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02-075 Pavement restoration proj. 2002-01CONTRACT FOR PiJBLIC WORKS This CONTRACT made on ~~,~ ~/ U5}- ~~. ~~~, by the CITY OF CUPERTINO, a municipal corporation of the State of alifornia, hereinafter called CITY, and O'Grady Paving, Inc., 2513 Wyandotte Street, Mountain View, CA 94043, hereinafter called CONTRACTOR. IT IS HEREBY AGREED by CITY and CONTRACTOR as follows: 1. THE CONTRACT DOCUMENTS. The complete contract consists of the following contract documents: 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 and Special Provisions. c. Plans and Specifications for PAVEMENT RE~iTORATION. PROJECT 2002-01. d. Faithful Performance Bond and Materials Bonci. 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. f. This Contract for Public Works. All of the above documents are intended to coopc;rate so that any work called for in one and not mentioned in the other, or vice versa, is to be e~:ecuted 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 Plan:; and Specifications shall prevail. THE WORK. CONTRACTOR agrees to furnisY~ 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 pavement restoration, as called for, acid in the manner designated in, and in strict conformity with, the Plans and Specifications pre~~ared by the Engineer and adopted by CITY, which Plans and Specifications are entitled, respectively Pavement Restoration, Project 2002-01, and 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, transportation 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. Contract Page lof 6 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 $73,500.00 (SEVENTY THREE THOUSAND AND 00/100 DOLLARS) subject to additions and/or deductions as provided in the Contract Documents, per Exhibit A attached hereto. 4. DISPUTES PERTAINING TO PAYMEIVT 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 C~~ntract, 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 of the parties, or in accordance with Section 6, paragraph "f' of the General Provisions. 5. PERMITS, COMPLIANCE WITH LA`V. 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 preserv<<tion 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 without timely notice to CITY of its readiness for inspection and without the approval thereof or consent thereto by CITY. Should any such work be covered up without such notice, approv~~l, 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 accordance 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 ENVIRONME1vTAL REQUIREMENTS. CITY shall have the right to make changes in this Contract di.~ring 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 the 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 tree agreement of the parties. Contract Page 2of 6 9. TERMINATION, AMENDMENT OR r/IODIFICATION. This Contract may be terminated, amended or modified, with the mutu<<1 consent of the parties. The compensation payable, if any, for such termination, amendment or modification, shall be determined either by 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 tree 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 in 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 N[ATERIALS. 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 CITE.' may arrange for mill, factory or laboratory inspection and testing of same. 12. TERMINATION FOR BREACH OR II\ SOLVENCY. If CONTRACTOR should be adjudged a bankrupt, or should make a general ~~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 tie made, the Contract shall, upon the expiration of said ten (10) days, cease and terminate. In the event of any such termination, CITY shall immediately serve notice thereof upon CONTR~,CTOR'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 upon it of notice of termination does not give CITY written notice of its intention to take over 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 sante 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 CITY 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 may be- on the site of the work and necessary therefor. 13. THE CITY'S RIGHT TO WITHHCILD 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 Contract Page 3of 6 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 CITY shall be considered as a payment made under the Contract by CITY to CONTRACTOR, and CITY shall not be liable to CONTRACTOR for any payment made in good faith. Such payment may be made without prior judicial determination of the claim or claims. With respect to any retention of payment by CITY to ensure performance of the Contract, CONTRACTOR will be entitled to substitute securities as provided in Section 4590 of the California Government Code as more fully described in CITY'S Notice to Contractors. 14. NOTICE AND SERVICE THEREOF. Any notice from one party to the other under this Contract shall be in writing, and shall be dated anti signed either by the party giving such notice, or by a duly authorized representative of such pasty. Any such notice shall not be effective for any purpose whatsoever unless served in the following manner: (a) if the notice is given to CITY, either by personal delivery thereof to the Engineer of CITY, or by depositing same in the United States mails, enclosed in a sealed envelope;, addressed to CITY OF CUPERTINO; 10300 TORRE AVENUE; CUPERTINO, CA 95014; postage prepaid and certified; (b) if the notice is given to CONTRACTOR, either by personal delivery thereof to CONTRACTOR, or to CONTRACTOR'S duly authorized representative at the site of the project, or by depositing same in the United States mails enclosed in a sealed ~:nvelope, addressed to O'GRADY PAVING, INC., 2513 WYANDOTTE STREET, MOUN7CAIN VIEW, CA 94043, postage prepaid and certified; and (c) if notice is given to CONTRACTOR'S surety or any other person, either by personal delivery thereof to CONTRACTOR'S s~zrety or other person, or by depositing same in the United States mails, enclosed in a sealed envelope, addressed to CONTRACTOR'S surety or person, as the case may be, at the address of CONTRACTOR'S surety or the address of the person last communicated by such person to thf; party giving the notice, postage prepaid and certified. 