTING SEAWALLS / PARKING AREA
16 f / JOIN EXISTING PAVEMI
%/ JOIN EXISTING PAVEMENT
AND C&G
2 5 4 3 in
EXISTING
(AND GUTTER CURB
I I I I I I I I I I I
T
1 1 1 1 1 1
EXISTING PRIVATE WALL
TO REMAIN
i-
�I I I I
EXISTING SUNKEN SIDEWALK
AND PAVERS TO REMAIN
1O REMOVE EXISTING CATCH BASIN AND BACKFILL VOID WITH 95% COMPACTED CLEAN SAND.
2O INSTALL NEW CATCH BASIN AND LOCAL DEPRESSION. (SEE ATTACHED DETAIL)
3O RECONSTRUCT 13" CF TYPE A CURB AND GUTTER.
® RECONSTRUCT EXISTING CURB AND GUTTER.
5O RECONSTRUCT EXISTING PAVEMENT WITH 6" THK. FULL DEPTH A.C. SECTION MIN. 5' WIDTH
AND VARIABLE LENGTH FROM 16' TO 20', OVER RECOMPACTED SUBGRADE TO 95% COMPACTION.
6O RESTRIPE WHITE HATCHING AS NEEDED.
28TH STREET STORM DRAIN REPAIR PLAN
NOT TO SCALE
1
a g
?2' DOWELL NEW CATCH BASIN .
INTO EXISTING BULKHEAD
WITH 4 - ##4 18" LONG EPDXY
COATED REBARS•AT EVEN
.90 SPACING
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Exhibit B
CITY OF NEWPORT BEACH
BOND NO. 58673710
LABOR AND MATERIALS PAYMENT BOND
WHEREAS, the City of Newport Beach, State of California, has awarded to Associated
Pacific Constructors, Inc. hereinafter designated as the "Principal," a contract for the 28`h Street
Street -End Catch Basin and Pavement Repairs, located at 495 Embarcadero in the City of
Morro Bay, 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,
WESTERN SURETY COMPANY duly authorized to transact
business under the laws of the State of California, as Surety, (referred to herein as "Surety') are
held firmly bound unto the City of Newport Beach, in the sum of Nineteen Thousand, Four
Hundred Thirty-Seven and 961100 Dollars ($19,437.96) 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 obligations of this Bond, a reasonable attorneys fee, to be fixed by the Court as required by
the provisions of Section 3250 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 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 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.
10
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 7th day of MAY 2010. 10
1
Associated Pacific Constructors, Inc. Authorized Signature itie
(Principal)
P"A- 6 Ge
WESTERN SURETY COMPANY
Name of Surety Authorized Agent Si nature
6300 CANOGA AVE., STE. 1150W
3Q999Td�IB-- IsI -LISm -4"A 8d.3.6''
Address of Surety
918 713 -2031
Telephone
SHIRLEY LITTELL- ATTORNEY IN FACT
Print Name and Title
NOTARY ACKNOWLEDGMENTS OF BOTH CONTRACTOR AND SURETY MUST BE
ATTACHED
11
ACKNOWLEDGMENT
................................................ ...............................
State of California
County of
as.
SEE NOTARY ACKNOWLEDGMENT ATTACHED
On before me, Notary
Public, personally appeared
,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 helshelthey executed the
same in his /her /their authorized capacity(ies), and that by his /her /their signatures(s) on the
instrument the person(s), 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 official seal.
Signature
(seal)
ones ... .............anne u.. ..........................•..... u................
OPTIONAL INFORMATION
Date of Document
Type or Title of Document
Number of Pages in Document
Document in a Foreign Language
Type of Satisfactory Evidence:
_ Personally Known with Paper Identification
Paper Identification
,V Creddble Witness(es)
Capacity of Signer:
Trustee
Power of Attorney
—CEO /CFO /COO
_ President / Vice - President / Secretary / Treasurer
Other:
Other Information:
Thumbprint of Signer
❑ Check here If
no thumbprint
or fingerprint
Is available.
CALIFORNIA ALL - PURPOSE ACKNOWLIDOMENT
State of California
County of
Ventura
On May 7, 2010 before me, Judith A. Benites, Notary Public
Date Here Insert Name and Title of the Oeber
personally appeared Shirley Littell
Name(s) of Signer(s)
gAliH A. KNITES
Commisalon / 1071051
Notary Pe08c - caafamia
Nmtura cou"
Canrm
No 20.2013+
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.
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.
