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05-057, Don & Mike's Sweeping AGREEMENT THIS AGREEMENT, made and entered into this 1st day of July, 2005, by and between the CITY OF CUPERTINO, a municipal corporation of State of California, hereinafter referred to as "CITY", and Don & Mike's Sweeping a Contractor with offices at 901 Dell Avenue, Campbell, CA 95008 hereinafter referred to as "CONTRACTOR"; WITNESSETH: WHEREAS, CITY desires to retain the CONTRACTOR for STREET SWEEPING SERVICES, PROJECT NO. 2005-01; and WHEREAS, CITY desires to engage CONTRACTOR to provide these services by reason of its qualifications and experience for performing such services, and CONTRACTOR has offered to provide the required services on the terms and in the manner set forth herein; NOW, THEREFORE, in consideration of their mutual covenants, the parties hereto agree as follows: 1. DEFINITIONS: .; (a) The word "City" as used in this agreement shall mean and include all the territory lying within the municipal boundaries of the city of Cupertino, California, as presently existing, plus all territory which may be added thereto during the term of this agreement by annexation or otherwise. (b) The term "City Manager" shall mean the duly appointed City Manager of the City of Cupertino, California, or his designated representative. 2. THE CONTRACT DOCUMENTS. The complete contract consist 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 STREET SWEEPING. PROJECT NO. 2005-06 d. Faithful Performance Bond. e. Insurance Agreement, Certificate of Insurance, Endorsement of Primary Insurance, Additional Insured Endorsement, Endorsement of Aggregate PAGE 1 OF9 Limits of Insurance per Project, Waiver of Subrogation Endorsement Worker's Compensation Insurance and Notice of Policy Cancellation Endorsement. f. This Agreement. All of the above documents are intended to cooperate so that any work called for in one and not mentioned in the other, or vice versa, 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 slurry sealing various streets, 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 Plans and Specifications are entitled, respectively, STREET SWEEPING, PROJECT NO. 2005-06 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. 3. PROJECT COORDINATION. (a) City. The City Engineer shall be a representative of the CITY for all purposes under this agreement. The Assistant Director of Public Works hereby is designated as the PROJECT MANAGER for the City Manager, and he shall supervise the progress and execution of this agreement. (b) Contractor. CONTRACTOR shall assign a single PROJECT DIRECTOR to have overall responsibility for the progress and execution of this agreement for CONTRACTOR. Don Vierra hereby is designated as the PROJECT DIRECTOR FOR CONTRACTOR. Should circumstances or conditions subsequent to the execution of this agreement require a substitute PROJECT DIRECTOR designee shall be subject to the prior written acceptance and approval of the PROJECT MANAGER. PAGE 2 OF9 4. DUTIES OF CONTRACTOR. Services to be furnished in accordance with EXHffiIT "A" BID PROPOSAL and contract specifications. (a) Laws to be Observed. CONTRACTOR shall: (1) Procure all permits and licenses, pay all charges and fees, and give all notices which may be necessary and incident to the due and lawful prosecution of the services to be performed by a CONTRACOR under this agreement; (2) Keep itself fully informed of all existing and future federal, state, and local laws, ordinances, regulations, orders, and decrees which may affect those engaged or employed under this agreement; (3) At all times observe and comply with, and cause all of its subcontractors and employees, if any, to observe and comply with, all of said laws, ordinances, regulations, orders, and decrees mentioned above; (4) Immediately report to the PROJECT MANAGER in writing any discrepancy or inconsistency it discovers in said laws, ordinances, regulations, orders, and decrees mentioned above in relation to any plans, drawing, specifications, or provisions of this agreement. 