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04-125 Storm Drain Catch Basin Cleaning (3)RECORDING REQUESTED BY City of Cupertino WHEN RECORDED MAIL TO City Clerk's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 ~ii~i~W~iiii~ui~~iiii~~~u~~ Pages 3 Fees.... No Fees Taxes... Copies.. AMT PAID BRENDA DAVIS SANTA CLARA COUNTY RECORDER Recorded at the request of City RDE # 003 3/23/2005 2 47 PM (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NO FEE INACCORDANCE WITH GOY. CODE 6103 CERTIFICATE a~F COMPLETION ArJD NOTICE OF ACCEPTA VCE OF COMPLETION STORM DRAIN CATCH BASIN CLEANING PROJECT 2004-07 Original O For Fast Endorsement City Hall 10300 Torre Avenue Cupertino, CA 95014-3255 (408) 777-3354 PUBLIC WORKS DEPARTMENT CERTIFICATE OF COMPLETION AND NOTICE OF ACCEPTAI\~CE OF COMPLETION STORM DRAIN CATCIH BASIN CLEANING PROJECT' 2004-07 NOTICE IS HEREBY GIVEN THAT I, Ralph A. Qualls, Jr., Director of Public Works and City Engineer of the City of Cupertino, California, do hereby certify that the work and improvements in hereinafter described in the contract which was entered into, by, and between the City of Cupertino and National Plant Services, Inc., on November 18, 2004,, in accordance with the plans and specifications for said work, have been completed to my satisfactio~l and acceptance of completion was ordered on March 8, 2005. That said work and improvements consisted of furnishing all labor, materials, tools, and equipment required to complete said project, all as more particularly described in the plans and specifications for said project. `-mod C.Q Lc c~ Director of Public Works and (~ity Engineer of the City of Cupertino Date: March 8, 2005 LL u~-- Printed on Recycled Paper VERIFICATION I have reviewed this Certificate of Completion and Notice of Acceptance of Completion. To the best of my knowledge, the information contained herein is true and complete. I verify under penalty of perjury under tree laws of the State of California, that the foregoing is true and correct. Executed on the 10`h of March, 2005 at Cupertino, California. ~~~ ILtiC~1~I s~ . f~~Q,?.~ 6~ Administrative Clerk City of Cupertino o~-~ a s~ E. CONTRACT FOR PUBLIC WORKS This CONTRACT made on /y0 V'• ~ $ ~ 71J0 ~{ by the CITY OF CUPERTINO, a municipal corporation of the Suite of California, hereinafter called CITY, and National Plant Services, Inc. hereinafter called ('ONTRACTOR. IT IS HEREBY AGREED by CITY and CONTRACTOR as follows: 1. THE CONTRACT DOCUMENTS. The complete contract consists of this contract and the following contract documents incorporated herein by reference: a. Notice to Contractors, Proposal, Time of Completion, Estimated Quantities, Noncollusion Affidavit, Bidder Qualification Form, Subcontractors Form and Signature Form. b. Standard Specifications, General Provisions, Special Provisions and Technical Provisions. c. Specifications for Storm Drain Catch Basin ~~leaning, Project No. 2004-07 d. Faithful Performance Bond. e. Insurance Agreement, Certificate of Insurance, Endorsement of Primary Insurance, Additional Insured Endorsement, Endorsement of Aggregate Limits of Insurance per Project, Waiver of Subrogation Endorsement Worker'; Compensation Insurance and Notice of Policy Cancellation Endorsement. All of the above documents are incorporated into this contract by reference so that any work called for in one and not. mentioned in another, is to be executed the same as if mentioned in all of said documents. The documents comprising the complete contract are sometimes hereinafter referred to as the Contract Documents. In case of conflict between the Plans and the Specifications on the one hand, and this Contract on the other, the Plans and Specifications shall prevail. 