Signa ure:
Place Nmary Seal mWar Stamp Above OPTIONAL Signature aic
Though the information below is not required by law, it may prove uable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Deecripiton of Attact" Document
Title or Type of Document: Labor and Materials Payment Bond
Document Date: May 7. 2010 Number of Pages: 2
Signer(s) Other Than Named Above: _
Capacity(les) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer —
❑ Individual
• Partner — ❑ Limited ❑ General Top of thumb here
KX Attorney in Fact
• Trustee
• Guardian or Conservator
• Other.
Signer Is Representing:
Western Surety Compa y
Signer's Name:
• Corporate Officer — Tifle(s):
• Individual
• Partner — ❑ Limited ❑ General Top of thumb here
• Attorney in Fact
• Trustee
• Guardian or Conservator
❑ Other:
Signer Is Representing:
Nmm AAmdalien -YiM Dn SM Avn.. P n My 94rP•f.Mla ft CA 9191.'1.' P,w NM nal!JnMmam
u
Hem M6g67 Reorder. Car Tdl -Free 141OM76 -6W
ACKNOWLEDGMENT
• asalaqr.YYY.Yamrr •.YrarYrafaafaaaaaaaaralarraara Ya Ya.M aYr YYY q Pqa aq ... oarrr axl
State of Cafllprnia
County of y1 /!inS Obi p� )88.
On May/&, '--ZL0Zb before me, �U <� eIZG"�?, Notary
Public, perso alh ly appeared u 1 F � P.✓
- -,who
proved to me on the basis of satisfactory evidence to be the person(* whose nameH islara
subscribed to the within instrument and acknowledged to me that hetmieAhey executed the
same in hislfwltheir authorized capacity(+es), and that by hisAefRikeir signaturesm on the
Instrument the person*, or the entity upon behalf of which the persona} 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 oNicial seal. RwH1A UIDW O
_ C.ormnbgon # 1671299
/7 Sett Lint CbYpo CQU*
- COmnBq�bttAolr29,2010
Signature CX //
( ^eali
p Bala aaaasaanla a�yla as tl Y'a YMaa arH gYaYllr #ao elp aaas ra Barge gtaYagtraq YY YgYf aqq qYl
Date of Document
Type or Title of Document
Number of Pages in Document
Document in a Foreign Language
OPTIONAL INFORMATION
%yilGc 1 7A1 0 Thumbprint of Signer
L® home X41 Z1Y L �1
Type of Satisfactory Evidence:
_ Personally Known with Paper Identification
_ Paper Identification
Credible Witness(es)
02
Capacity of Signer:
Trustee
_ Power of Attorney
CEO /COO
T resider / Vice- President /Secretary /Treasurer
Other Information:
Check here If
no thumbprint
or fingerprint
is available,
Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Shirley Littell, Individually
of Oxnard, CA, its We and lawful Attomey(s) -in -Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds,
undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized outer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, me hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be hereto affixed on this 23rd day of March, 2010.
W°E�e WESTERN SURETY COMPANY
t°�o p °RVI�
s
�a, 6[AxlsjP
$rrOM
Paul rBrufka, Senior Vice President
State of South Dakota )
ss
County of Minnehaha 1l
On this 23rd day of March, 2010, before me personally came Paul T. BmFlat, to me known, who, being by me duly swom, did depose and say: that he
resides in the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and which
executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so
affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his time thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires \ \ \4M4M44 \44444 \ \44 \ \\ F
+' D. KRELL `+
November30,2012 1 NOTARY PUBLIC /�f
r SOUTH DAKOTA
♦\ \\\4444444444444 \4 \44\�
D. Krell, Noruy Public
CERTIFICATE
1, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my time and affixed the seal of the said corporation this 7th day of May 2010 .
0:V'WV_2"3___ WESTERN SURETY COMPANY
cy;
L. Nelson, Assistant Secretary
Farm F4280 -09 -06
Authorizing By -Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders
of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
Exhibit C
CITY OF NEWPORT BEACH
BOND NO. 58673710
FAITHFUL PERFORMMCE-BOND
The premium charges on this Bond is $ 280.00
being at the rate of $ 14.40
thousand of the Contract price.
WHEREAS, the City of Newport Beach, State of California, has awarded to Associated
Pacific Constructors, Inc hereinafter designated as the "Principal," a contract for the 28"' Street
Street -End Catch Basin and Pavement Repairs, located at 495 Embarcadero in the City of
Morro Bay, 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 [he Contract.
NOW, THEREFORE, we, the Principal, and WESERN SURETY 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 Nineteen Thousand, Four Hundred Thirty -Seven and 961100 Dollars
($19,437.96) 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 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.