15. ASSIGNMENT OF CONTRACT. Neither the Contract, nor any part thereof, nor moneys due or to become due thereunder, shall be assigned by CONTRACTOR without the prior written approval of CITY. 16. COMPLIANCE WITH SPECIFICAT][ONS OF MATERIALS. Whenever in the Specifications, any material or process is indicated or specified by patent or proprietary name, or by name of manufacturer, such Specifications must be met by CONTRACTOR, unless CITY agrees in writing to some other material, process or article offered by CONTRACTOR which is equal in all respects to the one specified. It shall be CONTRACTOR'S responsibility to prove equality of any such material, process or article o ffered as a substitution to the one(s) specified. 17. WORKER'S COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE. CONTRACTOR shall take out and maintain during the life of this Contract Worker's Compensation Insurance and Employer's Liability Insurance for all of CONTRACTOR'S employees employed at the site of the project. In case any work is sublet, CONTRACTOR shall require any and all :>ubcontractors similarly to provide Worker's Compensation and Employer's Liability Insurance for all of the latter's employees unless such employees are covered by the protection afforded to the CONTRACTOR. Contract Page 4of 6 In signing this Contract CONTRACTOR makes the following certification, required by Section 1861 of the Labor Code: "I am 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 to undertake self insurance in accordance with the provisions of the Labor Code, and I will comply with such provisions before commencing the performance of the work of this Contract." 18. ACCIDENT PREVENTION. Precaution shall be exercised at all times for the protection of persons (including employees) and 1-roperty. The safety provisions of applicable laws, building codes and construction codes shall 1>e 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 restoring 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 following 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 damage that may happen to said building, work, or equipment or any part thereof, or in, on, or abort 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 guarantee:; 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 any defect in the work, materials, apparatus or equipment, whether latent or patent, revealed to CITY within one (1) year of the date of acceptance of completion of this Contract by CITY, CONTRACTOR will forthwith remedy such defects without cost to CITY. 21. DEFERRED ALTERNATE SELECTION. The City reserves the right for the term of the Contract, the deferred selection of none, any or all alternate bid items at the bid price. The alternates chosen would be for any sites currentl~r under construction or to be constructed in the future. Contract Page `iof 6 CALIFORNIA ALL- PURPOSE ACKNOWLEDGEMENT State of California County of Santa Clara On July 26, 2002 before me, Nesha~ Phillips, Notary Public Date Name, Title of Officer (e.g., "Jane Doe, Notary Public'') personally appeared _ Craig E. Young_,__. Name(s) of Sigtmr(s) ®personally known to me or ev~ene-~~ to be i:he person(} whose name{} is/are subscribed to the within instrument and acknowliedged to me that he/sf~~ executed the same in his/ #er f ~iei~authorized capacity(ies), and that by his/he~~eir signature( on the instrument the person(-s~, or the entity upon behalf of which the person - ~ . - - ~ {s} actedl, executed the instrument. ~~. , ;~.. ~ is j ~" = :~ -' << V~'ITNESS m hand and official seal Place Notary Seal Above ! Signs Notary Public ^PTIClNA Though the information below is not required 6y law, it may prove valuable to persons relying an the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named CALIFORNIA ALL- PURP08]E ACKNOWLEDGEMENT State of California County of Santa Clara On Jul 26, 2002 before me, Nesha~ Phillips, Notary Public Date Name, Title of Officer (e.g., "Jane Doe, Notary Public'') personally appeared _ Cram E. Young Name(s) of Signer(s) ® personally known to me or p~~e~-i^ -~.,, ,.., ;'", balls-e€-~sa~s€ae#e~ ev~lez~e~~ to be the person} whose name(s~ is/are subscribed to the within instrument and acknowledged to me that he/sa~e~tl~ executed the same in his/ber~te~-authorized capacity(les), and that by his/h°~i~ signature4s} on the instrument the person}, or the entity upon behalf of which the person ,_. _._ , _ - {s3 acted, executed the instrument. - _ ~._ c ., -_ ~~ ~°t WITNE S d and official seal r ~~; Place Notary Seal Above Si a of Notary Public ---oPTIQ~NA:.r Tiwugh the information below is not required by lam, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this fiorm to another document. Description of Attached Document Title or Type of Document: Document Date: ]number of Pages: Signer(s) Other Than Named P.O. No. IN WITNESS WHEREOF, the parties have executed this Contract, in duplicate, the day and year first hereinabove written. CITY OF CUPERTINO: • ,~ ~ g. l L.fl~, By: City Manager _~ Attest: ,'c'il'yL ~`~- City Cl Date: ~' f ia~da- , 2002 City Clerk APPROVED AS CONTRACTOR: O' Gradv Paving, Inc. By: r-• 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. Social Security # ~`l-~y~3~~~ Federal Tax I.D. # Contractor's License No. o10/G f ~ PROJECT NAME & NUMBER: Pavement Restoration, Project 2002-01 CONTRACTOR NAME & ADDRESS: O'Grady Paving, Inc. 2513 Wyandotte Street Mountain View, CA 94043 CONTRACT AMOUNT: $73,500.00 ACCOUNT NUMBER: 270-9450-9300 FILE NOS: 98,493.72 Contract Page tiof 6 CALIFORNIA ALL- PURPOSE ACKNOWLEDGEMENT State of California County of Santa Clara On Tuly 26, 2002 before me, Nesh~~ Phillips, Notary Public Date Name, Title of Officer (e.g., "Jane Doe, Notary Public') personally appeared _ Craig E. Young Name(s) of Signer(s) ® personally known to me or ~_~ r ~~~ +~ to be i:he person{s} whose name4s} is/aye subscribed to the within instrument and acknowledged to me that he/stie~ey executed the same in his/be~l~authorized capacity(ies), and that by his/h~i~ signature{s} on the instrument the person{s~, or the entity upon behalf of which the person'. . »:-~~ ~:.