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14-076 Breneman Inc Project No. 2013-06 2013 Reconstruction of Curbs, Gutters,Sidewalks Phase 2 n DOCUMENT: 22722530 Pages: 3 II I I '� RECORDING REQUESTED BY: Fees. . . , No Fees i Cop es. . _ City of Cupertino AMT PA I D REGINA ALCOMENDRAS RDE # 025 WHEN RECORDED,MAIL TO: SANTA CLARA COUNTY RECORDER 9/26/2014 Recorded at the request of 2: 14 PM City Clerk's Office C i ty City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NO FEE IN ACCORDANCE WITH GOV. CODE 27383 Certificate of Completion and Notice of Acceptance of Completion RECONSTRUCTION OF CURBS, GUTTERS, AND SIDEWALKS CITY PROJECT NUMBER 2013-06 Original 0 For Fast Endorsement • � 1 City Hall 10300 Torre Avenue Eli Cupertino, CA 95014-3255 (408) 777-3354 C U P E RT I N O PUBLIC WORKS DEPARTMENT CERTIFICATE OF COMPLETION AND NOTICE OF ACCEPTANCE OF COMPLETION RECONSTRUCTION OF CURBS, GUTTERS,AND SIDEWALKS CITY PROJECT NUMBER 2013-06 I NOTICE IS HEREBY GIVEN THAT I, Timm Borden, Director of Public Works and City Engineer of the City of Cupertino, California, do hereby certify that the work and improvements for curb, gutter and sidewalk reconstruction, performed at various locations in Cupertino, California, in hereinafter described in the contract which was entered into, by, and between the City of Cupertino and Breneman, Inc., April 25, 2014, in accordance with the plans and specifications for said work, have been completed to the City's satisfaction and acceptance of completion was ordered on August 19, 2014. 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. Director of Public Works and City Engineer of the City of Cupertino Date: September 17, 2014 a -NO FEE" City of Cupertino CERTIFICATE OF ACCEPTANCE is hereby given in order to comply with the provisions of Section 27383 of the Government Code. This is to certify that the development agreement RECONSTRUCTION OF CURBS, GUTTERS, AND SIDEWALKS CITY PROJECT NUMBER 2013-06 and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on August 19, 2014, and the grantee consents to recordation thereof by its duly authorized officer. I certify under Penalty of Perjury under the laws of the State of California that the foregoing paragraph is true and correct. Dated: September 22, 2014 By: " Q.I iI Andrea Sapjers Senior Office Assistant, City Clerk CITY OF 0 ProjectNo.2013-06 CUPERTilJO NOTICE OF AWARD April 25,2014 Breneman Inc. 2000 Norris Road Walnut Creek,CA 94506 CONTRACT FOR: 2013 Reconstruction of Curbs. Gutters and Sidewalks - Phase 2 The-Contract Sum of your contract.is7wo Hundred Ninety-eight Thousand,One Hundred bollars and Zero Cents ($298,100.00) awarded April 15,2014 by the City Council of the Cityof Cupertino: 1. Copies of each of the proposed Contract Documents (except Specifications and Drawings) were provided to youbn April 17,2014. 2. You must comply with the following conditions precedent by 5:00 p.m. of the 10°i Calendar Day following the date of this Notice of Award,that is,,by Map 9,2014. Please return them to me atthe address below. a. Deliver to City three fully executed counterparts of Document 00520 (Contract). Each-of_the Contract Documents must bear your signature on the cover page. b. Deliver to City two original Document 00610 (Construction.Performance Bond), executed by you and your surety. c. Deliver to City two original Document 00620 (Construction Labor and Material Payment Bond), executed by you,and your surety. d. Deliver to City two original,set of the insurance certificates from Document 00530 (Insurance.:Fonns) with endorsements required under'Document,00700(General Conditions). e. Deliver to,Citytwo,original copies of Docmnen00630(Guaranty), each executed by you. f. Deliver to Cityone original copy of the W-9 form completed. 1 Failure to comply with these conditions within the time specified will entitle City to consider your Bid abandoned,to annul this Notice.of Award,and to declare.your Bid security forfeited. 4.. Within 21 Days after you comply with the conditions in paragraph 2 of this Document 00510, City will return to you one fully signed'counterpart of Document 00520(Contract) with,the Contract-Documents. 5. Upon commencement of the Work,you and each of your.Subcontractors°shall certify and make available for inspection payroll records on forms provided by the Division of Labor Standards Enforcement, in accordance with Section 1776bfthe California.Labor Code. THE CITY OF CUPERTINO,a MmricipabCorporation of the5tate.of California("City") Jo Anne Johnson Engineering Technician City of Cupertino Nolice,of Award 2013 Reconstruction of Curbs, Gutters and Sidewalks—Phase 2 Project No.2013-66 OFFICE OF THE CI1Y CLERK CITY HALL 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3223• FAX: (408)777-3366 C U P E RT I N O W EBSITE:www.cupertino.org May 15,2014 Breneman Inc 2000 Norris Road Walnut Creek CA 94596 Re: Bid,Award, Project Number 2013-06. 2013 'Reconstruction of curbs, gutters, and sidewalks- Phase'2 Your bid bond and contract for the above-stated project is enclosed. If you have,any questions or need additional information, please contact the Public Works Department at (408) 777-3354. Sincerely, / e Andrea.Sanders City Clerk's Office, cc: Public Works Enclosure OFFICE OFTHE CITY CLERK CITY HALL 10300 TORRE AVENUE •CUPERTINO, CA 950143255 TELEPHONE: (408)777-3223• FAX: (408)777-3366 CUPERTINO WEBSITE:www;cupertino.org May 15,2014 J.J.R. Construction, Inc. 1120 Ninth Avenue San Mateo, CA-94402 RE: Bid Award, Project Number '2013-06. 2013 Reconstruction of curbs, gutters, and sidewalks-Phase 2 Thank you for your participation in the City of Cupertino's bid process for the above-stated project. The contract was awarded to Brenenan„Inc. Your bid bond and statement,of qualifications envelope are enclosed. If you have any questions or need additional information, please contact the Public Works Department at(408) 777-3354. Sincerely, /y/✓/G/iLTlj�GGLto Andrea Sanders City Clerk's Office cc: Public Works Enclosure 8q 1-y " 511, Project No.2013-06' v DOCUMENT 00520 CONTRACT FI+ THIS'CONTRA'CT,.dated this day of.-�I �_. 2014, by and betweei mao (whose place of business is located iat 2000 Norris Road; Walnut Creek, CA 94596 ("Contractor"), aiid tlic CITY OF'CUPER'I'INO, a Municipal'Coipoirati'on of the-State of Californm (`City") Icting under and by viitue:of the authority veste&in the City by die laws of the,Stateof California. WFIEREAS', City,on the 13°i day.of April, 2014 awarded to Contractor the•followi'ng Project PROJECT NUMBER 2013-06 2013 RECONSTRUCTION OF CURBS; GUTTERS, AND SIDEWALKS- PHASE 2 NOW, THEREFORE, in consideration of tile mutual covenants hereinafter set forth, Contractor and,City agree as'i'ollows: Article I. Work 1.1 Contractor shall complete all Work specified in the Contract Documents, in accordance with the Specifications. Drawings,.and all other terms and conditioins ofRhe,Contract Documents. Article 2. Agency and Notices to City 2.1 City has designated RogcT Lee, Assistant.Director of Public'Works, twact,as.City's authorized Relmcsentative(s), who will represent City in performing City's iiuties'and responsibilities and esercisin5 City's rights(and authorities in Contract Documents. City may change '.the individual(s) acting.as City's Authorized Representative(s), or delegate,onetormore specific functions to one or'naorespecific City's'Representatives;.incl ud iiag�wi thout liniitati'on engineering, architectural„inspection°and general administiative functions, at any time with notice and without liability to Contractor- Each City's Representative is the beneficiary of all Contractor-obligations. to City. .including without limitation,all releases and indemnities. M All notices or demands to.City tinder the Contract Documents shall:be,to City's Authorized Representative at: 10300 Torre,Avenne,Cupeili'no,California 95014 or to such,other person(s),and,.fddiess(es)�as City�shall provide to,Contractoi. Article 3. Contract Time.,and Liquidated Damages 3..1 Conti act Time. The Contract Tinte will commence to ron on;thcdate indicated in the Notice to Proceed. City inaygive a Notice to Procced at�any time within 30 Days�aftcr they-Noticeof Award. Contractor shall not do+any Work at the Site prior.to the date on which the Contract rinac-commences to rnla. Contractor shall achieve Final Completion of tile entire Work and be ready for Final Piymenton accordance with Section 06700(General.Provisions)no later than August.A.,2014 as provided in Document 00700 (General Provisions) City'ofCupertino 00520- I Contract 2013.Reconstruction'ofCurbs, Gutters and Sidewalks—Phase2 Project.No.2013-06 3.2 Liquidated Damages. City^and Contractor recognize that time is of the essence of this Contract and that City will stiffer financial loss inrthe form of"contract administration expenses-(such as,project management and consultant expenses). ifall or any part of the Work is not'completed within the times,specified above,plus any extensions thereof.allowed in accordance with the Contract.Documents. Consistent with Document-00700:(General provisions),.Contractor and City agree that becauseoNhe,nature of the Project, it would be impractical or extremely difficulGto fix the amount of actual damages incurred by City because of a delay in completion of all or any pmt of the Work. Accordingly,.City and Contractooagree that as liquidated damages for delay Contractor shall pay City: 3.2,1 $,75 for each Calendar Day that expires after the-time,specified herein for Contractor to.achieve..Final Completion of the entire Work as specified above. 