15-194 Pioneer Contractors Inc, Service Center Roof ProjectRECORDING REQUESTED BY
City of Cupertino
WHEN RECORDED MAIL TO
City Clerk's Office
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
NO FEE IN ACCORDANCE
WITH GOV. CODE 27283
DOCUMENT: 23454286
II IIII I 1111111111111111
REGINA ALCOMENDRAS
SANTA CLARA COUNTY RECORDER
Recorded at the request of
City
Pages :
Fees .... * No Fees
Taxes .. .
Copies . . ___ _
AMT PAID
RDE t:t 024
10/06/2016
9 :07 AM
(SPACE ABOVE THIS LINE FOR RECORDER'S USE)
NOTICE OF COMPLETION
CITY PROJECT NAME: Service Center Roof Project
D For Fast Endorsement
3
"NO FEE"
City of Cupertino
NOTICE OF COMPLETION is hereby given in order to comply with the provisions of
Section 27283 of the Government Code.
This is to certify that the Notice of Completion dated September 28, 2016 for
CITY PROJECT NAME: Service Center Roof Project
and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino
on September 28, 2016 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 28, 2016
By: ~~
Lauren Sapudar
Senior Office Assis tant
CUPERTINO
Recording Requested By :
When Recorded Mail To:
City of Cupertino
10300 Torre Ave .
Cupertino , CA 95014
SPACE ABOVE THIS LINE IS FOR RECORDER 'S USE
NOTICE OF COMPLETION
Civil Code§§ 8182 , 8184, 9204, and 9208
NOTICE IS HEREBY GIVEN THAT:
1. The undersigned is the agent of the owner of the project described below.
2 . Owner's full name is : City of Cupertino , California .
3. Owner's address is : City Hall , 10300 Torre Ave ., Cupertino , CA 95014.
4 . The nature of owner's interest in the project is:
_X_ Fee Ownership Lessee Other: ________ _
5. Construction work on the project performed on the owner's behalf is generally described as
follows :
6 .
7 .
8.
City Project Name: Service Center Roof Project
Work Consisted of cold-applied built-up asphalt roof restoration and placement of new roofing
system on prepared deck covering approx imately 7300 square feet.
The name of the original contractor for the project is : _Pioneer Contractors , Inc. ___ _
The project was completed on : __ January 25 , 2016 ____________ _
The project is located at: __ 10555 Mary Avenue, Cupertino , CA 95014 _____ _
Verificat ion : In signing this document, l ,.the undersigned , declare under penalty of perjury under the laws
of the State of California that I have read this notice , and I know and understand the contents of th is
notice , and that the facts stated in this notice are true and corre8:::::::>
1pr5/2c/fe; Santa Clara County ~d.L
Date 'and Place · Signature
~imm Borden
/ Director of Public Works and City Engineer
ea lb l6 — 37 el
DOCUMENT 00520
CONTRACT
THIS CONTRACT, dated this 1.."3rdday of NOvaob1P ,2015 ,by and between PIONEER CONTRACTORS
INC> whose place of business is located at 1485 Armstrong Ave, San Francisco, CA 94124 ("Contractor"), and the
CITY OF CUPERTINO, a Municipal Corporation of the State of California ("City") acting under and by virtue of the
authority vested in the City by the laws of the State of California.
WHEREAS,City,on the 15ih day of November,2015 awarded to Contractor the following Project:
SERVICE CENTER ROOF PROJECT
NOW,THEREFORE, in consideration of the mutual covenants hereinafter set forth, Contractor and City agree
as follows:
Article 1. Work
1.1 Contractor shall complete all Work specified in the Contract Documents, in accordance with the Specifications,
Drawings,and all other terms and conditions of the Contract Documents.
Article 2. Agency and Notices to City
2.1 City has designated Roger Lee,Assistant Director of Public Works to act as City's Authorized Representative(s),
who will represent City in performing City's duties and responsibilities and exercising City's rights and authorities
in Contract Documents. City may change the individual(s) acting as City's Authorized Representative(s), or
delegate one or more specific functions to one or more specific City's Representatives,including without limitation
engineering, architectural, inspection and general administrative 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.
2.2 All notices or demands to City under the Contract Documents shall be to City's Authorized Representative at:
10555 Mary Avenue,Cupertino,California 95014 or to such other person(s)and address(es)as City shall
provide to Contractor.
