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05-111, CB Construction CONTRACT FOR PUBLIC WORKS 1 ~ 1 the CITY OF This CONTRACT made on / ~ ~ ~ by CUP~ERTINO, a municipal corporation of the State of Calif rnia, hereinafter called CITY, and C B Construction Co. hereinafter called CONTRACTOR. IT IS HEREBY AGREED by CITY and CONTRACTOR as follows: 1. THE CONTRACT DOCUMENTS. The complete contract consists of this contract and the following contract documents incorporated herein by reference: a. Notice to Contractors, Proposal, Time of Completion, Estimated Quantities, Noncollusion Affidavit, Bidder Qualification Form, Subcontractors Form and Signature Form. b. Standard Specifications, General Provisions and Special Provisions. c. Plans and Specifications for Reconstruction of Curbs, Gutters and Sidewalks. Project No. 2005-08 d. Faithful Performance Bond and Payment Bond. e. Insurance Agreement, Certificate of Insurance, Endorsement of Primary Insurance, Additional Insured Endorsement, Endorsement of Aggregate Limits of Insurance per Project, Waiver of Subrogation Endorsement Worker's Compensation Insurance and Notice of Policy Cancellation Endorsement. All of the above documents are incorporated into this contract by reference so that any work called for in one and not mentioned in another, is to be executed the same as if mentioned in all of said documents. The documents comprising the complete contract are sometimes hereinafter referred to as the Contract Documents. In case of conflict between the Plans and the Specifications on the one hand, and this Contract on the other, the Plans and Specifications shall prevail. 2. THE WORK. CONTRACTOR agrees to furnish all of the tools, equipment, apparatus, facilities, labor, transportation and materials necessary to perform and complete in a good and working order, the work of reconstructing curbs, gutters and sidewalks, 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, Reconstruction of Curbs, Gutters and Sidewalks, Project No. 2005-08and which Plans and Specifications are identified by the signatures of the parties to this Contract. It is understood and agreed that said tools, equipment, lp be aterfonnedland a ompl ted as relquired in said Plansland furnished, and that said work sh p Specifications under the sole direction of CONTRACTOR, but subject to the inspection and approval of CITY, or its representative. CITY hereby designates as its representative for the purpose of this Contract the Engineer, Mr. Ralph A. Qualls, Jr. 1 3. CONTRACT PRICE. CITY agrees to pay, and CONTRACTO3 175.00 tFoureHundred payment for the work above agreed to be done, the sum of $ 42 , Twenty Three Thousand, One Hundred Seventy Five Dollars and a °E h bit ~Auattached additions and/or deductions as provided in the Contract Documents, p hereto. 4. DISPUTES PERTAINING TO PAYMENT FOR WORK. Should any dispute arise respecting the true value of the work done, or any work omitted, or any extra work which CONTRACTOR may be required to do, or respecting the size of any payment to CONTRACTOR during the performance of this Contract, said dispute shall be determined either by reference to the Unit Prices bid, if applicable, or in accordance with agreement of prices, if applicable, or in accordance with the agreement of the parties, or in accordance with Section 6, paragraph "f ' of the General Provisions. 5. PERMITS, COMPLIANCE WITH LAW. CONTRACTOR shall obtain and bear all expense for all necessary permits, licenses and easements for the construction of the project, give all necessary notices, pay all fees required by law, and comply with the laws, ordinances and regulations relating to the work and to the preservation of the public health and safety. 6. INSPECTION BY THE CITY. CONTRACTOR shall at all times maintain proper facilities and provide safe access for inspection by CITY to all parts of the work, and to the shops wherein the work is in preparation. Where the Specifications require work to be specially tested or approved, it shall not be tested or al thereof oriconsen ther totby CITYT Should anyisuch for inspection and without the approv work be covered up without such notice, approval, or consent, it must, if required by CITY, be uncovered for examination at CONTRACTOR'S expense. 7. EXTRA OR ADDITIONAL WORK AND CHANGES. Should CITY at any time during the progress of the work require any alterations, deviations, additions or omissions from the Plans and Specifications or the Contracoid the Contra tI but the cost or value thereof will be the same shall in no way affect or make v 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 ENVIRONMENTAL REQUIREMENTS. CITY shall have the right to make changes in this Contract during the course of construction to bring the completed improvements into compliance with environmental requirements or standards established by State and Federal statutes and regulations after 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 the agreement of the parties. 9. TERMINATION, AMENDMENT OR MODIFICATION. This Contract may be terminated, amended or modified, with the mutual consent of the parties. The compensation 2 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 the work by the acts or neglect of CITY, or its employees, or those under it by contract or otherwise, or by changes ordered in the work, or by strikes, lockouts by others, fire, unusual delay 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 MATERIALS. CONTRACTOR shall notify CITY a sufficient time in advance of the manufacture, production or testing of materials to be supplied under this Contract, in order that CITY may arrange for mill, factory or laboratory inspection and testing of same. 12. TERMINATION FOR BREACH OR INSOLVENCY. If CONTRACTOR should be adjudged a bankrupt, or should make a general assignment for the benefit of creditors, or if a receiver should be appointed on account of insolvency, or if CONTRACTOR or any subcontractor should