5. COMPENSATION. For the performance of the services described herein by CONTRACTOR, CITY shall pay CONTRACTOR the sum of$ 9,918.00 (Nine Thousand Nine Hundred and Eighteen Dollars and No Cents) per month, less any deductions for work not performed and or liquidated damages, payable upon submission by CONTRACTOR of itemized billings in triplicate; provided, however, that the total sum payable to CONTRACTOR shall not exceed $ 119,016.00 (One Hundred Nineteen Thousand and Sixteen Dollars and No Cents) per year. These amounts are based on $ 14.25 (Fourteen Dollars and Twenty Five Cents) per curb mile for 696 curb miles per month. Emergency and additional street sweeping shall be at $ 95.00 (Ninety Five Dollars and NO Cents) per hour or at $ 14.25 (Fourteen Dollars and Twenty Five Cents) per mile. 6. LIQUIDATED DAMAGES. The CONTRACTOR shall diligently prosecute the work to completion as scheduled. The CONTRACTOR further understands that he shall pay liquidated damages to the City of Cupertino in the sum of One Thousand Dollars ($1,000.00) for each and every day that services are not completed on time and/or streets are omitted. Omitted streets must be swept by the following day. In case of breakdown by main sweeper, immediate service within one hour by a second sweeper is required to complete daily schedule. If down for more PAGE 3 OF 9 than one hour, liquidated damages will be assessed at the rate of One Hundred Dollars ($100.00) per hour for each hour above and beyond one hour. 7. TERM. The term of this agreement shall be one (1) year from the start date of the agreement. The City shall retain the option to extend the term of the agreement for one (1) additional year from the expiration of the original term, for a possible total of two years. The start date of this agreement shall be July 1,2005. Any such renewal after the first years shall be accomplished by the City providing a written notice of renewal to the Contractor at least 30 days prior to expiration of the term. Any such renewal shall contain the same provisions as the original agreement, including an increase or decrease in compensation paid to the Contractor. Any increase or decrease in the previous contract price shall be based on the annual percentage change in the Consumer Price Index (CPI) as of June of the year the adjustment is being made. The CPI shall be the San Francisco/Oakland Consumer Price Index for all urban wage earners. 8. TEMPORARY SUSPENSION. The City Manager shall have the authority to suspend this agreement, wholly or in part, for such period as he deems necessary due to unfavorable conditions or to the failure on the part of the CONTRACTOR to perform any provision of this agreement. 9. SUSPENSION~ TERMINATION. (a) Right to Suspend or Terminate. The City may suspend or terminate this agreement for any reason by giving thirty (30) days written notice. (b) Payment. Upon such suspension or termination, CONTRACTOR shall be paid for all services actually rendered to CITY to the date of such suspension or termination; provided, however, if this agreement is suspended or terminated for fault of CONTRA TOR, CITY shall be obligated to compensate CONTRACTOR only for that portion of CONTRACTOR'S services which are of benefit to CITY. 10. INSPECTION. CONTRACTOR shall furnish CITY with every reasonable opportunity for CITY to ascertain that the services of CONTRACTOR are being performed in accordance with the requirements and intentions of this agreement. All work done and all materials furnished, if any, shall be subject to the PROJECT MANAGER'S inspection and approval. The inspection of such work shall not relieve the CONTRACTOR of any of its obligations to fulfill its agreement as prescribed. PAGE40F9 11. ASSIGNMENT: EMPLOYEES. (a) Assignment. Both parties shall give their personal attention to the faithful performance of this agreement and shall not assign, transfer, convey, or otherwise dispose of this agreement or any right, title, or interest in or to the same or any part thereof without the prior written consent of the other party, and then only subject to such terms and conditions as the other party may require. A consent to one assignment shall not be deemed to be a consent to any subsequent assignment. Any assignment without such approval shall be void and, at the option of the other party, shall terminate this agreement and any license or privilege granted herein. This agreement and any interest herein shall not be assignable by operation of law without the prior written consent of the other party. 12. NOTICES. All notices hereunder shall be given in writing and mailed, postage prepaid, by certified mail, addressed as follows: TO CITY: Office of the City Clerk 10300 Torre Avenue Cupertino, CA 95014 TO CONTRACTOR: Attention of the PROJECT DIRECTOR at the address of CONTRACTOR recited' above. 