2. THE WORK. CONTRACTOR agrees to furnish all of the tools, equipment, apparatus, facilities, labor, transportation and materials necessary to perform and complete in a good and working order, the work of cleaning storm catch basins, as called for, and in the manner designated in, and in strict conformity with, the Plans and Specifications prepared by the Engineer and adopted by CITY, which Specific~itions are entitled, respectively, Storm Drain Catch Basin Cleaning, Project No. 2004-07 anti which Plans and Specifications are identified by the signatures of the parties to this Contract. It is understood and agreed that said tools, equipment, apparatus, facilities, labor, transporta~:ion and materials shall be furnished, and that said work shall be performed and completed as required in said Plans and Specifications under the sole direction of CONTRACTOR, but subject to the inspection and approval of CITY, or its representative. CITY hereby designates as its representative for the purpose of this Contract the Engineer, Mr. Ralph A. Qualls, Jr. 1 3. CONTRACT PRICE. CITY agrees to pay, and CONTRACTOR agrees to accept, in full payment for the work above agreed to be done, the sum of Fifty Seven Thousand Eight Hundred and Fifty Dollars and no Cents ($57,850.00) subject to additions and/or deductions as provided in the Contract Documents, per Exhibit A attached hereto. 4. DISPUTES PERTAINING TO PAYMENT FOR WORK. Should any dispute arise respecting the true value of the work done, or any work omitted, or any extra work which CONTRACTOR may be required to do, or respecting the size of any payment to CONTRACTOR during the performance of this Contract, said dispute shall be determined either by reference to the Unit Prices bid, if applicable, or in accordance with agreement of prices, if applicable, or in accordance with the agreement c-f the parties, or in accordance with Section 6, paragraph "f' of the General Provisions. 5. PERMITS, COMPLIANCE WITH LAW. CONTRACTOR shall obtain and bear all expense for all necessary permits, licenses and easements for the construction of the project, give all necessary notices, pay all fees required by la~,v, and comply with the laws, ordinances and regulations relating to the work and to the preservation of the public health and safety. 6. INSPECTION BY THE CITY. CONTRACTOR shall at all times maintain proper facilities and provide safe access for inspection by CITY to all parts of the work, and to the shops wherein the work is in preparation. Where the Specifications require work to be specially tested or approved, it shall not be tested or covered up ~,vithout timely notice to CITY of its readiness for inspection and without the approval thereof ar consent thereto by CITY. Should any such work be covered up without such notice, approval, or consent, it must, if required by CITY, be uncovered for examination at CONTRACTOR'S expense. 7. EXTRA OR ADDITIONAL WORK AND CHANGES. Should CITY at any time during the progress of the work require any alterations, deviations, additions or omissions from the Plans and Specifications or the Contract Documents, CITY shall have the right to do so, and the same shall in no way affect or make void the Contract, but the cost or value thereof will be added to, or deducted from, the amount of the Contract price, as the case may be, by a fair and reasonable valuation, which shall be determined either by reference to the Unit Prices bid, if applicable, the Standard Specifications, or in accc-rdance with the agreement of the parties. No extra work shall be performed or change be made except by a written order from CITY, duly authorized by resolution of the City Council, and by all agencies whose approval is required by law, stating that the extra work or change is authorized, and no claim for an addition to the Contract sum shall be valid unless so ordered. 8. CHANGES TO MEET ENVIRONMENTAL REQUIREMENTS. CITY shall have the right to make changes in this Contract during the course of construction to bring the completed improvements into compliance with environmental requirements or standards established by State and Federal statutes and regulations after tr-e Contract has been awarded or entered into. CONTRACTOR shall be paid for such changes either by reference to the Unit Prices bid, if applicable, or in accordance with the agreement of the parties. 9. TERMINATION, AMENDMENT OR MODIFICATION. This Contract may be terminated, amended or modified, with the mutual consent of the parties. The compensation payable, if any, for such termination, amendment or modification, shall be determined either by 2 reference to the Unit Price bid, if applicable, the Standard Specifications, or in accordance with the agreement of the parties. 