HomeMy WebLinkAboutC-4626 - Grade Adjustments for Utilities StructuresCITY OF NEWPORT BEACH CITY CLERK
NOTICE INVITING BIDS
Sealed bids may be received at the office of the City Clerk,
3300 Newport Boulevard, Newport Beach, CA 92663
until 10:00 AM on the 19`h day of April, 2011,
at which time such bids shall be opened and read for
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Title of Project
Contract No. 4626
$94,000.00
Engineer's Estimate
��t FO Rai
Vt
;Sheen G. Badum
is Works Director
Prospective bidders may obtain Bid Documents, Project Specifications and
Drawings by contacting Mouse Graphics at (949) 548 -5571
Located at 659 W. 19th Street, Costa Mesa, CA 92627
Contractor License Classification(s) required for this project: "A"
For further information, call Frank Tran, Project Manager at (949) 644- 3340
BID INFORMATION IS AVAILABLE ON THE CITY WEBSITE:
htti)://www.NewportBeachCA.gov
CLICK: Online Services / Bidding & Bid Results
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
TABLE OF CONTENTS
NOTICE INVITING BIDS .......................................................... ............................... Cover
INSTRUCTIONS TO BIDDERS ......................................................... ..............................3
14
BIDDER'S BOND ............................................................. : ..............................................
5
DESIGNATION OF SUBCONTRACTOR( S) ...................................... ..............................8
TECHNICAL ABILITY AND EXPERIENCE REFERENCES .............. ..............................9
NON-COLLUSION AFFIDAVIT ...................................... ...............................
13
DESIGNATION OF SURETIES ....................................... ...............................
14
CONTRACTOR'S INDUSTRIAL SAFETY RECORD ........................ .............................15
ACKNOWLEDGEMENT.OF ADDENDA ........................................... .............................17
INFORMATION REQUIRED OF BIDDER ........................................ .............................18
NOTICE TO SUCCESSFUL BIDDER ............................................... .............................21
CONTRACT.................................................................................... ...............................
22
FAITHFUL PERFORMANCE BOND ................................................
.............................30
LABOR AND MATERIALS PAYMENT BOND ..................................
.............................33
PROPOSAL................................................................................ ...............................
PR-1
SPECIALPROVISIONS ................................................................. ...........................SP
-1
2
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
INSTRUCTIONS TO BIDDERS
The following documents shall be completed, executed and received by the City Clerk in
accordance with NOTICE INVITING BIDS:
INSTRUCTIONS TO BIDDERS
BIDDER'S BOND
DESIGNATION OF SUBCONTRACTORS
CONTRACTOR'S INDUSTRIAL SAFETY RECORD
INFORMATION REQUIRED OF BIDDER
ALL ADDENDA TO PLANS AND SPECIFICATIONS AS ISSUED BY AGENCY PRIOR TO
BID OPENING DATE (if any)
TECHNICAL ABILITY AND EXPERIENCE REFERENCES
NON - COLLUSION AFFIDAVIT
DESIGNATION OF SURETIES
PROPOSAL
2. Cash, certified check or cashiers check (sum not less than 10 percent of the total bid price)
may be received in lieu of the BIDDER'S BOND. The title of the project and the words "Sealed
Bid" shall be clearly marked on the outside of the envelope containing the documents.
3. The City of Newport Beach will not permit a substitute format for the Contract Documents listed
above. Bidders are advised to review their content with bonding and legal agents prior to
submission of bid.
4. BIDDER'S BOND shall be issued by an insurance organization or surety (1) currently
authorized by the Insurance Commissioner to transact business of insurance in the State of
California, and (2) listed as an acceptable surety in the latest revision of the Federal Register
Circular 570. The successful bidder's security shall be held until the Contract is executed.
5. The estimated quantities indicated in the PROPOSAL are approximate, and are given solely to
allow the comparison of total bid prices.
6. Bids are to be computed upon the estimated quantities indicated in the PROPOSAL multiplied
by unit price submitted by the bidder. In the event of discrepancy between wording and figures,
bid wording shall prevail over bid figures. In the event of error in the multiplication of estimated
quantity by unit price, the correct multiplication will be computed and the bids will be compared
with correctly multiplied totals. The City shall not be held responsible for bidder errors and
omissions in the PROPOSAL.
7. The City of Newport Beach reserves the right to reject any or all bids and to waive any minor
irregularity or informality in such bids. Pursuant to Public Contract Code Section 22300, at
the request and expense of the Contractor, securities shall be permitted in substitution of
money withheld by the City to ensure performance under the contract. The securities shall
be deposited in a state or federal chartered bank in California, as the escrow agent.
In accordance with the California Labor Code (Sections 1770 et seq.), the Director of Industrial
Relations has ascertained the general prevailing rate of per diem wages in the locality in which
the work is to be performed for each craft, classification, or type of workman or mechanic
needed to execute the contract. 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. All parties to the contract shall be governed by all provisions of the
California Labor Code — including, but not limited to, the requirement to pay prevailing wage
rates (Sections 1770 -79131 inclusive). A copy of the prevailing wage rates shall be posted by
the Contractor at the job site.
9. The Contractor shall be responsible for insuring compliance with provisions of Section 1777.5
of the Labor Code Apprenticeship requirements and Section 4100 et seq. of the Public
Contracts Code, "Subletting and Subcontracting Fair Practices Act ".
10. All documents shall bear signatures and titles of persons authorized to sign on behalf of the
bidder. For corporations, the signatures shall be of a corporate officer or an individual
authorized by the corporation. For partnerships, the signatures shall be of a general partner.
For sole ownership, the signature shall be of the owner.
The signature below represents that the above has been reviewed.
932798F\
Contractor's License No. & Classification
EBS Utiliii'es Adiustine. Inc.
Bidder
President
le Joseph
April 18, 2011
Date
BOND #08739462
PREMIUM NIL,
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
BIDDER'S BOND
We, the undersigned Principal and Surety, our successors and assigns, executors, heirs
and administrators, agree to be jointly and severally held and firmly bound to the City of
Newportt Beach, a charter city, in the principal sum of TEN PERCENT OF AMOUNT BID
Dollars ($ t D% ), to be paid and forfeited to the City
of Newport Beach if the bid proposal of the undersigned Principal for the construction of GRADE
ADJUSTMENTS FOR UTILITY STRUCTURES, Contract No. 4626 in the City of Newport
Beach, is accepted by the City Council of the City of Newport Beach and the proposed contract
is awarded to the Principal, and the Principal falls to execute the Contract Documents in the
form(s) prescribed, including the required bonds, and original insurance certificates and
endorsements for the construction of the project within thirty (30) calendar days after the date of
the mailing of °Notiflcation of Award ", otherwise this obligation shall become null and void.
If the undersigned Principal executing this Bond is executing this Bond as an individual,
it is agreed that the death of any such Principal shall not exonerate the Surety from its
obligations under this Bond.
Witness our hands this 14TH day of
EBS UTILITIES ADJUSTING, INC.
Name of Contractor (Principal)
FIDELITY AND DEPOSIT
COMPANY OF MARYLAND
Name of Surety
C/O ZURICH 1400 AMERICAN LANE
SCHAUMBURG, IL 60196
Address of Surety
(818) 409 -2800
Telephone
BY:
2011.
Signaturerfitle
CHARLES L. FLAKE(ATTORNEY -IN -FACT
Print Name and Title
(Notary acknowledgment of Principal & Surety must be attached)
a a a a v a a a a v a c a a v a a a a v a a v a a a a a a a a a a a{va a v c a a a a a v a a a.a a v e e a e e v a o o a e e e a e a v v a e v e e v e a,
State of Cal"rfornia
County of
On
Public, personally appeared
proved to me on the basis of satisfactor
subscribed to the within instrument and
same in his /her /their authorized capacit
Instrument the person(s), or the entity of
instrument.
I certify under PENALTY OF PERM
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature
me,
Notary
evidence to be the person(s)'whose name(s) islare
acknowledged to me that,fie /shelthey executed the
ies), and that by hispOr/their signatures(s) on the
n behalf of which t e person(s) acted, executed the
under the iaws of the State of California that the
(seal)
v a v v a v a v v o a v v v v aaaaavaa a a a a a an a a a dd a a o v v o v v v a v v e v v v o v a e av v a o v v a o v a a o a a a a v a a v a v,
Date of Document
Type or Title of Document
Number of Pages in
Document in a Foreign
Type of Satisfactory Evidence:
Personally KnoWn!with Paper
Paper Identification
Credible Witness(es)
Capacity of Signer:
_ Trustee
_ Power of Attorney
_ CEO /CFO /COO
_ President I Vice - President I Secretary
_ Other:
Other Information:
INFORM 77ON
Gl
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ACKNOWLEDGMENT
o o o a ov a v e e a e a o a o v v o v o o o o e v oo v a e o v o a a o a o v.. o o v o no o. v a o a v v a o o a v a v e a o avooa o ev vvoo,
State of California
County of
ss.
On before me,
Public, personally appeared
Notary
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 hls /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 thePtate of California that the
foregoing paragraph is true and correct.
WITNESS.my hand and official seal.
Signature
(seal)
vvavvavaavo aaav ovvvv vv vvava aavv vvv vvvowvvv v v vvv vv vo va v o v v a v.vvvv v v v v v v a v c a a a v va
Date of Document
Type or Title of Document
Number of Pages in Document
Document in a Foreign Langua
Type of Satisfack
_ Personally
_ Paper Ider
Credible A
Paper Identificalien
INFORMATION
Capacity of Signer:
Trustee
_ Power of Attorney
CEOICFO /COO
_ President / Vice - President / Secretary / Treasurer
Other:
Other
7
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CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT
STATE OF CALIFORNIA
County of Orange
On 4 -14 -11 before me, Lexie Sherwood Notary Public
Dale Here Insert Name and Title of the Officer
personally appeared Charles L. Flake
_. LEXIE SHERWOOD
•, -�, s
C �'y:: `1.