322 $75`per Calendar Day-for failwe,to remove concrete fromra work°area withinthe:satne,caleitdacweek. 3.2`3 $75,per Day for failutc to Ieplace asphalt to rinish grade-within 30 calendar days. 'Liquidated damages shall,apply: cumulatively and, except as provided below, sli_ill be presuJired to' be the ,damages suffered by City resulting from delay incompletion of the Work. 3.3 Liquidated damages for delay shall only cover administrative;overhead, interest on bonds, and general loss of public use damages suffered by City as a result of delay. Liquidated damages .shall not covet the'cost of completion of the Work, damages resulting-front detective Work, lost revenues.01'costs of substitute facilities, or dantages.suffered by others who then seek to recover their damages from City (for'example, delay,claiins.of cthed coritractors, subcontractors, tenants;or.otherthird-parties), and defense costs thereof. Article 4.. Contract Sunt 4.1 City.shall pay Contractor'the Contract Stun for completion of Work in accordance with Contract Documents as set forth in Contractor's did, attached hereto: See Exhibit"A"attached :Article 5. Contractor's Representations in order to induce City,to enter into this Contract,Contilunor'makes'the followitigxepresentatiors and wartatities: 5.1 ,Contractor has visited the Site and has examined thoroughly and understood the nature and extent of the Contract Documents,,Work,,Sile, locality, actual conditions, as-built conditions, and all local conditions, and federal, state and local laws and regulations that in any manner may affect 'cost, progress, performance or furnishing of Work or which relate to any aspect of the rucans: ntethods,4echniques, sequences or procedures,of "construction to be,employed by Contiactor'and safety precautions and programs incidcnCthere[o. 5.2 Contractor has examined thoroughly and understood all reports of exploration and .tests of subsurface conditions,,as-built drawings„drawings, products specifications or reports, available for Bidding purposes, of physical conditions, including Underground Facilities, or which may :appear in the Drawings. Contractor accepts°the•determi nit ion set forth in theseDocuments.and Document 00700(GeneralProvisions)'oftlie lititited extent of the information contained in such materials=upon which Contractor may be entitled to rely: Contractor agrees that except for the infoirrnation so identified. Contractor does not and shall not rely"on any other information contained in,stich reports and drawings. 5.3 Contractor has conducted or obtained and has understood all such examinations, investigations, explorations,. tests, reports and studies (in addition to or to suppleme tit,those referred to in Section 5`.2 of,this'Document 00520) that pertain to the 'subsurface conditions, as-bUIlt conditions, underground facilities; and all other physical conditions at or contiguous to the Site of otherwise that may affect the cost,progress, performance or furnishing of Work, as Contractor considers necessary for.the perfoemance,orfurnishing of Work al jllc Contract Sum, within the Contract Time aiief in accordance with the other terms and conditions of the Contract CitwofCupertin0 00520 -2 Contract 2013 Reconstruction of Curbs,, Gutters and Sidewalks—.Phase 2. Project-No.2013'06 'Documents; including specifically the provisions of Document 00700 (General Provisions); and no.additional esaminatiorm; iirvestigations;.explorations, .tests,.reports, studies or similar information,or data are or avill be required by,Contractor for such purposes. 5.4- -Contractor has correlated its knowledge and the.results of all SUCH observations, ezaiiiinations, .investigations; exploi ations,tests, reports and'stUdies with the terms and conditions of the Contract Documents. 5.5 Contractor has,,given City prompt written notice,of all conflicts, errors, ambiguities,.or,discrepancies•that it:has rm discovered in oaong the Contract Documents and as-built drawings and actual conditions and the written resolution thereof.through Addenda issued by City is acceptable to Con?actor. 5.6 Conttactol is duly organized, euslingJand.in good standing Under applicable state hive, and is duly qualified to conduct bUSiness ill the State'dr alifoniin. 5.7 Contractor has drily, authorized the execution, delivery and performance of this Contract, the enter Contract ,Documents and the Work to be perforated herein. The,Contract Documents;do nohviolate or create a,default Undeiany instrument, contract..order,oi-decree binding on Contractor. 5;8 Contactor has listed Subcontractors pursuant to the Subcontractor Listing Law;.California Public Contracting Code,§4100 el se9'.,in document 00340 (Subcontractors,Liist) Article 6. Contract Document's 61 Contract Documents consist of the following documents, including all changes,raddenda,and modifications thereto: Document 00002 Signature Page Document 00003 Project Directory Document 00012 Caltr{ins/City Cross-Refere iicc Table Document 00100 Advertisement For Bids Document 00200 Instructions to Bidders Document 00210 Indemnity and�Releaise Agreement Document 00400 Bid Form Document�0041 1 Bond Accompanying,Bid Docunte111 00430 Subcontractors List Document 004'50 Statement of Q tali fiCatl'On5 Document 00481 Non-Collusion Affidnvit DOCIImen00482 Bidder Certifications Document 00520 Contract Documenv00530 Insurance Forms Docuntent00610 ConstructionPerforniance Bond Document 00620 Construction.Labor and Material',.Payment Bond Document.00630 Guaranty Document 00650 Agreeinent and Release of Any and All Claims DOClnnenl-00660 Substitution Request Fortn Document 60700 General Conditions Document 00800 Special Conditions Docuntent00820 Traffic_Conuol Requirements DOCU ittent 00821 Insurance Document 00822 Apprenticeship Program Technical Specifications Addencia(s) Drawings/Plans City of Cupertino 00520.-3 Contract 2013 Reconstruction of Curbs, Gutters and;Sidewalks—Phase,2 Project No.20'13,06 6.2 There are no Conflict Documents other. than those listed in this Document,00520: Article 6. ']'he Contract Dgctiments may only be amended, modified or supplemented as provided in' Document 00700 (General Provisions): Article 7. Miscellaneous 7.1 Terns used in this Contract are.defined in Document 00700 (General Provisions) and will have the meaning indicatelftherein. 7.2 It is understood and agreed that in no instance are the personssigninggthis.Contract for oron behalf.ofCity or actingii as an employee, agent, or representative of City, liable e on this Contract or any of the Contract Documents, or upon any warranty of authority, or otherwise, and it is further understood find igreed that liability of the, City is Binned and confined to such liability as authorized or imposed by the Contract Documents,or applicable law. 7.3' Contractor shall not assign any portion of the .Contract Documents, and may ,subcontract portions of the :Contract Documents only in compliance with the .Subcontractor Listing,Law,. California Public Contracting Code,t4;I00-e)seq. 7.4, The Contract Sum includes all allowances(ifaoy). 