-~~~ ~~' ~'"'j-= %' {s} acted., executed the instrument. ~' ., . ~ ~.` ~_ k~~ ~~_ ,. ' ~~ ` - ~~~ `~`~ vVTTNESS m and and official seal Place Notary Seal Above Signature of Notary Public OPTIC~NA~ Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named INSURANCE FORr/IS INSTRUCTIONS FOR ITEMS 3, 4, 5 AND 6, THE FORMS PROVIDED BY THE CITY OF CUPERTINO MUST BE USED. FORMS OTHER THAN T1:iESE WILL NOT BE ACCEPTED. ALL DOCUMENTS MUST BE ORIGINALS •~ SUBMIT IN TRIPLICATE 1. Insurance Agreement - Must be signed by Cor.~tractor. 2. Certificate of Insurance to the City of Cupertino -must be completed by the insurance agent or must provide a certificate on the c~~mpany's form. They must contain the same information. 3. Endorsement of Primary Insurance -must be signed by the insurance agent for general liability and automobile liability only. 4. Additional insured endorsement -must be sighed by the insurance agent for general liability and automobile liability only. 5. 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. 6. Waiver of subrogation endorsement worker's compensation insurance -must be signed by the insurance agent for worker's compensation only. 7. Notice of policy cancellation endorsement -must be signed by the insurance agent or must be on the company's certificate of insurance form for all insurances. Insurance Instructions ;.. CI OF CUPEIZTINO INSURANCE AG~tEEMENT 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 oi' that Code, and will comply with such provisions before commencing the performance of the wort; of this Contract. B. Contractor and all subcontractors will carry 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 or comprehensive general liability insurance, automobile liability insurance and builder's all risk insurance. All insurance coverage shall be in amounts required by the City and shall be 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, ~tll 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 direr:tors, officers, agents and employees, as determined by the City, as additional insureds on said policies. Insurers must be licensed to do business in 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. D. Before Contractor performs any work <<t, 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 name and policy number of each carver 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 mountain 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 dur~-tion of the warranty period. Notwithstanding nor diminishing the obligations of Contractor with rE;spect to the foregoing, Contractor shall maintain in full force and effect during the life of this Contr~~ct, the following insurance in amounts not less than the amounts specified and issued by a compan}~ admitted in California and having a Best's Guide Rating of A, Class VII or better. Worker's Compensation Liability In accordance with the Worker's Compensation Act of the State of Califomia - $1,000,000 per . occurrence. Insurance Agreernent Page 1 of 2 Public Liability -either commercial general Combined single limit of $1.0 million per liability or comprehensive general liability; ~ occurrence; $2.0 million in the aggregate. including provisions for contractual liability, personal injury, independent contractors and property damage coverages. 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. (Contr or's Nam Dated: i~'L~~ Lc S t 20 J~ Insurance Agreement Page 2 of 2 Client#: 1590 OGRADPAVI `ac~~Rn. CERTIFICATE OF LIABILITY INSURANCE o~~(22 jot PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Construction Urilt ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ABD Insurance & Financial SerV1CeS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 305 Walnut Street Redwood Clty, CA 94063 INSURERS AFFORDING COVERAGE INSURED ' IIVSURERA:St. Paul Fire & Marine O Grady Paving, Inc. 2 IlysuRERB:State Compensation Insurance Fund 513 Wyandotte Street _ilvsuRER c: Mountain View, CA 94043 IIJSURER D: IIJSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURI.D NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDffION OF ANY CONTRACT OR OTHER DOCIJMENT WfrH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREI~I IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDffIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DAl'E MM/DD/ POLICY EXPIRATION DATE MM/DD/ LIMITS A GENERAL LIABILITY KK08301220 04/01/02 04/01/03 EACH OCCURRENCE $1, 000, 000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire $1 O O O O O CLAIMS MADE OCCUR MED EXP (Any one person) $rj 0 0 0 PERSONAL & ADV INJURY $1 O O O O O O GENERAL AGGREGATE $2 O O O O O O GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $2 OOO, OOO POLICY X PROT LOC A AU TOMOBILE LIABILITY KK08301220 04/01/02 04/01/03 X ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $1 OOO i , 0 0 0 -- ALL OWNED AUTOS BODILY INJURY $ SCHE DOLE D AUTOS (Per person) X HIRED AUTOS BODILY INJ URY $ X NON-OWNED AUTOS (Per accident) -- PROPERTY DAM E AG $ (Per accident) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ ~ OCCUR CLAIMS MADE AGGREGATE $ _ $ ~ _ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND 16 8 2 9 6 7 0 2 0 7/ 0 1/ 0 2 0 7/ 0 1/ 0 3 X WC STATU- OTH- -- EMPLOYERS' LIABILITY WAIVER OF SUBROGATIOI4 : E.L. EACH ACCIDENT $1 ~ 0 0 0 , 0 0 0 AS RESPECTS WORKERS' C MPENSATION AND EMPLOYE ' S LIABILI Y, THE E.L.DISEASE-EA EMPLOYE $1 , 0 0 0 0 0 0 E.L. DISEASE-POLICY LIMI $1, O O O, O O O OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: Project #2002-O1; Pavement Restoration. The City of Cupertino ("City") and its directors, officers, engineers, agents and employees, and all public agencies from whom permits will be obtained and their directors, officers, engineers, agents ar~d employees are named (See Attached Descriptions) FICATE HOLDER I I ADD City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHEE~IRATION DATETHEREOF,THEZSSUING INSURER WILL~'~4O~Yl~gCMAIL3 ~_ DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMEDTOTHELEFT,~~[}~~~~@~Q~p[}{, P7dB~1GXf~Q4C9E9}C64E7SI4~IQ 7CSiE4Li.