12
In the event that the Principal executed this bond as an individual, it is agreed that the
death of any such Principal shail 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 7TH day of MAY , 2010
Associated Pacific Constructors, Inc. ;Auoriz eed .atyUr[�efritl
(Principal)✓G •Ge///P�
WESTERN �� A✓�(�e�r�.�fJ-
SURETY COMPANY
Name of Surety Authorized Agent Si nature
6300 CA3706A AVE., STE. 1150w
- SHIRLEY LITTELL- ATTORNEY IN PACT
-WO-1 era s6,-9A 911267 -- Address of Surety
818 713 -2031
Telephone
Print Name and Title
NOTARY ACKNOWLEDGMENTS OF BOTH CONTRACTOR AND SURETY MUST BE
ATTACHED
13
ACKNOWLEDGMENT
...................... a.................,....... ..............................r
State of California
County of )Ss.
On before me,
Public, personally appeared
SEE NOTARY ACKNOWLEDGMENT ATTACHED
Notary
---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 signatures(s) on the
instrument the person(s), 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 official seal.
Signature
rseali
................. .............................a. ..044.......................\.1
OPTIONAL INFORMATION
Date of Document
Type or Title of Document
Number of Pages in Document
Document in a Foreign Language
Type of Satisfactory Evidence:
Personally Known with Paper Identification
Paper Identification
_Credible Witness(es)
Capacity of Signer:
Trustee
Power of Attorney
�CEOICFO /COO
_ President I Vice - President I Secretary I Treasurer
Other:
Other Information:
Thumbprint of Signer
0 Check here if
no thumbprint
or fingerprint
Is available.
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California
County of
Ventura
On May 7. 2010 before me, Judith A. Bonitos_ Notary Public
Date Here Insert Name g Ti a Vie L_a
personally appeared Shirley L i t t e l l
Name(s) of Signer(s)
LeJUD1TN III, IBIITES
Conwabtloa r 18716S/
won Celli
Carom Now 20 2013+
who proved to me on the basis of satisfactory
evidence to be the person(s) whose name(s) istare
subscribed to the within instrument and acknowledged
to me that he/she/they executed the same in
his/herRheir 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.
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.
Sig ature:
Placa Nolary Soar andoor Stamp Above Signet r ublio
OPTIONA —
' Though the information below is not required by law, it may prove ve uable to persons relying on the document
and could prevent fraudulent removal and reattachmem of this form to another document.
Description of Me~ Dasument
Title or Type of Document: Faithful Performance Bond
Document Date: May 7. 2010 Number of Pages: 2
Signer(s) Other Than Named Above: _
Capacity(ies) Claimed by Signer(s)
Signers Name:
❑ Corporate Officer — Title(s):
❑ Individual
❑ Partner — ❑Limited ❑General
JOK Attorney in Fact
• Trustee
• Guardian or Conservator
❑ Other.
Signer Is Representing:
Western Surety
Signers Name:
❑ Corporate Officer — Title(s):
❑ Individual
• Partner — ❑ Limited ❑ General Top of thumb here
• Attorney in Fact
• Trustee
• Guardian or Conservator
• Other:
Signer Is Representing:
02008 National Notary AvAditton, 9350 De Soto Ave., P.O. Box 2402•Choonnonh, CA 913138402 -v .NalimalNolary.oig Item N59D7
ACKNOWLEDGMENT
/.. s. VN ................... 4..fa f..... ............ a.'..Yllhalfa.aawl{tl b.aY 00.0.0....1
State of California
County of �4/� za'k 4� /SAS) ss.
On M� /y before me, D " , I / u/I Notary
Public, perso alally appeared �sLUI ! &1
,who
proved to me on the basis of satisfactory evidence to be the person(&) whose name(e) is/we-
subscribed to the within instrument and acknowledged to me that. he /sloe /they- executed the
same in his /her /their authorized capacity(ies), and that by his /k6r /their signatures(e) on the
instrument the person(e), 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 seat. ROBIN J. LUDWIG
commYebn # 1671299
Notary Public • calftmia
San Lub ObI County
!�'G%�R!1M t./ /L.c� lrl5b MVConwn.6rgnaMaY29,ZO10y
Signature /
f -sap
a " "..0.. Pa. &.aaa a ..0afa.allo.YNo# *1.BnoR#..aa.M1.M a- 0-99. .a. 0.Y bb.ab0.,1b1
Date of Document
Type or Title of Document
Number of Pages in Document
Document in a Foreign Language
OPTIONAL INFORMATION
,4 - 7_7 /)/ d
1�emee,QI,
Type of Satisfactory Evidence:
Personally Known with Paper Identification
^ Paper Identification
Credible Witness(es)
CZ
Capacity of Signer.