7.5 In entering;into a public works contract or a subcontract to supply goods, set vices pursuant.to a public works contract. Contractor or Subcontractor offers and agrees toassign to.the awarding.body all rights, tifle�aud interest mand to all causes of action it may have under Section4 of the Clayton„Act(15'U.S.C. §15)or under the Cartwright Act (Chapter'2 (commencing with'Section 16700) of Part 2 of Division 7 of tile Business and Professions Code), arising from purchases of goods, services or materials pursuant to.tile public works contract or the subcontract. This-assignment shml be,made'and become effective at the time City tenders final payment to Contractor, without further acknowledgment by tlie'parties. 7.6 Copies,of the,geneml,prevailing rates of per,diem wages4or each,craft, classification. or type of worker needed to execute the Contract,:asdetermined..by'Direcica of.theState of California Depart of Industrial Relations; are,deemed included in the Contract Documents and on file at City's,office,�or may be obtained of the:State of California web site littp://www dir.ca;gov/DLSR/PWD/Notthent.htntl and .shall be -made available to any interested party oil 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 'Conlractor.shall comply with such provisions brlore commencing the perfornance,of the Work of the=Contract Documents. 7.7 ,Should any part, temi or'provision of this Contract of rally of the Contracb.Documents,or'anvdocument required herein or therein"lo be executed of delivered, be declared invalid, void or unenforceable, all remamin�';parts, terms and .provisions shall remain in full force:and effect and shall in no way be invalidated,; impaired or affected thereby. If the provisions of any law causing such. invalidity, illegality or unenforceability may be waived, they are hereby waived to the end that this Contractand the:'Contract Documents may be deemed valid and binding contracts„enforceable in accordance with their terms to the greatest extent permitted by applicable law. In the event any provision not otherwise_'included in the Contract.Documents is'.regtiuM to be'incilided by any applicable law, that provision is-deemed included,Herein by this reference(or,,I'such provision is required to be included in any particular'portion ofthe'Contract Documents,;that provision.is deemed included in that portion). 7.8 TliisnContract.and the Contract;Documents shall be deemed to have been entered.into in the County of Santa Clara, State.of California, and governed,in 611'respectsby California law'(excluding choice of law roles). The exclusive venue (or all disputes or litigation h:reunder'sliall be in Santa Clara County. Both parties hereby, waive their rights'+wider California Code'of Civil Procedure Section 394 to file a+motion to transferany action or proceeding arising out of the Contract Documents to another venue. Contractor accepts the Claims Procedure in Document 00700, Article 12.,eslablishcd under the California Government Code, Title I. Division 3.6, Part 3, Chapter 5. City of Cupertino 00520.-4 Contract 2013 Reconstruction ofCurUs,'Gutters aid.Sidewalks-Phase 2 Project No. 2013-06 IN WITNESS WHEREOF'the parties have.exeeuted this Contract irruiplicate thelday and year first above written. - 2013 RECONSTRUCTION OF CURBS,GUTTERS AND SIDE.WALKS.—PHASE 2 - CITY: CONTRACTOR: CITY OF CUPERTINO;a Municipal Corporation oflhe State ol'California By: 4atLjrej Attest: James Breneman [Please print name Ilene] City Clerk: Grace Schmidt j LI President Approved as to form by City Attorney: Title: [if Corporation: Chairntnn , President,:or Vice President] -��Q �� Cityt\ttorney Carol Kordde By: [Signature] 1 liereby certify, under penalty of perjhry,that Tin nn Borden, [Please print name here] Director.of..Public Worksrof Ih¢City of Cupertino,was.duly vathorized to executelthis document. Title: [If orporation: Secretary, Assistant'Secretaq, Chief Financial Officer,of Assistant"heasurer] Dated: � 2 2°1y 872124 AB State Conti'acto RS License No. Classification 2/29/16 David Brandt,City,'Manuger'of the City ofCupertino,.a Expiration Date Municipal Corporation of the State of California 26-4100852 Designated Representative: Taxpayer ID No. Name: Roger Lee Name: James Breneman President Title: Assistant;Director of Public Works Title: Address: 10300.Torre.Ave., Cupertino, 'CA 95014 Address: 2000 Norris Road, Walnut Creek, CA '94.596 Phone: 408-777-0269 Phone: 925-457-2026 FHc51htile: 408 777-3354 Facsimile 925-44'6-6600 (�(ppo�S84� S�` 1\r NO'IAR vCKNOLEDCENuNT IS kEQUIRED. Jr s AMOUNT: $298;1'00;00 -f CORPORATION CORPORAIt, SEA], AND CORPORAII, NOTA AGCOUNNUMBER: 270'.-8403:93?6,$298,100.00 f1 r. ACi<NCWCED ME�rANDFEDER FEDERAL Ri:QUtaED. ]r• NOI n CORPORATION SOCIAL SECURery ACCOUNT NUMBER:-270-8404-9325'(Contingeiicy) No. iSaeQUIRE6 FILE NO.: 98,493.100 END OF"DOCUMENT City of Cupertino 00520 -5 Contract 2013 Reconstruction ofCurbs,�Gutters andSidewalks- Phase;2 California All-Purpose Acknowledgement STATE OF CALIFORNIA ) COUNTY'OF ) SS'.(�.a° n hr� �•��� � ) I On before me, H. Hills, Notary Public, personally appeared:. ,o/A n kS 61/L.ENEI�I AEI who proved to me on the Fasts of satisfactory evidence to be the person (s) whose name (s) is/are "subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures (s) on this instrument, the person (s).or upon behalf of which the person (s)acted, executed' the instrument. I certify under PENALTY OF PERJURY under the law of the State of California that the foregoing paragraph is true:.and correct. Witness my hand and official seal. f � a- N H.HILL S COMM. 01948020 otary PubI1c_California CoC 'ta•C ..ty omm. 'resA 13,3015 SI n e ry OPTIONAL INFORMATION 3, .,.le ..J G?:.?s: � :.,rP... .,K,,,p,:1.:Bf . ;y"% ..ter:1C1'r.�.i i2. , :(: :.;r. J,..lI,.. '.f3v .:v .,,..a3/ ...r4.Fr-.t}'•I• .J, ., '-.:.-.[+ 1 . tL;:3tt e.y,�_ .c?i«i.:r.t'C ,•.1l.r{.j.,t Description of Attached Document z1 . RIW � i The preceding"Certificate of Acknowledgment is attached to a I Method of Signer IdentificationLL docurnent titled/for the purpose:Of I Proved to me on Jile basis oi•satisfactory evidence: Li form(s)of identification [t credible witness(es) I containing, ,pages, and dated _ Notarial event is detailed in notary'journal on: TISe signer(s) capacity or authority islare,,as: I Page:#.— Entry Individual(s) Notary contact: J:j Allonley;in-fact i i=1 corporateofficer(s) other I-i Additional Signer Signer(s)Thumbprints(s) =.i GuardianlConseivelor A Partner-Limned/General C_! Trustees) Other: li a repiesenting: r f r;i ••...9..,r t]P _@itt: a ii:{� i -P�fi;i Ess-m.v�.m. usra��awu..amen�--^.•••,•�•ca.xm••-®•�aaus.�w.aase'�+m:aes�o�.. �rem,ov¢a ccs EXHIBIT A .Project No.2013-06 SCHEDULE; Dr BID PRICES All Biil:itenls,including'lump.sunls andnntit prices,.must be'filled incompletely. Quotc in figures only,.unless words are. specifically requested. Specialty Items are identified on the Bid;Forin in the desci iption. 4JNI, .".'EST UNIT ,TOTAL r'A EM ''. DESCRIPTION ' rT" qjy PRICE OVER ONE(1)CU YD.CONC TOSIX(6)'-CIJ. YD.{81-486 S.F:.4""sdwlk;d 8-108 L,F:sid.:Cit Gutter — q 1.Remove and'Replace 4"'Sitic"alk(11 19) S.F. 2100 2..Remove and Replace 5"Sidewalk(1-19). 0 "! r 2:1 Driveway Detail—Detached Sidewalk(1-20) S:E: 0 / e 2.2 Driveway Detail'—Mono]ithii:.Sidewalk(1-21) S.F. '525 rd 2 � 3.Remove avid Rep)ace.Curb&`Gutter(I-16 Type. L.F. 1150 -1 (,' 4 tp Oct& 4:Remove and Replace Roiled Curb&'Gutter(1'16 L.F. 1D0 �•b -1 0.�[) T eE '5.Doweling(I-23) (:A 350 Z. B:.- 1.Remove and Rep]ace 4"Sidewalk(I19) F.. 3000 r 2.Remove and Replace,5"Sidewalk(1 19) 0 2a Driveway Detail—Detached Sidewalk(1-20) S.F. 0 r 2:2.Driveway.Detail—Monolithic Sldewillk 0---21) ST 3.Remove and Replace.Curb,&:Ouuer(I-16Tyjie 11; .7O0 if �•6 oOO A2-fi - -- - 4.'Removeand Replace..Rol]ed Cur1b&^Gultea:(1-16, L.F. 0 -- f e L 5.Do.weliitg(1-23) EA 350 1— 78� CA},L CAT .GUR}hS AND LOCATIONS — C I.Remove Park Strip Improvements ST, 1700 2,Remove Median1stand.Flalwork S.F. 0 3.Valley Gotlec(1-t8) I S.F. 450 1 (0 7206: 44.Depressed Curb Curb EA 32 4666 I t 7,1 boto 5.