$AE~C REPRESENTATIVE ACORD25-S(7/s7)1 of 3 #5410751/M405712 OGF'ADPAVI AKL ©ACORDCORPORATION1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms e.nd conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Acunuz5-stnyi)~ pt 3 #5410751/M405712 DESCRIPTIONS (Continued from Page 1) as additional insureds as respects gener~~l liability per endorsement attached. AMS25.3(07197) 3 of 3 #5410751/M405712 POLICY NUMBER: KKO 83 0122 0 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OV~/NERS, LESSEES or CONTRACTORS QFORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE= Name of Person or Organization: City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to includE as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "~~our work" for that insured by or for you. Re: Project #2002-O1; Pavement Restoration. The City of Cupertino ("City") and its directors, officers, engineers, agents and employees, and all public agencies from whom permits will be obtained and their directors, officers, engineers, agents and employees are named as additional insureds as respects general liability per endorsement attached. CANCELLATION CLAUSE: IT IS UNDERSTOOD AND AGREED THAT THE ADDITIONAL INSURED [S] WILL BE GIVEN THIRTY [30] DAYS WRITTEN NOTICE BEFORE ANY CANCELLATION, NON-RENEWAL OR REDUCTION OF COVERAGE. CANCELLATION FOR NON-PAYMENT OF PREMIUM CAN BE TEN [10] DAYS PRIOR TO THE EFFECTIVE DATE, HOWEVER SUCH NOTICE MUST BE BY REGISTERED MAIL. ALL NOTICES WILL SPECIFICALLY REFER TO THE ABOVE PROJECT. LIMITS OF INSURANCE IT IS AGREED THAT ENDORSEMENT NO. CG2503 AMENDMENT AGGREGATE LIMITS OF INSURANCE [PER PROJECT] IS ADDED FOR THIS PROJECT. PRIMARY INSURANCE: IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS INSURANCE. CG 20 10 11 85 POLICY NUMBER: KK08301220 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT-AGGREGATE LIMITS OF INSURANCE (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE: PART The General Aggregate Limit under LIMITS OF INSURA~ICE (SECTION III) applies separately to each of your projects away from premises owned by or rented to you. CG 25 03 11 85 PUBC~C WORKS CUPEI~T1N0 CERTIFICATE OF INSURANCE TO THE CITY OF CT]PERTINO 'This certifies to the City of Cupertino that the following described policies have been issued to the insured named below and are in force at this time. Insured: O' Grady Paving. Inr.+ Address: 7513 Lvl~anrintta Strar~t ' Mountain View, CFi 94043 i ~. 'Description of operations/locationslproducts insw•ed (show contract name and/or number, if any): WORKER'S COMPENSATION * Statutory ~dlin. '~ TE~mLployer' S Gtata C'nm= anaati nn Ina Fund Llability (name of insurer) $ l,ooo,ooo $l,ooo,ooo $t,ooo,ooo Insurance Company's State License No. ~m hAh Check Policy Type: Each Occurrence $ 1 L1o[l, nay COMPREHENSIVE GENERAL '. LIABILITY [ .] .Premises/Operation's ~ GenESal Aggregate $ 2, o00 , o00 • (if applicable) [ ] Owners & Contractors . Protective Aggt~egate $~ , o00 , o0 0 [ ] Contractual for Specific . Contract Personal Injury [ x ] Products Liability [ ] XCU Hazards ' [ ] BroadForn~.P.D. Fire :Damage (any one fire) $ loo,ooo [ ] Severability of Interest Clause • [ X ] Personal Injury with Medical Expense $ 5 , o 0 0 Employee Exclusion Removed (any one person) or Self-Insured CONIlVIERCIAL GENERAL LIABILITY Retention $ Gt_ Paul Fire & Marine (name of insurer) Policy No. _ kxraR~ol ~~n Expiration Date 04/01 /0'~ Certificate of Insurance Agreement Page 1 of 2 AUTOMOTIVE/VEHICLE LIABILITY .B,ODILY INJURY PROPERTY DAMAGE Commercial Form Each Person Each Accident Liability Coverage Gt Panl Fire & Marina (name of insurer) $_ Each Accident $_ $_ ., or Combined Single Limit $~ 1, o 0 0: o 0 0 Policy No. xxn s ~n i ~ ~ n Expiration Date ~,~, ~ n ~ _ A copy of all Endorsements to the policy(ies) which in any way (a is initial) limit the above-listed types of coverage are attached to this Certificate of Insurfin.ce. This Certificate of Insurance is not an insurance policy and does not amend, extend or alter the ,coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or 'condition of any contract or any other document with respect to which this Certificate of Insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such p~~licies. TT I5 HEREBY CERTIFIED that the above policy(ies) provide liability insurance as required by the Agreement between the City and the insured. By. ~ ~ ~ Dated: 7„~3-/ ~0~ Att~.ch ertificate of Insurance and Additional Insured Endorsement on company forms. CertificatE of Insurance ~4greement Page 2 of 2 CUPE1~TtN0 ENDORSEMENT OF P]tIMARY INSURANCE In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or zny other Endorsement attached thereto, it is agreed as follows: ' The insurance afforded by this policy is p:dmary insurance, and no additional insurance held or owned by the designated additional insureds) shall be called upon to cover a loss under said additional policy. POLICY INFORMATION 1., Insurance Company: St _ Pats 1 Fi rP G Marine 2. Insurance Policy Number: xxo83olz2o 3. Effective Date of this Endorsement: ~ 2~io2 20 4. Insured: O' Grady Paving, Inc. All notices herein provided to be given by~ the Insurance Company to the City in connection with this policy and this Additional Insured Endorsement, -shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. j ~~ warrant that I have authority to bind the hereon do so bind this Company. !~ ~ (print/type name) listed Insurance Company and by my signature Signature of .Authorized Representative: (Original signature required on all n E;ments furnished to the District) Name of Agent/Agency:_ .Laurie Phirippidis Address: 305 walnut Street Redwood City, CA 94043 Title: Account Manager Telephone:~_ aaa 6333 Facsimile: 650 839 6964 Primary Endorsement Page 1 of 1 of CUPEi~T1NO ADDTITONAL INSURED ENDORSEMENT In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or' any other Endorsement attached thereto, it is agreed as follows: The City of Cupertino ("City") and its directors, officers, engineers, agents and employees, and all public agencies from whom permits will be obtained and their directors, officers, engineers, agents and employees are hereby declared to be additional insureds under the terms of this policy, but only with respect to the operations of the Co~itractor at or upon any of the premises of the City in connection with the Contract with the. City, or acts or omissions of the additional insureds in' connection with, but limited to its general supervision or inspection of said operations. ~, POLICY INFORMATION 1. Insurance Company: St. Paul Fire & Marine 2. Insurance Policy Number: xxo s 3 o i 2 2 0. 