13. INTEREST OF CONTRACTOR. CONTRACTOR covenants that it presently has no interest, and shall not acquire any interest, direct, or indirect, financial or otherwise, which would conflict in any manner or degree with the performance of the services hereunder. CONTRACTOR further convenants that, in the performance of this agreement, no subcontractor or person having such an interest shall be employed. CONTRACTOR certifies that no one who has or will have any financial interest under this agreement is an officer or employee of CITY. It is expressly agreed that, in the performance of the services hereunder, CONTRACTOR shall at all times be deemed and independent contractor and not an agent or employee or CITY. 14. INDEMNITY. CONTRACTOR hereby agrees to indemnify and save harmless CITY, its officers, agents, and employees of and from: (a) Any and all claims and demands which may be made against CITY, its officers, agents, or employees by reason of any injury to or death of any person or damage suffered or sustained by any person or corporation caused by, or alleged to have been caused by, any act or omission, negligent or otherwise, of CONTRACTOR or any subcontractor under this agreement or of CONTRACTOR'S or any subcontractor's employees or agents; PAGE50F9 (b) Any and all damage to or destruction ofthe property of CITY, its officers, agents, or employees occupied or used by or in the care custody, or control of CONTRACTOR, or in proximity to the site of the CONTRACTOR'S work, caused by any act or omission, negligent or otherwise, of CONTRACTOR or any subcontractor under this agreement or of CONTRACTOR'S or any subcontractor's employees or agents. (c) Any and all claims and demands which may be made against CITY, its officers, agents, or employees by reason of any injury to or death of or damage suffered or sustained by any employee or agent of CONTRACTOR or any subcontractor under this agreement, however caused, excepting, however, any such claims and demands which are the results of the sole negligence or willful misconduct of CITY, its officers, agents, or employees; (d) Any and all claims and demands which may be made against CITY, its officers, agents, or employees by reason of any infringement or alleged infringement of any patent rights or claims caused by the use of the apparatus, appliance, or materials furnished by the CONTRACTOR or any subcontractor under this agreement; and (e) Any and all penalties imposed or damages sought on account of the violation of any law or regulation or of any term or condition of any permit. CONTRACTOR, at its own cost, expense, and risk, shall defend any and all suits, actions, or other legal proceedings that may be brought or instituted by third persons against CITY, its officers, agents, or employees on any of the above claims or demands of such third person, or to enforce any of the above . penalties, and pay and satisfy any judgement or decree that may be rendered against CITY, its officers, agents, or employees in any such suit, action, or other legal proceedings. 15. WORKERS' COMPENSATION. CONTRACTOR certifies that it is aware of the provisions of the Labor Code of the State of California which require every employer to be insured against liability for workers' compensation or to undertake self- insurance in accordance with the provisions of that code, and it certifies that it will comply with such provisions before commencing the performance of the work of this agreement. 16. INSURANCE. CONTRACTOR, at its sole cost and expense, shall obtain and maintain in full force and effect throughout the entire term of is agreement the insurance coverage in amounts specified and having a Best's Guide Rating of "A", Class VII or better or that is otherwise acceptable to the City. Insuring not only CONTRACTOR, but also (with the exception of workers' compensation and employer's liability insurance), CITY, its officers, agents and employees, and each of PAGE 6 OF 9 them with respect to activities and services performed by CONTRACTOR for or on behalf of CITY under the provisions of this agreement. Certificates of such insurance, on the forms provided by CITY, shall be filed with CITY concurrently with the execution of this agreement or, with CITY'S approval, within ten (10) days thereafter. Said certificates shall be subject to the approval of the City Attorney and shall contain an endorsement stating that said insurance is primary coverage and will not be cancelled or altered by the insurer except after filing with the City Clerk thirty (30) days' written notice of such cancellation or alteration, and that the City of Cupertino is named as an additional insured. Current certificates of such insurance shall be kept on file at all times during the term of this agreement with a City Clerk. 