�Upgrade Existing:Curb,Ramps EA 27 6.RootBanicr EA Q :r 7.:Mediall island Curb L.F. 0 ✓ 8: ReconshvctionurCatch Basin Top EA 3 j 906 3606 , 9. AsphaltReplacement(6"Plcement)' TN 100 Zia .2060 d. a TOTAL Bid Form City ot•Cupertino 2013 Reconstruction or Curbs,Gutters and Sidewalks 00400-3 Phase 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 State of California 1 County of -Sal, -k On / g1 ;t /L ? o(Y before me, Kri> /e�•+ce � ✓a✓ /�n{zai P✓6 /rL Date Name,and Fitle of the Officer X personally appeared f 4t.V r d Q 1-,di Name(s) of Signer(s) who proved to me on the basis of satisfac ory evidence to be the person,(sf whose nam !s re Subscribed tot e within instrument'and acknowledged ^^^^����e that �ie/ he/they executed the same in er/their a he rized capacity 41 and that by Iii /her/their signatures on tffe instrument the KIRSTEN RENEE SOUARCIA p-rso*-j', or the entity upon behalf of which the Commission #''1906898 Person(.S'�acted, executed the instrument. i !o o E - Notary Public-California i Santa Clara county a I certify under PENALTY OF PERJURY under the laws My Comm. Expires Oct 4, 2014 of the State of California that the,foregoing paragraph is true and correct. WITNESS m y hand and official seal. Place Notary Seal Above Signature: Signature of Notary P lic OPTIONAL Though this section is optional, completing this information can deter,alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: G w "d-RrG 4 er.ati Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: • Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): • Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑General ❑Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑ Guardian or Conservator ❑Trustee. ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 2013 National Notary Association • www.NationalNotar,/.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 e Project No.2013-06 Bond.No: 505274P Premium:•$5,962.00 DOCUMENT 00610 Premium Based.on Final Contract Price CONSTRUCTION PERFORMANCE BOND . THIS CONSTRUCTION PERFORMANCE BOND ("Bond") is dated Sprit 25 2014. , is in the penal sum of Two Hundred Ninety Eight Thousand One Hundred 00/1 00th [which is'one liuiidred percent of-.the Contract.Price], and is entered into by and between the parties listed below to ensure the faithful performance of the Construction Contract listed below. This Bond,consists of this page,and the Bond Terms and Conditions,.paragraphs I through 12, att ached'to this page. Any singular reference to Breneman, Inc._ - ("Contractor"), Indemnity Company of California ("Surety"), the,City of Cupertino, a Municipal Corporation of the State�of California("City")or other party shall be considered plural where applicable. CONTRACTOR: SURETY: Rreneman Inc. Inds' nity^ •ompanyQf California. Name Name 2000 Norris Rd. 17771 Cowan :Suite 100 Address .Principal Place of Business Walnut'Creek, CA 94596 Irvine CA 92614 City/State/Zip City/State/Zip CONSTRUCTION CONTRACT: 2013 RECONSTRUCTION OF CURBS,GUTTERS AND SIDEWALKS-PHASE'2 PROJECT NUMBER-2013-06 at.Cupertino,:California. DATED April 25 12014 in the Arnount,of S 298,10&00 (the."Penal.Sum i -- - - -'• CON'TR-ACTOR.AS PRINCIPAL SURETY Company:. (Cot lSeal) Company: (Corp. Seal) - _ Signature: � Signam .J.1'11 ElisabteSalazar,.Attorney-in-Fact NatSie and/Title: AM AAJ Name.and Title: _ -. _ BOND TERMSAND CONDITIONS 1. Contractor and Surety,;joimly and severally, bind themselves,.their heirs,executors,.administrators, successors and assigns to City for the complete and proper performance of the Construction Contract, which is incorporated'lterein:by reference. _. If Contractor.completely,.and properly performs<all..of its obligations under the Construction:Contract; Surety and Contractor.shall have no obligation.under this^Bond. 3. If there is no City Default,Surety's obligatiowundenthis Bond shall arise after: 3.1 City has declared a Contractor Default under the Construction Contract,pursuant to the terns of the Construction Contract:and 3.2 City has agreed to pay the Balance of the Contract Sum: 3.11 To Surety in accordance with th.termsof this Bond and.thetConstructiom.Contract;or City of Cupertino Construction Performance Bond .2013 Reconstruction of Curbs.Gutters and Sidewalks 00610- 1 Phase 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Los Angeles On —Apr before me, Trina Lee Vega Notary Public Dae Here Insert Npme antl Ti IIC of the OIlcor ' personally appeared Elisabete.Salazar Na els7 of Stgner(s) who proved to me.on the+basis of satisfactory evidence to be the person($)whose name($) is/## subscribed to the within instrument and acknowledged to me that )W/she/4;lbY executed the same in,f i6er/Riff authorized TRINA LEE VEGA capacity(#$),and that by Ohtlher/Wh j signature($) on the instrument the ($). or the entity upon behalf of Commission /7 2056669 person Notary Public -California zz which the:person(p) acted, executed the instrument. z Los Angeles County Comm. Ex ires Feb 1, 2018 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my h d and off I seal. Place,Notary.Seal Above Slgnatll - Signature of Notary Public OPTIONAL. Though the information below is not required bylaw.it mayprow valuable,to�personsr relying on the document and could prevent flaudidenl removal and reattachmedt of ttil's donnito another document. Description of Attached Document Title;or Type of Document: Document Date: Numberof Pages: Signer(s) Other Than Named',Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: C Individual ❑ Individual C 'Corporate,Ofiicer—Title(s): n CorporaterOfficer—Tfle(s): )v- Partner—❑Limited C General - _ LI Partner—❑ Limited ❑ General _ Attorney in:Fact . - C Trustee lop of thumb here ❑Trusteey in Fact `. ❑Trustee Ion of Inurnti Fero L Guardian or Conservator D Guardian or Conservator G Other: ❑Outer. Signer Is Representing: Signer Is Representing: P 200]Nat ona.Notary ASSocal:oo•S350 De Soto Ava.,RO.B.2402•Clultsm,I CA 913132:102•WV,Nafola'War,., Itemtl590i R Ner:CeiRdl FreetA00-B Project No.2013-06 Bond No:505274P 00620 DO @Uiv1ENT, Premium.lncluded in Performance . - Bond CONSTRUCTION LABOR AIND MATERIAL PAYMENT BOND THIS CONSTRUCTION LABOR AND,MATERIAL PAYMENT BOND("Bond")is,d,ted April 25, 2014 ,is in the penal sum Two Hundred Ninety Eight Thousand One Hundred 00/100th tone hundred percent of the Contract Price], and isentei ed into by and between the parties?listed,below to ensure the payment of claimants underthe;Construction Contract listeil:below. This Bond consists of this page anti the Bond'Terms and Conditions, paragraphs f through. 14, attached' to this page. Any singular reference to B�nn�man Inc ("Contractor")' Indemnity Company of California ("Surety"), the Crty of Cupertino,n :Municipal Corporation of the State of Califomia Li considered plural where-applicable (" CY")=or other.party shall be CON'T'RACTOR: Breneman Inc. SURETY: ,Name Indemnity Company CQlifQrnia 2000 Norris Rd. Name Address 17771 Cowan Sui t Q 1017 Walnut Creek, CA 94596 Principal Place of Business - city/State,'Zip Irvine Ca 926.14 City/State/Zip CONSTRUCTION CONTRACT: 2013 RECONSTRUCTION OF CURBS, GUTTERS AND SIDEWALKS- PRAW2 PROJECT NLIMBER,2013-06 at Cupertino, California. DAtfGD _April 25 ,20j4 in the Amount:of-S 298100.00 (the"Pena l Siim CONTRACTOR AS PRINCIPAL Company: (Co Seal SURETY - .\ 0' ) Company: (Corp: Seal) _' - !Si_nature -" Signature: Name and T itle: Name and 'I:itle:Elisabet alazar, Attorney in-Fact BOND TERMS AND CONDITIONS Contractor and SuretY,joindyand severally, bind themselves, their heirs, executors, administrators, successors and assigns to City, anti to Claimants, to pay for labor, materials and equipment administrators, for use a the perforinshceof the ConstructiowConiract, which is incorporated.herein by reference. 2. With respect to City,this obligation shall be nulliand void if Contractor: 2:1 Promptly makes payment,directly or indiicctly,,.for all sums due Claimants;'atid 2.2 Defends,indemnifies and Bolds harmless City from all claims,demands; liens,or suits by anv.person or entity who furnished'labor, materials,or,equipment for use in the performance of the Construction Contact, provided City has promptly notified CPontractorand Surety (at the address set forth on the signature page of this Bond) of any claim!;, demands; liens or suits and tendered defense of such claims,demands,liens orsuits to Contractor'and Surety„and;provided"there.is;no City Default. City of Cupertino Construction Labor and Material',Payment Bond ?013 Reconstruction Of Curbs.Gutters,and Sidewalks 00620- 1 Phase'2 CALYFORNBA ALL-PURPOSE ACKNOWLEDGMENT r� cr.