Trustee
Power of Attorney
—CE O /C 00
esWe ! Vice- President /Secretary/ Treasurer
r:
Other Information:
❑ Check here if
no thumbprint
or fingerprint
is available.
Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Shirley Littell, Individually
of Oxnard, CA, its true and lawful Attomey(s) -in -Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds,
undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attomey, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be hereto affixed on this 23rd day of March, 2010.
ryc WESTERN SURETY COMPANY
3� \sgpv�.x
Paul 7.Bmflat, Senior Vice President
State of South Dakota
ss
County of Minnehaha
On this 23rd day of March, 2010, before me personally came Paul T. Bruftat, tome known, who, being by me duly swom, did depose and say: that he
resides in the City of Sioux Falls. State of South Dakov4; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and which
executed the above instrument that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that a was so
affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation
My commission expires •• +••` +++ + +++ ++++ + + + + +•+ +i
D. KRELL
November 30, 2012 NOTgpY PUBLIC
(R., DAKOTAS
♦ \ \4 +4444444\4\444444444
D. Krell, No ary Public
CERTIFICATE
1, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attomey hereinabove set forth is still in
force, and further cerlify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my name and affixed the seal of the said corporation this 7th day of May 2010.
v'"`n� WESTERN SURETY COMPANY
4�pa�i , w
4��r�8`px. �f�� f�
P
�� rte. Nelson, Assistant Sccinnary
Form 174280.0946
Authorizing By -Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By -law duly adopted by the shareholders
of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seat is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
Client#: 218769
PACONSTR2
ACORD,.. CERTIFICATE OF LIABILITY
INSURANCE
TYPE OFINSURANCE
51;3120 a"Y""
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Darren D. Caesar (805) 682.2571
HUB In i'I Insurance Serv. Inc.
40 East I Alamar Avenue
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE:
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. '
GENERAL LIABILITY
X COMMERCIALGENERALLIABILITY
CLAIMS MADE OCCUR
X BI/PDDed:5,000
Santa Barbara, CA 93105
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Northern Assurance Co of Americ
36369
Associated Pack Constructors, Inc.
Pacific Constructors, Inc.
INSURER a: National Union Fire Ins Co Pitt
19445
INSURER C: Netherlands Insurance Company
24171.
495 Embarcadero
Morro Bay, CA 93442
It4suRER D:
GENERALAGGREGATE "
NSURER E
GENL AGGREGATE UMITAPPLIES PER:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW RAVE 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. -
L'M
SR
TYPE OFINSURANCE
POLICY NUMBER
POUCYEFFECTNE
DATE MWDI3
POUCYEXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIALGENERALLIABILITY
CLAIMS MADE OCCUR
X BI/PDDed:5,000
NSJH70596
P &Iw /Crewlncl
Pollution Dab
10118/2009
10/1812010
EACH OCCURRENCE
51000000
OAMAGETORENTED
PREMISES (F.
5100000
MED EXP (Any ma person)
$5,000
PERSONAL 6 ADV INJURY
S1000;D60
X
See Remarks Section
GENERALAGGREGATE "
-5 M1)00.000
GENL AGGREGATE UMITAPPLIES PER:
PftOOUCT3- COMPfQ�A
ODO
C
°'
AUTOIIACBILF
IJAWML
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NO"WNED AUTOS
BAS331570
. ..
1011812009
1011812010
COMBINED SINGLE UMTT
(Ea accMeN1
ii 000,000
X
BODILYINJURY
(Parperson)
S .
X
BOdILYINJURY
(Vx auldanl)
$ I
X
PROPERTY DAMAGE. _
(Per eatldenQ
S ._. ..... .
GARAGE LIABILOY
ANY AUTO
...
...
_
..
AUrooNLY- EAACCIOENT
OTHER THAN 'EA ADC
AUTO ONLY: AGG
E
A
EXCESS I UMBRELLA LIABILITY
_x1 OCCUR F� CLAIMS MADE
DEDUCTIBLE
X RETENTION $5,000
NSJH71736.
'
10118/2009
10/16/2010
EACH OCCURRENCE -
s4000000
AGGREGATE
s4,000,000
3'
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANYT PROPRpIETOERRIPARTNEIVEXECUrME
OgFFT�I�ER EXCLUDED4
ISPECI.AL ROVIBNXJS below
5864828.WC
5864829 USLH
10/01/2009
10/0112010
_
X WC STATU- OTH,
i.