10. TIME FOR COMPLETION. All work under this Contract shall be completed in accordance with the Time for Completion section in the Proposal and the Specifications of this project. If CONTRACTOR shall be delayed in the work by the acts or neglect of CITY, or its employees, or those under it by contract or otherwise, or by changes ordered in the work, or by strikes, lockouts by others, fire, unusual delay iri transportation, unavoidable casualties or any causes beyond CONTRACTOR'S control, or by delay authorized by CITY, or by any cause which CITY shall. determine justifies the delay, then the time of completion shall be extended accordingly. -This paragraph does not exclude the; recovery of damages for delay by either party under other provisions in the Contract Documents,. 11. INSPECTION AND TESTING OF MATE]ItIALS. CONTRACTOR shall notify CITY a sufficient time in advance of the manufacture, production or testing of materials to be supplied under this Contract, in order that CITY may arrane for mill, factory or laboratory inspection and testing of same. 12. TERMINATION FOR BREACH OR INSOLVENCY. If CONTRACTOR should be adjudged a bankrupt, or should make a general s~ssignment for the benefit of creditors, or if a receiver should be appointed on account of insolvency, or if CONTRACTOR or any subcontractor should violate any of the provisions of the Contract, CITY may serve written notice upon CONTRACTOR and CONTRACTOR'S surety of its intention to terminate the Contract. Such notice shall contain the reasons for CITY'S intention to terminate the Contract, and unless within ten (10) days after serving of such notice, such violation shall cease and satisfactory arrangements for corrections thereof be made, the Contract shall, upon the expiration of said ten (10) days, cease and terminate. In t:he event of any such termination, CITY shall immediately serve notice thereof upon CONTRACTOR'S surety and CONTRACTOR, and the surety shall have the right to take over and perform the Contract; provided, however, that, if the surety within fifteen (15) days after the serving ixpon it of notice of termination does not give CITY written notice of its intention to take wer and perform the Contract, or does not commence performance thereof within thirty (30) days from the date of the serving of such notice, CITY may take over the work and prosecute the same to completion by contract, or by any other method it may deem advisable, for the account and at the expense of CONTRACTOR, and CONTRACTOR AND CONTRACTOR'S surety shall be liable to CITY for any excess cost occasioned by CITY thereby, and in such event (~ITY may, without liability for so doing, take possession of, and utilize in completing the work, such materials, appliances, plant and other property belonging to CONTRACTOR as maybe ~~n the site of the work and necessary therefor. 13. THE CITY'S RIGHT TO WITHHOLD CERTAIN AMOUNTS AND MAKE APPLICATION THEREOF. In addition to amounts which CITY may retain under other provisions of the Specifications until final completion and acceptance of all work covered by the Contract, CITY may withhold from payment to CONTRACTOR such an amount or amounts as in its judgment may be necessary to pay just claims against CONTRACTOR or subcontractors for labor and services rendered and materials furnished in and about the work. City may apply such withheld amount or amounts to the payment of such claims in its discretion. In doing so, CITY shall be deemed the agent of CONTRACTOR, and any payment so made by 3 self insurance in accordance with the provisions of the Labor Code, and I will comply with such provisions before commencing the performance oi'the work of this Contract." 18. ACCIDENT PREVENTION. Precaution shall be exercised at all times for the protection of persons (including employees) and property. The safety provisions of applicable laws, building codes and construction codes shall be observed. Machinery, equipment and other hazards shall be guarded or eliminated in accordance with the safety provisions of the Construction and Safety Orders issued by the Industrial Accident Commission of the State of California. 