&r 777=r rzrc-r-r ,. rr-r`�r��ryr-� State of California County of Los Angeles On_ApdL95 ens— before me, Trina Lee Veaa Notary Public' a H I N tlTlle of the 0111cer personally appeared Elisabete Salazar Namely)of Signerla) who proved to me on the basis of satisfactory evidence to be the person($)whose name($) is/Atq subscribecLto the within instrument and acknowledged to me that Y/0/shE/iW#/executed the same in rffif$/her/Mik authorized _ TRINA LEE VEGA capacity(jO), and that by )}11A 1tier/fn#f.signature($) on the Commission#2056669 9 instrument the erson a _o _ P ($); or the entity upon Behalf of .z Notary Public-California z which the person(�) acted,,executed the instrument. Los Angeles'County ' ( M Comm. Ex Tres Feb t,20181 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand:and off ici I;seal. Place Nmary Seal Abme Signature - of Notary Public OPTIONAL Thciugh;he information below is notYequired by law,it may prove-valuable to persons relying.on4he document and could Prevent traudulent removal and reatrachmerl.oithis form to.anothec document. Description of Attached Document Title or Tyne of Document: ,Document Date: _ Number of Pages: Signer(,) Other Than Named Above: Capacity(ies)Claimed by•Signer(s) Signer's Name: • Individual Signer's Name: ❑ Individual • Corporate Officer—Title(s): fl Corporate Officer—Ti fle(s): !� Pariner—O Limited CI General Attorney in Fact LI Partner'—❑ Limited El General C Trustee rop of mumb Here C Attorney in Fact U Guardian or Conservator ❑Trustee Ton olahlmib here. ❑Gusrdian.or Conservator f Other. r ❑Other: Signer Is Representing: Signer Is Representing: �I g 2007 Nat,.al NOmry ASSaGarion•9350 Oe SO Ava PG.B6i2402 Chii.mr,,.CA 0313 2402•w y J 11en 85901 a drCall ToeFeet 6008]6-682) POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY'COMPANY OF CALIFORNIA PO Box"19725,IRVINE,CA 92623 (949)263=3300. KNOW ALL BY THESE PRESENTS that except as expressly.limited,DEVELOPE IRS'SURFI Y AND INDEMNITY:COMPANY and INDEMNITY COMPANY OF CALIFORNIA,do each hereby make,constitu a and appoint: - - ***Patricia'Zenizo, Margaret S. Rodriguez,.MWO Micciche,:Elisabete'.Salazar,jointly or severally*** as their true and lawful Attorney(s)-in-Fact,to make,execute,deliver and acknowledge,for and on behalf of said corporatiohs,.assureties,bonds,undertakings and contracts of surely- ship giving and granting unto said Attorney(s)-in-Fact full power and authority to do and to perform every,act necessary,requisite or proper to be done in connection therewith as secret said hereby ratified could confirmed.but reserving Ib each of said corporalions.full power,of substitution and revocation,and all of the acts of said Attorney(s)-in-Fact,'.pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by aulhority,of the Io'lowing resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANYand INDEMNITY COMPANY OF CALIFORNIA,.effective as of January lst,.2008. RESOLVED,that a combination ofany two of the Chairman of the Board,the President,Execulive:Vice-President;Senior Vice-President or any Vice President of the corporations be'and that eachof them hereby,is authorized to execute this Power of Atlorneg;qualifying,the allonfey(s)named in the Power of Attorney to execute;on behalf of the icoporations,bands undertakings and contracts of suretyship;and that the Secretary any Assistant Secretary of either of,lhe corporations be,,and each of them hereby is,authorized to attest the execution of any such Power of Attorney; RESOLVED,F.URTHER that the signatures of such officers may be;affxed to ally such Power of Attorney or to'any certificate relatinglthereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures shall,be valid and binding upon the corporations when so affixed and in the'future with respect to any bond,undertaking or contract of suretyship tc which it is attached, IN WITNESS,WHEREOF,,DEVELOPERS SURETY AND;INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents 7o be signed by their respective officers and attested by their respective Secretary or Assistant Secretary,this November..,2013. - By: 1� ANp Daniel Yeung,.Senior Vice-Presideol ¢F eAN.y O,r. •• -_ yJ,JC iyPORq�� 22 -1G DFtPOgq n !' BY. G -a,- 10 ..�._ s OCT.S T — , Markel Lansdon, ;0 1936 ;3. w 1967 ViceBresident. Slate of California G,•.;OW P,„T�aa Off-O,q</FOPN\P d= - •'-,` County of Orange On November 21 2013 before me, Antonio Alvarado,Notary Public Date 'Here Insert Name and Title of the Officer .personally appeared Daniel Young and Mmi Lansdon Name(s)of Signer(s), who proved to me oil the basis of satisfactory evidence to be the Personrs)whose name(s)'is/are subscribed to the within instrument and acknowledged tome that helig a/Ill executed the same in his/herdheir authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s),or the entity upon behalf of which the person(s)acted executed the mstrpmenl. #M I certify under PENALTY OF PERJURY undecthe laws of the State of California that the foregoing paragraph'.is Ime ano correct. WITNESS'mYhand and official seal. Place Notary Seal Above Signature- '04• CERTIFICATE Antonio Alvarado,Notary.Public: The undersigned,as Secretary or Assistant Secretary,of DEVELOPERS SURETY AND,INDEMNITY:COMPANY or INDEMNITY COMPANY OF CALIFORNIA;does hereby certify that the foregoing Power of Attorney,remains in full force and has not been revoked and,furthermore,that the provisions of the resolutions of the respective Boardsbf Directors of said'cmiaoialions set fodh in the Power of Attorney are in force as of the date�of/this;Cedificate. This Certificate is executed in the City of Irvine,California,.this 76 day of AyIn(t By: Cassie J,Berrisfor ; ssistant Secretary ID-1380(Rev.11/13) r - i California All-Purpose Acknowledgment STATE OF CALIFORNIA ) COUNTY OF C� On before me, H. Hll � Ma Pc, personally appeared: who proved to me on the basis of satisfactory evidence to be the person (s) whose name (s) is/are subscribed to the within instrument and the same in his/her/their authorized capacity (acknowledged to me that he/she/they executed ies); and that by his/her/their signatures (s) on this instrument, the person (s) or the entity upon behalf of which the person (s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the law of the State of California that the foregoing paragraph is true and correct. Witness .y-hand and official seal. H.HILLS W: °,- COMM. x1948020 N N 6.3D. "� Nosa y bile Calf(ornia�_ Contra C."" County COmm�E iresA. 13.2015' — gnature of Notary OPTIONAL INFORMATION u; r ! in r i -i i tt3 ,yR 1 to ei rl fl") e° Description of Attached Document is . . The preceding Cel tlficate of Acknowledgment is art ac ed to a Method of Signer Identification —._. document titled/for'tiie purpose - - Ili Proved to me an the basis of satisfactory evidence: r- L! form(s)of identification (_'credible svitness(es) containing_'pages, and dated Notarial evenris detailed in notary journal on, Thesigher(s) capacity or authority is/are as Page#_ Entry#_ Individual(s) I 1. Attorney-in-fact I Notary contact. _1 Corpoi ate officer(s) Other i sties: ._,... _ _ _1 Addifional'Signer Ll Signer(s)Thumbprints(s) j _I Guardian/Conservalor - Partner-Limited/General i E.' kustee(g) 01hen. representing; i VVrI i? 1 rn„�Pr� r 1.C5,'Irirt California All-Purpose Acknowledgment STATE OF CALIFORNIA ) COUNTY OF 1 � .1,r�Y ('1.,,.� j ss' c_ On 0 before me, H. Hills, - Nota Public; personally appeared: who proved to me on the basis of sahsfactory evldence to be the person (s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity (ies), and that by his/her/their signatures (s) on this instrument, the person (s) or the entity upon behalf of which the person (s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the law 'of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. H.HILLS � ' y� COMM. 0 1948020 �• Noraiy Dublic•California Contra Costa Couniy Comm. irez'4. 13�2015 fttignauraOf Notary OPTIONAL INFORMATION r is .iwi �.- f I r a Description of Attached Document Not �y The preceding Certificate of.Acknowledgment•is att8cned,to a Method of Signer Identification 1 document titled/for the purpose of _ Proved to me on the:basis of sahsfactory evidence: r L! fcnn(s):of identification I^I credible lJitn ess(es) j containing_pages, and dated. Notarial evenCis detailed in notaryvurnal:on: The signer(s) capacity or authority as; age t<_ Entry#_ Individual(s) 'j Attorney-in-fact Notary contact: r I I_ 'Corporale-Officers) Omar I LI Additional.Signer ] Signer(s)Thumbpnnts(s) Guard'an/Conservator Partner-Limited/General i L Truslee(s) C_! Other. representing: i r is - cis ar.:ma. >•8+3memsi�rrcamtimwaer...