violate any of the provisions of the Contract, CITY may serve written notice upon CONTRACTOR and CONTRACTOR'S surety of its intention to terminate the Contract. Such notice shall contain the reasons for CITY'S intention to terminate the Contract, and unless within ten (10) days after serving of such notice, such violation shall cease and satisfactory arrangements for corrections thereof be made, the Contract shall, upon the expiration of said ten (10) days, cease and terminate. In the event of any such termination, CITY shall immediately serve notice thereof upon CONTRACTOR'S surety and CONTRACTOR, and the surety shall have the right to take over and perform the Contract; provided, however, that, if the surety within fifteen (15) days after the serving 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 same to completion by contract, or by any other method it may deem advisable, for the account and at the expense of CONTRACTOR, and CONTRACTOR AND CONTRACTOR'S surety shall be liable to CITY for any excess cost occasioned by CITY thereby, and in such event 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 maybe on the site of the work and necessary therefore. 13. THE CITY'S RIGHT TO WITHHOLD CERTAIN AMOUNTS AND MAKE APPLICATION THEREOF. In addition to amounts which CITY may retain under other provisions of the Specifications until final completion and acceptance of all work covered by the Contract, CITY may withhold from payment to CONTRACTOR such an amount or amounts as in its judgment may be necessary to pay just claims against CONTRACTOR or subcontractors for labor and services rendered and materials furnished in and about the work. 3 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 maybe 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 and signed either by the party giving such notice, or by a duly authorized representative of such party. 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, enclosedCi~ERTINO, eCA195014a postagetprepIaid od CUpERTINO; 10300 TORRE AVENUE, 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 UnitShelbturne Way, LosoGatos, CAe95 30, post ge addressed to, C B Construction Co., 17484 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 surety 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 maybe, at the address of CONTRAg TOR'S sureto to to eyed aid and the person last communicated by such person to the party givin the notice, p g p p 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 SPECIFICATIONS 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 offered 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 subcontractors similarly to provide Worker's Compensation and Employer's Liability Insured to the CONTRACTOR, employees unless such employees are covered by the protection afford 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 4 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 property. The safety provisions of applicable laws, building codes and construction codes shall be observed. Machinery, equipment and other hazards shall be guarded or eliminated in accordance with the safety provisions of the Construction and Safety Orders issued by the Industrial Accident Commission of the State of California. 19. CONTRACTOR'S RESPONSIBILITY FOR THE WORK. CONTRACTOR shall not be responsible for the cost of repairing or 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 about 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 supplier in the project which is the subject of this Contract, unless a lesser quality is expressly authorized in the Plans and Specifications, in which event CONTRACTOR unqualifiedly guarantees such lesser quality; and that the work as performed by CONTRACTOR will conform with the Plans and Specifications or any written authorized deviations therefrom. In case of 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. 5 P.O. No. 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 currently under construction or to be constructed in the future. IN WITNESS WHEREOF, the parties have executed this Contract, in duplicate, the day and year first hereinabove written. CITY OF C ERTINO: CONTRACTOR: C B Construction Co. r'(~7 yr By, l ~ Z3. ~ avid W. Knapp By. C1~n.~~.y,~~ -(3 . Ciecur Attest: Notary acknowledgment is required. If a City C k corporation, corporate seal and corporate notary acknowledgment and Federal Tax I.D. are required. If not a corporation a Date: ~ o~ 3 , 20 OS Social Security No. is required. City Clerk Social Security # Federal Tax I.D. # APPROVE AS FO $ Bl ~ ~ t ~ Contractor's License No. City Attorney Project Name & Number: Reconstruction of Curbs, Gutters and Sidewalks, Project No. 2005-08 Contractor's Name & Address: C B Construction Co. 17484 Shelburne Way Los Gatos, CA 95030 Contract Amount: $ 423,175.00 Account Numbers: 270-9451-9300 - $389,925.00 270-9450-9300 - $33,250.00 File No: 50,342 6 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT i ,I State of California SS. , ~ County of ~:~Y%~G~ L.~e~ l ~ ~ On l~ o~JDQs before me, ~ I Date Name and tle of icer e. ~ ( g., "Jane Doe, Notary bl~ i personally appeared ,/j i_.., i Name(s) of Signer(s) ` I i ? personally known to me ' ~ i ~t~roved to me on the basis of satisfactory ~ evidence to be the person whose name~s~ is/~ subscribed to the within instrument and ~ LORNA K. ROACH acknowledged to me that he/ i,, COMM. #1559592 s~?e>'ttTBy'executed ~i ~ _ c~ the same in hisfhEflf>f a authorized 1 NOTARY PUBLIC • CALIFORNIA • SANTA CLARA COUNTY capacity(, and that by his/heff#heir-~ ~ rFO~ My Comm. Expires Mar. 16, 2009 signature) on the instrument the personn~f, or the entity upon behalf of which the person ' i acted, executed the instrument. WIT and and official se i Signature ublie I OPTIONAL ~ _ Though the information below is not required bylaw, it may prove valuable to persons relying on the document and could prevent ~ /raudulent removal and reattachment of this /orm to another document. Description of Attached Document ~ Title or Type of Document: Document Date: ~ 7Db' Number of Pages: Signer(s) Other Than Named Above: i ~~1 Capacity(ies) Claimed by Sign Signer's Name: i ~ IndiVld I Top of thumb here t l ? Corp ate Officer - T' e(s): ? Pa er - ? Limite ? General ~ ~ ? orney-in-Fact 1; ? rustee ? uar ' r Conservator ? Other: Signer Is Representing: H '~.'