17. CONTRACT SECURITY. The CONTRACTOR shall furnish a surety bond in an amount equal to four (4) months of the contract price as security for the faithful performance of this Contract. 18. AGREEMENT BINDING. The terms, covenant, and conditions of this agreement shall apply to, and shall bind the heirs, successors, executors, administrators, assigns, and subcontractors and both parties. 19. WAIVERS. The waiver by either party of any breach or violation of any term, covenant, or condition of this agreement or any provision, ordinance, or law shall not be deemed to be a waiver of any other term, covenant, condition, ordinance, or law or of any subsequent breach or violation of the same or of any other term, covenant, condition, ordinance, or law. The subsequent acceptance by either party of any fee or other money which may become due hereunder shall not be deemed to be a waiver of any preceding breach or violation by the other party of any term, covenant, or condition of this agreement or of any applicable law or ordinance. 20. COSTS AND ATTORNEYS FEES. The prevailing party in any action brought to enforce the terms of this agreement or arising out of this agreement may recover its reasonable costs and attorneys' fees expended in connection with such an action from the other party. 21. WAGE RATES. Contractor is required to pay prevailing wage rates on this project. Copies of the general prevailing rates of per diem wages for each craft, classification, or type of worker needed to execute the Contract, as determined by Director of the State of California Department of Industrial Relations, are deemed included in the Contract Documents and on file at City's office, and shall be made available to any interested party on request. Pursuant to Section 1861 of the Labor Code, Contractor represents that it is aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that Code, and PAGE70F9 Contractor shall comply with such provisions before commencmg the performance ofthe Work ofthe Contract Documents. 22. AGREEMENT CONTAINS ALL UNDERSTANDINGS. This document represents the entire and integrated agreement between CITY and CONTRACTOR and supersedes all prior negotiations, representations, or agreements, either written or oral. This document may be amended only by written instrument, signed by both CITY and CONTRACTOR. All provisions of this agreement are expressly made conditions. This agreement shall be governed by the laws of the State of California. PAGE80F9 IN WITNESS WHEREOF, the patties have executed this Agreement, in duplicate, the day and year first hereinabove written. CONTRACTOR: Don & Mike's Sweeping DOA/ g r4IIt:['S Sb)[[IlIA/y n I' , IF 9nl DELL 4VE C4~PB[LL.CA By: AlL"\... (l.~ 'l.JL4l..---/ 95008 Notary acknowledgement is required. If a corporation, corporate seal and corporate Notary acknowledgement and Federal Tax I.D. are required. If not a corporation a Social Security No. is required. CITY OF Mayor ~JJ- City Clerk -- Soc. Security # Federal Tax LD By: Attest: Contractor's License No. n/ a Date: 1--13 City Clerk , 2005 Project Name & Number: STREET SWEEPING, PROJECT NO. 2005-06 Contractor's Name and Address: Don & Mike's Sweeping 901 Dell Avenue Campbell, CA 95008 Phone: 408-866-2072 Contract Amount: $ 9,918.00 per month; $ 119,016.00 per year Account Numbers: 230-8004-7014 = $ 60,000.00 and 520-8003-7106 = $ 59,016.00 File Number: 50,206.04 PAGE90F9 SEE ATTACHED NOTARY CERTIFICATE CALlFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~~d<<d"C~>(X.Q(;Q('dd~ddifd'<<'<<difd"''<?~~<<~'';;<>':Xif~<>G<'~~~d<<<<<<~.Q.~ ~ State of califOrnia} ~ ~ County of SCt,,~ Cto:Y9 ss. ~ ~ t+ M' V 't A-S ~ ~ ::.: 'P~:~ ~::\ :t m~ ;: :~~~~oo_,..._~_'''"'~ i ~ N~e~~;::~:~:y known to me ~ ~, JO proved to me on the basis of satisfactory ~,. . ~; evidence 6 g g R to be the person(~) whose name(~) is/aFe g R subscribed to the within instrument and g g )' -- - ..... _ ..... 