3.' Effective Date of this Endorsement:_~~ ,• << x/22/02 20 t{., j,~~d; 0' Grady Pavin~~ , Inc . All notices herein provided to be given by th.e Insurance Company to the City. in connection'' with this policy and this Additional Insured Endorsement, shall be mailed to or delivered to the City at 10300 Toae Avenue; Cupertino, California 9' 014. I, °'~~ / ~° T ~ 1 `'i `~D ~ ~~^S (printltype name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. ~ ~ ~ ~ . Leo Signature of Authorized Representative: (Original signature required on all En ors its furnished to the District) Names of Agent/Agency:_ Laurie Phirippidis Title: Account Manager Address: 305 walmut street Telephone: .650 839 X6333 Redwood City, CA 94063 FaCSlmile: 650 839 6964 Additional Insured Endorsement Page 1 of 1 OF CUPERTIND In consideration policy to which this follows: COMPREHENSIVE GENERAL LIABn,7"ry COMIV.~RCIAL GENERAL LIABILITY ENDORSEMENT OF AGGREGATE T,TMTTS OF INSURANCE PER PROJECT of the policy premium and notwithstanding any inconsistent statement in the Endorsement is attached o:r any other Endorsement attached thereto, it is as This Endorsement modifies the insurance provided •under the General Liability Coverage part the below-referenced policy of insurance. The general aggregate Imit under T •TMTTS (>F INSURANCE applies separately to the project desCIlbed . 8S lt~nn~_m ~ P3VPincn} R _stn;~tion POLICY INFOI2.MATION I. Insurance Company: St. Paul Fire & Marine 2. Insurance Policy Number: xxos3oi22o 3. Effective Date of this Endorsement: x/22/02 20 4. Insured: O'Grady Paving, Inc. 5. Additional Insured: City of Cupertino, its directors, officers, agents and employees All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this Additional Insured Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. ~ ~ I, warrant that I haf~e authority't~ hereon do so bind this Company. Company Signature of Authorized Represents ' e: ~~ ~ ~~;~ (Original signature required on all End merts furnished to the District) at/type name) by my signature Dames of ~ • Agent/Agency: Laurie_Phiripgidis T7.tle'_Account Manager 4ddress: 305 walnut street ~ .Telephone: 550 ,~~_ Rar~~,r,r.a C~ y CA 94063 FaC5lmile: 6S(1 R39 _Fi9Fiq Aggregate Limits F'sndorsement Page '1 of 1 OF CUPEI~TINO WAIVER OF SUBROGATION ENDORSEMENT WORIDER'5 COMPErfSATION INSURANCE , In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows: ~' It is agreed that with respect to such insurance as, is afforded by the policy, the Insurance Company waives any right of subrogation it may require' against the City of Cupertino, and each of its directors, officers, agents, consultants and emF-loyees by reason of any payment made on account of injury, including death resulting therefrom, su"tained by any employee of the insured, arising out of the performance of the above-referenced Contract. POLICY INFORMATION 1. Insurance Company: State Compensation Insurance Fund 2. Insurance Policy Number: 168296702 ~. 3. Effective Date of this Endorsement: x/.22/02 20 ~. Insured: 0' Grady ,Paving, Inc. All notices herein provided to be given by ttie Insurance Company to the City in connection ~vith this policy and this Additional Insured Endorsement, shall be mailed to or delivered to the City it 10300. Torre Avenue; Cupertino, California 95014. I' ~ ~~~ ~ (print/type name) varrant that I h ve authority to bind the below listed Insurance Company and by my signature iereon do so bind this Company. signature of ,Authorized Representativ (Original signature required on all Endo en.ts furnishe to the District) James of ~gent/Agency: Laurie Phirip~i.dis Title: Account Manager address: 305 Walnut Street Telephone: ,~_ ~~ 333 Redwood 'City, CA 94063 Facsimile' 650 839 6964 Subrogation Endon~ement Page 1 of 1 +~: C CUPEl~T1N0 NOTICE C-F POLICY CANCELLATIOrf ENDORSEMENT In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows: . Cancellation Notice. The insurance afforded by this policy shall not be suspended, voided, canceled, reduced in coverage or in limits, or ma~~erially altered, except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to the City of Cupertino ("City"). Such notice shall be addressed to the City as indicated below. POLICY INTORMATION 1. Insurance Company: St. Paul Fire & Marine 2. Insurance Policy Number: xxos3ol220 3. Effective Date of this Endorsement: " x/.22/02 20 4. Insured: O' Grady Pavin~3, Inc. All notices herein provided to be given by fie Insurance Company to the City in connection ~' with this policy and this Additional Insured Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. I, ~ ~ ~ ~ (print/type name) warrant that I ve authority o ind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representativ : ~~ (Original signature required on all Endo meats furnished to the District) Names of Laurie Phirippidis AgentlAgency: ~ ~ , ... _ _ _ _ _ _ _ _ _ _ Title: Account Manager Address: 305 Walnut Street Telephone: tin ~__633~ Redwood City. CA 94063 Facsimile: 650 839 6964 Cancellation Endorsement Page 1 of 1 Bond No.: 103871340 PRE~U1il!`4fSFO~0001~~~;:~~.~'~~~„^ Premium: $551.00 APiD tS SUB,icC1'TO t~q,it!^'~~:"`.