-- ,; Project No.2013-.06 DOCUM ENT'00630 GUARANTY TO THE CITY OF CUPERTINO, a Municipal Corporation of the Statelof California("City"), for construction of 2013 RECONSTRUCTION OI'CURRS,GUTT,ERS,AND SIDEWALKS- P_ HASE 2 CUPERTINO,CALIFORNIA The undersigned guarantees all construction performed pin this Project and also guarantees all material and equipment incorporated therein. Contractor hereby,grants to City for 'a period of one year following the,date of Final Acceptance,,or°such longer period specifie-d in the:Contract Documents, its unconditional warranty of the'quality andzadequacyrofall of the Work including,. without limitation, all labor, materials and equipulCut provided by Contractor"and its Subcontractors of.all tiers in connection with the Work. Neither final,payment nor use.otoccupancy of the Work',perforined by the COrul1c101' shall corstittnc�an acceptance of Work not doneiin accordance with this Guaranty or relieve Contractor of liability imres'pect to•any'express wanantics or responsibilities for Funky materials or worlonanship. Contractor shall rennedy any defects in.the Work and pav for any damage resulting therefrom, which shall appear within one year, or longer if specified, fi`ont the date of Final Acceptance. - If within one year after the date of Final Acceptance, or such longer period of time as stay be prescribe(] by laws or regulations, or by the terms of Contact DOCnncots, Any Work is found to be 'defective, Contractor shall promptly,. without cost to City and in accordance with CnV's written instructions, correct such detective Work. Contactor shall remove any-defective Work rejected by City and replace it wnh Work that is not defective, and satisfactorily corrector removerand.replace any damage to other Work or the work of,othersrresulting theref-om. IrContracloi fails to pioniptly comply with.the:terms oBsuch instructions,or in an emergency where delay would cause serious risk of loss of damage; City may have'the defective Work corrected orthetrejected Work removed and replaced. Contractor shall pay for all claims, costs; fosses and damages caused by,or resulting foul such renloval,and replacement, Where Contractor fails�to ,correct defective Work, or defects are discovered outsideahe',correction period, City shall have all rights and remedies granted by law. Inspection of the'Work shall,not relieve Contractor ofanwof its obligations under the Contract Documents. Even,thou�lr equipment_, inatet ials,or Work required,to be provided under the Contract'Documents have been inspe,cted,:aecepted, and estimated for payment,.Contractor shall, at its own expense, replace or repair any such equipment, micl ial, or Work found to be,defectve of otherwise not to conip'ly with the i—iltiirenients of the Contract DocuiiientS up to the;endrof the guarantypeeiod. All abbreviations and definitions of terms used in ,this.Aereement shall have the meanings set forth in the Contract Documents,.including without means of limitation. Section 06700 (General Conditions). "file fore5mng-Gtr aranly is in addition to any other warranties,of Contractor contained ill the Contract Documents, anil not lieu or.any and all other liability imposed on Contactor under the Contract Docuients and at law with respect to Contractor's 'duties. obligations, and performance under the Contract Documents. In the event of any conflict or inconsistency between the teinis of this Guaranty.and',any warranty or obligation Of tile Contractor under the Contract Documents for at law, such inconsistency.or conflict shall be resolved in favor of the higher level of obligation.of the Contractor. Bfeneman Inc contractor's Name 20"00 Norfs Road Address Walnut Creek, CA 94596 4,/21/14 City/State/Zip - ,Date END OF DOCUMENT City 01"Cupertino 00630- 1 Guaranty Recodstmerion oCCurbs..Gwlcrs and Sidew'alk's JAMEBRE-01 DUJ1 4 A2G� CERTIFICATE OF LIABILITY INSURANCE DATE(MM;DD,yY YY' 4/21/2014 FBELOW.CERTIFICATE IS ISSUED AS A MATTER.OF INFORMATION ONLY AND CONFERS.NO RIGHTS UPON THE CERTIFICATE'HOLDER, THIS TIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER,THE COVERAGE AFFORDED BY THE POLICIES THIS CERTIFICATE OF INSURANCE' DOES' NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RESENTATIVE OR.PRODUCER,.AND'THE CERTIFICATE HOLDER. IMPORTANT: If the.certificate holder is an ADDITIONAL INSURED, the Polici ies) must be endorsed. If SUBROGATION IS WAIVED, subject to' the terms and conditions of the policy, certain policies may require an endorsement. A.statenrent;on this,certificate does not confer rights to the certificate hot in lieu of Such entlorsemengs). - .PRODUCER -cohri — NAME: Automatic Data Processing Insurance Agency,Inc PHOtlE �FA% 1 ADP Boulevard INC.N. Extl: IAID No) Roseland,NJ 07068 E-Mali REGRESS' INBURER(5)AFFORDING{OVERAGE NAIC0 INSURER A-NorGuard Insurance Company X31470 INSURED Breneman Inc INSURER B:. 2000 Norris.Rd INSURER C.:. Walnut Creek,CA 94596 INSURER D: INSURER E INSURER 5: COVERAGES', CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO'CERTIFY THAT THE,POLICIES OF INSU RANCE.USTED BELOW HAVE'BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED: NOTWITHSTANDING,ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER t70CUMENT WITH'RESPECT TO WHICH THIS EXCLUSONSA DYCONDITIONS.OF UCHI POLICIES.LMITSSHOWNCYY MAY HAVE BEEENYRErD000DED BY PAIDCLAIM YD:HEREIN IS SUBJECLIMTO ALL THE TERMS, INSR AODL SUER LTR TYPE OF INSURANCE POLICY EFF POLICY EXP GENERAL(ABILITY EACH OCCURRENCE S COMMERCIAL GENERAL IABILIIY PREMSEESEe N TED ndu) �= C[-AIMS-MADE ❑OCCUR MEO EXP(Any one person( S PERSONAL R'ADV INJURY S GENERAL AGGREGATE S GEN'L.AGGREGATE LIMITAPIPPLIEIS'PER PRODUCTS,-COMP/OP.ADS S POLICY PRO._ LOU 5 HUTOMORILElIADILITY COMBINED SINGLE LIMIT ANY AUTO BODILY 9NJURY(Per.person) is ALL OWNED SCHEDULED AUTOS ,AUTOS BY INJURY(Per accident) 'S NON OWNEO HIRED AUTOS' AUTOS: ccldanl) UMBRELLA LIAR .5 - -- OCCUR EACH OCCURRENCE 5 E%CESSI UA8. CLAIMS=MADE AGGREGATE b. DED RETENTION S AND EMPS COMPENSATION WC STATU 0TH AND EMPLOYERS'LIABILITY X A ANY PRO PRIETOR/PARTNER/EXECUTIV[ YIN TORY LIMITS ER' X BRWC452334 12/29/2013 1212912014 OFFlCEPoM EMBER EXCLUDED? NIA EL EACH ACCIDENT JJ s, 1,000,00 (Mandatorybeun E.L.DISEASE-EA'EMPLOYEE S' 1,000,00 t yes,RISC!be OF O DESCRIPTION OF OPERATIONS below E.L.DISEASE .POLICY LIMIT [-11,000,00( DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is requiredj' Wail Subrogation in favor ofCity of Cupertino CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOV DESCRIBED POLICIES',BE CANCELLED BEFORE City of Cupertino THE EXPIRATION DA E DATE THEREOF, NOTICE WILL BE DELIVERED IN 10300 Torre Ave ACCORDANCE WITH THE POLICY PROVISIONS: Cupertino, CA 95014- AUTHORIZED REPRESENTATIVE ©1988-'2010ACORD CORPORATION. All rights reserved. ACORD 25.(2010/05) The ACORD name and logo are registered'marksof ACORD r '._— - — - - - - - WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FRO14 OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will riot"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-contractJhat requires you to obtaimthis°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 1_o2__% of the. California workers' compensation premium otherwise due on such remuneration: Schedule Person or Organization Job'Description Blanket Waiver•-Any person ororganization for whom the MICA Operations Nanted,Insured hastagreed by written contract to,fiunish Iris waiver. Thislendorsenentchanges,therpolicy to WHO,it is ateched.and is effective.on Ihe'dale.issued unless otherwise staled. (.The information'below is required only when this endorsement is issued subsequent to preparation of the'policy.) Endorsement.Effective rdolicy No: BRWC452334 Endorsement No. Insured Insurance.Company Countersigned By 01998'by the Workers' Compensation Insurance Rating,Bureau of California.AII'rights reserved. �coRO CERTIFICATE OF LIABILITY ,INSURANCE 21°DI " 4i2 v/zo-/20114 THIS CERTIFICATE IS ISSUED AS A„MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER..THIS CERTIFICATE. DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND; EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW., THIS CERTIFICATE+OF INSURANCE DOES NOT'CONSTITUI'E A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED � REPRESENTATIVE.OR'PRODUCER„AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder.is;an ADDITIONAL INSURED,the pelicy(ies).must tie endorsed, If SUBROGATION IS WAIVED,subject to j the