~`-fi~~`~.`L~Ci~~~~`ti`~`~i'~`~'~'~'~`~'~`--~4.~'~~: _ ~`C.`~~Ci'~~tr'~rti`~%~i~i~~%G`~`~i`~"ti~`~i`~`_~i~`~`fi'~f.'~f~'~`~v~~` ©;7999 National Notary Association • 9350 De Soto Ave P.O. Box 2402 • Chatsworth, CA 91373 2402 • www.nationalnotary.org Prod. No 5907 Reorder: Call Toll-Free 1-800 876-682 7 ~,~~~J~J BID PROPOSAL RECONSTR UCTIDN OF CURBS, GUTTERS AND SIDEWALKS, PROJECT 2005-08 TO: THE DIRECTOR OF PUBLIC WORKS, CITY OF CUPERTINO, STATE OF CALIFORNIA Dear Sir: In compliance with the plans and specifications furnished for the work of the RECONSTRUCTION OF CURBS, GUTTERS AND SIDEWALKS, PROJECT 2005-08 for the City of Cupertino, the undersigned, hereby declare that I have read the proposal requirement, visited the sites, and examined the specifications. I, the undersigned, hereby propose to do all work required to complete the work in accordance with the plans and specifications for the prices set forth in the following schedule. I further understand that said prices include all costs including, but not limited to, local, state and federal taxes, and transportation costs. Bidders shall complete the entire Statement of QualiFcation and sccbmit it with the bid proposal documents Failure to complete tl2e questio~znaire or inclusion of any false statement(s) shall be ,groauzds for immediate disgualif cation. 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 RECONSTRUCTION OF CURBS, GUTTERS AND SIDEWALKS, PROJECT 2005-08 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 E~HIBI'~ A Bid Est.Qty. .Unit Item Unit Item ,~P.rice Total 1. 25,500 S.F. Remove & Reconstruct Sidewalks I-~ aS throughout the City for all $ I U /S.F.~ $ oZ~ 1, 3~5 Quantities of work at any location Per S.F. 2. 2,000 L.F. Remove & Reconstruct Curbs & ~o Gutters throughout the City for all $ ~ ~ /L.F. $ ~ ~ , GCS C~ Quantities of work at any location Per L.F. 3. 1,500 S.F. Remove & Reconstruct Driveway _ Aprons throughout the City for al] $ ~ ~ 5v /S.F. $ ~ ~ 7sU Quantities of work at any location Per S.F. 4. 100 L.F. Place cutback in A.C. area at lip of ~ G gutter throughout the City at any $ ~ ~ /L.F. $ ~ tJU location Per L.F. 5. 150 EACH Grinding of existing Curbs, Gutters Vo and Sidewalks throughout the City $ ~ d /EA• $ ~ r CC ~ at any location Per EACH 6. 1,000 S.F. Parkstrip Maintenance throughout --7 S U the City at any location $ I /S•F• $ ~ ? S~ Per S.F. 7. 10 EACH Remove ex. City Street Tree throughout the City at any location $ SU~~ /EA. $ S ~ 00 Per EACH 8. 5 EACH Water Service Repair ~l , / Per EACH 9. 4 EACH Install Handicap Ramp $ ~ ~ OU /EA. $ ~ , ~O U Per EACH 10. 3,500 S.F. A.C. Hotmix Patch $ ~ 5-Z ~3 as~ /S.F. $ Per EACH TOTAL BID $ Bid Proposal Page 2 of 8 EXHIBIT A I, the undersigned, agree that if this proposal is accepted, I will enter into a contract with the City of Cupertino to provide all necessary 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 $ ya3 I `J, as required by law and the Notice to Bidders. (10% of bid amount) Bid Proposal Page 3 of 8 ~~1~~, NONCOLLUSION AFFIDAVIT TO BE EXECUTED B~' BIDDER AND SUBMITTED WITH BID I, the undersigned, being first duly sworn, depose and say that I am O VJVl~2~ of ~ l.1JY ~ ~'L> C~'LOI~~ (Business Title) (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 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 effectuate a collusive or sham bid. Bid Proposal Page 4 of 8 ~~uut~L 1 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 ~ ~ years. Our experience in work comparable with that required by the proposal contract is ~ years operating under the following different name(s). ~ Cny~~-~yyc~-h c~r~ My California Contractor's License Number is CAS ~J 1 liZ UGl ~ The classification of my Contractor's License is Cis ~ ` The expiration date for my Contractor's License is ~ - 3l - 2~U~ -1 * (This Section for City use only) * he above information has been verified by ~GdOMr+~`~°' T on d®!~ * 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 - ~tIB~T A BIDDER HISTORY OF WORK The following is an example of work similar in character to that required in the proposed contract which our organization or personnel in our organization has completed within the past three (3) years. For Whom Contact Year Location T e of Work Performe`d~ Phone No. Amount C~`.~~ ~ 'CZ~,Vmc~-e s~-~ ~,czc~ L-(OAS'" ~S~X)~'- ~ c ti ~ ~ s ~ ~ k~.~; CSC ~C~.r.~ ~~l -3fS CZeur, c~-E ~ . r-e,Pt c~.c ~ CL~~I ~ L-I ~ ~-U~ ~ ` ~ ~ Sc~~t~ SsC,; ~ . Q~.L t?~ ~ S~t,~ -~ls`c~ ~ ~Oc_'~~-- OU S ~I~ ~U`" ICSi(::v.: C.I~tL~i ~ ~'tv~ C~Cns..~ ~J ~ ~-l ~ ' S ~ ~LC) `'J k Bid Proposal Page 6 of 8 ~ U ~ 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 provid with a full and complete set of plans and specifications for this project by the bidder. 1. Name Contractor's License No. Address & phone no. Work to be Performed 2. Name ~ Contracto s License No. Address & phone no. Work to be erformed P 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 o. Work to be p formed 6. Name Contractor's License No. Addre & phone no. Work to be performed Bid Proposal Page 7 of 8 ~C~BIT 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 NAME OF BusINESS C~v+ ~ ~-e~-~ C (~;~-.-~cc~a~IIVESS C~ Cyv~~~~.JC-~- ~c~ C~ CORPORATION: CO-PARTNERSHIP: ^r' INDIVIDUAL: ~,l1rl 5-~Gl~U~-E!~ ~ . JOINT VENTURE: OTHER: (Describe) Name and Signature of Bidder: ~ ~~e~r 13-~ a--~' t o t e e) Date: -P,tnn ,(f-- ~ ~U o~(~(?S Address (mailirig & location): ~JUt~ vh° l~ Ou.