COMiA. #1856389 E
NOTARY PUBLIC o CALIFORNIA n
��'"
ORANGE COUNTY
Comm. Exp. JULY 27, 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. /
Signature 6,(/C� 6U68d
.Place Notary Seal Above Signature of Notary Public
OPTIOAfAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Individual
❑ Corporate Officer — Title(s):_
❑ Partner— ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer is Representing:
Top of thumb here
Number of
Signer's Name:
❑ Individual
❑ Corporate Officer — Title(s)_
❑ Partner— ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Top of thumb here
?S�C"�- 4$`- �._``f'Y3�f:?ilk,`�
0 2007 National Notary ASocletioo- 9350 De Solo Ave., P.O. Bo %2402 - Chatsworth, CA 91313 .2402 - www.NatlonalNOtary.org Ilem45907 Reorcec Call Tall -Free 1- 800 - 8765827
Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary,
in pursuance of authority granted by Article Vl, Section 2, of the By -Laws of said Company, are set forth on the
reverse side hereof and are hereby certified to be in full force and effect on the date h e dos by nominate, constitute
and appoint Richard A. COON, Charles L. FLAKE, David L. CULB n e all of
Anaheim, California, EACH its true and lawful agent and v ma deliver, for, and on
its behalf as surety, and as its act and deed: any an s n ° cution of such bonds or
undertakings in pursuance of these prose 1� m� tmy, as fully and amply, to all intents and
purposes, as if they had been d �f t ac`kn h ,ularly elected officers of the Company at its office
in Baltimore, Md., ' tz p per attorney revokes that issued on behalf of Richard A. COON,
Charles L. FLAKE, a ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005.
The said Assistant C cbcstliereby certify that the extract set forth on the reverse side hereof is a true copy of Article VI,
Section 2, of the By -L s said Company, and is now in force.
IN WITNESS WHEREOF, the said Vice - President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of
November, A.D. 2006.
ATTEST:
'co otvoy.`
oa
°, IBC9 i
State of Maryland i ss:
City of Baltimore J
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
Eric D. Barnes Assistant Secretary
By:
William J. Mills
Vice President
On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland, duly
commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being
by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid,
and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of
the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
,�•\e,ll'1` y4t �` L.7';v�:V.]/!Li� � �— f- AJ!`ny.l
Constance A. Dunn Notary Public
My Commission Expires: July 14, 2011
POA-F 012 -4150H
ACKNOWLEDGMENT
.......................................... ...............................
State of Calif rnia
County of V\ \'\ ;kN s_N \ ,k )Ss.
On 4 " before me,
Notary Public, personally appeared
who pro d to me on the basis of satisfactory evidence to be the person whose
�me's) is subscribed to the hin instrument and acknowledged to me that
executed the same in his her/their authorized capacity, and that by
his signaturesN on the instrument the personN), or the entity upon behalf of
which the persons 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.
La
SignatLfre
01- JEFF LEE
Commission * 1771954 Notary Public •California
Riverside County
tvly Comm. Expires act 5, 2011
.......................................... ...............................
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
CEO /CFO /COO
President / Vice - President / Secretary / Treasurer
Other:
Other Information:
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City of Newrport Beach
GRADE ADJUSTMENTS FOR UTUTl' STRUCTURES
Contract No. 4626
DESIGNATION OF SUBCONTRACTOR(S)
State law requires the listing of all subcontractors who will perform work in an amount in
excess of one -half of one percent of the Contractor's total bid. If a subcontractor is not listed, the
Contractor represents that he /she is fully qualified to and will be responsible for performing that
portion of the work. Substitution of subcontractors shall be made only in accordance with State law
and /or the Standard Specifications for Public Works Construction, as applicable.
Pursuant to Public Contract Code Section 22300 appropriate securities may be substituted
for any monies to be withheld to ensure performance under the Contract.
The Bidder, by signing this designation, certifies that bids from the following subcontractors
have been used in formulating the bid for the project and that these subcontractors will be used
subject to the approval of the Engineer and in accordance with State law. No changes may be
made in these subcontractors except with prior approval of the City of Newport Beach. (Use
additional sheets if needed.)
Subcontractor's Information
Bid Item
Description of Work
%of
Number
Total Bid
Name:
Address:
Phone:
State License Number:
Name:
Address:
Phone:
Slate License Number:
Name:
Address:
Phone:
State License Number:
EBS Utilities Adjusting, Inc.
Bidder
0
/ President
Authorized Signatureffitle Joseph Nanci
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
TECHNICAL ABILITY AND EXPERIENCE REFERENCES
Contractor must use this formM Please print or type.
Bidders Name EBS Utilities Adjusting, Inc.
FAILURE OF THE BIDDER TO PROVIDE ALL REQUIRED INFORMATION IN A
COMPLETE AND ACCURATE MANNER MAY BE CONSIDERED NON - RESPONSIVE.
For all public agency projects you have worked on (or are currently working on) in the
past 2 years in excess of $15,000, provide the following information:
No. 1
Project Name /Number
Project Description
Improvement of Los Coyotes Diagonal (R -6782)
Street Improvements
Approximate Construction Dates: From
Agency Name
City of Long Beach
090-010 To: 01/2011
Contact Person Charles Ramey Telephone (562) 570 -6200
Original Contract Amount $ 3,517,661 Final Contract Amount $ 3,517,661
If final amount is different from original, please explain (change orders, extra work, etc.)
Did you file any claims against the Agency? Did the Agency file any claims
against you /Contractor? If yes, briefly explain and indicate outcome of claims.
NO / NO
No. 2
Project Name /Number Marengo Avenue Street Improvements
Project Description Street Improvements
Approximate Construction Dates: From
Agency Name City of South Pasadena
08/2010 To: 11/2010
Contact Person Gabriel B. Nevarez Telephone (626) 403 -7240
Original Contract Amount $ I 119.132 Final Contract Amount $ 1,119,132
If final amount is different from original, please explain (change orders, extra work, etc.)
Did you file any claims against the Agency? Did the Agency file any claims
against you /Contractor? If yes, briefly explain and indicate outcome of claims.
NO / NO
No. 3
Project Name /Number
Project Description
Street Improvements - White Ave (42181035)
Street Improvements
Approximate Construction Dates: From
Agency Name
City of Pomona
04/2010 To: 09/2010
Contact Person Linda Lowry Telephone (909) 620 -2261
Original Contract Amount $ 2,239,960 Final Contract Amount $ 2,239,960
If final amount is different from original, please explain (change orders, extra work, etc.)
Did you file any claims against the Agency? Did the Agency file any claims
against you /Contractor? If yes, briefly explain and indicate outcome of claims.
NO NO
10
AIM
Project Name /Number Colima Road
Project Description Street Improvements
Approximate Construction Dates: From 01/2010 To: 09/2010
Agency Name County of Los Angeles
Contact Person PirouzBozorgnia Telephone (626) 458 -3145
Original Contract Amount $ 1,461,718 Final Contract Amount $ 1,461,718
If final amount is different from original, please explain (change orders, extra work, etc.)
Did you file any claims against the Agency? Did the Agency file any claims
against you /Contractor? If yes, briefly explain and indicate outcome of claims.
NO NO
No. 5
Project Name /Number
Project Description
Approximate Construction Dates: From
Agency Name
Contact Person
To:
Telephone (
Original Contract Amount $ Final Contract Amount
If final amount is different from original, please explain (change orders, extra work, etc.)
Did you file any claims against the Agency? Did the Agency file any claims
against you /Contractor? If yes, briefly explain and indicate outcome of claims.
11
No. 6
Project Name /Number
Project Description
Approximate Construction Dates: From
Agency Name
To:
Contact Person Telephone ( )
Original Contract Amount $ Final Contract Amount $
If final amount is different from original, please explain (change orders, extra work, etc.)
Did you file any claims against the Agency? Did the Agency file any claims
against you /Contractor? If yes, briefly explain and indicate outcome of claims.
Attach additional sheets if necessary.
Attach to this Bid the experience resume of the person who will be designated as
General Construction Superintendent or on -site Construction Manager for the
Contractor.
Upon request, the Contractor shall attach a financial st ment and other information
sufficiently comprehensive to permit an appraisal of Contractor's current financial
conditions.
EBS Utilities Adjusting, Inc. / President
Bidder Authorized Signature/Title Joseph Nand
12
=51
Art Ballin
General Superintendent
Experience
30+ years experience
Art has several years of experience in all aspects of the construction industry including: new
construction projects, reconstruction projects, and developmental projects.
His education includes a combination of schooling, hands on work in the field, and several
years of management experience.
EBS
1320 E 6th St #100
Corona, CA 92879
(951) 279 -6869
(714) 448 -1158 Cell
CitV of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
NON - COLLUSION AFFIDAVIT
Stale of California )
) ss.
County of Orange )
Joseph Nanci being first duly sworn, deposes and says that he or she is
President of EBS Utilities Adjusting, Inc. , the party making the
foregoing bid; that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership,
company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that
party making the foregoing bid; that the bid is not made in the interest of, or on behalf of, any undisclosed
person, partnership, company, association, organization, or corporation; that the bid is genuine and not
collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a
false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder
or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any
manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid
price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that
of any other bidder, or to secure any advantage against the public body awarding the contract of anyone
interested in the proposed contract; that all statements contained in the bid are true; and, further, that the
bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents
thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation,
partnership, company association, organization, bid depository, or to any member or agent thereof to
effectuate a collusive or sham bid. n
I declare under penalty of perjury of the laws of the Slate 7 is that the foregoing is true and correct
EBS Utilities Adjusting, Inc. resident
Bidder Aut orized Signature/Title Joseph Nanci
Subscribed and swom to (or affirmed) before me on this day of 2011
by , proved to me on the basis of
satisfactory evidence to be the person(s) who appeared before me.
I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
[SEAL]
13
Notary Public
My Commission Expires:
JURAT
.......................................... ...............................
State of CaI jjornia �
County of h�v��S\�T2� } ss.
Subscribed and sworn to (or affirmed) before\ me on this A day of
CX 20_�L__, by
proved to me on the basis of satisfactory evidence to be the personNj who appeared
before me.
JEFF LEE
Commission # 1 771954
r -a f Notary Public - California £
Riverside County
My Comm. Expires Oct 5, 2011
\\VV'k
Signature SfNotary
.......................................... ...............................
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
CEO /CFO /COO
President / Vice - President / Secretary / Treasurer
Other:
Other
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City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
DESIGNATION OF SURETIES
Bidders name EBS Utilities Adjusting, Inc.
Provide the names, addresses, and phone numbers for all brokers and sureties from
whom Bidder intends to procure insurance and bonds (list by insurance /bond type):
Culbertson Insurance Services, Inc.
5500 E. Santa Ana Cyn. Rd., Ste. 201
Anaheim, CA 92807 -3103
921 -0530
Fidelity & Deposit Company of Maryland
801 N Brand Blvd, Penthouse Suite
Glendale, CA 91203
(818) 409 -2800
14
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
CONTRACTOR'S INDUSTRIAL SAFETY RECORD
TO ACCOMPANY PROPOSAL
Bidders Name EBS Utilities Adjusting, Inc.