4_ ~ .... .... _ _, ..... acknowledged to me that he/sReAAey executed g g la MRUDUtA H. VYAS f the same in his/hefftheir authorized ~t g ;(: Commission'1363355 r capacity(ie~), and that by his/~r g g ~. Notary PUbl.iC _ California ~ signature(~) on the instrument the person~), or g B ~ Santa Clara County '"' ( the entity upon behalf of which the person(~) g ~ _ _ _ ~~m_~~u: ~ ~ acted, executed the instrument. ~ ~,. WITNESS my hand and official seal. ~,' .. X,;' fY)-\ ~ 0,.'; ~; Signature of Notary Public : > B g ~ OPTIONAL ~ ~ 0 ~.',::,;' hough the information below is not required by law, it may prove valuable to persons relying on the document and could prev. t ti.0ti.,:S ~ fraudulent removal and reattachment of this form to another document. ;~ R g B g g g ~ Document Date: Number of Pages: ~ R Signer(s) Other Than Named Above: g ~ ~ B g g Signer's Name: g R g ~ D Individual g ~.. D Corporate Officer - T s): ~;.' ~; D Partner - D Limi D General ;~ X1 D Attorney-in-F g g D Trustee g g D Guar . g ~ D 0 r: ~ R g.. R ":<Y,)6<o/-<X,;<Y':><'./X':'/o/'C<:,,'<:.<)<:..(,'<X><:Z<<4'6.~'6-:.)(Y...<<<<,<,j,><::.(Y'~<<<<<::<:'C<"'C<~<<<::<"'<~'C<:'4<<'<.".(.<<<::<4x:;;>o> @ 1999 National Notary Association' 9350 De Soto Ave., P.O. Box 2402' Chatsworth, CA 91313.2402' www.nationalnotary.org Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 EXHIBIT A BID PROPOSAL STREET SWEEPING, PROJECT 2005-06 TO: THE DIRECTOR OF PUBLIC WORKS, CITY OF CUPERTINO, STATE OF CALlFORNIA Dear Sir: In compliance with the plans and specifications furnished for the work of the STREET SWEEPING, PROJECT 2005-06for 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 costs including, but not limited to, local, state and federal taxes, and transportation costs. Bidders shall complete the entire Statement of Qualification and submit it with the bid proposal documents. Failure to complete the Questionnaire or inclusion of anv false statement(s) shall be J!rounds for immediate disqualification. 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 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 STREET SWEEPING, PROJECT 2005-06as 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 Five Hundred Dollars ($500.00) per day, for each and every day services are not completed on time and/or streets are omitted. 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 Item 1. 2. Est.Qty. Unit Item 1. 696 Miles per Street Sweeping Month Per Mile per Month $ 14. 25 per Month EXHIBIT A Unit Price Total /Mile $9, 918. 00 /Month TOTAL YEARLY BID AMOUNT $ 9, 918. oCMonth X 12 = $119.016. oofYear .' EMERGENCY AND ADDITIONAL SWEEPING: Emergency and Additional Street Sweeping on hourly rate Per Hour Emergency and Additional Street Sweeping per Curb Mile Per Mile $ 95. 00 /Hour $ 14.25 /Mile Bid Proposal Page 2 of 8 EXHIBIT A I, the undersigned, agree that ifthis proposal is accepted, I will enter into a contract with the City of Cupertino to provide all necessary machinery, 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 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. Attached hereto is the required certified check or bid bond in the amount of $ 11, 901 . 60 , as required by law and the Notice to Bidders. (10% of bid amount) Bid Proposal Page 3 of 8 EXHIBIT A NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY. BIDDER AND SUBMITIED WITH BID 4 the undersigned, being first duly sworn, depose and say than am .r PRE-SIDE-N7 (Business Title) of DON & ~IKE-'S SWeE-PINg (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, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding. 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 :r~."" bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or "0'[ 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 infonnation 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. Bid Proposal Page 4 of 8 EXHIBIT A 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 for 21 years. Our experience in work comparable with that required by the proposal contract is years operating under the following different name(s). My California Contractor's License Number is NONE. The classification of my Contractor's License is The expiration date for my Contractor's License is ****************************************************************************** * (This Section for City use only) * The above information 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 Page 5 of 8 EXHIBIT A BIDDER mSTORY 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. Year Location app/1..ox:. 10Y/1..-6 Newa/1..k rn Tvpe of Work For Whom Performed CI7l} o '1 N F '" ./) .R J( Contact phone No. PAf1 D[f1[J ((] Amount App/1.. 0 x:. $3~000.00 A/Qggf ^J"{l{l,Qi.~~ Ph#510-794--2372 -6weepina hPnvJCP ~nnn Oq c~gg App/1.. 