~i Telephone Number: ~U~ 3S ' CJ ~3 FS Acknowledgment of all addenda received is required by circling each addendum number. ~~,,1 O3 ~ ~ ~J O 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 CITY OF CUPEI~TINO INSURANCE AGREEMENT A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker's compensation or undertake ~self- insurance in accordance with the provisions of that Code, and will comply with such provisions before commencing the performance of the work of this Contract. B. Contractor and all subcontractors will 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. LIMITS Worker's Compensation In accordance with the Worker's Compensation & Employers' Liability 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; Combined single limit of $1.0 million per including provisions for contractual liability, occurrence; $2.0 million in the aggregate. personal injury, independent contractors and products -completed operations hazard. Automobile Liability -comprehensive covering Combined single limit of $1.0 million per owned, non-owned and hired automobiles. occurrence. Consultants only: Errors and Omissions liability. $1.0 million per occurrence. n By. ( ntractor's Name) ~b~ ~ 1 ~ ~ 20 ~,~.v~ Dated: PLEASE SEE ATTACHED CURRENT CALIFORNIA NOTARY FORM Insurance Agreement Page 2 of 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT i State of California f ~ ss. i County of ~G i~2u!/ ~ ~ i. ~ I ~ i' On ~707~ before me, i Date ~ Name and Rle of icer (e.g., "J a Doe, Notary Pu i /~1 ~I personally appeared ~ i Name(s) of Signer(s) ~i ? personally known to me i' droved to me on the basis of satisfactory 1 i ~ evidence i to be the person whose name~'f is~e I - subscribed to t e within instrument and IORNA K. ROACH acknowledged to me that he/sge~tt~y't?xecuted COMM. #1559592 the same in his/I~ertfi:heir- authorized ~ NOTARYPtJBI.1C-CAl{fORN1A ~ capacity(i~), and that by his/ F' ~ SANTA CLARA COUNTY signature//~~ on the instrument the person , or l~'' Comm. Expires Mar. 16, 2009 n behalf of which the ee sobr"` F Mll the entity up• i acted, executed the instrument. I~ WIT hand and official seal. ii Signature of OPTIONAL ~,I " Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent i , fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: i Document Date: Number of Pages: ~I ' ` Signer(s) Other Than Named Above: ~ Capacity(ies) Claimed by Signer ~ ~i Signer's Name: i ? Individ al Top of thumb here ? Cor rate Officer -Title(s): ? P rtner - ? Limited ? Ge al i`S Attorney-in-Fact I Trustee ~~S ? Guardian or Co rvator Other: Signer Is Representing: - - arc`~tr~:~;`~.'~4.~t.'~t:`c~.`~(,'~k,`~.~:~.~c.~t>`~s~.~t:`~t;`~t. __'`Ct;~.~c`~.~t;~>~c.~t,~a~.`~r~t:~t>~;`~.~:~t:`ac~. © 1999 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 Chatsworth, CA 97313-2402 • .nationalnotary.org Prod. No. 5907 Reorder Call Toll-Free 1-800-676-6627 . CITY OF CUPE(~TINO CERTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO 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: Gnr 5ko~ln~r [3. 13.e c.~ ba ~3 Cc~v~ Ctr-e,E~ Coin ~~rvc~ C-cJ Address: ~-I JVl SOU i,..os ~---~a~o~ Cam. ~ U3"~-- Description of operations/locations/products insured (show contract name and/or number, if any): WORKER'S COMPENSATION * Statutory Min. * Employer's e `~cp.~r-C ~Utnd ~~{lS Cd Liability (name of insurer) $ 1 ~,L,c \ . $ 1 w~. ~ 1 . $ 1 v~n,i Insurance Company's State License No. Check Policy Type: Each Occurrence $ 1 ~ ~ COMPREHENSIVE GENERAL LIABILITY [ tJJ' Premises/Operations General Aggregate $ a rn 1 (if applicable) [ ~wners & Contractors Protective Aggregate $ rI [ ] Contractual for Specific Contract Personal Injury [Products Liability [ ] XCU Hazards [ ] Broad Form P.D. Fire Damage (any one fire) $ / DO qpQ [ ~Severability of Interest Clause [ Personal Injury with Medical Expense $ S 6100 Employee Exclusion Removed (any one person) or Self-Insured COMMERCIAL GENERAL LIABILITY Retention $ oOd lUa~~~c~a~~s .Z~,s~u~rvcC ~MoA~,Y (name of insurer) Policy No. (7 S 3 07 $ ~ fv Expiration Date g / d 6 Certificate of Insurance Agreement Page 1 of 2 AUTOMOTIVE/VEHICLE LIABILITY BODILY INNRY PROPERTY DAMAGE Commercial Form Each Person Each Accident Liability Coverage $ $ Each Accident 1~~~/ussi J~ ~~rS~R~t~~-C (name of insurer) $ or Combined Single Limit $ ~ d48~ OC~O Policy No. ~ 1 ~ 3 ~1 ~{qa 3 Expiration Date ,3 v2~ 0(0 A copy of all Endorsements to the policy(ies) which in any way (agent's initial) limit the above-listed types of coverage are attached to this Certificate of Insurance. 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 policies. IT IS HEREBY CERTIFIED that the above policy(ies) provide liability insurance as required by the Agreement between the City and the insured. By. (~A Dated: I l ~ 1"1 ~ OS 20 Attach Certificate of Insurance and Additional Insured Endorsement on company forms. Certificate of Insurance Agreement Page 2 of 2 CITY Of CUPEt~TINO ADDITIONAL INSURED ENDORSEMENT and ENDORSEMENT OF PRIMARY INSURANCE and NOTICE OF POLICY CANCELLATION ENDORSEMENT ff'' Project Title and Number: GZ~.Ccan ~E-vU c~-~ can 6 ~ C~Cb y c~ vN~r~ C~.11~ c~ In consideration of the policy p~ r~nium 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 Contractor 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. The insurance afforded by this policy is primary 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. Cancellation Notice. The insurance afforded by this policy shall not be suspended, voided, canceled, reduced in coverage or in limits, or materially 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 INFORMATION 1. Insurance Company: xl~Vr'6AZi 2S -~~ts' VRA nlc~G C4MaifiN y 2. Insurance Policy Number: GS 30~ O / 3. Effective Date of this Endorsement: 8` I g I OS 20 4. Insured: C~fi~2/S7"0?NC2 13~g2 D~3A C.g Can~~t,caLTl dti Additional Insured and Primary Insurance and Notice of Cancellation Endorsement Page 1 of 2 All notices herein provided to be given by the Insurance Company to the City in connection with this policy and these Endorsements, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. I, i1G ~ow c (LS (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative: ( _ (Original signature required on all Endorsements furnished to the District) Names of ~'e' C 7°~''~L'e'S Agent/Agency: J~~.l W~ ~L~ ~ ~S'sd Title: g~vK~ Address: ~ (a-~ C R p lz f 1,r2 S7s Telephone: y0~ 3~9 g(6 ZvS G ft~S C 5 ~3 Facsimile: Y~ 37~ 755 Additional Insured and Primary Insurance and Notice of Cancellation Endorsement Page 2 of 2 f~f ~G~ CITY OF CUPEI~TINO COMPREHENSIVE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ENDORSEMENT OF AGGREGATE LIMITS OF INSURANCE PER PROJECT Project Title and Number: Q~rar~•51cry ~ C~z(~ , a ~l~kGS" ~ ~5 1~~ P~ers~ - o~ . In consideration of the policy premium nd notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is as follows: This Endorsement modifies the insurance provided under the General Liability Coverage part of the below-referenced policy of insurance. The general aggregate limit under LIMITS OF INSURANCE applies separately to the project described as POLICY INFORMATIONt p Y~ ~ ~ n, 1. Insurance Com an ~ '~J ~ ~'7~ ~ 'O~LC 2. Insurance Policy Number: G S ~C)-] 3. Effective Date of this Endorsement:_~~ ~ ~y _20 4: Insured: (,~tlt(~ ~"O~~~IX' 1 a • t3~',Q~(f g,~1~~ U C~ CCNZ`~; rUG~1Gln 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 Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. I, CY IC pGtA~y~ (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative: (Original signature required on all Endorsements furnished to the District) Names of Agent/Agency: ~G~ ~l lQU~ s -~~.7~jL ~ Title: ~ ~r D~l~!~ Address: (~,`1 C Telephone: 0$ `^61Co ~ l.(~ G~ a~ ~ Cam. G'S G 1~ Facsimile: y0 $ ~"1 ~ `7SS Aggregate Limits Endorsement Page 1 of 1 CCG. CITY OF CUPEI~TINO WAIVER OF SUBROGATION ENDORSEMENT WORKER'S COMPENSATION INSURANCE Project Title and Number: c~-w~-t~ O ~ GU~~S , C~U~C~~ t s1~P~1.7 S Pro~EC.F'P~ ~UUS - o ~ In consideration of the policy premium nd 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 against the City of Cupertino, and each of its directors, officers, agents, consultants and employees by reason of any payment made on account of injury, including death resulting therefrom, sustained by any employee of the insured, arising out of the performance of the above-referenced Contract. POLICY INFORMATION 1. Insurance Company: S~i9'TC' COMQCII~$/4-j ~0~ ..~~1$ cJ~2,q/~(.G ~lJ/~,b 2. Insurance Policy Number: J -5 ~ QO(o- f 3. Effective Dante of this Endorsement: ~ - 3 J ~ D 5 20 4. Insured: l.~l-fIL~S~~IfiG/Z ~G~/fQdE~ ~ CO~s%~ZcIL~On ~D All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. I, ~~iG ~0~.-~G ~ S (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative: (Original signature required on all Endorsements furnished to the District) Names of II.. L%R~L ~OcJE,2-S Agent/Agency: ~~nl ~1~~'/IrMS /4'SSOG Title: ~ /20~~- Address: ~ l ~ a 7 cA o~.1 a~2 ~ 7~ a'- Telephone: 3 7q ~~G / ~o s G A c ~ 9so ~ ~o~ 3~q 7s~ .3 Facsimile: Subrogation Endorsement Page 1 of 1 k'AITI~FUL PERFORMANCE ;ONT KNOW AI..L MEN I:tY THESE PItESEN'f ~ BOND # 6 9 8 0 71 Christopher Bearden dba: CB Construction THAT '~~~E, ~ Principal, (contractor's ztam~. and Nationwide Mutual INsurance Company ~ ~ Surety, (bondizxg company's nauxe) are held Fund firn:~.l~~ bound unto the City of Cupertixao, ' :ate c 'California, in the sum of Four Hundred Twenty Thr ho ~ nr3 nnP uunr3se GAvent.~Five lawful zztoney of the Unitc~:d States, for the paymeztt of which will ~d .ruly ~ ~ be made, we biund ourselves, our heirs, ~::xecutor::;, successors and assigns, joi>utly and several y, .firr ly by these presents. THE CON7::~]:TION of the foregoing obligation is such i gat, W1~ERE,A`:~, the Principal has entered into eont pct with the City dated November 1 200 5 with the obligee to do and erfon .the following work to-wit: Reconstir ~ i~n~ of „rhG r,.~„ti-arc anr~ ~ ~ d~.,i]4g Prod ect #2005-08 NOW, THL:s].tEFOXtE, if the said principal shall well a .d tru: • perform the work contracted to be perf armed ua•ctier said contract, then this obligati,oxa sha?. be vc d; otherwise to remain in Full force and ~s~'ect. xN WITIV7:'sSS WHEREOF, tb,is instrument has teem c' ~y ex cuted by Pzaricipal aid Surety ~s 16th dayo:l.', Novem er ,20 05. (To be signed by 1:''riztcipal and Surety, Notary acknoWledgmei : requ ~ed) CON'I'IZ~,.CTOR Christopher Bearden CB Construction Principal - Natio_nwid__e_ Mutual Insurance Com any_ - Surety 777 Alvarado Road #201 Street Address:_ City, Stag., Zip_.._ La Mesa , CA 91 9 41 _ ~iZiL ~o,,.~~s By: _ Attozxtey-In-Fact The above bond i;:, ;accepted and approved this ~ ~ day of ~ lUo ~~B~~ , 20 d5. PLEASE SEE ATTACHED CURREP7T CALI~Cf,~ti'IA NOT~IRY FORPv1 . raithful t'erformance Bozcd Page 1 of CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~.cs~~.~.c ~~~~<~.c~.~c.~~r~r.~r~.~r.~.~.~r~<~~~~rc ~.ccs~~.~.~.~r~<~.c~r~.~~~r~r.~.~~~v; State of County o L e~Qf-~ On /1~~7~ o2~s ~7 before me, Date Q Na e d tle of Officer (e.g., "Jan ,Notary Public") ~ personally appeared ~.CJ ~i~~ ~.p~d Name(s) of Signer(s) ? personally known to me - OR proved to me on the basis f satisfactory evidence to be the person(s) whose nam (s re ubscribed to the within instrument and acknowledge to me that he/she e xecuted the same in his/he their uthorized capacit ies and that his/he heir ignatur~n the instrumen the perso s), LORNA K. ROACH or the entity upon behalf of which the erso s ac COMM. #1559592 p ~ ~ ~ NOTARYPUBIIC-CALIFORNIA ~ executed the instrument. • SANTA CLARA COUNTY F A Nly Comm. Expires Mar. 16, 2009 WITNESS my hand and official seal. re of Notary Public OPT/ONAL 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 k!~~ Title or Type of Document: Document Date: Number of Pages: y Signer(s) Other Than Named Above: .(G~ Capacity(ies) Claimed by Signer(s) Signer's Name: ~ Signer's Name: ~7/~-Q~ individual ? Individual ? orporate Officer ? Corporate Officer Title(s): Title(s): ? Partner - ? Limited ? General ? Partner - ? Limited ? General ? Attorney-in-Fact Attorney-in-Fact ? Trustee _ _ ? ustee ? Guardian or Conservator . ? Guardian or Conservator . C' ? Other: Top of thumb here ? Other: Top of thumb here Signer Is Representing: Signer Is Representing: `~ts~C.