Record Last Five (5) Full Years
Current Year of Record
The information required for these items is the same as required for columns 3 to 6, Code 10,
Occupational Injuries, Summary-- Occupational Injuries and Illnesses, OSHA No. 102.
15
Current
Record
Record
Record
Record i
Record
Year of
for
for
for
for
for
Record
2010
2009
2008
2007
2005
Total
2011
No. of contracts
33
127
113
25
298
Total dollar
Amount of
$731
$2,457
$3,305
$472
$6,965
Contracts (in
Thousands of $
No. of fatalities
0
0
0
0
0
No. of lost
Workday Cases
0
2
1
0
3
No. of lost
workday cases
involving
0
0
0
0
permanent
transfer to
another job or
termination of
employment
The information required for these items is the same as required for columns 3 to 6, Code 10,
Occupational Injuries, Summary-- Occupational Injuries and Illnesses, OSHA No. 102.
15
Legal Business Name of Bidder EBS Utilities Adjusting, Inc.
Business Address: 1320 E 6th St #100, Corona, CA 92879
Business Tel. No.: (951) 279 -6869
State Contractor's License No. and
Classification: 720016
Title President
The above information was compiled from the records that are available to me at this
time and I declare under penalty of perjury that the information is true and accurate
within the limitations of those records.
Signature of
bidder
Date
Title
Signature of
bidder
Date
Title
Signature of
bidder
Date
Title
Signature of
bidder
Date
Title
18,2011
Signature Requirements: If bidder is an individual, name and signature of individual
must be provided, if doing business under a fictitious name, the fictitious name must be
set fort along with the County. If bidder is a partnership or joint venture, legal name of
partnership /joint venture must be provided, followed by signatures of all of the
partners /joint ventures or if fewer than all of the partners /joint ventures submit with
evidence of authority to act on behalf of the partnership /joint venture. If bidder is a
corporation, legal name of corporation must be provided, followed by signatures of the
corporation President or Vice President or President and Secretary or Assistant
Secretary, and the corporate seal, or submit with evidence of authority to act on behalf
of the corporation. All must be acknowledged before a Notary Public, who must certify
that such individuals, partners /joint ventures, or officers were proven on the basis of
satisfactory evidence to be the persons whose name are subscribed to and
acknowledged that they executed the same in their authorized capacities.
[NOTARY ACKNOWLEDGMENT and CORPORATE SEAL MUST BE ATTACHEDI
it.
ACKNOWLEDGMENT
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
State of Cali'f`ornia \\
County of \OFFS \v��. ) ss.
On �\\ before
Notary Public, personally appeared Vic• �v `Joy�<\
who prov d to me on the basis of satisfactory evidence to be the person ) whose
amen is subscribed to the wit in Instrument and acknowledged to me that
Uhe she/they executed the same in hi � authorized capacity, and that by
his signaturesN. on the instrument the personnN, or the entity upon behalf of
w Ich the personN 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
JEFF LEE
Commission # 7771954
:C :p -,a Notary Public - California
Riverside County
MyComm. Expires Oct 5, 2011
.......................................... ...............................
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 Wtness(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.
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Bidders name
Contract No. 4626
ACKNOWLEDGEMENT OF ADDENDA
EBS Utilities Adjusting, Inc.
The bidder shall signify receipt of all Addenda here, if any, and attach executed
copy of addenda to bid documents:
Addendum No. Date Received Signature
I
17
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
INFORMATION REQUIRED OF BIDDER
Bidder certifies under penalty of perjury under the laws of the State of California that the
following information is true and correct:
Name of individual Contractor, Company or Corporation:
Business
1320 E 6th St #100, Corona, CA 92879
Telephone and Fax Number:
EBS Utilities Adjusting, Inc.
(951) 279 -6869 / (951) 279-9112 FAX
California State Contractor's License No. and Class: 932798
(REQUIRED AT TIME OF AWARD)
Original Date Issued: 05/2009 Expiration Date: 05/31/2011
List the name and title /position of the person(s) who inspected for your firm the site of
the work proposed in these contract documents:
Joe Nanci, Manager
The following are the names, titles, addresses, and phone numbers of all individuals,
firm members, partners, joint ventures, and company or corporate officers having a
principal interest in this proposal:
Name Title Address Telephone
Joseph Nanci President 1320 E 6th St #100, Corona, CA 92879 (951) 279 -6869
Corporation organized under the laws of the State of California
in
The dates of any voluntary or involuntary bankruptcy judgments against any principal
having an interest in this proposal are as follows:
All company, corporate, or fictitious business names used by any principal having
interest in this proposal are as follows:
For all arbitrations, lawsuits, settlements or the like (in or out of court) you have been
involved in with public agencies in the past five years (Attach additional Sheets if
necessary) provide:
Provide the names, addresses and telephone numbers of the parties;
Briefly summarize the parties' claims and defenses;
Have you ever had a contract terminated by the owner /agency? If so, explain.
NO
Have you ever failed to complete a project? If so, explain.
NO
For any projects you have been involved with in the last 5 years, did you have any
claims or actions by any outside agency or individual for labor compliance (i.e. failure to
pay prevailing wage, falsifying certified payrolls, etc.)? Yes /00
19
Are any claims or actions unresolved or outstanding? Yes to)
If yes to any of the above, explain. (Attach additional sheets, if necessary)
Failure of the bidder to provide ALL requested information in a complete and accurate
manner may be considered non- responsive.
EBS Utilities Adjusting, Inc.
Bidder
Joseph Nanci
(Print name of Owner or President
of Corp Cation /Company)
/ President
Authorized Signature/Title
President
Title
Date
2011
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 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 Slate of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Notary Public in and for said
My Commission Expires:
20
(SEAL)
ACKNOWLEDGMENT
.......................................... ...............................
State of California
County of '�,VRCS�3�� } ss.
On before m�
Notary Public, personally appeared 'X L�aO\
who prov d to me on the basis of satisfactory evidence to be the person whose
meKq� afe. subscribed to the In Instrument and acknowledged to me that
e y executed the same in his authorized capacity�s), and that by
his signatures"( -4 on the instrument the personj* , or the entity upon behalf of
wfch the personXacted, 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. JEFF LEE
_..
i Commission # 1771954
Notary Public - California
�ei' ezy Riverside County
My comm. Expires Oct 5, 2011
Signatu ?e
.......................................... ..............................I
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
_ CEO /CFO /COO
_ President / Vice - President / Secretary / Treasurer
Other:
Other Information:
Thumbprint of Signer
❑ Check here if
no thumbprint
or fingerprint
is available.
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
NOTICE TO SUCCESSFUL BIDDER
The following Contract Documents shall be executed and delivered to the Engineer within
ten (10) days (not including Saturday, Sunday and Federal holidays) after the date shown on the
"Notification of Award" to the successful bidder:
• CONTRACT WITH REQUIRED INSURANCE CERTIFICATES AND ENDORSEMENTS
• LABOR AND MATERIALS PAYMENT BOND
• FAITHFUL PERFORMANCE BOND
The City of New Beach will not permit a substitute formal for these Contract
Documents. Bidders are advised to review their content with bonding, insuring and legal agents
prior to submission of bid. Original Certificate(s) of Insurance, General Liability Insurance
Endorsement, and Automobile Liability Insurance Endorsement shall be provided as
required by the Contract documents and delivered to the Public Works Department within
ten (10) working days after the date shown on the Notification of Award to the successful
bidder.
The Labor and Materials Payment Bond and Faithful Performance Bond shall be issued by
an insurance organization or surety (1) currently authorized by the Insurance Commissioner to
transact business of insurance in the State of California, and (2) listed as an acceptable surety in
the latest revision of the Federal Register Circular 570.
Pursuant to Public Contract Code Section 22300, appropriate securities may be substituted
for any monies to be withheld to ensure performance under the Contract.
Insurance companies affording coverage shall be (1) currently authorized by the Insurance
Commissioner to transact business of insurance in the State of California, and (2) assigned
Policyholders' Rating A (or higher) and Financial Size Category Class VII (or larger) in accordance
with the latest edition of Best's Key Rating Guide: Property- Casualty. Coverages shall be provided
as specified in the Standard Specifications for Public Works Construction, except as modified by
the Special Provisions. Certificates of Insurance and additional insured endorsements shall be on
the insurance company's forms, fully executed and delivered with the Contract. The Notice to
Proceed will not be issued until all contract documents have been received and approved by the
City.
21
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
CONTRACT
THIS CONTRACT FOR PUBLIC WORKS entered into this day of , 2011, by
and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter
City( "City ") and EBS Utilities Adjusting, Inc., a California corporation ("Contractor"), is made with
reference to the following facts:
WHEREAS, City has advertised for bids for the following described public work:
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
The work necessary for the completion of this contract consists of replacing survey
monument frame and cover, water valve frame and cover to grade. This contract also
includes replacing and adjusting sewer and storm drain manholes to grade in the Big
Canyon Community.
WHEREAS, Contractor has been determined by City to be the lowest responsible bidder
and Contractor's bid, and the compensation set forth in this Contract, is based upon Contractor's
careful examination of all Contract documents, plans and specifications.
NOW, THEREFORE, City and Contractor agree as follows:
A. CONTRACT DOCUMENTS The complete Contract for the Project includes all of the
following documents: Notice Inviting Bids, Instructions to Bidders, Proposal, Bidder's Bond,
Non - Collusion Affidavit, Notice to Successful Bidders, Faithful Performance Bond, Labor
and Materials Payment Bond, Permits, Standard Special Provisions and Standard
Drawings, Plans and Special Provisions for Contract No. 4626, Standard Specifications for
Public Works Construction (current adopted edition and all supplements) and this Contract,
and all modifications and amendments thereto (collectively the "Contract Documents').
The Contract Documents comprise the sole agreement between the parties as to the
subject matter therein. Any representations or agreements not specifically contained in the
Contract Documents are null and void. Any amendments must be made in writing, and
signed by both parties in the manner specified in the Contract Documents.
B. SCOPE OF WORK Contractor shall perform everything required to be performed, and
shall provide and furnish all the labor, materials, necessary tools, expendable equipment
and all utility and transportation services required for the Project:
All of the work to be performed and materials to be furnished shall be in strict accordance
with the provisions of the Contract Documents. Contractor is required to perform all
activities, at no extra cost to City, which are reasonably inferable from the Contract
Documents as being necessary to produce the intended results.
22
C. COMPENSATION As full compensation for the performance and completion of the
Project as required by the Contract Documents, City shall pay to Contractor and Contractor
accepts as full payment the sum of Eighty -One Thousand, Nine Hundred and 00/100
Dollars ($81,900.00).