0 x:. lR{/n,l, rJlplJnfinn,rn A/nnn! 61"'J~,Qiqg City ot C!:lJ'[R7INO Bo~ Rizzo App/1..ox:. Rr.n ,jIlin $84-56.00 mo. 'P/'#':?77_n5"'- c.i.ty ot John f..AJ1PBfLf. Tnqllin/n App/1..ox:. ~S)7).OO TTb. l.{/fl Camp~ell Ca -6t/1..eet -6weeping Ph1l866-2127 Bid Proposal Page 6 of 8 EYJIIBIT MI/ft 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 (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 Address & phone no. Work to be Performed 2. Name Address & phone 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. Contractor's License No. Contractor's License No. Bid Proposal Page 7 of 8 EXHIBIT A BIDDER'S SIGNATURE FORM IF YOU ARE AN INDIVIDUAL, SO STATE. IF YOU ARE A COMPANY OR A CO- PARTNERSHIP, STATE THE COMPANY NAME 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-TREASURER, AND MANAGER. THE CORPORATE SEAL MUST BE AFFIXED TO THIS FORM. ENTER THE NAME OF YOUR BUSINESS ON THE LINE OPPOSITE THE APPROPRIATE BUSINESS TYPE. TYPE OF BUSINESS ~t~€€t ~w€€pinq NAME OF BUSINESS DON & rUKE-' S SUJE-E-PINq CORPORATION: DON & fYlIKE-' S SUJE-E-PIN(j P~€~id€nt Don Vi€~~a, S€c~€ta~y 7~€a~u~€~ Jim Vi€~~a,fYIanag€~ Don Vi0~~a CO-PARTNERSHIP: INDIVIDUAL: JOINT VENTURE: OTHER: (Describe) jJ tfYV 1/ ~VLA/ DON VTfRRA (Print or type name) Name and Signature of Bidder: Date: 5-24-05 Address (mailing & location): 901 j)f r r 4I1D/UE. CAfYlPBfLf. rA 9Snn8 Telephone Number: (1. 0 8) R (If) - ) n 7 ) E-Mail Address: N/A Acknowledgment of all addenda received is required by circling each addendum number. ~ 2 3 4 5 6 7 8 9 10 Bid Proposal Page 8 of 8 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 Contractor. 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 and 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 compensation insurance - must be signed by the insurance agent for worker's compensation only. Insurance Instructions 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 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 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, 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 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 or that is otherwise acceptable 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 name 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 duration 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. Worker's Compensation & Employers' Liability LIMITS In accordance with the Worker's Compensation Act of the State of California- Worker's comp- "statutory" per CA Law; Employers' Liability- $1,000,000 per occurrence. Insurance Agreement Page 1 of 2 General Liability - commercial general liability; including provisions for contractual liability, personal injury, independent contractors and products - completed operations hazard. Combined single limit of$1.0 million per occurrence; $2.0 million in the aggregate. Automobile Liability - comprehensive covering owned, non-owned and hired automobiles. Combined single limit of$I.0 million per occurrence. Consultants only: Errors and Omissions liability. $1.0 million per occurrence. B8% ~I~~~~'S SWEEPINg (Contractor's Name) By: ,t)~{~~2AG/ Da1ed:1f /2- 0/ 20 ();- Insurance Agreement Page 2 of 2 Jun 27 05 10:5Sa State Farm - Joan Peros, Agent Lie. #0577260 Auto - Life - Health - Home - Business 8060 Santa Teresa Blvd., Suite 210 Gilroy, CA 95020 Ph: 408-847-6650 Fax: 408-847-6621 . . . ','n~ jOlUL~!O.~,13_8Bl,@s!a~fap:n.com "facsimile transmittal "'1 . .... ~ ~ '.: ,.,.. . To: Fax: 408-866-4631 Mary DOD & Mike's Sweeping From: Mitchell Vaughn - Joan Peros Office Date: 6/27/2005 Re: City Of Cupertino Certs OfInsurance Pages: 5 cc: o Urgent o For Review o Please Conment o Please Reply o Please Recycle . . . . . . Notes: Dear Mary, Please find attached the Certificates of Insurance along with the Waiver of Subrogation for workers comp for the City of Cupertino. I don't have a copy of Additional Insured endorsement and have requested that from the regional office and that will take a couple of days to get. I talked with .Toan and this is the form that we must use due to limitations set by the states department of insurance. Give me a call if you have any questions. Sincerely, Mitchell Vaughn for Joan Peros ~JJ .................... p. 1 . Jun 27 05 10:5Sa 10.2 CERTIFICATE OF INSURANCE o STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois IZI STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois o STATE FARM FIRE AND CASUAlTY