te-rmsand conditions of the policy;certain policies may require an endorsement. A statement on this certificate does not confer'rights to the' certificate holder in lieu.of.such.:endorsement(s). - PRODUCER CONTACT - BrOwn';BuBrown Insurance Brokers Of;Sacramento, Inc PHONE ' P. O, Box 619043 1#OH38004 1A+C,10-F&D:�1 fZf32@633 IAlc go).:$00.7q.3-0083' RosevillE:CA95661-9043 ao RIESS' INSURERIS)AFFORDING:COVERAGE NAIC N INSURED INSURERA.'lames_Hi_v�LlnsuLance�.oTDp�ny -2203 ,JAMES88 INSURERS n1ury National ;26905_ Breneman Inc INSURER O:FIDaIl41a_Parf1 2000 Norris Road 9453 Walnut Creek CA 94596 INSURER°:; INSURER E? INSURER F.: COVERAGES. CERTIFICATE NUMBER: 148448128; REVISION`NUMBER: THIS IS TO CERTIFY THAT THE'POLICIES OF INSURANCE.LISTED BELOW HAVE-BEEN ISSUED TO THE INSURED NAMED ABOVE FOR.THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF'ANY'CONTRACT ORFOTHER DOCUMENT WITH RESPECT TO WHICFI THIS I CERTIFICATE MAY BE ISSUED.ORIMAY PERTAIN,'THE'INSURANCE AFFORDED;BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE PERMS: EXCLUSIONS'AND CONDITIONS OF SUCHTOLICIES..LIMITS,SHOWN MAY'HAVE 13EENREDUCED BY PAID;CLAIMS: INSR AOOL SUBS POLICY Err POLICY EXP ITS, TYPE OF INSURANCE IN SR AVE POLICY.NUMBER _ A GENERAL LIABILITY 301201YYYI' MMIDDIYYYY. LIMITS Y Il100572081 b/30/20143/30/2015 EACH OCCURRENCE 111:0001000 X COMMERCIAL GENERAL LIABILITY LAMA T RERTED PREMISES�Ea occurrence) I 550',000 CLAIMS MADE OCCUR MED EXP(Any one person) SEXCLUDED' PERSONAL H ADV INJURY 151,00e000' GENERAL AGGREGATE' 52,000;000 GEN'L AGGREGATE LIMIT.APPLIES PER PRODUCTS-COMPIOP AGG. 52,000:000 X POLICY PRO n LOG 5 JECT B AUTO MOBILE LIABILITY Y BAP0180416 /30/2014 130/2015 omBi bEDD X$1,0001000 1 ANY AUTO BODILY INJURY(Per person) S ALL OWNED �1 SCHEDULED - - AUTOS IH_I AUTOS' - BODILY I NJURY'(He,accioenl) b X HIRED AUTO$ X NON SWNED PROPERTY.DAMAGE Per accidem S S C UMBRELLF LIAB X' OCCUR Y 27303145 /30/2014 /30/2015 AGGREGATE $51000;000 IIy” EACH OCCURRENCE DEDE5 L1 RETENTIONS CL'AIMB'MApE I „55;000:000 5 REPS COMPENSATION STATU O AND EMPLOYERS LI ABILIT Y a YJ N IIM ANY PROPRIETORIPARTNERIEXECUTI- UFndatoMEMBER[XCLUDED?' NIA EL,EACH ACCIDENT (ManUdscribe NH) E.L.DISEASE-EA EMPLOYE 5 r yes,ESC IPTION OFF CESCRIPTION OE-0PERATIONSbelow _ EL DISEASE POLICY LIMIT I S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach,ACORD 1B1,Additional Remarks Schedule,if more space is required) Certificate holder is included,as,an Additional Insured under Commercial.General Liability policy per endorsement^CG 20.1b 07.04 &CG 20 37 07 04 and Commercial,Auto per endorsement CN 615 (07/11.),sub)ect to.a'wntten,co"ntractbetween the,Named Insured and the Additional Insured. Sample endorsement attached, —Subject to company aporova l., -City of Cupertino, it's City Council, boards,and=com missions,'officers, employees and volunteers. RE: Removing,and replacing:concrete,-:Project name is 2013 Reconstruction of'Curbs, Gutters;and Sidewalks-Phase 2: i CERTIFICATE HOLDER CANCELLATION SHOULD ANY,OF THE ABOVE DESCRIBED POLICIES;BECANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED, IN City;Of Cupertino ACCORDANCE'WITH THE POLICY PROVISIONS. 1 10300 Torre'Avenue - Cupertino CA 95014 AUTHORIZED REPRESENTATIVE I ©1988-2010 ACORD CORPORATION: All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks,of ACORD CENTURY-NATIONAL INSURANCE C 0 M PAN P.O.Box 3999 •North Hollywood,,CA 91609;0599 For .Service Call YcurBrokcr. For Clvms.Call:,800 733-7:980 Namc Of 111SUIcd: E.ndorscrrtcaa Effective 13RI:NI;MAN INC 04t08/2614 at 10:37 AM t'olicy..Nunlbcr: Policy TcYnmi Covcrs",froai: 'r:'ndorscmcnt Nnmbcr: I3AR01 X04'66 12 01 AM on 03130/2014 to.03/30/2015,at 12:0:1AM 003' Name ofAgaicv: BROWN 8 BROWN OF CALIF INC 153700 THIS;ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC ADDITIONAL INSUREDS The following provision is added to Section F, page 1, Words and Phrases: By this endorsement, your broker may complete an Acord additional Insured form with the policy liability limit shown on the declarations page,then the entity you are required in a written contract ("the contract'`) to name as an insured, ("the,Additional Insured") is an insured but only with respect to vehicle liability arising out of"yourwork", for the,Additional Insured. The Limits of insurance provided for the Additional Insured shall not,be greater than those required by the contract and, in no event, shall the Limits of'this policy be increased by this endorsement. All insuring agreements, exclusions', terms and conditions of the Policy shall apply to the coverage(s) provided to the Additional insured and such,coverage shall not be enlarged or expanded by reason of the contract.. This insurance does not apply to Bodily Injury or Property Damage occurring after all work on the project to be performed by the Named Insured at the site of the covered operations has been completed.by them. An additional insured is only insured for liability which is the result of an act or omission of the "NAMED INSURED" on the policy and shall have no coverage under this endorsement or'the policy for its own acts or omissions, or those of its agents or employees, or those of any other person or entity for which it is vicariously liable. Attached list shows the Additional Insureds.currently on this policy with an additional insured endorsement. CLAIMS: In the case of any claim on this policy, Broker shall notify the underwriting department, if the claim is reported to the broker, that there maybe a particular certificate holder or additional insured involved in the claim. CANCELLATION: Should this policy cancel for non pay there will be $10. per certificate and $10. per Additional Insured Endorsement charge because of the inordinately huge number of Certificates and Additional Insured Endorsements and the large amount of work• involved in the cancellation. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Date Printed: 04/08/2014 Sample ANDREW PAULUS _ .. CN�G 15107111) Page 1 THIS ENDORSEMENT CHANGES THE'POLICy. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL,COVERAGEPARTS, The Company'agrees'lo'waive any right of recov-iy against any person or organization,as required by written contract, because of payments we rnake'forinjury-or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5004US'11-06 Page 'I of Sample THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Or anization s : If no entry appears above, this endorsement applies to all Additional Insureds:covered under this policy. _ Any coverage provided'to an Additional Insured under.lhis policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary excess, contingent or.on any other basis unless a-wnllen'contract or written agreement specifically requires that this ihsurance,apply on a primary and noncontributory basis ALL OTHER TERMS.AND CONDITIONS OF THE POLICY'REMAIN UNCHANGED, AP5031 US 04-10 Page 1 of"1 Sample POLICY NUMBER: 000572081 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS,ENDORSEMENT CHANGES THE POLICY. PLEASE.READ IT CAREFULLY. ADDITIONAL INSURED -. .OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided. under the following: COMMERCIAL GENERALLIABILITY COVERAGE FART SCHEDULE Name Of,Additional Insured Person(s) Or Organization(s): Location s •Of'Covered Operations Where required by written contract>.oragreement All operations+of the named insured Information re uiredto complete this Schedule, if riot shown above, will be shown in therDeclarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional Insured the person(s) or additional insureds, the following additional exclii- organization(s) shown in the Schedule, but only sons apply: with respect to liability for"bodily injury", "property This insurance does riot apply to "bodily injury"or damage" or "personal and advertising, injury' ptopertydamage" occurring:after: caused, in whole or In part, by: 1. All work, inclydiriy, materials, parts or equip= 1. '�ouract$orolnissiuns; or anent furnished do connection with such work, 2. The acts or omissions of those acting on your on the project (other than service, maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) desig- covered operations hzfs,been completed; or rated,above. 