`~t>~s~,`~;`~>`~.`r~>~?`t;`~`~:`cc`~ts~>`c~.r~>~t>`~>~>~:`ct;`~>`~>`~>~:`~>~;`r~:`~;`~>~-G`~:`~:~;`~;`~>`c~.`~t~`~:`~t;`cC:`~~:`~c>`~;~>`a';~'S © 1995 National Notary Association • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184 Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 PAXMENT BAND KNOW AI.L MIEN E,Y THESE PRESENT: BOND # 6 9 8 0 71 Wf3iEREA,S, the City of Cupertino, State of Californi• aztd Christopher Bearden dba: CB Construction Los Gatos, CA hereinafter desigmti•t~;d as "Principal" Dave ezitered into or re al gut t Re c o n s t r u c t i o ncto f providing :for the i:n,;tallatiozx, construction, and erection by l: in~cip• . of Curbs, Gutters and sidewalks Project 2005-08 more parti~:ularly d~a~;eribed iw said contract; and izicozporated 1: rein t f reference. VVI:iEREA`:•, said principal is required to furnish a bc~ .d in ~tinection with said contract, providing •that if ssai~ Principal, or any of his oz its subcontr;: tors, ball fail to pay for materials, provisions:, proven•:i~:r or outer supplies oz teams used in, ul. n, fo: or about the performance of work cont~'acted to• be done, or for any work or labor done th~ 'eon c ~ atay kind, the Surety on said bond shall pay the s~~e to the extent hereinafter set forth; Christopher Bearden NC)W, THI;~IZEFORE, WE, Co truction as Principal, con ctor's nazx~ and Nationwide Mutual Insuran~e ~ompany as Surety, (bonding company's name) firmly bind oursel~v~~s, our executors, acimip,istrators, success: ~ anc assigns, jointly and severally, unto the ~Uity of upcrtino, and any and all mateaialnaez~, ~ersoz ,companies, or corporations furnishing tnateri~.l.~, provisions, provender ox other suppli s use ~ •in, upon, for or about the performa:uee of tl ic: aforesaid work contracted to be execu.:d or terformed under the contract hereinabove znemt:ioned, and incorporated herein by refere .ce, a d all persons, companies oz cotporatic-ns lendi:n;~ or hiring teams, implements or machine r, for ~r contributing to said wor)s, to be dope, :~tid all 7:~ecsons who perfotxzt work or labor upon t e son and all persons who supply both worla; and ms, ;E~ria$,4 2 3os1 7 5 ~ 0 0 ~ not been paid by F' ncip~ or by arty other person, in the just and fi~il sum c:~f TJ:iE CO~~ L>TTTON OF THIS OBLIGATION IS SUs H TF ~T if said principal, his or its subcotatractors, h~;i~rs, executors, adrninistxators, ~successars ~r ass has, shall fail to pay for any materials, provisi.~?~ns, provender or other supplies 'or teas s us< l itt, upon, for or about the performa~iee of that work contracted to be done, or for any w.: k or 1 bor thereon of euty kind, or for amoupts clue utidc::r the Unerrtploywent Insurance Act with re; sect t< such work or labor, or any and all damages arisizig under the original contract, then said Sure. y wil: day the sa~oae and also will pay in case suit is bro~ ~.~;ht upon this bond, such reasonable attornr ~'s fee rs shall be fixed by the court. This bozid. ,hall insure to. the benefit of arty and all ~ersor ,companies, and corporations entitled to file el~runs under Section 1184.1 of the Code of C: vil Pr cedure, so as to give a right of action to kltem or il<eir assigns ip any suit brought upon this b~ sd. ~a~snent Bond Inge 1 of 2 Ant the sa:ic. Surety, for value received, hereby stir elates; and agrees that zzo change, extension, of time, ,:~.l~:eratioz~ or addition to the terms of the coy: ract c to the work to be per~Pormed tllereuzxder or the s~.~~,cifications accompanying the same sha11 a any ,vise affect its obligations ozt this bond, and it c;;Does hereby waive notice of a,~y such chat ;e, e~ ensio~, of time, alteration or additioxA to the terna.s of the contract or to the wozk or to tb~e spc~ ibcat ins. ~N VJI'l'NE'>5 V1rHEREOF, this instruta~ent has been d' ly ext :uted by )'rincipal and Surety this 1 6th _day ol:'_ November , 200 5 . (To be sigxied by ~'rincipal grid Surety. Notary acknowledg~xaE~ is rey ized.) CONTR.A,~;,TOR Christopher Bearden dba: B Construction Los Gatos, CA Principal ~ Nationwide Mutual Insurance Company_ Surety W Alvarado Road #201 Street Ad~:iress: City, State:, Zip^.._ La Mesa, ('_A 91 A41 1 ~Du.l~~ By. A,ttorney-In-k'act The abovE, bond i.~ f~cceptcd axed approved this '6 day of^~1v~4~rtB~.,2 , 20 0'S. PLF~SE SSE A~rkCKrD CUEiR~kVT C~,LI~GwrriA NOTARY FORPvI Payment Bond Page 2 of 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of County o v On ~ / ~ o2LY.~~ before me, ~,t.~ ' ~ Date ~ and itle of fficer e. r~~ ( g., 'Jane Doe, Notary P li~ personally appeared ~ Name(s) of Signer(s) ? personally known to me - OR proved to me on the basis satisfactory evidence to be the person(s) whose nam (s s re ubscribed to the w~thin instrument and acknowledged to me that he/sh th xecuted the same in his/h their uthorized capacit ies and that by ` F LORNA K. ROACH his/her/ ei natur s~n the instrument the perso (s ~ COMM. #1559592 ~ or the entity upon behalf of which the perso (s) acted, ~ ~ - NOTARY PUBLIC • CALIfORNVI ~ executed the instrument. ~'I • SANTA CLARA COUNTY ~ F A My Comm. Expires Mar. 16, 2009 WITNESS my hand and official seal. ~(~i IP nat otary Public c; OPTIONAL Though the information below is not required bylaw, 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 current Title or Type of Document: Document Date: Number of Pages: ~o rl Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ~J dc~~~~~.J Signer's Name: ~ ~4adividual ? Individual ? Corporate Officer ? Corporate Officer Title(s): Title(s): ? Partner - ? Limited ? General ? Partner - ? Limited ? General ? Attorney-in-Fact t~Attorney-in-Fact ? Trustee _ _ ? Trustee ? Guardian or Conservator ? Guardian or Conservator ? Other: Top of thumb here ? Other; Top of thumb here r{ Signer Is Representing: Signer Is Representing: %c`~%`~t:`ct,~c>`~`~>`~:`~>~.