COMPANY, Scarborough, Ontario o STATE FARM FLORIDA INSURANCE COMPANY. Winter Haven, Florida o STATE FARM LLOYDS, Dallas, Texas insures the following policyholder for the coverages indicated below: Policyholder DON & MI KE I S SWEEPING INC This certifies that I .,.AII.... .. .....u.C\ 901 DELL AVE CAMPELL, CA 95008 CITY OF CUPERTINO STREET SWEEPING Address of policyholder Location of operations Description of operations The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms, exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims, POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date : Expiration Date (at beginning of policy period) 97-wK-6782-3 Comprehensive 9/10/04 9/10/05 BODILY INJURY AND Business Liability : PROPERTY DAMAGE - - -- - -. - -.. -.... - - - - - - - -.. - -.. -..- .~- PrOducts ~ 'Completed -Op~~aiioris- -.. -- -.. - - - - - - -- -. - - - -- - -- This insurance includes: I8J Contractual Liability Each Occurrence $ 1,000,000 I8J Personal Injury I8J Advertising Injury General Aggregate $2,000,000 I8J MEDICAL EXPENSES: $5,000 0 Products - Completed $2,000,000 0 Operations Aggregate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Date : Expiration Date (Combined Single Lirnit) 97-EK-8071-G I8J Umbrella 9/10/04 , 9/10/05 Each Occurrence $1,000,000 o Other Aggregate $1,000,000 POLICY PERIOD Part I - Workers Compensation - Statutory Effective Date : Expiration Date 97-WQ-4547-7 Workers' Compensation 12/13/04 12/13/05 Part II - Employers Liability and Employers Liability Each Accident $1,000,000 Disease - Each Employee $ 1, 000 , 000 Disease - Policy Limit $1,000,000 POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date : Expiration Date (at beginning of policy period) D38 2411-D04-0SK Auto 4/4/05 : 4/4/06 SOO/lMM/500 062 3520-D16-0SE Auto 4/16/05 , 4/16/06 SOO/lMM/500 V23 971-D30-05I Auto 3/30/05 2/30/06 SOO/lMM/500 THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Name and Address of Certificate Holder CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO, CA 95014 If any of the described policies are canceled before their expiration date. State Farm will try to mail a written notice to the certificate holder 30 days before cancellation. If however, we fail to mail such notice, no obligation or liability will be imposed on State Fann or its agents or representatives. 50\\11\ p~.'C& f::~ 7 Signature of Authorized Repres latlve AGENT Title JOAN PEROS Agent Name Telephone Number 408 - 84 7 - 6650 6/27/05 Date 558-9$4 as Rev.11-08-2004 Printed in U.S.A Agent's Code Stamp ~~n~~e J PEROS 05-2326 S SlUeON "ALLEY f154 CERTIFICATE OF INSURANCE o STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois I:8J STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois o STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario o STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida o STATE FARM LLOYDS, Dallas, Texas insures the following policyholder for the coverages indicated below; Policyholder DON & MIKE'S SWEEPING INC. Jun 27 05 10:57a .,..,. .... A This certifies that 1....".Cl Address of policyholder Location of operations Description of operations 10.3 901 DELL AVE. CAMPBELL, CA 95008 CITY OF CUPERTINO STREET SWEEPING The policies listed below have been issued to the pollcyholder for the policy periods shown. The insurance described in these policies is subject to all the terms, exclusions, and conditions of those policies. The Ii mils of liability shown may have been reduced by any paid claims. POLICY NUMBER This insurance includes: POLICY NUMBER V23 9717-A16-05I V24 6025-A09-05J 315 5741-B04-05W TYPE OF INSURANCE POLICY PERIOD Effective Date : Expiration Date LIMITS OF LIABILITY (at beginning of policy period) BODILY INJURY AND PROPERTY DAMAGE Each Occurrence $ General Aggregate $ Products - Completed $ Operations Aaoregate BODILY INJURY AND PROPERTY DAMAGE (Combined Single limit) Each Occurrence $ Aggregate $ Part J - Workers Compensation - Statutory Part II - Employers Liability Each Accident $ Disease - Each Employee $ Disease - Policy Limit $ LIMITS OF LIABILITY (at beginning of policy period) 500/1MM/500 500/1MM/500 500/1MM/SOO THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN, Comprehensive Business Liability -[JProdu-~ts-:-CorT;p(eted .Operations. - - - - - -- -------- - - --- ~ - - - -- o Contractual Liability o Personal Injury o Advertising Injury o Medical Expenses: $5,000 o o EXCESS LIABILITY o Umbrella o Other POUCY PERIOD Effective Date : Expiration