03-026 A-1 Norcal & Sons~ `/ X11
CUPEI~TINO ~1 ~~
AGREEMENT
CITY OF CI,IPERTINO
~~ ~
10300 Torre Avenue
Cupertino, CA 95014
(408) 777-3200
NO.~~ ~ Si~
BY THIS AGREEMENT, made and entered into on the 29 day of JANUARY , 20Q3,
by and between the CITY OF CUPERTINO (Hereinafter referred to ens CITY) and
Name (1) A-1 NORCAL & SONS _ (2)
Address T g43 GUNSTON TniA~' City SAIV JOSE Zip 95124 Phone (408) 4"19-f13h3
(Hereinafter referred as CONTRACTOR), in consideration of their mutual covenants, the parties hereto agree as follows:
CONTRACTOR shall provide or furnish the following specified services and/or materials:
REMOVE & SALVAGE EXISTING CLAY ROOF TILE FROM LIBRARY PRIOR TO DEMO OF BUILDING BY OTHERS
EXHIBITS: The following attached exhibits hereby are made part of '!his Agreement:
EXHIBIT "A" -PROPOSAL WITH LUMP SUM BID
TERMS: The services and/or materials furnished under this AgreemE~nt shall commence on JANUARY 29, 2003
and shall be completed before FEBRUARY 7, 2003
COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR:
NOT TO EXCEED LUMP SUM BID OF $5,200.00
California Labor Code, Section 1771 requires the payment of prevailing wages to all workers employed on a Public Works contract in
excess of $1,000.00.
GENERAL TERMS AND CONDITIONS
Hold Harmless: Contractor agrees to save and hold harmless the City, its officers, agents and employees from any and all damage and
liability, including all costs of defending any claim, caused by or arising out of the performance of this Agreement. City shall not
be liabl f r acts of Cont actor in performing services described herein.
ue to negligence, errors and omissions
Insurance: Should the City require evidence of insurability, Contract~~r shall file with City a Certificate of Insurance before commencing
any services under this Agreement. Said Certificate shall be subject to the approval of City's Director of Administrative Services.
Non-Discrimination: No discrimination shall be made in the employment of persons under this Agreement because of the race, color,
national origin, ancestry, religion or sex of such person.
Interest of Contractor: It is understood and agreed that this Agreement is not a contract of employment in the sense that the
relationship of master and servant exists between City and undersigned. At all times, Contractor shall be deemed to be an independent
contractor and Contractor is not authorized to bind the City to any contracts or other obligations in executing this agreement. Contractor
certifies that no one who has or will have any financial interest under this Agreement is an officer or employee of City.
Changes: This Agreement shall not be assigned or transferred without the written consent of the City. No changes or variations of any
kind are authorized without the written consent of the City.
CONTRACT CO-ORDINATOR and representative for CITY shall be:
NAME DAVID
DEPARTMENT PTTRT.Tf: wO~S
This Agreement shall become effective upon its execution by t:,ITY, in witness thereof, the parties have executed this
Agreement the day and year first written above.
CONTRACTOR:
By ~t--'--~`'~-~.
Title O !~/ ///~~-
Soc. sec. # 5"~3 GZ a~ l ~ / ~
APPROVALS ~ ~ ;~~~ ~ •~Q~°~j
CITY OF CUPERTINO:
Ely
71t1e PTTRT.Tr' j,,]0~~ ~~(~~~ ~~iT~zGr$
EiXPENDITURE DISTRIBUTION ~~~[ G
T HE D DA ACCOUNT NUMBER AMOUNT
A ,~
CITY CLERK DATE
i
White: City Clerk / 'd Green: Finance Yellow: Contractor Pink: Receiving ~ Gold: Department
~JWIE3IT A
TILE SHAKES
FiBERC3LASS _ DRY ROT
COMPOSITION
3HINGLE5
2069 Camden Ave. Suite 209
San Jol:ie, CA 96124
439-036 I..ic. #352331
CELL 264-8001 _26~y~.405 288-2264
FAx B USA. PAGER
Prcposal Srrbm~ed To ~ ~
i
-
`~ Ahpne ~ paw
~~v
r i ~r ~-
carer
~ ~ ~ ~ ~N ~
StrBef ~ _ ,/~ G/~;~ Job Lccat~on
v
City, State, Zrp
1 Contract Number Corresponding lnspecton a '
,/1GL Lf~ ~G~Q. ~ N~ ~m`lv /9L f-ct ~/N G~rC>'O~"-~
/C-'r ~J~~ yr i ~L4 -><S r~'o,~~ •5 i~~'1-i '~o ~~ti~5/~
The approximate starting and compbtion dates for this job are~s~~ ~~rnd /~5/I•ftir2 a pectlvety. The actual dates of
the work may vary as much as several weeks from the dates given here. The Owner will be informs if arty scheduling changes
are made. Any pianninp or coordinating by the Owner should be based an the dates which Hte Contractor has given to him verbally
We, NOi?IGAL, propose hereby to furnish material ~tnd labor in accordance with above specifications and the
stipulations on both sides of this contract for the sure of:
~ ~ ~ ~ %fr~f~ f/.~y~ / ~~ ~ /~~r/~,~~~lars {s 5 f Z ~c~ i
Payments to be made as follows: C.O.D. cn materi~ll
The full amount of contract is to be paid no later than COMFt,cTIC N days after completion of work. Any akera6on ar deviation from the
t~•:; ms and specifications of this contract involving extra cost M material or labor wiq only be executed upon written orders for same
and will become an eaira charge over ttte sum mentioned in tttis contract. Ail agreements must be made in writing
AUtiiOfi2~Cl ;~ Note: This proposal may be withdrawn by me, rf not acoepted,
5ignature~ -~~~~~~~~~~/ ° 1 signed and returned to us wkhln days.