,00,Q00
E.L. EACH AOCIOENT..' -
q1
EL. DSEASE-EA EMPL
FS1 006'000 '
E.L. DISEASE - POUCVLIMIr
51,000000
A
DTMm Rented /Hired
Equipment
NSJH70596
10/18/2009
10118!2010
$500,000 Limit '
$1,000 Ded.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENOGRSEMENT (SPECIAL PROVISIONS ? ,
Project: 28th Street, Street -End Catch Basin and Pavements Repairs
Project Description: Repair of Catch basin and paved areas
City, its elected or appointed officers, agents, officials, employees, and volunteers are to be covered as
Additional insureds as respects: liability arising out of activities performed by Cron behalf of
(See Attached Descriptlons)
City of Newport Beach
Public Works Department
Attn: Shauna Oyler
3300 Newport Boulevard
Newport Beach, CA 92658 -8915
) -25 (2009101) 1 of 3
ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
EREOF, n1E ISSUING INSURER.W ILL ENDEAVOR TO MAIL . sn. DAYS WRITTEN
'O THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FABJJRETO 00 SO SHALL
NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE MSURER, rr8 AGENTS OR
#S712479/M553532 a 1988 -2009 ACORD CORPORATION. -All.ridlj A`eserved.`c
The ACORD name and l000 are realsterEd madrs of ACCRD BR43
II IT, I MCA _1�kI
If the certificate holder is an ADDITIONAL INSURED, the policy(es) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may ;? ..... - ..
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder In lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance does not constitute a contract between the Issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon. _
ACORD ?s (20aB101) 2 of 3 'gS712479IM553532
DESCRIPTIONS (Continued from Page 1)
Contractor Including the insureds general supervision of Contractors; products and completed operations of
Contractor; premises owned, occupied or used by contractors or automobiles owned, leased, hired or borrowed -
by Contractor. The coverage shall contain no special limitations on the scope of protection afforded the
City, its elected or appointed officers, officials, employees, agent or volunteers as respects to the
General Liability and Auto Liability Policies, per the forms attached: Endorsement# 9 and GECA 701 (01107)
Blkt. Commercial Auto Gold Endorsement.
Contractors insurance coverage shall be primary insurance and /or primary source of recovery as respects
City, its elected or appointed officers, agents, officials, employees and volunteers as respects to all
claims, losses, or liability arising directly or indirectly from the Contractors operations or services
provided to the City. Any Insurance or self- insurance maintained by City, its officers, officials,
employees and volunteers shall be excess of the Contractors insurance and shall not contribute with it
under the General Liability and Auto Liability Policies, per the forms attached: Endorsement # 9 - Includes
the Primary Wording Clause and GECA 701 (01107) Blkt. Commercial Auto Gold Endorsement - Includes Primary
Wording Clause.
The insurer shall agree to waive all rights of subrogation against City; it is elected or appointed
officers, agents, officials, employees and volunteers for losses arising form work performed by Contractor
for City under the Auto Liability; General Liability and Workers Compensation Policies, per the forms
attached: Endorsement # 9 -Includes the Walver of Subrogation Clause. and GECA 701 (01107)
Blkt. Commercial Auto Gold Endorsement; Includes the Waiver of Subrogation Clause and Blanket Waiver of
Subrogation as respects to the Workers' Compensation Policy.
Protection & Indemnity /Hull & Machinery Coverage;
"Moe" - $10,000 BI /PH Dad. .:.
"JC Freeze" w /crane - $10,000 BI /PH Dad.
"JBoat" - $1,000 BI1PH Ded.
"Whity" - $1,000 BI /PH Dad.
"CSI Skimmer" - $1,000 Bl1PH Dad.
"Mari" - $10,000 BI1PH Dad.
"Mani I" - $10,000 BI /PH Dad. .
"Mani ll" . .$10,000 BI /PH Dad.
"Napa Valley" - $10,000 BYPH Dad.
"Sea Queer'- $10,000 BI /PH Dad.
"Bree- Tessa" - $10,000 BI1PH Dad.
"AmyBee" - $10,000 BVPH Dad.
AMS 25.3 (2009101) 3 of 3 #S712479/M553532
Ailk
INTERNATIONAL
MARINE 1Q M 1.97
UNDERWRITERS
ENDORSF,MENT # 9
To be attached and made part of Policy Number N5JH 70596
Of The Northern Assurance Company of America
Issued to: Associated Pacific Constructors, Inc.