This compensation includes:
(1) Any loss or damage arising from the nature of the work,
(2) Any loss or damage arising from any unforeseen difficulties or obstructions in the
performance of the work,
(3) Any expense incurred as a result of any suspension or discontinuance of the work, but
excludes any loss resulting from earthquakes of a magnitude in excess of 3.5 on the
Richter Scale and tidal waves, and which loss or expense occurs prior to acceptance of
the work by City.
D. NOTICE OF CLAIMS Unless a shorter time is specified elsewhere in this Contract, before
making its final request for payment under the Contract Documents, Contractor shall submit
to City, in writing, all claims for compensation under or arising out of this Contract.
Contractor's acceptance of the final payment shall constitute a waiver of all claims for
compensation under or arising out of this Contract except those previously made in writing
and identified by Contractor in writing as unsettled at the time of its final request for
payment. The Contractor and the City expressly agree that in addition to all claims filing
requirements set forth in the Contract and Contract Documents, the Contractor shall be
required to file any claim the Contractor may have against the City in strict conformance
with the Tort Claims Act (Government Code 900 et seq.).
E. WRITTEN NOTICE Any written notice required to be given under the Contract
Documents shall be performed by depositing the same in the U.S. Mail, postage prepaid,
directed to the address of Contractor and to City, addressed as follows:
CITY
City of Newport Beach
Public Works Department
3300 Newport Boulevard
PO Box 1768
Newport Beach, CA 92658
Attention: Frank Tran
(949)644-3340
CONTRACTOR
EBS Utilities Adjusting, Inc.
1320 E. 6'" Street, #100
Corona, CA 92879
951 - 279 -6869
951- 279 -9112 Fax
F. INSURANCE Without limiting Contractor's indemnification of City, and rip or to
commencement of work, Contractor shall obtain, provide and maintain at its own
expense during the term of this Contract, a policy or policies of liability insurance of the
type and amounts described below and in a form satisfactory to City.
Coverage and Limit Requirements.
Workers' Compensation. Contractor shall maintain Workers'
Compensation Insurance providing statutory benefits and employer's
liability insurance with limits of at least one million dollars ($1,000,000)
each type for Contractor's employees in accordance with the laws of the
State of California, Section 3700 of the Labor Code. In addition,
Contractor shall require each subcontractor to similarly maintain Workers'
23
Compensation Insurance and Employer's Liability Insurance in
accordance with the laws of the State of California, Section 3700 for all of
the subcontractor's employees. The insurer issuing the Workers'
Compensation insurance shall amend its policy by endorsement to waive
all rights of subrogation against City, its elected or appointed officers,
agents, officials, employees and volunteers. Contractor shall submit to
City, along with the required certificate of insurance, a copy of such
waiver of subrogation endorsement.
b. General Liability. Contractor shall maintain commercial general liability
insurance in an amount not less than one million dollars ($1,000,000) per
occurrence, two million dollars ($2,000,000) General Aggregate and two
million dollars ($2,000,000) Products and Completed Operations
Aggregate for bodily injury, personal injury, and property damage,
including without limitation, blanket contractual liability. Coverage shall be
at least as broad as that provided by Insurance Services Office form CG
00 01. None of the policies required herein shall be in compliance with
these requirements if they include any limiting endorsement that has not
been first submitted to City and approved in writing.
C. Automobile Liability. 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 Contract, including coverage for any owned, hired, non -owned or
rented vehicles, in an amount not less than one million dollars
($1,000,000) combined single limit for each accident.
Builders Risk. For Contracts with Construction /Builders Risk property
exposures, Contractor shall maintain Builders Risk insurance or an
installation floater as directed by City, covering damages to the Work for
"all risk" or special form causes of loss with limits equal to one hundred
percent (100 %) of the completed value of contract, with coverage to
continue until final acceptance of the Work by City. At the discretion of
City, the requirement for such coverage may include additional protection
for Earthquake and /or Flood. City shall be included as an insured on such
policy, and Contractor shall provide the City with a copy of the policy.
2. Other Insurance Provisions.
Evidence of Insurance. Contractor shall provide certificates of insurance
to City as evidence of the insurance coverage required herein, along with
a waiver of subrogation endorsement for workers' compensation and an
additional insured endorsement for general liability. Insurance certificates
and endorsements must be approved by City's Risk Manager prior to
commencement of performance or issuance of any permit. Current
evidence of insurance shall be kept on file with City at all times during the
term of this contract. All of the executed documents referenced in this
contract must be returned within ten (10) working days after the date on
the "Notification of Award," so that the City may review and approve all
insurance and bond documentation. City reserves the right to require
complete, certified copies of all required insurance policies, at any time.
24
b. General liability insurance provisions. Primary and excess or umbrella
liability policies are to contain, or be endorsed to contain, the following
provisions:
i. 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 or on behalf of Contractor, including the insured's general supervision of
Contractor; products and completed operations of Contractor; premises owned, occupied or
used by Contractor. The coverage shall contain no special limitations on the scope of protection
afforded to City, its elected or appointed officers, officials, employees, agents or volunteers.
Contractor shall submit to City a copy of the additional insured endorsement along with the
required certificates of insurance.
ii. Contractor's 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 Contractor's 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 Contractor's insurance and shall not contribute with it.
iii. Contractor's insurance shall apply separately to each insured
against whom claim is made or suit is brought, except with respect to the limits of the insurer's
liability.
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. Notice of Cancellation. Contractor agrees to oblige its insurance broker
and insurers to provide to City with thirty (30) days notice of cancellation
(except for nonpayment for which ten (10) days notice is required) or
nonrenewal of coverage for each required coverage except for builder's
risk insurance. The builder's risk policy will contain or be endorsed to
contain a provision providing for 30 days written notice to City of
cancellation or nonrenewal, except for nonpayment for which ten (10)
days notice is required.
e. Self- Insured Retentions. Contractor agrees not to self- insure or to use
any self - insured retentions on any portion of the insurance required
herein and further agrees that it will not allow any indemnifying party to
self- insure its obligations to City. If contractor's existing coverage includes
a self- insured retention, the self- insured retention must be declared to
City. City may review options with the contractor, which may include
reduction or elimination of the self- insured retention, substitution of other
coverage, or other solutions. Contractor agrees to be responsible for
payment of any deductibles on their policies.
25
Timely Notice of Claims. Contractor shall give City prompt and timely
notice of any claim made or suit instituted arising out of or resulting from
Contractor's performance under this Contract.
g. Waiver. All insurance coverage maintained or procured pursuant to this
Contract shall be endorsed to waive subrogation against City, its elected
or appointed officers, agents, officials, employees and volunteers, or shall
specifically allow Contractor or others providing insurance evidence in
compliance with these requirements to waive their right of recovery prior
to a loss. Contractor hereby waives its own right of recovery against City,
and shall require similar written express waivers and insurance clauses
from each of its subcontractors.
Enforcement of Contract Provisions. Contractor acknowledges and
agrees that any actual or alleged failure on the part of the City to inform
Contractor of non - compliance with any requirement imposes no additional
obligations on the City nor does it waive any rights hereunder.
Requirements not Limiting. Requirements of specific coverage features or
limits contained in this Section are not intended as a limitation on
coverage, limits or other requirements, or a waiver of any coverage
normally provided by any insurance. Specific reference to a given
coverage feature is for purposes of clarification only as it pertains to a
given issue and is not intended by any party or insured to be all inclusive,
or to the exclusion of other coverage, or a waiver of any type.
City's Remedies. City shall have the right to order the Contractor to stop
Work under this Contract and /or withhold any payment(s) that become
due to Contractor hereunder until Contractor demonstrates compliance
with the requirements of this article. In the alternative, City may purchase
the required coverage and charge Contractor the cost of the premiums or
deduct the cost from Contractor's payments.
Coverage not Limited. All insurance coverage and limits provided by
contractor and available or applicable to this Contract are intended to
apply to the full extent of the policies. Nothing contained in this Contract
or any other Contract relating to the city or its operations limits the
application of such insurance coverage.
Coverage Renewal. Contractor will renew the coverage required here
annually as long as Contractor continues to provide any services under
this or any other contract or Contract with the City. Contractor shall
provide proof that policies of insurance required herein expiring during the
term of this Contract have been renewed or replaced with other policies
providing at least the same coverage. Proof that such coverage has been
ordered shall be submitted prior to expiration. A coverage binder or letter
from Contractor's insurance agent to this effect is acceptable. A certificate
of insurance and /or additional insured endorsement as required in these
specifications applicable to the renewing or new coverage must be
provided to City within five days of the expiration of the coverages.
26
G. RESPONSIBILITY FOR DAMAGES OR INJURY
City and all officers, employees and representatives thereof shall not be
responsible in any manner: for any loss or damages that may happen to the
Work or any part thereof; for any loss or damage to any of the materials or other
things used or employed in performing the Work, for injury to or death of any
person either workers or the public; or for damage to property from any cause
arising from the construction of the work by Contractor, or its subcontractors, or
its workers, or anyone employed by it.
2. Contractor shall be responsible for any liability imposed by law and for injuries to
or death of any person or damage to property resulting from defects, obstructions
or from any cause arising from Contractor's Work on the Project, or the Work of
any subcontractor or supplier selected by the Contractor.
3. To the fullest extent permitted by law, Contractor shall indemnify, defend and
hold harmless City, its City Council, boards and commissions, officers, agents,
volunteers, and employees (collectively, the "Indemnified Parties ") from and
against any and all claims (including, without limitation, claims for bodily injury,
death or damage to property), demands, obligations, damages, actions, causes
of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses
(including, without limitation, attorney's fees, disbursements and court costs) of
every kind and nature whatsoever (individually, a Claim; collectively, "Claims "),
which may arise from or in any manner relate (directly or indirectly) to any breach
of the terms and conditions of this Contract, any work performed or services
provided under this Contract including, without limitation, defects in workmanship
or materials or Contractor's presence or activities conducted on the Project
(including the negligent and /or willful acts, errors and /or omissions of Contractor,
its principals, officers, agents, employees, vendors, suppliers, subconsultants,
subcontractors, anyone employed directly or indirectly by any of them or for
whose acts they may be liable or any or all of them).
Notwithstanding the foregoing, nothing herein shall be construed to require
Contractor to indemnify the Indemnified Parties from any Claim arising from the
sole negligence or willful misconduct of the Indemnified Parties. Nothing in this
indemnity shall be construed as authorizing any award of attorney's fees in any
action on or to enforce the terms of this Contract. This indemnity shall apply to
all claims and liability regardless of whether any insurance policies are
applicable. The policy limits do not act as a limitation upon the amount of
indemnification to be provided by the Consultant.