Dave Helmuth
ACCEPTANCE OF PROPOSAL -The above prices, specification<.: and conditions ara satistactory and are hereby accepted. You are
authorized to do the work ss specified. Payment will be made as c~utiined above,
pate of AceQptartco: Signature:
s~anature:
0121'03 12:on a4os777JJJ3 CITY CC?PERTI~O ~ao2:oue
CUP TINO C,ERTIFICATF. OF INSUR.LIVCE TU TAB CITY OF CiJPE.RTINO
This certifies to the City of Cupertino that the following described policies havo been issued to the
insured named below and are in force at this urns.
Insured:
Address; ~-
~~
Deacriptior of operationsllocatioas/produc.ts insured (show contract name ancL"or number, if any):
srs~rr.~c~~-s~w~®m~oo=ao=as:~~~sa~: zm=va~soasmsz aasSas~~s sas ~~ ~e
WORKER'S COMPENSATION fi Statutory Mir-.
~ ~~ ~- ,, ~ ~~ ` Fmoloyer'a
~,117~ = ~ ~~~ _ Liahiliry
(name of insurer)
-~--{--
Insurance Company's State License No~~ ~_.,
Check Policy Type; Each O~xurrence S ITGU~ O o0
COMPREHBNSIVT GENERAL
LLP-BILITY O
PratoiseslOpecauons Caentral AggreBax ~~ ~ ~~ , (~
(if applicable)
~Ownca6 & Contrsctors
Protective
Contractual for Specific
Contract
$ ) , Q00 , Gi~O
[ ) Products Liability
[ ) XCU Hazards
p~j Broad Fam PD.
[ ] Sevsrability of Interest
Clause
Aggrags-tc
Petaonal Injury
Fire Dunage (any ono fire)
~~~~.~
~~ ~~~0
[ ] Per9onal Injury with Medical Expense $ ~~QC2_-
Employee Exclusion Removed (any one: person}
or Self-Insured
CO ERCIAL GENERAL LIABILITY Itntendon S J`~~O
_.~1~tt11~Yb n) ~ 5~~41ue~. .c~ . _
(name of insurer) _ ~
Policy No..~ ~ ~.~.~~5103 ~'~ Expirarion Dace_,12 ' ~ 3_
Certificate of ln6urance Agieament Page ~ of 2
o1••za~oa 12:00 ~auwT77J3JS CITI CUPEkTI~t'+ ®t+os;~o~
j AVI'dMt)TIVF/VEHICL.E LIABIL[7Y
~ Commercial Form
Liability Coverage
BdDILY INJURY
Each Person
PROPEF~rY llA„ti1AGE
Each .~uident
f ~~I~'~~ r Ns ~~ ~I~c
{namc of instunr)
5--- ,---
>~acr, ACCidant
or
Combined Single Limit $~ ~ ,__
Policy I`'o. I ~~ ~~ ~ ~Ezgiration Date zo D~
~~ A copy of a!l Endnrsemcnts tc, the policy its; which in any way
~agesnt's initial) limit the above-lisu~d types of coverage srn 3ttaehed to this
Certificate of Ia3tuancc.
-his Certificate of Insurattee is not an inflt:rtvice policy and does not ameed, extend •ar alter Nc
:overagt afforded by the policies listed ttarein. hatwithstanding an}' :agesfrcrrtent, term, or
:ondltion of any Contract or ally odter docuruCnt with respect to wltij,ch this Cerdficate of Iresuranee
nay b.° issued or nay pertain, the insurance afford;;d by Nc policias dr;crit~ed herein is subject to
J.1 the tccins, ezclusfoos and conditions of such po:ieies.
T IS HEREBY CERTIFIED that the Rbnvc poiicy+"its} provide liability insurance as regnired by
he Agreement be een a ity and the itisurad.
lY~_-~~~-__ ~. Dated: _ 20Q~
utach Certificate of Insurance and Additional lnattred Endorsornept On company forms.