Article 3. Contract Time and Liquidated Damages
3.1 Contract Time.
The Contract Time will commence to run on the date indicated in the Notice to Proceed. City may give a
Notice to Proceed at any time within 30 Days after the Notice of Award. Contractor shall not do any Work at
the Site prior to the date on which the Contract Time commences to run.
Contractor shall achieve Final Completion of the entire Work and be ready for Final Pa in accordance
with Section 00700(General Conditions)by Nnvcmbcr 313-2vr5. /2/{I/ZO/,s
3.2 Liquidated Damages.
City and Contractor recognize that time is of the essence of this Contract and that City will suffer financial loss
in the form of contract administration expenses(such as project management and consultant expenses),if all 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 00800 (Special Conditions) and
City of Cupertino 00520- 1 Contract
Service Center Roof Project
Technical Specifications, Contractor and City agree that because of the nature of the Project, it would be
impractical or extremely difficult to fix the amount of actual damages incurred by City because of a delay in
completion of all or any part of the Work. Accordingly, City and Contractor agree that as liquidated damages
for delay Contractor shall pay City:
3.2.1 $500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Final
Completion of the entire Work as specified above.
Liquidated damages shall apply cumulatively and, except as provided below, shall be presumed to be the
damages suffered by City resulting from delay in completion of the Work.
Contractor should be aware that California Department of Fish and Game, and other State and Federal agencies,
may also levy fines and penalties for the harming, harassing or killing of protected wildlife and endangered
species. Contractor hereby agrees to become familiar with and adhere to wildlife and endangered species
protection requirements.
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 cover the cost of
completion of the Work, damages resulting from defective Work, lost revenues or costs of substitute facilities,
or damages suffered by others who then seek to recover their damages from City(for example, delay claims of
other contractors,subcontractors,tenants,or other third-parties),and defense costs thereof.
Article 4. Contract Sum
4.1 City shall pay Contractor the Contract Sum for completion of Work in accordance with Contract Documents as
set forth in Contractor's Bid Form 00400.
Article 5. Contractor's Representations
In order to induce City to enter into this Contract, Contractor makes the following representations and warranties:
5.1 Contractor has visited the Site and has examined thoroughly and understood the nature and extent of the
Contract Documents, Work, Site, 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 means,methods,techniques,sequences or procedures of
construction to be employed by Contractor and safety precautions and programs incident thereto.
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, which are identified in Document 00320 (Geotechnical
Data,Hazardous Materials Surveys and Existing Conditions),or which may appear in the Drawings. Contractor
accepts the determination set forth in these Documents and Document 00700 (General Conditions) of the
limited extent of the information contained in such materials upon which Contractor may be entitled to rely.
Contractor agrees that except for the information so identified, Contractor does not and shall not rely on any
other information contained in such 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 supplement 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 or otherwise that may affect the cost,progress,performance or
furnishing of Work,as Contractor considers necessary for the performance or furnishing of Work at the Contract
Sum, within the Contract Time and in accordance with the other terms and conditions of the Contract
Documents, including specifically the provisions of Document 00700 (General Conditions); and no additional
examinations, investigations, explorations, tests, reports, studies or similar information or data are or will be
required by Contractor for such purposes.
City of Cupertino 00520-2 Contract
Service Center Roof Project
5.4 Contractor has correlated its knowledge and the results of all such observations, examinations, investigations,
explorations,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
discovered in or among the Contract Documents and as-built drawings and actual conditions and the written
resolution thereof through Addenda issued by City is acceptable to Contractor.
5.6 Contractor is duly organized, existing and in good standing under applicable state law, and is duly qualified to
conduct business in the State of California.
5.7 Contractor has duly authorized the execution, delivery and performance of this Contract, the other Contract
Documents and the Work to be performed herein. The Contract Documents do not violate or create a default
under any instrument,contract,order or decree binding on Contractor.