4. To the extent authorized by law, as much of the money due Contractor under and
by virtue of the Contract as shall be considered necessary by City may be
retained by it until disposition has been made of such suits or claims for damages
as aforesaid.
5. The rights and obligations set forth in this Article shall survive the termination of
this Contract.
H. EFFECT OF CONTRACTOR'S EXECUTION Execution of this Contract and all
other Contract Documents by Contractor is a representation that Contractor has visited
the Project Site, has become familiar with the local conditions under which the work is to
27
be performed, and has correlated all relevant observations with the requirements of the
Contract Documents.
CONFLICT If there is a conflict between provisions of this Contract and any other
Contract Document, the provisions of this Contract shall prevail.
WAIVER A waiver by City or any term, covenant, or condition in the Contract
Documents shall not be deemed to be a waiver of any subsequent breach of the same
or any other term, covenant or condition.
IN WITNESS WHEREOF, the parties hereto have caused this contract to be executed
the dates written below.
APPROVED AS TO FORM
OFFICE—OF ATTORNEY
Date:
Lennie Mulvihill
Assistant City Attorney l�
ATTEST: 15 — In- _ I
Date:
A& hw
Leilani I. rown
City Clerk
W
CITY OF NEWPORT BEACH
A California Municipal Corporation and City
and Charter City
Date: ! -I a�
By: C— y,
Dave-kiff
City Manager
EBS UTILITIES ADJUSTING, INC.
A California Corporation
By:
(corporate Officer)
Title:
Print Name:
Date: 11 5 2
By: A'4�1
(Financial Offic (V)
Title:
Print Name:
Date:oa,
ACKNOWLEDGMENT
.......................... a ...................................... gram ....
State of Calif rnia
County of ,V�CS \�� } ss.
On S 2� \� before m
Notary Public' onally appeared
who prov d to me on the basis of satisfactory evidence to be the person whose
namerts.) is are- subscribed to the In instrument and acknowledged to me that
e executed the same in his herH+�eir authorized capacity�ies�, and that by
Is her/their signaturesls) -on the instrument the person or the entity upon behalf of
w ich the person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
9 ,. JEFF LEE
Commisslon # 7771954
Notary Public - California
Riverside County
my Comm. Expires Oct S. 2011
Signat e
.................. ............................... a .................
.....,
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
CEO/CFO/COO
President / Vice - President / Secretary / Treasurer
Other:
Other
Thumbprint of Signer
❑ Check here if
no thumbprint
or fingerprint
is available.
EXECUTED IN TWO COUNTERPARTS
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
BOND NO. 7622813
FAITHFUL PERFORMANCE BOND
The premium charges on this Bond is $ 1.106
being at the rate of $ 13.50 thousand of the Contract price.
WHEREAS, the City Council of the City of Newport Beach, State of California, by motion
adopted, awarded to EBS Utilities Adjusting, Inc., hereinafter designated as the "Principal ", a
contract for construction of GRADE ADJUSTMENTS FOR UTILITY STRUCTURES, Contract
No. 4626 in the City of Newport Beach, in strict conformity with the plans, drawings, specifications,
and other Contract Documents maintained in the Public Works Department of the City of Newport
Beach, all of which are incorporated herein by this reference.
WHEREAS, Principal has executed or is about to execute Contract No. 4626 and the
terms thereof require the furnishing of a Bond for the faithful performance of the Contract;
NOW, THEREFORE, we, the Principal, and FIDELITY AND DEPOSIT COMPANY
OF MARYLAND 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 Eighty -One Thousand, Nine Hundred and 001100 Dollars ($81,900.00)
lawful money of the United States of Arimerica, 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.
29
As a part of the obligation secured hereby, and in addition to the face amount specified in
this Performance Bond, there shall be included costs and reasonable expenses and fees, including
reasonable attorneys fees, Incurred by the City, only in the event the City is required to bring an
action in law or equity against Surety to enforce the obligations of this Bond.
Surety, for value received, stipulates and agrees that no change, extension of time,
alterations or additions to the terms of the Contract or to the work to be performed thereunder or to
the specifications accompanying the same shall in any way affect its obligations on this Bond, and
it does hereby waive notice of any such change, extension of time, alterations or additions of the
Contract or to the work or to the specifications.
This Faithful Performance Bond shall be extended and maintained by the Principal in full
force and effect for one (1) year following the date of formal acceptance of the Project by the City.
In the event that the Principal executed this bond as an individual, it is agreed that the
death of any such Principal shall not exonerate the Surety from Its obligations under this Bond.
IN WITNESS nfHEREOF, this instrument has been duly executed by the Principal and
Surety above nlilmed, Jbri the 3RD day of MAY 2011.
alf7r&31�01+
EBS Utilities Adjusting, Inc. (Principal) Aa orized SignatureMbe
FIDELITY AND DEPOSIT
COMPANY OF MARYLAND
Name of Surety Authorized -Agent Signature
C/O ZURICH
1400 AMERICAN LANE
SCHAUMBURG, IL 60196 CHARLES L. FLAKE / ATTORNEY -IN -FACT
Address of Surety Print Name and Title
818- 409 -2800
Telephone
NOTARY ACKNOWLEDGMENTS OF CONTRACTOR AND SURETY MUST BE
ATTACHED
30
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
STATE OF CALIFORNIA
County of Orange
On 5 -03 -11 before me, Lexie Sherwood, Not PublIC
Date Here Insert Name and Title of the Officer
personally appeared Charles L- Flake
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is /are subscribed to the
LEXIE SHERWOOD within instrument and acknowledged to me that he /shefthey
CCMM. #1856389 executed the same in his /her /their authorized capacity(ies),
� NOT ORANGE °CALIFORNIA 0!2 and that by his/her /their signature(s) on the instrument the
ORANGE COUNTY person(s), or the entity upon behalf of which the person(s)
Comm. Exp. JULY 27, 2013 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 G�. �LUJ
Place Notary Seal Above Signature of Not y Public
ublic
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❑ Corporate Officer —Title(s):—
❑ Partner — ❑Limited ❑General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Top of thumb here
Signer's Name:
❑ Individual
❑ Corporate Officer— Title(s):—
❑ Partner— ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
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02007 National Notary Association • 9350 Be solo Ave., P.O. Box 2402 • Chatsworth, CA 91313 -2402 - www.Nadonalrlolary,org Item X$907 Reordec Cell Toll -Fee 1- 600 - 076.6627
ACKNOWLEDGMENT
.......................................... •.............................I
State of Calif $rn�ia \\
County of h ) ss.
On CS J v before me �L'� ���
Notary Public personally appeared IN\
who prov d to me on the basis of satisfactory evidence to be the person`s.) whose
me(sj. subscribed to the in instrument and acknowledged to me that
a ;IaLy executed the same in his herA4" -4 authorized capacity(ies,), and that by
his signaturesN on the instrument the person or the entity upon behalf of
w Ich the personNacted, 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.
JEFF LEE
� d # 1 771954
Notary P ubli c
- California �
Riverside County '-
MyConm. Expires Oct 5, 2011
Sign�atureN\
............ ............................... a . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
OPTIONAL INFORMATION
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Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary,
in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said Company, are set forth on the
reverse side hereof and are hereby certified to be in full force and effect on the date h e das I Creby nominate, constitute
and appoint Richard A. COON, Charles L. FLAKE, David L. CU , n a OOD, all of
Anaheim, California, EACH its true and lawful agent and 1a d deliver, for, and on
its behalf as surety, and as its act and deed: any an l n .f a of such bonds or
undertakings in pursuance of these presen -1 i y, as fully and amply, to all intents and
purposes, as if they had been d t ac n h Lularly elected officers of the Company at its office
in Baltimore, Md., iie`u1�_pe ° c attorney revokes that issued on behalf of Richard A. COON,
Charles L. FLAKE, ��dJ'` a thew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005.
The said Assistant s4iereeby certify that the extract set forth on the reverse side hereof is awe copy of Article VI,
Section 2, of the By- s said Company, and is now in force.
IN WITNESS WHEREOF, the said Vice - President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of
November, A.D. 2006.
ATTEST:
'ra otvosl
o °
'r I8B0 �
4*.mn
State of Maryland lss:
City of Baltimore J
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
Eric D. Barnes Assistant Secreuui
k'
11X 'V
By:
William J. Mills Vice President
On this 15th day of November, A.D. 2006, before the subscriber. a Notary Public of the State of Maryland, duly
commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being
by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid,
and that the seal affixed to the preceding instrument is the Corporate Seal or said Company, and that the said Corporate Seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of
the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
q''('gq'nup`J•``
POA -F 012 -4150H
Constance A. Dunn Noiary Public
My Commission Expires: July 14, 2011
EXECUTED IN TWO COUNTERPARTS
City of Newport Beach
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
Contract No. 4626
BOND NO. 7622813
PREMIUM: INCLUDED IN PERFORMANCE BOND
LABOR AND MATERIALS PAYMENT BOND
WHEREAS, the City Council of the City of Newport Beach, State of California, by motion
adopted, has awarded to EBS Utilities Adjusting, Inc., hereinafter designated as the "Principal," a
contract for construction of GRADE ADJUSTMENTS FOR UTILITY STRUCTURES, Contract
No. 4626 in the City of Newport Beach, in strict conformity with the plans, drawings, specifications
and other Contract Documents in the office of the Public Works Department of the City of Newport
Beach, all of which are incorporated herein by this reference.
WHEREAS, Principal has executed or is about to execute Contract No. 4626 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,
FIDELITY AND DEPOSIT COMPANY OF MARYLAND 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 Eighty -One Thousand, Nine
Hundred and 00 /100 Dollars ($81,900.00) lawful money of the United States of America, said
sum being equal to 100% of the estimated amount payable by the City of Newport Beach under the
terms of the Contract; for which payment well and truly to be made, we bind ourselves, our heirs,
executors and administrators, successors, or assigns, jointly and severally, firmly by these present.
THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal or the Principal's
subcontractors, fail to pay for any materials, provisions, or other supplies, implements or machinery
used in, upon, for, or about the performance of the work contracted to be done, or for any other
work or labor thereon of any kind, or for amounts due under the Unemployment Insurance Code
with respect to such work or labor, or for any amounts required to be deducted, withheld and paid
over to the Employment Development Department from the wages of employees of the Principal
and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect
to such work and labor, then the Surety will pay for the same, in an amount not exceeding the sum
specified in this Bond, and also, in case suit is brought to enforce the obligations of this Bond, a
reasonable attorney's fee, to be fixed by the Court as required by the provisions of Section 3250 of
the Civil Code of the State of California.