Conifltate of Insurance A~e,ncnt ~o~e ~ at 2
01~2~'07 1::U1 $aob777J~1J CI?'i ~LTPER7I~t1
CUPEl~TINO
ADDITIONAL INSUR4D ENDORSEMENT
and
ENpUR9E1~NT OF PRI1~lARY INSURANCE
sad
NOTICIi OF POLICY
CANCELL:e-TION ENDORSEMEN'T'
Project Title and Number
fool%UUfl
In consideration of the policy promium and notwith~ttanding any inconsistent statement in the policy
to which this Endorseu~ent is attacl-ed or any othtr Endorsement at[acl-ad thereW, it is agretd ss
follows:
The City of Cupertino ("City") and its directors, officers. engineers, agents and cmgloyaes,'
and aII public e~encics from whom partttics wil! be obtained and their directors, oYflcers, engineers,
agents and empioyeas are hrreby declared to be additional insureds under the terms of this policy,
but only with respect to the operations of the Conductor at or upon any ~i the premises of the City
in connection with the Contract with rite City, or acts or. omissions of the additional insureds in
connection with, but lirttited to its general suparviaion or inspection of said operations.
Thu inswrai~ce afforded by this policy is prit*iary insurance, and no additions! insurance hdd
or owned by the designated additional insureds) shall be called upon to cover a loss under said
additional policy.
Cancellation Notice. The insurance afferdcd by this policy shill not be su&pendcd. voided,
canceled, reduced in coverage ctt in limits, .u maeetially Altered, txcepi after thirty (30) days' ptzor
written notice by certified mail, return receipt requested, has been given to t]~ City of Cupertino
("City"). Such notice shall be addressed to the Cite as indicated below.
POLICY INFO1tMA7ION
1. Insurance Coutpany : U ~l-l:l IN Cry ~J~ v 2.~- dU C~, ' ~ - -
2. Insurance Policy Ntuttber: _~' ~a~ ._~ ~~) ~3,~~ ___._~
~ ~
3. Effective Date of this Endorser :tt: ! ~ ~~! ~ ^_„_-. _ ._Z0~
4. Insured ~ ~~~ t - h~~ ~ L
Acididonet fnPUred and Prima, '~nsuranco and Notice of Caaaellodon F~dorbzn~n~ Page 1 of 2
~1~T9%u3 12:01 '84obi?7933) CITY CUPERTI~O ®J03~u08
All notices herein provided to be given by the [nsurauce Company to the City In connection
with this policy and these Endotsemettts, shall Oe mailed to or delivered to the City at 1A300 Torre
Avenue; Cupertino, California 93014.
I,
warrant that I have authority to bind the taelow lis
hereon do so bind this Corr-pany.
._--(pnnvtypo name}
Company and by my signature
/.
Signature of Aut>zorized Representative:~~ ~ ~"(~
(Original signaturo required on all F~dotsemencs furnished to the District)
.names of
AgendAgenCy:~~ ~~~ ~il~~s-4%"~L~! TJ
Address: Gl _~-_,~
J S~ - ~l J ~~
Tltie: ~ t~D // //
Telcphono: ~~~ ~ `~'~~
Fecsin~ile: C ~ ~D ~f~~~
Additional Im.aird and ?timaty Insuruncc and Notice of Cancallatio~ Rndocsemnnt Page 2 of
ul~za!us 1:: U1 Q1097773S3a CITT CUPERTI`o ~ OOGi008
CUP INO
WAIVER OF SUBROGATION ENDORSEMENT
WORKER'S COtiIPENSA,TION WSi?RANCE
Project Title and Number:
In consideration of the policy premium and notwithstanding any inconsistent ~tatetnent In the
policy to which this Endarsernent is attectted or any other Endorsement attached thereto, it is agreed
as follows;
It is agreed that with raspdct to such insurance as is afforded by the policy, the Insurance
Company waives any right of subrogation against tha City of Ct.partina, and each of its directors,
officers, agentti, consultants and employees by reason of any payment made on account of injury,
includir-g death t~ulting therefn,m, sustained by any emplo}•ee of the insured, arising out of the
performance of the above-referenced Contract.
POLICY INFORMATION
1. lnswanct Company: {v)T~'~~
r ~~p_-.~__ _ __
2. Insurance Policy Number:- ~ 3 ~ c"7 ~ ~~ d ~~
3. Bffectivc Date of this Endorserncnt: 20~
4. Insured:
T
All notices herein providrd to be given by the lnswance Compagy to the City In eonnectian
with this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre
Av~Ye, Cupertino, Cal1ifornia 9SOl~i.
I, •+-~ e S /4/(f~ Q - (print/type name) I!
warrant that I have authorlry to bind t}~e below listed Insu ce Company
hereon do su bind this Company. /0
Signature of Authorized Representative: 'C _~/~ _
Original signature required on all Endorsentcnts furnished to the District)
at~d by my signature
Nstnes of T ~
Agent/Agency: ! ~. 1~ ~ ~lLJ 5 ~.(..~~ Ti cte: __~~~~,~ ---
Address: ~`-v ~ ~ _-_ Talephona:~ ~-~ ~~
J / 1 U _,,,_ Facsimile ~~~
Sutxugaria~n F,,nd~usetoen: Pte 1 of 1