5.8 Contractor has listed Subcontractors pursuant to the Subcontractor Listing Law, California Public Contracting
Code§4100 et seq.in document 00340(Subcontractors List)
Article 6. Contract Documents
6.1 Contract Documents consist of the following documents,including all changes, addenda,and modifications
thereto:
Document 00400 Bid Form
Document 00430 Subcontractors List
Document 00450 Statement of Qualifications
Document 00460 Schedule of Major Equipment and Materials Suppliers
Document 00481 Non-Collusion Affidavit
Document 00482 Bidder Certifications
Document 00505 Notice of Intent to Award
Document 00510 Notice of Award
Document 00520 Contract
Document 00530 Insurance Forms
Document 00550 Notice to Proceed
Document 00610 Construction Performance Bond
Document 00620 Construction Labor and Material Payment Bond
Document 00630 Guaranty
Document 00650 Agreement and Release of Any and All Claims
Document 00660 Substitution Request Form
Document 00680 Escrow Agreement for Security Deposit in Lieu of Retention
Document 00700 General Conditions
Document 00800 Special Conditions
Document 00821 Insurance
Document 00822 Apprenticeship Program
Technical Specification
Addenda(s)
Drawings/Plans
6.2 There are no Contract Documents other than those listed in this Document 00520,Article 6. Document 00320
Geotechnical Data, Hazardous Material Surveys and Existing Conditions), and the information supplied
therein, are not Contract Documents. The Contract Documents may only be amended, modified or
supplemented as provided in Document 00700(General Conditions).
City of Cupertino 00520-3 Contract
Service Center Roof Project
Article 7. Miscellaneous
7.1 Terms used in this Contract are defined in Document 00700 (General Conditions) and will have the meaning
indicated therein.
7.2 It is understood and agreed that in no instance are the persons signing this Contract for or on behalf of City or
acting as an employee, agent, or representative of City, liable on this Contract or any of the Contract
Documents, or upon any warranty of authority, or otherwise, and it is further understood and agreed that
liability of the City is limited 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§4100 et seq.
7.4 The Contract Sum includes all allowances(if any).
7.5 In entering into a public works contract or a subcontract to supply goods, services or materials pursuant to a
public works contract, Contractor or Subcontractor offers and agrees to assign to the awarding body all rights,
title and interest in and to all causes of action it may have under Section 4 of the Clayton Act(15 U.S.C.§I5)or
under the Cartwright Act(Chapter 2(commencing with Section 16700) of Part 2 of Division 7 of the Business
and Professions Code), arising from purchases of goods, services or materials pursuant to the public works
contract or the subcontract. This assignment shall be made and become effective at the time City tenders final
payment to Contractor,without further acknowledgment by the parties.
7.6 Copies of the general prevailing rates of per diem wages for each craft,classification,or type of worker needed
to execute the Contract,as determined by Director of the State of California Department of Industrial Relations,
are deemed included in the Contract Documents and on file at City's office, or may be obtained of the State of
California web site http://www.dir.ca.gov/DLSR/PWD/Northern.html and shall be made available to any
interested party on request. Pursuant to Section 1861 of the Labor Code, Contractor represents that it is aware
of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability
for workers' compensation or to undertake self-insurance in accordance with the provisions of that Code, and
Contractor shall comply with such provisions before commencing the performance of the Work of the Contract
Documents.
7.7 Should any part,term or provision of this Contract or any of the Contract Documents,or any document required
herein or therein to be executed or delivered, be declared invalid, void or unenforceable, all remaining 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 Contract and 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 required to be included by
any applicable law, that provision is deemed included herein by this reference(or, if such provision is required
to be included in any particular portion of the Contract Documents, that provision is deemed included in that
portion).
7.8 This Contract and the Contract Documents shall be deemed to have been entered into in the County of Santa
Clara, State of California, and governed in all respects by California law (excluding choice of law rules). The
exclusive venue for all disputes or litigation hereunder shall be in Santa Clara County. Both parties hereby
waive their rights under California Code of Civil Procedure Section 394 to file a motion to transfer any action
or proceeding arising out of the Contract Documents to another venue. Contractor accepts the Claims
Procedure in Document 00700,Article 12,established under the California Government Code,Title 1,Division
3.6,Part 3,Chapter 5.
7.9 Contractor and all subcontractors shall comply with the Uniform Administrative Requirements for State and
Local Governments set forth in the Code of Federal Regulations (CFR), Title 49, Part 18. In addition, the
Contractor agrees to comply with the cost principles and procedures set forth in Office of Management and
City of Cupertino 00520-4 Contract
Service Center Roof Project
Budget Circular A-87. The Contractor agrees that a reference to either Office of Management and Budget
OMB)Circular A-87of the Code of Federal Regulations,Title 49, Chapter 1,Part 31,whichever is applicable,
and the Code of Federal Regulations, Title 49, Part 18, will be included in any subcontracts entered into as a
result of this contract.
City of Cupertino 00520-5 Contract
Service Center Roof Project
IN WITNESS WHEREOF the parties have executed this Contract in quadruplicate the day and year first above written.