Effective May 13, 2010 and in consideration of the premium charged, it is agreed that the following entity is
hereby named as Additional Insured with respect to Section I: Part I — Marine General Liability, Pntt II —
Protection & Indemnity, and Part IV — Pollution Liability, with full waiver of subrogation, as respects to 28th Street,
Street -End Catch Basin and Pavement Repairs as their interests may appear:
City of Newport Beach
Public Works Department
3300 Newport Boulevard
Newport Beach, CA 92658 -8915
It is further agreed that this policy: shall be considered primary over all other coverages available to the
Additional InSnred, but only with respect to their interest on project 28th Street, Street -End Catch Basin
and Pavement Repairs
All other terms and conditions remain oiichanged.
Dated: May 13, 2010
f
i
Signature'of Au6oTi�zed Representative
COMMERCIAL AUTO GOLD ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SECTION II - LIABILITY COVERAGE
A, COVERAGE
WHO IS AN INSURED
The following is added;
d Any organizalian, oiharthan a partnership or jov venme, over which you r*Wntafn ovvInershlp ix
a rrsajoily inieresi owthe effective date "Of this Coverage Form, if there is no similar insurance
available to [hat organization.
Any nronla5tjon you newly aequh'e or.lomt other Phan a partnership or joint ventpro, and ovnr
whiph yriti friaiMafh ownership of a majority Interest. Hawover, coverage under this provfsfon
does not apply:
If there is slmilar'insurance or a self - insured retention plan available to that organization; or
(2) To "bodily injury" or "property damage' that occurred before you acquired or formed the
organization.
f. Any volunteer or employee of yours while using a covered "auto" you do not own, hire or borrow
In yqur business or your personal affairs. Insurance provided by this endorsement is excess over
any other Insurance available to any volunteer or employee. .
g. Any person, organization, trustee, estate or governmental entity with respect to the operation,
maintenance or use of a covered "auto" by an Insured, If:
(1 ) You are obligated to add that person,.organization, trustee, estate or governmental erAity as
an addilicinal insured:to.this policy by.,
(a) an expressed provision of an "insured contract", or written agreement; or
(h) an expressed condition of a written permit issued to you by a governmental or
public authority.
(2) The "hddfiy' inJriry'!or "'preperiy damage" is caused by -ah " @ecidenl" vahich tales p lays aftc11
(a) You executed the "insured contract" or wdttett agreement; or
(b) the permit has been issued to you,
t -. -r
GWA 701 (01W) lnelndes cop7sigdred rmacrial of lnsurynoe Services Off=,, me rcuh ib permission Psge I or i
2. COVERAGE EXTENSIONS
Supplementary Payments.
Subparagraphs (2) and (4) are amended as follows:
(2) Up to $2500 for cost of bail bonds (including bonds for related traffic law violations) required
because of an "accident" we cover. We do not have to furnish.lhese bonds.
(4) All reasonable expenses Incurred by the "Insured" at our requesl, including actual loss of earning
up to $500 a day because of time off from work.
SECTION III - PHYSICAL DAMAGE COVERAGE
A. COVERAGE
The following is added:
5. Hired Auto Physical, Damage
2, Any "auto" you lease; Kira, rent or borrow. from someone other than your employees or partners
or rnemtieis :ottl7eirhotiseElo6ils.a'mli eyed "auW "frrreact7of your physical damage coverages.
b, The most we will pay for "loss" In anyone "accident" is the smallest of:
(1) $50,000
(2) The actual cash value of the damaged or stolen property as of the time of the "loss" or
(3) The cost of repairing or replacing the damaged or stolen property with other property of like
kind and quality.
If you are liable for the "accldept ", we will also pay up to 1600 per "accident" far the actual loss of
use to the owner of the covered "auto ".
c. our obligation to pay for, repair, return or replace damaged or stolen property A411 be reduced by
an amount that is equal to (he amount of the largest deductible shown for any owned " aulo" for
that coverage. However, any Comprehensive Coverage deductible shown in the Declarations
does not apply to "loss" caused by fire or lightning.
d. For this coverage, the Insurance provided is primary for any covered "auto"-you hire Withuuf d
driver and excess over any other collectible insurance for anti covered "auto" that you hire with a
driver.