19. CONTRACTOR'S RESPONSIBILITY FOR THE WORK. CONTRACTOR shall not be responsible for the cost of repairing or re:storing damage to the work caused by Acts of God. NEVERTHELESS, CONTRACTOR shall, if the insurance premium is a separate bid item, obtain the insurance to indemnify CITY for any damage to the work caused by Acts of God. "Acts of God" shall include only the follov~~ing occurrences or conditions and effects: earthquakes and tidal waves, when such occurrences or conditions and effects have been proclaimed a disaster or state of emergency by the President of the United States or by the Governor of the State of California, or were of a magnitude at the site of the work sufficient to have caused a proclamation of disaster or state of emergency having occurred in a populated area. Subject to the foregoing, CITY shall not, in any way or manner, be answerable or suffer loss, damage, expense or liability for any loss or dam~:ge that may happen to said building, work, or equipment or any part thereof, or in, on, or aboirt the same during its construction and before acceptance. 20. CONTRACTOR'S GUARANTEE. CONTRACTOR unqualifiedly guarantees the first-class quality of all work and of all materials., apparatus and equipment used or installed by CONTRACTOR or by any subcontractor or supl-lier in the project which is the subject of this Contract, unless a lesser quality is expressly authorized in the Plans and Specifications, in which event CONTRACTOR unqualifiedly guarantees such lesser quality; and that the work as performed by CONTRACTOR will conform with the Plans and Specifications or any written authorized deviations therefrom. In case of an,y defect in the work, materials, apparatus or equipment, whether latent or patent, revealed to CITY within the time period specified in the technical provision from the date of acceptance of completion of this Contract by CITY, CONTRACTOR will forthwith remedy such defects without cost to CITY. 5 P.O. No. 21. DEFERRED ALTERNATE SELECTIO:~T. The City reserves the right for the term of the Contract, the deferred selection of none, any ~~r all alternate bid items at the bid price. The alternates chosen would be for any sites currently under construction or to be constructed in the future. IN WITNESS WHEREOF, the parties have eacecuted this Contract, in duplicate, the day and year first hereinabove written. CITY CUP RTINO: By: ~ ~. 3° • ~ ~ avid W. Knapp City Manager Attest: ~~z~ .----~ City Cle Date: /~PJ J ,~ , 20 Q City Clerk CONTRACTOR: aen+rr~ ~. •11~~ ~Ibrt ~,~' B~~: Notary acknowledgment is required. If a corporation, corporate seal and corporate notary acknowledgment and Federal Tax I.D. are required. If not a corporation a Social Security No. is required. APPROVED AS ~'O FORM: ,, ~' ~ %~ ~ City A o ey Social Security # Federal Tax I.D. # Contractor's License No. 3~1~3 Project Name & Number: Storm Drain Catch ]gasin Cleaning, Project No. 2004-07 Contractor's Name & Address: National Plant Service, Inc. 1461 Harbor Avenue Long Beach,, CA 90813-2741 Contract Amount: $57,850.00 Account Number: 230-8004-7014 -~ X21 pp~p, dp ~ 2to "~6r2'~3oo~d 5, ~~50.0o c~~ File No: 97,566 6 ACKNOWLEDIsEMENT STATE OF CALIFORNIA ) SS. COUNTY OF LOS ANGELES ) On November 17, 2004, before me, Timothy L. Shirk, personally appeared Dennis R. Keene, proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, an~3 that by his signature on the instrument the person, or the entity upon behalf of which th~~ person acted, executed the instrument. WITNESS my hand and official seal. ..~ T1l1~OTHY L. SHIRK NOTARY PUBLIC Commission ~ 1367425 State of California ~ NotsM F9ubtic-C.atifom~ ~ tatyc-~~~s_ Aut9~ 2I, ~6 FXEEIIBITA BID PROPOSAL STORM DRAIN CATCH BASIN (:LEANING, PROJECT 2004-07 TO: THE DIRECTOR OF PUBLIC WORKS, CITY OF CUPERTINO, STATE OF CALIFORNIA Dear Sir: In compliance with the plans and specifications furnished for the work of the STORM DRAIN CATCH BASIN CLEANING, PROJECT 2004-07 for the City of Cupertino, the undersigned, hereby declare that I have read the proposal requirement, visited the sites, and examined the specifications. I, the undersigned, hereby propose; to do all work required to complete the work in accordance with the plans and specifications for the prices set forth in the following schedule. I further understand that said prices include all co:~ts including, but not limited to, local, state and federal taxes, and transportation costs. Bidders shall complete the entire Statement of Oualifcation and submit it with the bid proposal documents. Failure to complete ti!e questionnaire