~.fEJi ~o"F'"~C°"''~ F~icE FAITHFUL PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENT: THAT WE, O'Grady Paving , Inc . as Principal, ~ (contractor's name) , and Travelers Casualty and Surety Company of America as Surety, (bonding company's name) are held and firmly bound unto the City of Cupertino, State of California, in the sum of Seventy Three Thousand Five Hundred and NO/100 ($73,500.00)--------------- lawful money of the' United States, for the payment of which will and truly to be made, we bind ourselves, our heirs, executors, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION of the foregoing obli€;ation is such that, WHEREAS, the Principal has ent~:red into a contract with the City dated 20 with the obligee to do and perform the following work to-wit: Pavement Restoration, Project 2002-01 NOW, THEREFORE, if the said principal shall well and truly perform the work contracted to be performed under said contract, then this obligation shall be void; otherwise to remain in full force and effect. IN WITNESS WHEREOF, this instrument has been duly executed by Principal and Surety this 22nd day of July ~ 20 02 , (To be signed by Principal and Surety, Notary acknowledgment required) Travelers Casualty and Surety Company of America Surety Street Address: 225 Lennon Lane, Suite 200 City, State, Zip Walnut Creek, CA 94598 B ~~ Y• Attp y-In-Fact , KathE~rine G. Zerounian ~~ The above bond is accepted and approved this _ day of , 20_. Faithful Performance Page l of 1 CALIFORNIA ALL- PURPOSE ACKNOWLEDGEMENT State of California County of Santa Clara On July 26, 2~2 before me, Nesh~i Phillips, Notary Public Date Name, Title of Officer (e.g., "Jane Dce, Notary Public") personally appeared _ Craig E. Young Name(s) of Signer(s) ® personally known to me or p~e~-~:~ -- }'~~ basi~f~€-sa#~s€ae~er~ e~idexe~~ to be i:he person( whose named isjare subscribed to the within instrument and acknowl'.edged to me that he/she{~key executed the same in his/he~t~e~authorized capacity (ies), and that by his/ die-' , signatux~e{s; on the instrument the person, or the entity upon behalf of which the person . ~- ~} acted., executed the instrument. ,. ,. F _ -> ~ ~' ~' y11'ITNESS and and official seal Place Notary Seal Above Si of Notary Public OPTIONA:. Though the information belozo is not required by law, if may prove valuable to persons relying on the document and could prevent fraudulent removal and reattnchmenf of this form to another document. Description of Attached Document Title or Type of Document: Document Date: )Number of Pages: Signer(s) Other Than Named California All Purpose Acknowledgment State of California County of San Mateo On July 22, 2002 ,before me, Erin Bautista, Notary Public Date Name l3 Title of Officer/Notary personally appeared Katherine G. Zerounian Names(s) of Signers(s) personally known to me, or proved to me on the basis of satisfactory evidence to be the person{s} whose name{s~ is/aye subscribed to tl-~e within instrument and acknowledged to me that Jae/she/try executed the same in Jams/her/t~aei~authorized capacity`s and that by Jars/her/~he}r signature{s} on the instrument the person{s}; or the entity upon behalf of which the person{-s) acted, executed the instrument. WITNESS my hand and official seal. ~~~ . Notary Public OPT/~~NAL (The information below is not required by law) Description of Attached Document Title/type of Document Date of Document Other Signer(s) No. of Pages ERIN BAllTISTA Gommission ~ 1352711 i Notary Public - California Ssn Mateo County My Comm. Expires Apt 25, 2006 a~•,a~^ h:\docs\surety\forms\notary.doc Bond No.: 103871340 Premium: Included LABOR AND MATERIAL BOND KNOW ALL MEN BY THESE PRESENT: WHEREAS, the Ciry of Cupertino, State of California, and O'Grady Paving, Inc. hereinafter designated as "Principal" have entered into or are about to enter into a contract providing for the installation, construction, and erection by Principal of Pavement Restoration, Project 2002-O1 more particularly described in said contract; and :incorporated herein by reference. WHEREAS, said principal is required to furnish a bond in connection with said contract, providing that if said Principal, or any of his or~ its subcontractors, shall fail to pay for materials, provisions, provender or other supplies or teams used in, upon, for or about the performance of work contracted to be done, or for any work or labor done thereon of any kind, the Surety on said bond shall pay the same to the extent hereinafter ;;et forth; NOW, THEREFORE, WE, 0' Grady F~aving , Inc . as Principal, (contractor's name) and Travelers Casualty and Surety Company of America as Surety, (bonding company's name) firmly bind ourselves, our executors, administrators, successors and assigns, jointly and severally, unto the City of Cupertino, and any and all materialmen, persons, companies, or corporations furnishing materials, provisions, provender or other supplies used in, upon, for or about the performance of the aforesaid work contracted to be executed or performed under the contract hereinabove mentioned, and incorporated herein by reference, and all persons, companies or corporations lending or hiring teams, implements or machinery, for or contributing to said work to be done, and all persons who perform work or labor upon the same, and all persons who supply both work and materials, whose claim has not been paid by Principal or by any other person, in the just and full sum of Seventy Three Thousand ~5ive Hundred and NO/100. ($73 , 500.00 ) THE CONDITION OF THIS OBLIGATION IS SUCH THAT if said principal, his or its subcontractors, heirs, executors, administrators, successors or assigns, shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon, for or about the performance of the work contracted to be done, or for any work or labor thereon of any kind, or for amounts due under the Unemployment Insurance .Act with respect to such work or labor, or any and all damages arising under the original contract, thf;n said Surety will pay the same and also will pay in case suit is brought upon this bond, such reasonable attorney's fee as shall be fixed by the court. This bond shall insure to the benefit of any and all persons, companies, and corporations entitled to file claims under Section 1184.1 of the Code of Civil Procedure, so as to give a right of action to them or their assigns in any suit brought ~.ipon this bond. Labor and Material Pa;;e 1 of 2 CALIFORNIA ALL- PURP03;E ACKNOWLEDGEMENT State of California County of Santa Clara On July 26t 2002 before me, Nesh~i Phillips, Notary Public Date Name, Tifie of Officer (e.g., "Jane Doe, Notary Public'') personally appeared _ Craig E. Young Name(s) of Signer(s) ® personally known to me or ~~.. ~,,, „r ,.