33
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, afterations or additions to the terms of the Contract or to the work to be performed thereunder
or the specifications accompanying the same shall in any wise affect its obligations on this Bond,
and it does hereby waive notice of any such change, extension of time, alterations or additions to
the terms of the Contract or to the work or to the specifications.
In the event that any principal above named executed this Bond as an individual, it is
agreed that the death of any such principal shall not exonerate the Surety from its obligations under
this Bond.
IN WITNESS WHEREOF, this instrument has been duly executed by the above named
Principal and Surety, on a 3RD day of MAY _'2011.
EBS Utilities Adjus ng, Inc. (Principal) Authorized SignatureTtle
FIDELITY AND DEPOSIT
Name of Surety
C/O ZURICH
1400 AMERICAN LANE
SCHAUMBURG. IL 60196
Address of Surety
818- 409 -2800
Telephone
Authorized'Agent Signature
CHARLES L. FLAKE / ATTORNEY -IN -FACT
Print Name and Title
NOTARY ACKNOWLEDGMENTS OF CONTRACTOR AND SURETY MUST BE
ATTACHED
34
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
STATE OF CALIFORNIA
County of Orange
On 5 -03 -11 before me, Lexie Sherwood, Notary Public
Date Here Ins an Name and Title of the Officer
personally appeared Charles L. Flake
Name(s)of Signers)
LEXIE SHERWOOD
COMM. #1856389 R
NOTARY PUBLIC °CALIFORNIA n
ORANGECOUNTY
Comm. Exp. JULY 27, 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 a official seal
Signature lJ /(D/LU�25GG
Place Notary Seal Above Signature-of N61ary Public
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and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document
Signer(s) Other Than Named
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Individual
❑ Corporate Officer — Title(s):_
❑ Partner— ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
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❑ Individual
❑ Corporate Officer— Title(s):
❑ Partner — ❑Lmited ❑General
❑ Attorney in Fact
❑ Trustee °
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
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02007 National Notary Association- 9350 De Salo Ave., P.O. Boa 2402 - Chatsworth, CA 91313- 2402 - www.NationalNotary.arg Item115907 Reorder: Call Toll -Free 1- 800 - 976.6627
ACKNOWLEDGMENT
.......................................... ..............................I
State of California
County of K ss.
On �3�G�t S ,2��� before me
Notary Public, personally appeared ��t T�,
who prov d to me on the basis of satisfactory evidence to be the persons.) whose
nameFsj. is afe. subscribed to the w't in instrument and acknowledged to me that
he executed the same in hi herftheir authorized capacityties), and that by
is r signatures'(s.). on the instrument the person, or the entity upon behalf of
w ic` Fl h7 tperson(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
r. JEFF LEE [
f ' "%y J. Commission # 1771954 C
Notary Public - California
_ • �`• Riverside County -
My Comm. Expires oct 5.2011
.................... ............................... a . . . . . . . . . . . . . . . . . . . . .
OPTIONAL INFORMATION
Date of Document
Type or Title of Document
Number of Pages in Document
Document in a Foreign Language
Type of Satisfactory Evidence:
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Trustee
Power of Attorney
CEO /CFO /COO
_ President / Vice - President / Secretary / Treasurer
Other:
Other Information:
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Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary,
in pursuance of authority granted by Article Vl, Section 2, of the By -Laws of said Company, are set forth on the
reverse side hereof and are hereby certified to be in full force and effect on the date h e des by nominate, constitute
and appoint Richard A. COON, Charles L. FLAKE, David L. CULAE, a OOD, all of
Anaheim, California, EACH its true and lawful agent and ma u d deliver, for, and on
s behalf as surety, and as its act and deed: an ° �faA"pgs, xecution ol'such bonds or
undertakings in pursuance of these presen I 0 )' m° WW, as fully and amply, to all intents and
purposes, as if they had been d VS t 'Mac ularly elected officers of the Company at its office
in Baltimore, Md., ' & p per s attorney revokes that issued on behalf of Richard A. COON,
Charles L. FLAKE,, C 1 ' _ a ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005.
The said Assistant es4lereby certify that the extract set forth on the reverse side hereof is a true copy of Article VI,
Section 2, of the By -LA)6s said Company, and is now in force.
IN WITNESS WHEREOF, the said Vice- President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of
November. A.D. 2006.
ATTEST:
oi_
State of Maryland l ss:
City of Baltimore J
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
Eric D. Barnes Assistant Secretes -y
LE
William J. Mills
Vice President
On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the Slate of Maryland, duly
commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being
by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid,
and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of
the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
111111 111��,`;
POA -F 012 -4150H
Constance A. Dunn Notary Public
My Commission Expires: July 14, 2011
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
PROPOSAL
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
CONTRACT NO. 4626
To the Honorable City Council
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 the Instructions to
the Bidders, has examined the Plans and Special Provisions, and hereby proposes to furnish all materials
except that material supplied by the City and shall perform all work required to complete Contract No. 4626 in
accordance with the Plans and Special Provisions, and will take in full payment therefore the following unit
prices for the work, complete in place, to wit:
ITEM QUANTITY ITEM DESCRIPTION AND UNIT UNIT TOTAL
AND UNIT PRICE WRITTEN IN WORDS PRICE PRICE
1. Lump Sum
Mobilization
Two - thousand,
@ Four - hundred, R Fifty Dollars
and
Zero Cents
$ 2,450.00
Per Lump Sum
2. Lump Sum
Traffic Control
@ Eight- hundred, Twenty- FiveDollars
an
Zero Cents
$ 825.00
Per Lump Sum
3. 105 EA.
Remove & Replace Survey Monument
Frame & Cover to Grade
@ Three Hundred Dollars
and
Zero Cents $ 300.00
$ 31,500.00
Per Each
4. 70 EA.
Remove & Replace Water Valve
Frame & Cover to Grade
@ Three Hundred Dollars
and
Zero Cents $ 300.00
$ 21,000.00
Per Each
PR2of2
ITEM QUANTITY ITEM DESCRIPTION AND UNIT UNIT TOTAL
AND UNIT PRICE WRITTEN IN WORDS PRICE PRICE
5. 45 EA. Adjust Manhole Frame & Cover to Grade
@ Two - Hundred, Seventy -Five Dollars
and
Zero Cents $ 275.00 $ 12,375.00
Per Each
6. 22 EA. Remove & Replace Manhole Frame & Cover
and Adjust to Grade
@ Six- Hundred, Twenty -Five Dollars
and
Zero Cents $ 625.00 $ 13,750
Per Each
TOTAL PRICE IN WRITTEN WORDS
Eighty -one Thousand, Nine Hundred Dollars
and Zero Cents $ 81,900.00'
Total Price (Figures)
April 18, 2011
Dale
(951) 279 -6869 / (951) 279 -9112
Bidder's Telephone and Fax Numbers
932798A
Bidder's License No(s).
and Classification(s)
EBS Ut fies Adjusting, Inc.
Bidder
/ President
der's Authorized Signature and Title Joseph Nanci
1320 E 6th St #100, Corona, CA 92879
Bidder's Address
Bidder's email address: ABALLIN @EBS- FNC.US
PUBLIC WORKS DEPARTMENT
1
1
1
1
1
2
2
2
2
2
2
2
2
3
3
3
3
3
4
INDEX
FOR
SPECIAL PROVISIONS
GRADE ADJUSTMENTS FOR UTILITY STRUCTURES
CONTRACT NO. 4626
INTRODUCTION
PART 1--- GENERAL PROVISIONS
SECTION 2
SCOPE AND CONTROL OF THE WORK
2 -6
WORK TO BE DONE
SECTION 3
CHANGES IN WORK
3 -3
EXTRA WORK
3 -3.2
Payment
3 -3.2.3
Markup
SECTION 4
CONTROL OF MATERIALS
4 -1
MATERIALS AND WORKMANSHIP
4 -1.3
Inspection Requirements
4 -1.3.4
Inspection and Testing
SECTION 5
UTILITIES
5 -1
LOCATION
5 -2
PROTECTION
5 -8
SALVAGED MATERIALS
SECTION 6
PROSECUTION, PROGRESS AND ACCEPTANCE
OF THE WORK
6 -1
CONSTRUCTION SCHEDULE AND
COMMENCEMENT OF THE WORK
6 -7
TIME OF COMPLETION
6 -7.1
General
6 -7.2
Working Days
6 -7.4
Working Hours
1
1
1
1
1
2
2
2
2
2
2
2
2
3
3
3
3
3
4
SECTION 7
RESPONSIBILITIES OF THE CONTRACTOR 4
7 -7
COOPERATION AND COLLATERAL WORK 4
7 -8
PROJECT SITE MAINTENANCE 4
7 -8.5
Temporary Light, Power and Water 4
7 -8.5.1
Steel Plates 5
7 -8.6
Water Pollution Control 5
7 -8.6.1
Best Management Practices and Monitoring Program 5
7 -10
PUBLIC CONVENIENCE AND SAFETY 5
7 -10.1
Traffic and Access 5
7 -10.2
Storage of Equipment and Materials in Public Streets 6
7 -10.4
Public Safety 6
7- 10.4.1
Safety Orders 6
7 -10.5
"No Parking" Signs 6
7 -10.7
Notice to Residents and Temp Parking Permits 7
7 -15
CONTRACTOR LICENSES 7
7 -16
CONTRACTOR'S RECORDWAS BUILT DRAWINGS 7
SECTION 9
MEASUREMENT AND PAYMENT 7
9 -3
PAYMENT 7
9 -3.1
General 7
9 -3.2
Partial and Final Payment 8
PART 2--- CONSTRUCTION MATERIALS
SECTION 201
CONCRETE, MORTAR, AND RELATED MATERIALS 8
201 -1
PORTLAND CEMENT CONCRETE 8
201 -1.1.2
Concrete Specified by Class 8
PART 3 - -- CONSTRUCTION METHODS
SECTION 300 EARTHWORK 9
300 -1 CLEARING AND GRUBBING 9
300 -1.3 Removal and Disposal of Materials 9
300 -1.3.1 General 9
300 -1.5 Solid Waste Diversion 9
SECTION 302 ROADWAY SURFACING 9
302 -5 ASPHALT CONCRETE PAVEMENT 9
302 -5.1 General 9
302 -5.4 Tack Coat 9
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
SPECIAL PROVISIONS
GRADE ADJUSTMENTS FOR UTILITY STRUCTURE:
CONTRACT NO. 4626
INTRODUCTION
SP1OF9
All work necessary for the completion of this contract shall be done in accordance with
(1) these Special Provisions; (2) the Plans (Drawing No. S- 5244 -S); (3) the City's
Standard Special Provisions and Standard Drawings for Public Works Construction,
(2004 Edition), including Supplements; (4) Standard Specifications for Public Works
Construction (2003 Edition), including supplements. Copies of the Standard Special
Provisions and Standard Drawings may be purchased at the Public Works Department.