or inclusion of any false statement(s) shall be grounds for immediate disqualification. I, the undersigned, also understand that the qua~itities shown below are estimates only, being given as a basis for comparison of bids. The City of Cupertino does not state that the actual amount of work will correspond but reserves the -right to increase or decrease the amount of any class or portion of the work or to omit items or portions of work deemed unnecessary by the Engineer. The City of Cupertino reserves the right to unilaterally determine and award the contract to any qualified bidder based on the most advantageous proposal, to reject any or all bids, or to waive any irregularities in the procedures. The work to be done consists of furnishing all labor, methods of process, tools, machinery and material required to complete the STORM DRAIN CATCH BASIN CLEANING, PROJECT 2004-07 as described in the Special Provisions. I, the undersigned, shall diligently prosecute the: work to completion as scheduled. I further understand that I shall pay to the City of Cupertino the sum of One Hundred Fifty Dollars ($150.00) per day, for each and every day services are not completed as scheduled and/or specified. In the event of discrepancies between the written unit price and the numerical unit price, the written price shall govern. NAT10NAL PLANT SERVICES, INC. 1461 HARBOR AVENUE LONG BEACH, CA 90813 Bid Proposal F'age 1 of 8 ESTIMATED QUANTITIES The bid unit prices for this project shall be as outli~ied below Bid Est.Qty. Item Unit Item Unit Price Total 890 EACH Clean Storm Drain Catch B~isin $t ~ lam. 0 1 Per E CH $ ~_~ /EA. TOTAL BID $ 5 ~C55'o.~ $ 57,4SO o~ ln~i9`~ NATIONAL PLANT SERVICES, INC. 1461 HARBOR A~ ENUE LONG BEACH, CA 90813 Bid Proposal Page 2 of 8 I, the undersigned, agree that if this proposal is accepted, I will enter into a contract with the City of Cupertino to provide all necessary machi~zery, tools, apparatus, and other means of construction and to do all the work specified in thc; contract in the manner and time specified. I, the undersigned, declare that this bid is made without connection with any person, firm, or corporation making a bid for the same work, and' is in all respects fair, and without collusion or fraud. I, the undersigned, recognize that the Director of Public Works of the City of Cupertino will reserve the right to establish the priority of one .job over another and each starting date where conflict of construction schedules occur. d/ Attached hereto is the required certified check or bid bond in the amount of ~~ 6~ , as required by law and the Notice to Bidders. (10% of bid amount) cL~~ n~-noNaL ~.anrr sERVicES, ~nrc, 1461 HARBOR AVENUE LONG BEACH, CA 90813 ~... Bid Proposal Page 3 of 8 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I, the undersigned, being first duly sworn, depose ~~.nd say that I am Q~ ~ (Business Title) of jJ Ar- ~1 SCR-J~~ t~K (Business Name) 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, associ;~.tion, organization, or corporation. The bid is genuine and not collusive or sham. The bidder his 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. 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. All statements contained in the bid are true and, further, the bidder has not, directly or indirectly, submitted the bid price or any breakdown thereof, or contents thereof, or divulged informati~~n 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. lo'C~~ ~£~.K.wa A--Ketn~ Q.4,sn.r.F' NATIONAL PLANT SERVICES, INC. 1461 HARBOR AVENUE LONG BEACH, CA 90813 Bid Proposal F'age 4 of 8 BIDDER QUALIFICATION FORM In further compliance with the specifications furnished, I, the undersigned, submit the following statements as to my experience and qualifications ':o perform this work as a part of this proposal. We have been in business under the present name for v13 .years. My California Contractor's License Number is The classification of my Contractor's License is The expiration date for my Contractor's License is 3 S Aso 3 11~05~ ****************************************************************************** * (This Section for City use only) * The above info ation has been verified by on ~D Zl 0 * Contractors State License Board (800) 321-2752 or (408) 