~,,, ~-satis€ae-tee e~idenEa to be the person(-s~ whose name{} is/aye subscribed to the within instrument and aclcnow:[edged to me that he/shy executed the same in his/he~#-authorized capacity(ies), and that by his/''" signatui•e4s} on the instrument the person, or the entity upon behalf of which the person .. -. - - - Es} acted[, executed the instrument. s° .~., ~ _~ ~ ,~ . • ... ~~~; ~ ~ ~ r ~ ~ ~ ~ ~~~ F-~ V~'ITNESS hand and official seal ~._ Place Notary Seal Above ( Signature of Notary Public ^PTICrNA;l- T7wugh 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 farm to another document. Description of Attached Document Title or Type of Document: Document :Number of Pages: Signer(s) Other Than Named And the said Surety, for value received, hereby stipulates, and agrees that no change, extension of time, alteration or addition to the teems 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, alteration or addition to the terms of the contract or to the wor:k or to the specifications. IN WITNESS WHEREOF, this instrument has been duly executed by Principal and Surety this 22nd day of July , 20~~? . (To be signed by Principal and Surety. Notary acknowledgments required.) CONTRACTOR O'Grady Pav'ng, Inc. ~`' Principal Travelers Casualty and Surety Company of America Surety Street Address: 225 Lennon Lane, Suite 2C0 City, State, Zip Walnut Creek, CA 94598 By: , Atto ~y-In-Fact , KathE~rine G. Zerounian The above bond is accepted and approved this _ day of , 20-• Labor and Materiel Page 2 of 2 CALIFORNIA ALL- PURPOSE ACKNOWLEDGEMENT State of California County of Santa Clara On July 26, 2002 before me, Nesh~~ Phillips, Notary Public Date Name, Title of Officer (e.g., "Jane Doe, Notary Public'') personally appeared _ Craig E. Young____T Name{s) of Signer(s) ® personally known to me or e~~exF~ to be the person4s} whose name(s) is/aye subscrit~ed to the within instrument and acknowledged to me that he/sl~e~l~ey executed the same in his/#e~f±t~e~~-authorized capacity(~es), and that by his/he~ signature(-sr} on the instrument the person, or the entity upon behalf of which the person {s) acted., executed the instrument. ~.. .. WITNESS hand and official seal Place Notary Seal Above Si tore of Notary Pub c OPTIC~NA;~- Though the information below is not required by [aw, it may prove valuable to persons relying on the document and could prevent fraudulent renuwal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: ]number of Pages: Signer(s) Other Than Named California All Purpose Acknowledgment State of California County of San Mateo On July 22, 2002 ,before me, Erin Bautista, Notary Public Date Name Ft Title of Officer/Notary personally appeared Katherine G. Zerounian Names (s) of Signers(s) personally known to me, or proved to me on the basis of satisfactory evidence to be the person{s~ whose names) is/aye subscribed to tF~e within instrument and acknowledged to me that kie/she/ executed the same in #is/her/t~aei~authorized capacity's and that by firs/her/tom signature{s} on the instrument the person{s}; or the entity upon behalf of which the person{s} acted, executed the instrument. WITNESS my hand and official seal. ERINBAImSTA Commission # 1352711 Notary Public - California ~ ` San Mateo Couniy MY Comm. Expires Apr 25, Notary Public OPT/CANAL (The information below ;is not required by law) Description of Attached Document Title/type of Document Date of Document Other Signer(s) No. of Pages h:\docs\surety\forms\notary.doc TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CA5-UALTY APiD SLTF-ETY COMPANY FA,RNIINGTON CASUALTY COMPANY Hartford, Connecticut 06183-9062 POWER OF ATTORNEY AND CERTLFICATE OF AZJTFiORITY OF ATTOT~`lEY(S)-IlY-FACT z1NOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SCtRETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMLNGT4N CASUALTY COMPA~v-Y, coraorations duly organized under the laws of the State of Connecticut, and having their principal offices in the Ciry of Hartford, Count~f of Har`f'ord, State of Connecticut, (hereinafter the "Companies') hafh made, constituted and appointed, and do by these presents make, constitute a_nd appoint: Mark Roppo, Jason Jenkins, I~atherine G, Zeraunian, Erin Bautista, James B. Shea, Jeff Prevost, of Belmont, California, theiz true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within. the United States, the; following instrument(s); by his/her sole signature and act, ar~y and all bonds; recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, ,recognizance, or conditioial undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Comparses, and alI the acts of said Attorney(s)-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. , ''his appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are haw in full farce and effect: - VOTED, That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any assistant Treasurer, the Corporate Secretaryry or any Assistant Secretary may appoi.*~t Attomeys-in-Fact ~zd Agents to act for and on behalf of the company and may give ssch appointer such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's Seal bonds, reccgnizances, contracts of indemnity, and other writings obligstory in he nature of a bend, recognizance, or conditional under'akirg, and any of said off cers or the Board of Directors at any tune may remove any such appointee and revoke the power given him or her, VOi~,D: That the Chairman, the President, any Vice Chairman, any Executivf. Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is i_*~ writing and a copy thereof is fried in the office of the Secretary. VOTED; That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a.bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by fire President, any Vice Chairman, any Executive Vice President, any Senior Vice President os~any Vice President, any Second Vice President, the "reasoner, any assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a ~ ecretary or Assistant Secretary, or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power p:'escribed in his or her certificate or their certificates of authority or . by one or more Company officers psrsuant to a written delegation of authority, This Power of Attorney and Certificate of Authority is signed and ;ealed by facsimile~(mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards cf Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND S-URETY COMPANY and FARMINGTON CASUALTY COMPANY, which Resolution is now in full farce and effect: VOTED: That the signature of each of the following officers; President, ar.y Executive Vice President, any Senior Vice President, any Vice President, a_*fy Pssistant Vice President, any Secretary, any Assistant 5ecneta.r~, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vicc: Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile si~ature or facsimile seal shall be valid aid binding upon the Company and, any such power so executed and certified by such facsimile signature and facsi.*nile seal shall be valid and bindi+zg upon the Company in the future with respect to any bond or undertaking to which it is attached, BID PROPOSAL ~H'~ PAVEMENT RESTORATION PROJECT 2002-01 TO: THE DIRECTOR OF PUBLIC WORKS, CITY (~F CUPERTINO, STATE OF CALIFORNIA Dear Sir: In compliance with the plans and specifications furnished for the work of the PAVEMENT RESTORATION PROJECT in the City of Cupertino, PROJECT NO. 2002-OI, 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 anal specifications for the prices set forth in the following schedule. I further understand that said prices include all costs including, but not limited to, local, state and federal taxes, and transpc-rtation costs. I, the undersigned, also understand that the quantities 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 I~ortions 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 f~roposal, 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 PAVEMENT' RESTORATION, PROJECT 2002-01 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. Bid Proposal Page 1 of 8 Bid Est.Qty. Item Unit Item 1 6,000 S.F. Pavement Restoration (4") /5D c~ IZ ~ ~~G-.c S Per S.F. 2 9,000 S.F. Paveme t Restora ion (6") r=r vac. ~ ~(a-s ~ ~j Ce.~13 Per S.F. Unit Price Total $ / ~ /S.F. $ o~ ~ J _. TOTAL BID $ 7 S~ Bid Proposal Page 2 of 8 I, the undersigned, agree that if this proposal is acc~:pted, I will enter into a contract with the City of Cupertino to provide all necessary machin~:ry, tools, apparatus, and other means of construction and to do all the work specified in the contract in the manner and time specified. I, the undersigned, declare that this bid is made ~~vithout 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. ~~- Attached hereto is the required certified check ¢r t~id bond in a amount of $ , as required by law and the Notice to Bidders. (10% of bid amount) Bid Proposal Page 3 of 8 NONCOLLUSION AFFIDAVI:T TO BE EXECUTED BY BIDDER AND SUBM]:TTED WITH BID I, the undersigned, being first duly sworn, depose and say that I am of .~ c . uP _ (Business Title) (Business Nam the party making the foregoing bid, that the bid is riot made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder ha:; 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 ~~r anyone else to put in a sham bid, or that anyone shall refrain from bidding. The bidder teas not in any manner, directly or indirectly, sought by agreement, communication, or confers;nce 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 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 eiTectuate a collusive or sham bid. Bid Proposal Page 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 to perform this work as a part of this proposal. We have been in business under the present name fir ya years. Our experience in work comparable with that required by the proposal contract is ~~ ~- years operating under the following different namel;s). My California Contractor's License Number is _ a20 / G ~ ~ The classification of my Contractor's License is The expiration date for my Contractor's License is_ /~ - 3 t U 3 ****************************************************************************** (This Section for City use only) The above info ation has been verified by _ on ~~ ~~ * 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. Bid Proposal P<<ge 5 of 8 BIDDER HISTORY OF WORK The following is an example of work similar ire character to that required in the proposed contract which our organization or personnel in oiu organization has completed within the past three (3) years. For Whom Contact Year Location Tvne of Work Performed Phone No. Amount Bid Proposal Page 6 of 8 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 hire to perform any of the work for this project in an amount in excess of one-half of one percent x;0.5%) of the total bid are listed below. Only those listed below shall perform work on this proje-ct 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 / V ~ /y ~ Contractor's License No. Address & phone no. Work to be Performed 2. Name Contractor's License No. Address & phone no. Work to be performed 3. Name Contractor's License No. Address & phone no. Work to be performed 4. Name Contractor's License No. Address & phone no. Work to be performed 5. Name Contractor's License No. Address & phone no. Work to be performed 6. Name Contractor's License No. Address & phone no. Work to be performed Bid Proposal Pz~ge 7 of 8 BIDDER'S SIGNATURE FORM IF YOU ARE AN INDIVIDUAL, SO STATE. IF YOU ARE A COMPANY OR A CO- PARTNERSHIP, STATE THE COMPANY N~~1VIE 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, SECRETAR~C'-TREASURER, AND MANAGER. THE CORPORATE SEAL MUST BE AFFIXED TO Tl3IS FORM. ENTER THE NAME OF YOUR BUSINESS ON THE LINE OPPOSITE THE APPROPRIATE BUSINESS TYPE. TYPE OF BUSINESS NAME OF BUSINESS CORPORATION: CO-PARTNERSHIP: INDIVIDUAL: JOINT VENTURE: OTHER: (Describe) Name and Signature of Bidder: Date: Address (mailing & location): ~~~1?~ ~~~~~~ / / O cc n r'T~in ~i 9yay3 Telephone Number: ~~ GSC~ ~/,~; - ~ ~'a2 L Acknowledgment of all addenda received is requirf;d by circling each addendum number. (~ 2 3 4 5 6 7 8 9 10 Bid Proposal Paige 8 of 8