Copies of the Standard Specifications for Public Works Construction may be purchased
from Building News, Inc., 1612 South Clementine Street, Anaheim, CA 92802, 714 -517-
0970.
The following Special Provisions supplement or modify the Standard
Specifications for Public Works Construction as referenced and stated
hereinafter:
PART 1
GENERAL PROVISIONS
SECTION 2-- -SCOPE AND CONTROL OF THE WORK
2 -6 WORK TO BE DONE, Add to this section, "The work necessary for the completion
of this contract consists of replacing survey monument frame and cover, water valve
frame and cover to grade. This contract also includes replacing and adjusting sewer
and storm drain manholes to grade in the Big Canyon Community."
SECTION 3 - -- CHANGES IN WORK
3 -3 EXTRA WORK
3 -3.2 Payment
3 -3.2.3 Markup. Replace this section with,
SP2OF9
"(a) Work by Contractor. The following percentages shall be added to the
Contractor's costs and shall constitute the markup for all overhead and profits:
1) Labor ............. ............................... 15
2) Materials ........ ............................... 15
3) Equipment Rental ........................... 15
4) Other Items and Expenditures ........... 15
To the sum of the costs and markups provided for in this subsection, 1 percent shall
be added for compensation for bonding.
(b) Work by Subcontractor. When all or any part of the extra work is
performed by a Subcontractor, the markup established in 3- 3.2.3(a) shall be applied
to the Subcontractor's actual cost of such work. A markup of 10 percent on the first
$5,000 of the subcontracted portion of the extra work and a markup of 5 percent on
work added in excess of $5,000 of the subcontracted portion of the extra work may
be added by the Contractor."
SECTION 4 - -- CONTROL OF MATERIALS
4 -1 MATERIALS AND WORKMANSHIP
4 -1.3 Inspection Requirements
4 -1.3.4 Inspection and Testing. All material and articles furnished by the
Contractor shall be subject to rigid inspection, and no material or article shall be used in
the work until it has been inspected and accepted by the Engineer. The Contractor
shall furnish the Engineer full information as to the progress of the work in its various
parts and shall give the Engineer timely (48 -hours minimum) notice of the Contractor's
readiness for inspection. Submittals are required for all construction material.
SECTION 5 - -- UTILITIES
5 -1 LOCATION. Add the following after the 3rd paragraph: "Upon completion of the
work or phase of work, the Contractor shall remove all USA utility markings."
5 -2 PROTECTION. Add the following: "In the event that an existing pull or meter
box or cover is damaged by the Work and is not re- useable, the Contractor shall
provide and install a new pull or meter box or cover of identical type and size at no
additional cost to the City."
5 -8 SALVAGED MATERIALS. The Contractor shall salvage all existing sewer /storm
drain manhole (including grade rings), meter or valve box covers. The Contractor shall
salvage all removed cast iron pipes. Salvaged materials shall be delivered to the City's
Utility Yard at 949 West 16th Street. The Contractor shall make arrangements for the
delivery of salvaged materials by contacting Mr. Ed Burt, Utilities Operations Manager,
at (949) 718 -3432.
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SECTION 6--- PROSECUTION, PROGRESS AND ACCEPTANCE OF THE WORK
6 -1 CONSTRUCTION SCHEDULE AND COMMENCEMENT OF WORK. Add to this
section: "The time of completion as specified in Section 6 -7, shall commence on the
date of the 'Notice to Proceed.'
No work shall begin until a "Notice to Proceed" has been issued, a pre- construction
meeting has been conducted, and a schedule of work has been approved by the
Engineer. The Contractor shall submit a construction schedule to the Engineer for
approval a minimum of five working days prior to commencing any work. Schedule may
be bar chart or CPM style.
The Engineer will review the schedule and may require the Contractor to modify the
schedule to conform to the requirements of the Contract Documents. If work falls behind
the approved schedule, the Contractor shall be prohibited from starting additional work
until Contractor has exerted extra effort to meet the original schedule and has
demonstrated that the ability to maintain the approved schedule in the future. Such
stoppages of work shall in no way relieve the Contractor from the overall time of
completion requirement, nor shall it be construed as the basis for payment of extra work
because additional personnel and equipment were required on the job."
6 -7 TIME OF COMPLETION
6 -7.1 General. Add to this section: "The Contractor shall complete all work
under the Contract within 30 consecutive working days after the date on the
Notice to Proceed. The Contractor shall distribute the construction notices and
complete the work in each Work Area as shown on the Plan. The Contractor shall finish
one Work Area before starting the next Work Area.
The Contractor shall ensure the availability of all material prior to the start of work.
Unavailability of material will not be sufficient reason to grant the Contractor an
extension of time for 100 percent completion of work."
6 -7.2 Working Days. Revise 3) to read: "any City holiday, defined as January 1st
(New Year's Day), the third Monday in January (Martin Luther King Day), the third
Monday in February (President's Day), the last Monday in May (Memorial Day), July 4`h,
the first Monday in September (Labor Day), November 11th (Veterans Day), the fourth
Thursday and Friday in November (Thanksgiving and Friday after), December 24th,
(Christmas Eve), December 25th (Christmas), and December 315 (New Year's Eve). If
January 1st, July 4th, November 11th, December 24th, December 25th or December
31st falls on a Sunday, the following Monday is a holiday. If January 15 July 41h,
November 11th December 24th December 25t or December 31st falls on a Saturday,
the Friday before is a holiday."
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6 -7.4 Working Hours. Normal working hours are limited to 8:00 AM to 4:30 PM,
Monday through Friday.
The Contractor, subcontractors, suppliers, etc., shall not generate any noise at the work
site, storage sites, staging areas, etc., before or after the normal working hours
prescribed above.
Should the Contractor elect to work outside normal working hours, Contractor must first
obtain special permission from the Engineer. The request may be for 4:30 PM to 6:30
PM on weekdays or 8:00 a.m. to 6 p.m. on Saturday only. A request for working during
any of these hours must be made at least 72 hours in advance of the desired time
period. A separate request must be made for each work shift. The Engineer reserves
the right to deny any or all such requests. Additionally, the Contractor shall pay for
supplemental inspection costs of $123.00 per hour when such time periods are
approved.
SECTION 7 - -- RESPONSIBILITIES OF THE CONTRACTOR
7 -7 COOPERATION AND COLLATERAL WORK. Add to this section: "City forces will
perform all shut downs of water facilities as required. The Contractor shall give the City
seven calendar days notice of the time he desires the shut down of facilities to take
place.
A four -hour shut down of water facilities during the daytime hours of 10:00 a.m. to 2:00
p.m. or a six -hour shut down between the hours of 11:00 p.m. to 5:00 a.m. will be
allowed. The Contractor will be responsible for completing all water connections within
the time period allowed. The times and dates of any utility to be shut down must be
coordinated with the City of Newport Beach, Utilities Department, The City must
approve any nighttime work in advance.
The Contractor shall provide and install new water meter and valve boxes. Existing
water meter or valve box frames and covers shall be salvaged. Salvaged meter or
valve boxes and water pipe shall be delivered to the City's Utilities Yard at 949 West
16th Street. The Contractor shall make arrangements for the delivery of salvaged
materials by contacting Mr. Ed Burt, Utilities Operation Manager, at (949) 718 - 3402."
7 -8 PROJECT SITE MAINTENANCE
7 -8.5 Temporary Light, Power and Water. Add to this section: "If the Contractor
elects to use City water, he shall arrange for a meter and tender an $813 meter deposit
with the City. Upon return of the meter to the City, the deposit will be returned to the
Contractor, less a quantity charge for water usage and repair charges for damage to the
meter and monthly meter service charge of $90 per month."
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Water used during construction shall be paid for by the Contractor. This includes water
for flushing and pressure testing water lines, compaction, irrigation during maintenance
period for landscaping, etc."
7 -8.5.1 Steel Plates. Add this section: "Steel plates utilized for utility trenching
shall be the slip resistant type per Caltrans Standards."
7 -8.6 Water Pollution Control. Add to this section, "Surface runoff water, including
all water used during sawcutting operations, containing mud, silt or other deleterious
material due to the construction of this project shall be treated by filtration or retention in
settling basin(s) sufficient to prevent such material from migrating into any catch basin,
Newport Harbor, the beach, or the ocean. The Contractor shall also comply with the
Construction Runoff Guidance Manual which is available for review at the Public Works
Department or can be found on the City's website at
www .newportbeachca.gov /publicworks and clicking on permits, then selecting the link
Construction Runoff Guidance Manual.
7 -8.6.1 Best Management Practices and Monitoring Program. The
Contractor shall submit a Best Management Practice (BMP) plan for containing any
wastewater or storm water runoff from the project site including, but not limited to the
following:
a. No placement of construction materials where they could enter storm drain system,
which includes gutters that lead to catch basins.
b. Checking construction vehicles for leaking fluids.
c. Providing a controlled area for cleaning or rinse -down activities.
d. Monitoring construction activities.
e. Minimizing usage of water when saw- cutting and vacuum the residue.
f. Providing measures to capture or vacuum -up water contaminated with
construction debris.
g. Removing any construction related debris on a daily basis.
h. Protecting work areas from erosion.
The BMP will be approved by the Engineer prior to any work. The City of Newport
Beach will monitor the adjacent storm drains and streets for compliance. Failure of the
Contractor to follow BMP will result in immediate cleanup by City and back - charging the
Contractor for all costs plus 15 percent. The Contractor may also receive a separate
Administrative Citation per Section 14.36.030A23 of the City's Municipal Code.
7 -10 PUBLIC CONVENIENCE AND SAFETY
7 -10.1 Traffic and Access. Add to this section: "The Contractor shall provide
traffic control and access in accordance with Section 7 -10 of the Standard
Specifications and the Work Area Traffic Control Handbook (WATCH), also published
by Building News, Inc.