277-1244. ****************************************************************************** Where federal funds are involved, no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with the laws of the State of California, however, at the time the contract is awarded the contractor shall be properly licensed. NATIONAL PLANT SERVICES, INC. 1461 HARBOR AVENUE LC)NG BEACH, CA 90813 ~. Bid Proposal Page 5 of 8 Our experience iri work comparable with that required by the proposal contract is a23 years operating under the following different name:(s). BIDDER HISTORY OF WORK The following is an example of work similar in character to that required in the proposed contract which our organization or personnel in our organization has completed within the past three (3) years. For Whom Contact Year Location Type of Work Performed Phone No. Amount v~o0~" C~ ~SM-~~InAA- C~J• ~ASMr ~~~ ?~~(- b~?- sb3o ~ X0,660 ----- - o ~ ~c~~w~ - SAS ~a S~ 4'53 00~ ,'t0o~t r- (~~,A,~k- 0 6as~~s ~yt~. ~~ 90• ~o ~h ~'r c~*r~ ~~,~ ~a s ~V~- Bid Proposal ]'age 6 of 8 NATIONAL PLANT SERVICES, INC, 1461 HARBOR AVENUE LONG BEACH, CA 90813 ~: INNTIONALPIANT SERVICES, INC. 1461 HARBOR AVENUE LONG BEACH, CA 90813 SUBCONTRACTOR'S FORM The subcontractor(s), as defined in the General Provisions and in Section 7026 of the California Business and Professions Code, that I propose to ]lire to perform any of the work for this project in an amount in excess of one-half of one percent (0.5%) of the total bid are listed below. Only those listed below shall perform work on this project and each of them has been provided with a full and complete set of plans and specifications for this project by the bidder. 1. Name N~~~ Contractor's License No. Address & phone no. Work to be •Performedd 2. Name ~ , Address & phone no. .. Contractor's License No. Work to be performed 3. Name Address & phone no. Work to be performed 4. Name Address & phone no. Work to be performed 5. Name Address & phone no. Work to be performed 6. Name Address & phone no. Work to be performed Contractor's License No. Contractor's License No. Contractor's License No. Contractor's License No. Bid Proposal ]'age 7 of 8 BIDDER'S SIGNATURE FORM 1F YOU ARE AN INDIVIDUAL, SO STATE. IF YOU ARE A COMPANY OR A CO- PARTNERSHIP, STATE THE COMPANY 1`dAME AND LIST THE NAMES OF ALL INDIVIDUAL CO-PARTNERS COMPOSING THE COMPANY. IF YOU ARE A CORPORATION, STATE THE LEGAL NAME ~OF THE CORPORATION AND THE NAMES OF THE PRESIDENT, SECRETARY-TREASUEtER, AND MANAGER. THE CORPORATE SEAL MUST BE AFFIXED TO THIS FORM. ENTER THE NAME OF YOUR BUSINESS ON THE LINE OPPOSITE THE APPROPRIATF's BUSINESS TYPE. TYPE OF S ~- ~'N~l , ~N~.Mb NAME OF " BusnvESS s'~c~-hl -•~~~ _BUSnvESS st,2J•us~T~K• N~eCI~'l- ~PL,P~T CORPORATION: l~9~'IP~ ~~~`'~`~ l~~ CO-PARTNERSHIP: INDIVIDUAL: JOINT VENTURE: OTHER: Name and Signature of Bidder: Date: l0 (Describe) as R-.!~¢e~.x. (Print or type name) Address (mailing & location): ~~{,(P~ ~ARrbdL. ~~+'~- LAr~ ~~ t C~- `~00t3 Telephone Number: i{34'?b~~ Acknowledgment of all addenda received is required by circling each addendum number. 2 3 4 5 6 7 8 9 10 NATIONAL PLANT SERVICES, INC. 1461 HARBOR A4r`ENUE Bid Proposal Page 8 of 8 i~. ~~ B~CH~ CA gBg13 ~" ~ FP.~IM FAX N0. :151E13579039 Oct. 18 2004 11:23AM P1 't7%18%2040. 11:16 hAf( 4Ud ff! ~~~~ L;IiY L:Ut'titllNU IQUUIiUUI I,~ 1 CUPE~INtJ AI,-DEND- Z1M NO. 1 STGiRM D-.RAIN CATC~Y,BASIN C~..EANING PROJECT NO. 2004-07 .1~rD OP.ENIN'G: OiCTOBER 20, 2004 2: 001'.M. ISSU,~D DATE: Oc~TOBE.R Y8, 2004 The foltawing revision is hereby made to the above referanced project. 1. 'Che Notice to Proceed is avt~cipated to Ue: issued on November 1, 200x, nat dctobex 4, 2004. The completion date is unchange~~ and remains December 31, 2004. Alease indicate receipt of this aQdendum on the last page of the .~'r'aposal. FaYlur~ to d.o sn nLay pauso rojoction of your bid_ APpI~(~VED BY': ~. C.~~ ;' qlv~..^.. Qualls, Jz. D1rCOtOr Of Pt,ltilic Works ~,,~d, io(~c(ar- w-nowu.a~wrs~v~s,wa U81 FWiBORAVENUE ~, lONGBEACH,CA 90819 PIlnteO On Racycled Paper INSURANCE FORMS INSTRUCTIONS FOR ITEMS 3, 4 AND 5, THE FORMS PROVIDED BY THE CITY OF CUPERTINO MUST BE USED. FORMS OTHER THAN THESE WILL NOT BE ACCEPTED. ALL DOCUMENTS MUST BE ORIGINALS -SUBMIT IN TRIPLICATE 1. Insurance Agreement -Must be signed by Contr;~ctor. 2. Certificate of Insurance to the City of Cupertino -must be completed by the insurance agent or must provide a certificate on the company's form. They must contain the same information. 