6. Rental Reimbursement Coverage
We will pay up to 3Z5 ptn'day forup to 30 days, for rental reimtrt¢semenf' %expenses incurred by you
for the rental of an "auto" because of "loss" to a covered: "auto". Rental Reimbursement will be
based on the rental of a comparable vehicle, which . in many cases may be substantially less than $75
per day, and will only be aldwed for a peliod of tuna it should jalce to repair. or replace.: the vehicle
with reasonable speed and similar quality, up to a maximum of 30 days. We will also pay u p to $500
for reasonable and necessary expenses Incurred by you to remove and replace your materials and
equipment frorn'the covered "auto "_
GFCA 701 f01A171 lmtudu eoprrtghted material or Scales 010ecs,[at MM its perurrsslon Pnge?"f,f
If "loss" results from the total theft of a covered "auto' of the private passenger type, we will pay
under this coverage only that amount of your rental reimbursement expenses which is not
already provided under paragraph 4. Coverage Extension.
7. Lease Gap Coverage
If a long -term leased "auto" is a covered "auto" and the lessor is named as an Additional Insured -
Lessor, In the event of a total loss, we wilt pay your additional legal obifgatfon to The lessor for any
difference between the actual cash value of the "auto" at the time of the loss and the "outstanding
balance" of the lease-
"Outstanding balance" means the amount you owe on the lease at the time of loss less any amounts
representing taxes; overdue payments;, penalties, interest or charges resulting from overdue
payments, additional mileage charges; excess wear and tear charges; and lease termination fees,
P. EXCLUSIONS
The following is added to Paragraph 3
The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not
apply to (he accidental discharge of an airbag..
Paragraph 4 is replaced with the following:
4. We will riot pay for'9oss" to any of the following:
a: Tapes, records, disks or other similar audio, visual or data electronic; devices designed for use with
audio, visual or data electrdnic equipment.
b. Equipment designed or used for the detection or location of radar.
c. Any electronic equipment that receives or transmits audio, visual or data signals.
Exclusion 4.o does not apply to:
(1) Electronic equipment that receives or Iransmlls audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by
use of the power from the "auto's" electrical .system, in or upon the covered "auto'; or
(2) Any other electronic equipment that is:
(a) Necessary for:the normal operation of the covered "auto or the monitoring of the
covered'autoVoperallng system; or
(b) An integral part of the same unit housing any sound reproducing equipment described. in (1)
above and permanently fnstafled fn the opening of the dash -or console of (he covEred "auto"
normally used by the manufacturer for installation of a radio.
D. DEDUCTIQLE
The following Is added: No deductible applies to glass damage if the glass is repaired rather than
replaced.
GECA 101 (01/07). Includes eopyrigh+ed mmerral of rnsurnace Sen,(=Om<es, Inc with to permuslon Page] or 4
SECDON IV. BUSINESS AUTO CONDITIONS
A. LOSS CONDITIONS
Item 2.a. and b. are replaced with:
,2. Duties In The Event of Accident, Claim, Suit, or Lass
a. You must promptly notify us. Your duty to promptly notify us is effective when any of your
executive officers, partners, members, or legal representatives is aware of the accident, claim,
"suif ", or loss. Knowledge of an accident, claim, "suit ", or loss, by other employee(s) does not
imply you also have such knowledge.
b. To the extent possible, notice to us should include:
(1) How, when and where the accident or loss took place.
(2) The names and addresses of any injured persons.and witnesses; and
(3) The nature and location of any Injury or damage arising out of the accident or loss.
The following is added to S.
We waive any right of recovery we may have against any addilionat insured under Coverage A. i.
Who Is An Insured g., but only as respects Idss arlsing out Otte operation, maintenance or use of
a covered "auto" pursuant to the proyfs(ons of the "insured contract", written agreement, or permit.
S. GENERAL CONDITIONS
g. is added
7:
3. UNINTEMTIONALFAfLURE TO DISCLOSE HAZARDS
Yt'nlritnintentianai Nralft,te to dfsciose any hazords existif?g of the effective date of your pot icy will not
oaludlee the coveiago afforded. However, e0 have the right to collect addfffonai premium for any
such hazard.
COMMON POLICY CONDITIONS
2.1b, is replaced by the following:
b. 60 days before the effective date of cancellation if we cancel for any other reason.
GECA 701 t111107) Ineludescopyrighted eoslerml nrinsuranre Senlces Onh:er, Inc.lrith its permisslon Pace 4 of 4
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement changes the policy to which It is attached effective an the inception date of the policy unless a different
date is Indicated below.
[The IolMwing "attaching clause- need be completed only when this endorsement is issued subsequent to phaparatlon M the policy).
This endorsement, effective 12:01 AM 10(0112004 forms a part of Policy No. WC 005 -86 -4828
Issued to ASSOCIATED PACIFIC CONSTRUCTORS, INC,
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSOURGH, PA.