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Pedestrian access to all storefronts, offices, residences, etc., within the limits of work
must be maintained at all times. The Contractor shall cooperate with the Engineer to
provide advance notice to any and all establishments whose access will be impacted by
construction operations, particularly sidewalk construction. The Contractor shall furnish
and install signage, barricades, delineators, yellow safety ribbon, and any other
measures deemed necessary by the Engineer to safely direct the public around areas
of construction, and into (and out of) the affected establishments."
7 -10.2 Storage of Equipment and Materials in Public Streets. Delete the first
paragraph and add the following: "Construction materials and equipment may only be
stored in streets, roads, or sidewalk areas if approved by the Engineer. It is the
Contractor's responsibility to obtain an area for the storage of equipment and
materials. The Contractor shall obtain the Engineer's approval of a site for storage of
equipment and materials prior to arranging for or delivering equipment and materials to
the site. Prior to move -in, the Contractor shall take photos of the laydown area. The
Contractor shall restore the laydown area to its pre- construction condition. The
Engineer may require new base and pavement if the pavement condition has been
compromised during construction."
7 -10.4 Safety
7- 10.4 -1 Safety Orders. Add to this section: "The Contractor shall be solely
and completely responsible for conditions of the job -site, including safety of all persons
and property during performance of the work, and the Contractor shall fully comply with
all State, Federal and other laws, rules, regulations, and orders relating to the safety of
the public and workers.
The right of the Engineer or the City's Representative to conduct construction review or
observation of the Contractor's performance shall not include review or observation of
the adequacy of the Contractor's safety measures in, on, or near the construction site."
7 -10.5 "No Parking" Signs. The Contractor shall install, and maintain in place
"NO PARKING -TOW AWAY" signs (even if streets have posted "NO PARKING" signs)
which he shall post at least forty -eight hours in advance of the need for enforcement.
The signs will be provided at no cost to the Contractor. However, the City reserves the
right to charge $1.50 per sign following any excessive abuse or wastage of the signs by
the Contractor. In addition, it shall be the Contractor's responsibility to notify the City's
Police Department at (949) 644 -3717 for verification of posting at least forty -eight hours
in advance of the need for enforcement. The signs shall (1) be made of white card
stock; (2) have minimum dimensions of 12- inches wide and 18- inches high; and (3) be
City of Newport Beach "Temporary Tow -Away, No Parking" signs available at the
Public Works Department public counter.
The Contractor shall print the hours and dates of parking restriction on the "NO
PARKING -TOW AWAY" sign in 2 -inch high letters and numbers. A sample of the
completed sign shall be reviewed and approved by the Engineer prior to posting.
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7 -10.7 Notices to Residents. Ten working days prior to starting each Work
Area as shown on the Plan, the Contractor shall deliver a construction notice to
residents within each Work Area, describing the project and indicating the limits of
construction. The written notices will be prepared by the City, but shall be distributed by
the Contractor. Errors in distribution, false starts, acts of God, strikes or other
alterations of the schedule will require Contractor re- notification using an explanatory
letter furnished by the City.
7 -15 CONTRACTOR'S LICENSES. At the time of the award and until completion of
work, the Contractor shall possess a General Engineering Contractor "A" License.
At the start of work and until completion of work, the Contractor and all Sub - contractors
shall possess a Business License issued by the City of Newport Beach.
7 -16 CONTRACTOR'S RECORDS /AS BUILT DRAWINGS. A stamped set of
approved plans and specifications shall be on the job site at all times. In addition, the
Contractor shall maintain "As- Built" drawings of all work as the job progresses. A
separate set of drawings shall be maintained for this purpose. These drawings shall be
up -to -date and reviewed by the Engineer at the time each progress bill is submitted.
Any changes to the approved plans that have been made with approval from the
Engineer of Record or City Inspector shall be documented on the "As- Built" drawings.
The "As- Built" mark -ups shall be submitted and approved by the Engineer prior to final
payment or release of any bonds.
The Contractor shall maintain books, records, and documents in accord with generally
accepted accounting principles and practices. These books, records, and documents
shall be retained for at least three years after the date of completion of the project.
During this time, the material shall be made available to the Engineer. Suitable facilities
are to be provided for access, inspection, and copying of this material.
SECTION 9--- MEASUREMENT AND PAYMENT
9 -3 PAYMENT
9 -3.1 General. Revise paragraph two to read: "The unit and lump sum prices bid
for each item of work shown on the proposal shall include full compensation for
furnishing the labor, materials, tools, and equipment and doing all the work, including
restoring all existing improvements, to complete the item of work in place and no other
compensation will be allowed thereafter. Payment for incidental items of work not
separately listed shall be included in the prices shown for the other related items of
work. The following items of work pertain to the bid items included within the Proposal:
Item No. 1 Mobilization: Work under this item shall include providing bonds,
insurance and financing, preparing a construction schedule, distribution of construction
notices, and all other related work as required by the Contract Documents.
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Item No. 2 Traffic Control: Work under this item shall include delivering all required
notifications and temporary parking permits, post signs and all costs incurred notifying
residents. In addition, this item shall be 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 Remove and Replace Survey Monument Frame and Cover to Grade:
Work under this item shall include removing existing and replacing new survey
monument frame and cover to grade and all other work items as required to complete
the work in place.
Item No. 4 Remove and Replace Water Valve Frame and Cover to Grade: Work
under this item shall include removing existing and replacing new water valve frame and
cover to grade and all other work items as required to complete the work in place.
Item No. 5 Adjust Manhole Frame and Cover to Grade: Work under this item shall
include removing existing ring risers, adjusting, raising manhole frame and cover to
existing grade and all other work items as required to complete the work in place.
Item No. 6 Remove and Replace Manhole Frame and Cover to Grade: Work under
this item shall include removing existing frame, lid, existing ring riser, replacing new
frame, lid and adjusting to existing grade and all other work items as required to
complete the work in place.
9 -3.2 Partial and Final Payment. Add to this section: "Partial payments for
mobilization and traffic control shall be made in accordance with Section 10264 of the
California Public Contract Code."
PART 2
CONSTRUCTION MATERIALS
SECTION 201 - -- CONCRETE, MORTAR, AND RELATED MATERIALS
201 -1 PORTLAND CEMENT CONCRETE
201 -1.1.2 Concrete Specified by Class. Add to this section: 'Portland Cement
concrete for construction shall be Class 560 -C- 3250."
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PART 3
CONSTRUCTION METHODS
SECTION 300 - -- EARTHWORK
300 -1 CLEARING AND GRUBBING
300 -1.3 Removal and Disposal of Materials
Add to this Section: "Removal and disposal of material shall be done by City
approved Licensed and Franchised Commercial Solid Waste Haulers. A current list of
approved haulers can be provided upon request or be found on the City's website at:
www/ newportbeachca .gov /generalservices and clicking on refuse, then selecting the
link Franchised Haulers List."
300 -1.3.1 General. Add to this section: "The work shall be done in accordance
with Section 300 -1.3.2 of the Standard Specifications except as modified and
supplemented herein. Joins to existing pavement lines shall be full depth sawcuts.
Final removal between the sawcut lines may be accomplished by the use of
jackhammers or sledgehammers. Pavement breakers or stompers will not be permitted
on the job. The Engineer must approve final removal accomplished by other means.
The Contractor shall maintain the job site in a clean and safe condition. The Contractor
will remove any broken concrete, debris or other deleterious material from the job site at
the end of each workday."
300 -1.5 Solid Waste Diversion. Non - reinforced concrete and asphalt wastes
generated from the job site shall be disposed of at a facility that crushes such materials
for reuse. Excess soil and other recyclable solid wastes shall not be disposed of at a
sanitary landfill.
The Contractor shall maintain monthly tonnage records of total solid wastes generated
and solid wastes disposed of at a sanitary landfill. The Contractor shall report said
tonnage monthly to the Engineer on a form provided by the Engineer and provide
appropriate confirmation documentation from the recycling facility.
SECTION 302 - -- ROADWAY SURFACING
302 -5 ASPHALT CONCRETE PAVEMENT
302 -5.1 General. Add to this section: "The asphalt concrete (A.C.) used for surface
caps shall be III -C3 -AR -4000. The A.C. for base course shall be III- 132 -AR- 4000."
302 -5.4 Tack Coat. Add to this section: "Prior to placing the asphalt concrete
patches, a tack coat of Type SS -1h asphaltic emulsion at a rate not to exceed one —
tenth (1/10) of a gallon per square yard shall be uniformly applied to existing A.C. and
P.C.C. surfaces and edges against which asphalt concrete is to be placed."
CERTIFICATE OF INSURANCE
CHECKLIST
City of Newport Beach
This checklist is comprised of requirements as outlined by the City of Newport Beach.
Date Received: 4/29/2011 Dept. /Contact Received From: Shari Rooks
Date Completed: 5/2/2011 Sent to: Shari By: Joel
Company /Person required to have certificate: EBS Utilities Adjusting, Inc.
GENERAL LIABILITY
A. INSURANCE COMPANY: Great American Assurance Cc
B. AM BEST RATING (A- : VII or greater): A: XIV
C. ADMITTED Company (Must be California Admitted)
Is Company admitted in California?
Yes 7X]
No
D. LIMITS (Must be $1M or greater): What is limit provided?
$2,000,000
E. PRODUCTS AND COMPLETED OPERATIONS (Must
include): Is it included? (completed Operations status does
not apply to Waste Haulers)
Yes O
No
F. ADDITIONAL INSURED WORDING TO INCLUDE (The City
its officers, officials, employees and volunteers): Is it
included?
�'
Yes X I
No
G. PRIMARY & NON - CONTRIBUTORY WORDING (Must be
Yes
included): Is it included?
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 �X
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.
Will mail
II. AUTOMOBILE LIABILITY
A. INSURANCE COMPANY: N!aUSMI Underwriters
B. AM BEST RATING (A-: VII or greater) A; XY
C. ADMITTED COMPANY (Must be California Admitted):
Is Company admitted in California? Yes No 0
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):
Is it included? N/A Yes I No
F. 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.
Will Mail
III. WORKERS' COMPENSATION
A. INSURANCE COMPANY: Seabright Ins Co.
B. AM BEST RATING (A-: VII or greater): A -; IX
C. LIMITS: Statutory X
D. WAIVER OF SUBROGATION (To include): Is it included? Yes FNo
HAVE ALL ABOVE REQUIREMENTS BEEN MET?
IF NO, WHICH ITEMS NEED TO BE COMPLETED?
NOTES:
Approved:
May 2, 2011
Agent of Alliant Insurance Services
Broker of record for the City of Newport Beach
Yes aX No
0 Requires approval /exception /waiver by Risk Management B &B initials
Comments:
Approved:
Risk Management
Date