3. Endorsement of Additional Insured and Primary Insurance and Notice of Cancellation -must be signed by the insurance agent for general liability ar~d automobile liability only. 4. Comprehensive general liability/commercial general liability endorsement of aggregate limits of insurance per project - must be signed by the insurance agent for general liability only. 5. Waiver of subrogation endorsement worker's c~~mpensation insurance -must be signed by the insurance agent for worker's compensation only. Insurance Instnictions ~~~~ . ftS of CUPEI~TINO INSURANCE AGREEMENT A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability :for worker's compensation or undertake self- insurance in accordance with the provisions of that Code, and will comply with such provisions before commencing the performance of the work of'this Contract. B. Contractor and all subcontractors will c~ury worker's compensation insurance for the protection of its employees during the progress of the work. The insurer shall waive its rights of subrogation against the City, the City's officers, agents and employees and shall issue an endorsement to the policy evidencing same. C. Contractor shall carry at all times, on all operations hereunder, commercial general liability insurance, automobile liability insurance and build.er's all risk insurance. All insurance coverage shall be in amounts required by the City and shall lie evidenced by the issuance of a certificate in a form prescribed by the City and shall be underwritten by insurance companies satisfactory to the City for all operations, sub-contract work, contractual obligations, product or completed operations, all owned vehicles and non-owned vehicles. Said insurance coverage obtained by the Contractor, excepting worker's compensation coverage, shall name the City, its engineer, and each of its directors, officers, agents and employees, as determined by the City, as additional insureds on said policies. Insurers must be licensed to do business iii the State of California. The Insurers must also have an "A" policyholder's rating and a financial rating of at least Class VII in accordance with the current Best's Guide Rating or that is otherwise aca~ptable to the City. D. Before Contractor performs any work at, or prepares or delivers materials to, the site of construction, Contractor shall furnish certificates of insurance evidencing the foregoing insurance coverages and such certificates shall provide the natne and policy number of each carrier and policy and that the insurance is in force and will not be canceled or modified without thirty (30) days written notice to the City. Contractor shall maintain all of the foregoing insurance coverages in force until the work under this Contract is fully completed. The requirement for carrying the foregoing insurance shall not derogate from the provisions for indemnification of the City by Contractor under this Contract and for the duratio~i of the warranty period. Notwithstanding nor diminishing the obligations of Contractor with respect to the foregoing, Contractor shall maintain in full force and effect during the life of this Contract, -the following insurance in amounts not less than the amounts specified and having a Best's Guide Rating of A, Class VII or better or that is otherwise acceptable to the City. LIMITS Worker's Compensation In accordance with the Worker's Compensation & Employers' Liability Act of ~;he State of California -Worker's comp - "statutc-ry" per CA Law; Employers' Liability - $1,000,000 per occurrence. Insurance Agreement Page I of 2 General Liability -commercial general liability; Combined single limit of $1.0 million per including provisions for contractual liability, occurrence; $2.0 million in the aggregate. personal injury, independent contractors and products -completed operations hazard. Automobile Liability -comprehensive covering Combined single limit of $1.0 million per owned, non-owned and hired automobiles. occurrence. Consultants only: Errors and Omissions liability. $1.0 million per occurrence. ~~'~~ (Contractor's Name) By:~ Dated: D~" 20 ~'°~ Insurance Agreement Page 2 of 2