`~;`cc`~`~c~`~s~t,`~:`~;`~t;`ct>~t;~s~t>`ct,~C;`~C>~:`~s~`~:`~:~.~>`ct;`cC.~C:`~t:`ct>`~>`~>`~>`~t>`~>`~>`~sct:`6':~S © 1995 National Notary Association • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184 Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 Power of Attorney KNOW ALL MEN BY THESE PRESENTS That AMCO Insurance Company, a corporation organized under the laws of the State of Iowa, with its principal office in the City of Des Moines, Iowa, hereinafter called "Company", does hereby make, constitute and appoint ERIC M POWERS TYLER B. WILLIAMS LOS GATOS CA each in his individual capacity, its true and lawful Attorney-In-Fact with full power and authority to sign, seal, and execute in its behalf any and all bonds and undertakings and other obligatory instruments of similar nature (except bonds guaranteeing the payment of principal and interest of notes, mortgage bonds and mortgages) in penalties not exceeding the sum of FIVE HUNDRED THOUSAND AND NO/100 DOLLARS 500,000.00 ) and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts of said Attorney pursuant to the authority hereby given are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the following By-Laws duly adopted by the Board of Directors of the Company. ARTICLE 7 EXECUTION OF CONTRACTS "Section 7.4 Instruments Issued by the Corporation. Bonds, undertakings, and other obligatory instruments of similar nature, other than insurance policies and insurance endorsements, issued by the Corporation shall be validly executed and binding on the Corporation when signed by the President or a Vice President or by the Attorney(s)-In-Fact appointed by the President or by a Vice President." "Section ?.5 Appointment of Agents. The President or a Vice President shall have the power to appoint agents of the Corporation, or other persons, as Attorney(s)-In-Fact to act on behalf of the Corporation in the execution of bonds, undertakings, and other obligatory instruments of similar nature, other than insurance policies and endorsements, with full power to bind the Corporation by their signature and execution of any such instrument. The appointment of such Attorney(s)-In-Fact shall be accomplished by Powers of Attorney signed by the President or the Vice President." This Power of Attorney is signed and sealed by facsimile under and by the following By-Laws duly adopted by the Board of Directors of the Company. ARTICLE 7 EXECUTION OF CONTRACTS "Section 7.6 Verifications . The Secretary, or any Assistant Secretary, is authorized to certify that any such Power of Attorney signed is validly executed and binding on the Corporation and to certify that any bond, undertaking, or obligatory instrument of similar nature, other than insurance policies and endorsements, to which the Power of Attorney is attached is and shall continue to be a valid and binding obligation of the Corporation, according to its terms, when executed by Attorney(s)-In-Fact appointed by the President or Vice President." "Section 7.7 Use of Corporate Seal. It shall not be necessary to the valid execution and binding effect on the Corporation of any bond, undertaking, or obligatory instrument of similar nature, other than insurance policies and endorsements, signed on behalf of the Corporation by the President or a Vice President, or Attorney(s)-In-Fact appointed by the President or a Vice President, or of any Power of Attorney executed on behalf of the Corporation appointing Attorney(s)-In-Fact to act for the Corporation, or of any certificate to be executed by the Secretary or an Assistant Secretary, as hereinabove in Sections 7.4, 7.5, and 7.6 provided, that the corporate seal be affixed to any such instrument, but the person authorized to sign such instrument may affix the corporate seal. A facsimile corporate seal affixed to any such instrument shall be as effective and binding as the original seal." "Section 7.8 Other Facsimile Signatures. A facsimile signature of the President or of a Vice President affixed to any bond, undertaking, or obligatory instrument of similar nature, other than policies and endorsements, or to a Power of Attorney signed by such President or a Vice President, as herein in Sections 7.4 and 7.5 provided, or a facsimile signature of the Secretary or of an Assistant Secretary to any certificate as herein in Section 7.6 provided, shall be effective and binding upon the Corporation with the same force and effect as the original signatures of any such officers." "Section 7.9 Former Officers. A facsimile signature of a former officer shall be of the same validity as that of an existing officer, when affixed to any insurance policy or insurance endorsement, any bond or undertaking, any Power of Attorney or certificate, as herein in Sections 7.1, 7.2, 7.4, 7.5, and 7.6 provided." IN WITNESS WHEREOF, the Company has caused these presents to be signed by its Vice President and its corporate seal to be hereunto affixed this 23 day of ,,~j~~Y 2005 %::~°~t:: AMCO INSURANCE COMPANY / ~9EAL~ 1 B Vice President STATE OF IOWA ~ } ~ COUNTY OF POLK ss On this 23 day of JULY , 20a~ before me personally came Brett Harman, to me known, who, being by me duly sworn, did depose and say that he is Vice President of AMCO Insurance Company, the corporation described in and which executed the above instrument; that he knows the seal of said corporation, that the seal affixed to said instrument is such corporation seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and~th,,at~lh~e~has signed his name thereto pursuant to like authority, and acknowledged the same to be the act and deed of said corporation. }i~""^7 SANDYALlTZ Sandy Alitz COA~iSS10NNO.tS271i Notary Public in and for the~St~te of Iowa ~fYCGMM8B1i0N E7~;IE'S ~o.. ~~24 20ob CERTIFICATE I, the undersigned, Assistant Secretary of AMCO Insurance Company, a corporation organized under the laws of the State of Iowa, do hereby certify that the foregoing Power of Attorney is still in force, and further certify that Sections 7.4 through 7.9 inclusion of Article 7 of the By-Laws of the Company set forth in said Power of Attorney are still in force. IN TESTIMONY WHEREOF, I have subscribed my name and affixed the seal of the company ~ this day of L!