2: That portion of "your work" out of which the injury,or damage arises,has been put to its,ill - tended use by any person or orgariization oth- er than another contractor or subcontractor engaged, In performing operations for a princi- pal as;a part of thelsarne project. CG 20'10 07 04 Os 180 Properties, Inc., 2004 Page'1 of 1 ❑ Sample POLICY NUMBER: 000572081 COMMERCIAL GENERAL LIABILITY CG 2037 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This.edorserrient modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s). Location And Description Of Completed Opera- Or Organ lzation s : tlons Where requlred'by written contract or agreement All operations of the named.insured information required to complete this Schedule, if not shown above,will be shown in the Declarations, Section 11 -,Who Is An Insured is amended to include as an additional insured the persons) or organiza- {ion(s) shown in the Schedule, but,only with respect to liability for "bodily injury' or "property damage" Caused, inwhole.Or in part, by "your,work".atthe location. des y.- nated and described in the schedule of this endorse- menfperforrned for that additional I11SUred and included in the "products-completed operations.hazard". CG 20 3707 04 © ISO Properties; Inc , 2004' Page 1 of 1 ❑ Sample STEVENS CREEK ADA UPGRADES/RAMP'SITES LEGEND 1 Eastbound Stevens Creek Blvd. at East end of 85 bridge(South side of Stevens Creek) needs retrofit truncated dome mat installed. 2 Northbound 85 Exit to Eastbound Stevens Creek,needs retrofit truncated dome mat installed. 8 Ezit.from De Anza ol leg e parking lot onto Eastbound Stevens Creek directly across the street from thesports center tennis courts, ramp grade incorrect, need'to be removed and replaced. 12 Southwest corner of Stelling,Rd. at Stevens Creek/Flamp serves crosswalk Northward'to Sports Center sign/Needsretrofiftruncated dome rnatinstalled. 13 Southweshcorner ofStellingRd.atStevens Creek/serves crosswalk Eastward to Panda Express/Needs retrofit truncated dome mat installed. 14 Southeast corner of Stelling Rd. at Stevens Creek in°fronf.ofPanda/serves crosswalk Westward towards De Anza campus'attrafficsignal./Needs to tie removed and repl4nd 15 Southeast corner ofStelling Rd. at StevensCreek Blvtl:/RamE need's to be removed a replaced. 1"6 Stevens Creek Eastbound at Bianchi Way/SW needs retrofit dome mat ins 19 Stevens Creek Eastbound,atBiahchi Way/East street s retrofit truncmat installed. S Eastbound Stevens Creek/ist turn into staples parking lot/SW„needs retrofit truncat mat installed. 19 Rt.turn out of staples parking lot onto Eastbound Stevens Creek/sW'needs retrofit truncated dome mat installed. 20 Eastbound Stevens Creek/Last turn into staples parking lot/SW needs retrofit truncated dome mat installed. 22 Pavers beyond existing curb ramp need to be removed and'a curb poured perpindicular to existing section of sidewalk. Area beyond_curb is to.become planter area./See Kane 23 Section of sidewalk needs retrofit truncated dome mat installed 24 Southwest corner of De.Anza.Blvd in front of-Chevron. Ramp serves crosswalk leading Northbound towards brick building./Ramp needs to be removed and'replaced. 25 'cuthwest:corner of De Anza/front of Chevron,ramp:;erves crosswalk leading Eastbound on Stevens Creek to-Cali Mill Park/Ramp needs,retroft truncated dome mat installed and landing at top of ramp extended. 26 Southeast corner of De.Anza/Cali Mill site, servescrosswalk facing Westbound towards Chevron station/Ramp needs retrofit truncated dome mat installed. 27 Southeast corner of•of De Anza/Cali Mill site/serves crosswalk•facing northbound towards Valerogas station/Ramp needs retrofit truncated donne mat installed. 32 Northeast corner of De Anza/in front of Valero/serves crosswalk facing;Southbound towards Cali Mill Park site/Ramp needs retrofit-truncated dome mat installed. 33 Northeast comer of De Anza/in front-of Valero/serves crosswalk leading to brick bank building/Ramp'needs retrofit-truncated dome mat installed. 34 Northwest corner of De Anza/front of brick,bank.building/serves crosswalk leading Eastbound to Valerostation./Ramp needs retrofit truncated dome mat installed. 35 Westbound Stevens Creek/Rt turn to B Of pparking lot/Ramp needs retrofit truncated dome mat installed. Peb nd Stevens Creek/Exit to Northbound 85,'Adjacent to Oaks Parking Lot/Ramp needs me mat installed. reekWesbound onto Hwy 85 North onramp/concrete porkchop midway to ck/Needs retrofit truncated dome mat installed. d Stevens Creek at Hwy 85 bridge deck/,Ramp needs retrofit truncated dome mat Client#: 823451 BRENEMAN ACORDTM CERTIFICATE OF LIABILITY INSURANCE DAT 61 223!203120D,YYYY) 14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Tim Tarwater Tim Tarwater PHONE 916-945-5068 FAX»c No: 916-290-0187 A1C No 64 HUB Int'I Insurance Serv. Inc. ADDRESS: tim.tarwater @hubinternational.com P.O. BOX 4047 INSURER(S)AFFORDING COVERAGE NAIC#! Concord,CA 945244047 INSURER A:Ironshore Specialty Insurance C INSURED INSURER B! Breneman Inc. ' IN:iURER C 2143 Arnold Industrial Way Suite 20 INSURER D Concord,CA 94520 F;URER E iURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT R TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY D /YYYY MM/DDYYEYYY LIMITS LTR INSR WVD A GENERAL LIABILITY AGS07290 6/2412014 0612412015 EACH OCCURRENCE $1 000 000 rx COMMERCIAL GENERAL LIABILITY PREMISES(Ea o"cu ence $50,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $5,000 BI1PD Ded:5,000 PERSONAL&ADV INJURY •$1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X POLICY JECT LOC __ $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLA1MS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION TO STATU OTH- AND EMPLOYERS'LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L EACHACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) — _` _ E.L.DISEASE-EA EMPLOYEE $ If yes,describe under - -- DESCRIPTION OF OPERATIONS below -_ E.L.DISEASE-POLICY LIMIT $ 4' DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) Re: Removing and replacing concrete. Project Name is 2013 Reconstruction of CurBs,Gutters and Sidewalks- Phase 2. City of Cupertino, its City Council, Boards,and Commissions,Officers, Employees and Volunteers, Stevens Creek Associates, LLC and Harvest Properties, Inc.are listed as Additional Insured as respects to General Liability per endorsement#CG2010 0704 and CG2037 0704 as per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10300 Torre Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Cupertino, CA 95014 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2929809/M2929211 MH45 3 � POLICY NUMBER: AGS07290 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Additional Insureds shown in a written contract, or The insurance afforded by this policy for the benefit of written agreement that includes primary and the additional insured does not apply to non-contributory wording where required. 'property damage'to any building, structure or appurtenant structure intended to be occupied as The inclusion of one or more Insured under the terms of a 'private residence'. The term"private residence"includes single family homes or residences, this endorsement does not increase our limits of liability. multi-family homes or residences, condominiums, townhomes, and apartments. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of-this endorsement-_perfor_me_d_-for that additional insured and included in the "products-completed operations hazard'' i CG 20 37 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 ❑ i POLICY NUMBER:AGS07290 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Additional Insureds shown in a written contract, or The insurance afforded by this policy for the benefit of written agreement that includes primary and the additional insured does not apply to non-contributory wording where required. 'property damage'to any building, structure or appurtenant structure intended to be occupied as The inclusion of one or more Insured under the terms of a 'private residence'. The term"private residence" this endorsement does not increase our limits of includes single family homes or residences, liability. multi-family homes or residences, condominiums, townhomes, and apartments. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above, will be shown in-the Declarations. i Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the - - -schedule-of this--endorsement—performed .for.-_that additional insured and included in the -- - - -- "products-completed operations hazard". CG 20 37 07 04 ©180 Properties, Inc., 2004 Page 1 of 1 ❑