Date POLICY PERIOD Effective Date : Expiration Date Workers' Compensation and Employers Liability TYPE OF INSURANCE POLICY PERIOD Effective Date : Expiration Date 1/16/05 : 1/16/06 1/9/05 1/9/06 2/4/05 2/4/06 Auto Auto Auto Name and Address of Certificate Holder CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO, CA 95014 558-994a.5 Rev.11-08-2OO4 Printed in U.S.A. If any of the described policies are canceled before their expiration date, State Farm will try to mail a written notice to the certificate holder 30 days before cancellation. If however, we fail to mail such notice, no obligation or liability will be imposed on State Farm or its age ts or representatives. ~. ~ Signature of Au AGENT Tille JOAN PEROS Agent Name Telephone Number 408-847-6650 6/27/05 Date Agenfs Code Stamp Agent Code AFO Code J PEROS 05..2326 S SILICON VALLEY F154 Jun 27 05 10:57a 10.4 CERTIFICATE OF INSURANCE o STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois !8J STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois o STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario o STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida o STATE FARM LLOYDS, Dallas, Texas insures the following policyholder for the coverages indicated below: Policyholder DON & MIKE'S SWEEt'ING INC. PA'I .... A This certifies that 1.II.a...\ 901 DELL AVE. CAMPBELL, CA 95008 CITY OF CUPERTINO STREET SWEEPING Address of policyholder Location of operations Description of operations The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms, exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims. POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date : Expiration Date (at beginning of policy period) Comprehensive BODILY INJURY AND Business Liability , PROPERTY DAMAGE --... -- -- - - - ---------.- - ~- --- t]"prod~jctS-:-CO-mpleted "Operations""""" --- - - - u - ---" - n - - - --- This insurance includes: o Contractual Liability Each OcculTence $ o Personal Injury o Advertising Injury General Aggregate $ o Medical Expenses: $5,000 0 Products - Completed $ 0 Operations Aggregate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Date ; Expiration Date (Combined Single Limit) o Umbrella Each Occurrence $ o Other Aggregate $ POLICY PERIOD Part I - Workers Compensation - Statutory Effective Date : Expiration Date Workers' Compensation Part II - Employers liability and Employers Liability Each Accident $ Disease - Each Employee $ Disease - Policy Limit $ POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date : Expiration Date (at beginning of policy period) 355 9027-D26-05P Auto 4(26(05 : 4/26/06 500/1MM/SOO 082 6935-E16-05 Auto 5/16/05 5/16/06 500/1MM/500 THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Name and Address of Certificate Holder CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO, CA 95014 If any of the described policies are canceled before their expiration date, State Farm will try to mail a written notice to the certificate holder 30 days before cancellation. If however, we fail to mail such notice, no obligation or liability will be imposed on State Farm or its agents or representatives. -SO~^ .p-e/{J~ ~ J Signature of Authorized Representat AGENT 6/27/05 Th ~~ JOAN PEROS Agent Name Telephone Number 408-847-6650 Agenfs Code Sta~~ET.lOS 05 23~6 Agent Code ~r" f\ - .. AFOCode S SILICON VALLEY F154 558-994 a.S Rev. 11-08-2004 Printed in U.S.A. Jun 27 05 10:57a p.5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC040306 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be otherwise due on such remuneration. 5 % of the California workers' compensation premium Schedule Person or OrQanization CITY OF CUPERTINO 1030 TORRE AVE CUPERTINO CA 95014 Job DescriDtion STREET SWEEPING SMURFIT-STONE CONTAINER CORP ITS SUBSIDIARIES & AFFILIATES 1901 JUNCTION AVE SAN JOSE CA 95131 STREET SWBEPING CITY OF CAMPBELL DEVELOPMENT AGENCY, ITS OFFICERS, EMPLOYEE & VOLUNTEERS ATTN: DEPT OF PUBLIC WORKS 70 N FIRST ST CAMPBELL CA 95008 STREET SWEEPING This endorsement changes the policy to which it is attathed and is effective on the date issued unless otherwise stated, (The Infonnatlo. below is required only when this endorselllent is issued subsequent to prep.ation of the policy.1 Endorsement Effective Poley No. 97 -WQ-4 54 7 -7 Endorsement No. Insured DON &. MIKE'S SWEEPING INC Insurance Company STATE FARM FIRE AND CASUALTY COMPANY ~B CounlersignedBy _./rJ ,,, e/c.s.. ~,,) WC 040306 (Ed. 4~84) Printed in U.S.A.