~^ ~~re,c~ ~ 'y/ 50636 /,r °o.roa,,, This Power of Attorney expires ' gEAL; ~ Assistant Secretary Bda 1 (04-00) 00 ACORD,,,, CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 09/16/05 PRODUCER DOri Williams & ASSOC. IriC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 14127 Capri Dr. , Suite 2 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Los Gatos , CA 9 5 0 3 0 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED CHRISTOPHER B. BEARDEN INSURER A: NIC INSURANCE COMPANY DBA : CB CONSTRUCTION CO . INSURER e: PROGRESSIVE INSURANCE 14 7 4 8 4 SHELBURNE WAY INSURER C: THS STATE FUND INSURADICE COMPANY LOS GATO S, CA 9 5 0 3 0 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REC~UIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY GS 3 0 7 8 9 6 0 8/ 18 / 0 5 0 8/ 18 / 0 6 EACH OCCURRENCE $ 10 0 0 0 0 0 COMMERCIAL GENERAL LIABILITY FlRE DAMAGE (Any one fire) $ 10 0 0 0 0 CLAIMS MADE ~ OCCUR MED EXP (Any one parson) $ 5 0 0 0 PERSONAL & ADV INJURY $ l O O O O O O GENERAL AGGREGATE $ 2 0 0 0 O O O GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1 O O O O O O POLICY ~ Q LOC B AUTOMOBILE LIABILITY 0 41 3 9 4 9 2 3 0 9/ 2 2/ 0 5 0 3/ 2 2/ 0 6 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1 0 0 0 0 0 0 ALL OWNED AUTOS BODILY INJURY SCHEDULED ALROS (Per person) $ X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Pereccident) PROPERTY DAMAGE $ (Per accidenQ GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EKCESS LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ C WORKERS COMPENSATION AND 15 9 9 0 0 6- O l 0 7/ 31 / 0 5 0 7/ 31 / 0 6 X ToRYT Mfrs °ER EMPLOYERS' LIABILITY E.L EACH ACCIDENT $ l O O O O O O E.L DISEASE - EA EMPLOYEE $ l O O O O O O E.L DISEASE -POLICY UMR $ l O O O O O O OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS THE CITY OF CUPERTINO, ITS ENGINEER, AND EACH OF ITS DIRECTORS, OFFICERS, AGENTS AND EMPLOYEES, AS DETERMINED BY THE CITY ARE NAMED ADDITIONAL INSURED. JOB: RECONSTRUCTION OF CURBS, GUTTERS AND SIDEWALKS, PROJECT 2005-08 CERTIFICATE HOLDER % ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRI BED POLICIES BE CANCELLED BEFORETHE EXP I RATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 O DAYS WRITTEN CITY OF CUPERTINO NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 10300 TORRE AVENUE CUPERTINO, CA 95014 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ERIC POWER6 ' } ACORD 25-S (7/97) ©ACORD CORPORATION 1988 POLICY NUMBER: GS307896 - CB Construction COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED QWNERS, LESSEES O GQNTRACTORS (FORM B) ~ This endorsement modifies insurance provided under the following: . COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE. City of Cupertino Name of Person or Organization: 10300 Torre Avenue City of Cupertino Cupertino, CA 95014 its engineer, and each of its directors, officers, agents, and employees, as determined by the city are named additional insured. (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 "your work" for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 NG POLICYHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 09-16-2005 GROUP: 000713 POLICY NUMBER: 0009728-2004 CERTIFICATE ID: 2 CERTIFICATE EXPIRES: 07-01-2006 07-01-2005/07-01-2006 CITY OF CUPERTINO NG 10300 TORRE AVE CUPERTINO CA 85014 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. ~ , ~ AUTHORIZED REPRESENTATIVE PRESIDENT UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2005-08-16 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF CUPERTINO EMPLOYER BEARDEN, CHRISTOPHER B. NG 17484 SHELBURNE WAY L05 GATOS CA 95030 [JP2,CN) (REV.2-osl PRINTED 09-16-2005 DOCUMENT: 19081788 Pages 3 Fees.... ~ No Fees RECORDING REQUESTED BY I Taxes . Copies.. City of Cupertino AMT PA [ D WHEN RECORDED MAIL TO BRENDA DAV 1 S RDE # 004 'SANTA CLARA COUNTY RECORDER 8/28/2006 City Clerk's Off1Ce I~ecorded at the request of 10 37 AM City of Cupertino i t y 10300 Torre Avenue Cupertino, CA 95014-3255 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NO FEE INACCORDANCE WITH GOT! CODE 6103 CERTIFICATE OF' COMPLETION AN]D NOTICE OF ACCEPTANCE OF COMPLETION RECONSTRUCTION OF CURBS, GUTTERS & SIDEWALKS PROJECT N0.2005-08 i z~~ Original O For Fast Endorsement ~ City Hall 10300 Torre Avenue Cupertino, CA 95014-3255 CITY OF (408) 777-3354 CUPE~TINO PUBLIC WORKS DEPARTMENT CERTIFICATE OF COMPLETION AND NOTICE OF ACCEPTANCE OF COMPLETION RECONSTRUCTION OF CURBS, GUTTERS & SIDEWALKS PROJECT NO. 2005-08 NOTICE IS HEREBY GIVEN THAT I, Ralph A. Qualls, Jr., Director of Public Works and City Engineer of the City of Cupertino, C~~lifornia, do hereby certify that the work and improvements in hereinafter described in the contract which was entered into, by, and between the City of Cupertino and CB Construction Company, on November 17, 2005, in accordance with the plans and specifications for said work, have been completed to my satisfaction and acceptance of completion was ordered on July 18, :?006. That said work and improvements consisted of furnishing all labor, materials, tools, and equipment required to complete said project, all as more particularly described in the plans and specifications for said project. Cf Director of Public Works and City Engineer of the City of Cupertino Date: July 20, 2006 Printed on Rec.icled Paper "NO FEE" VERIFICATION I have reviewed this Certificate of Completion and Notice of Acceptance of Completion. To the best of my knowledge, the information contained herein is true and complete. I verify under penalty of perjury under the laws of the State of California, that the foregoing is true and correct. Executed on the 20th of July 2006 at Cupertino, California. Candice K:uc, City Cler;t's Office City of Cuperiino