We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against any person or organizalion with whom you have a written contract that requires you to obtain this
agreement from us, as regards any work you perform for such person or organization.
The additional premium for (his endorsement shall be 2 % of the total estimated workers compensation premium
for this policy.
WC 04 03 61 Countersigned by - - _ - _ _ - _ -, - - - - _
- - - - - - - .
(Ed. 11190)
.. — -
. -.. _
Authorized Representative
Insured: ASSOCIATED PACIFIC CONSTRUCTORS, IN Policy: N5JH70596
r ENDORSEMENT 9 Effective: 05 /13/2010 I Premium
1 This Endorsement Amends The Following Coverage Parts:
TOTAL ADDITIONAL PREMIUM
SCHEDULE OF FORMS, IMU 0008 01 07
ADD Form(s):
IMU 0010 01 07 Endorsement 9 - ADDITIONAL. INSURED PRIMARY 6 WAIVER
OFFF OF SUBROGATION
3 0401076 05/14/2010 LXL CPW PR 0.433
s0
IMU 00200107 Page 1 of 1
c u�a �acn
Insured: ASSOCIATED PACIFIC CONSTRUCTORS, IN Policy: NSJH70596
ENDORSEMENT 9
Effective: 05/13/2010
Effective May 13, 2010 and in consideration of the premium charged, it is
agreed that the following entity is hereby named as Additional Insured
under SECTION I - Commercial Marine Liability; Part I - Marine General
Liability; and Part. II - Protection & Indemnity, with full waiver of
subrogation as their interests may appear, but only with respect to work
performed by the Named Insured:
City of Newport Beach
Public Works Department
Attn: Shauna Oyler
3300 Newport Boulevard
Newport Beach, CA 92658 -8915
It is further agreed that this policy shall be considered primary over all
other coverages available to the Additional Insured, but only with respect
to their interest in the following projects: 28th Street (Street -End Catch
Basin and Pavement Repairs); and Edgewater Avenue Coping Improvements
project.
1 other terms and conditions remain unchanged.
3 0401076 05/14/2010 LXL CPW PR 0.433
IMU 00 10 MGL05 01 07
c_iuci tarn
CERTIFICATE OF INSURANCE
CHECKLIST
City of Newport Beach
This checklist is comprised of requirements as outlined by the City of Newport Beach.
Date Received: 05/20/2010
Date Completed: 05/2112010
Dept. /Contact Received From: Shari Rooks
Sent to: Shari Rooks By:
Company /Person required to have certificate:
I. GENERAL LIABILITY
Michelle Ross
Associated Pacific Constructors, Inc.
INSURANCE COMPANY: Northern Assuraance Co. of America
AM BEST RATING (A-: VII or greater): "A
ADMITTED Company (Must be California Admitted):
Is Company admitted in California?
D. LIMITS (Must be $1 M or greater): What is limit provided?
E. PRODUCTS AND COMPLETED OPERATIONS (Must
include): Is it included? (completed Operations status does
not apply to Waste Haulers)
F. ADDITIONAL INSURED WORDING TO INCLUDE (The City
its officers, officials, employees and volunteers): Is it
included?
G. PRIMARY & NON - CONTRIBUTORY WORDING (Must be
included): Is it included?
® Yes ❑ No
$1,000,000 plus
$4,000,000 Umbrella
® Yes ❑ No
® Yes ❑ No
H. 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
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.
Ii. AUTOMOBILE LIABILITY
A. INSURANCE COMPANY: Netherlands Insurance Co.
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 $1M min. BI & PD and $500,000 UM, $2M min
for Waste Haulers):
What is limits provided? $1,000,000
E. PRIMARY & NON - CONTRIBUTORY WORDING (For Waste
Haulers only): nla
Is it included? ❑ Yes ❑ No
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.
111. WORKERS' COMPENSATION
A. INSURANCE COMPANY: National Union Fire Ins. Co. of
B. AM BEST RATING (A-: VII or greater): "A "(XV)
C. LIMITS: Statutory
D. WAIVER OF SUBROGATION (To include): Is it included? ® Yes ❑ No
HAVE ALL ABOVE REQUIREMENTS BEEN MET?
IF NO, WHICH ITEMS NEED TO BE COMPLETED?
Approved:
/•ficaZ A'90ss
Agent of Brown & Brown
Broker of record for the City of Newport Beach
/f%ay 21, 2010
Date
❑ Requires approval/exceptiontwaiver by Risk Management
Comments:
Approved:
Management
Date
initials
// - ■