SERVICE CENTER ROOF PROJECT
CITY: CONTRACTOR:
CITY OF CUPERTINO,a Municipal Corporation of the LContractor's name
State of California
By:
Signature]
Attest:
Micligel L
Please print name here]
Ci y Clerk:.Grace Sc
Appr^ved as to form by City Attorney: Title: Yi U -Presideh t
If Corporation: Chairman,President,or Vice President]
9
City ttorney: By:
Signature]
Please print name here]
Title:
If Corporation: Secretary,Assistant Secretary,
Chief Financial` Officer,or Assistant Treasurer]
Dated: i \s o I is 7 7 8, 0-31
State Contractor's License No. Classification
IMO/20/
n,,, Iorden—Director ofPublic Works Expiration ate
Designated Representative: TaxpayerID
INo.gq4-,-
3357336
Name:Roger S.Lee Name: 4i'c iat/ Ll
Title:Assistant Director of Public Works Title: Vall —J l let h
Address: 10555 Mary Ave., Cupertino, CA 95014 Address: PlerAiin7Sirany,4s, (fan AGs01 (4-94121
Phone:408-777-3350 Phone: 41P17/- 0IV
Facsimile:408-777-3333 Facsimile: 415-&i i-044 r
AMOUNT: $79,800.00
ACCOUNT NUMBERS: it70X81—QV\ ' OO—akel0
FILE NO.:
END OF DOCUMENT
City of Cupertino 00520-6 Contract
Service Center Roof Project
Executed in Duplicate Bond Number:070019523
Premium:$1,021.00
Based on Total Amount of Contract
DOCUMENT 00610
CONSTRUCTION PERFORMANCE BOND
THIS CONSTRUCTION PERFORMANCE BOND ("Bond") is dated November 16,2015 , is in the penal sum of
Seventy Eight Thousand Eight Hundred and No/100 78,800.00)
which is one hundred 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 1 through 12,
attached to this page. Any singular reference to Pioneer Contractors, Inc. Contractor"),
The Ohio Casualty Insurance Company 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:
Pioneer Contractors, Inc. The Ohio Casualty Insurance Company
Name Name
1485 Armstrong Avenue 71 Stevenson Street, Suite 600
Address Principal Place of Business
San Francisco, CA 94124 San Francisco, CA 94105
City/State/Zip City/State/Zip
CONSTRUCTION CONTRACT:
SERVICE CENTER ROOF PROJECT
at Cupertino,California.
DATED November 18 2015 in the Amount of$78,800.00 the"Penal Sum")
CONTRACTOR AS PRINCIPAL:Pioneer Contractors, Inc. SURETY:The Ohio Casualty Insurance Company
Company: (Corp. /eal) Company: (Corp. Seal)
Signature: Signature: l'/
11
o
Name and Tit1; Herbert Li President Name and Title: n Daley,Attorney-in-Fact
BOND TERMS AND CONDITIONS
1.Contractor and Surety,jointly 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 herein by reference.
2.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 obligation under this Bond shall arise after:
3.1 City has declared a Contractor Default under the Construction Contract pursuant to the terms of the
Construction Contract; and
3.2 City has agreed to pay the Balance of the Contract Sum:
3.2.1 To Surety in accordance with the terms of this Bond and the Construction Contract;or
3.2.2 To a contractor selected to perform the Construction Contract in accordance with the terms of this
Bond and the Construction Contract.
City of Cupertino Construction Performance Bond
Service Center Roof Project 00610- 1
4.When City has satisfied the conditions of paragraph 3, Surety shall promptly(within 30 days) and at Surety's
expense elect to take one of the following actions:
4.1 Arrange for Contractor, with consent of City, to perform and complete the Construction Contract (but
City may withhold consent, in which case the Surety must elect an option described in paragraphs 4.2,
4.3 or 4.4,below);or
4.2 Undertake to perform and complete the Construction Contract itself, through its agents or through
independent contractors; provided, that Surety may not select Contractor as its agent or independent
contractor without City's consent; or
4.3 Undertake to perform and complete the Construction Contract by obtaining bids from qualified
contractors acceptable to City for a contract for performance and completion of the Construction
Contract, and, upon determination by City of the lowest responsible bidder, arrange for a contract to be
prepared for execution by City and the contractor selected with City's concurrence, to be secured with
performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the
Construction Contract; and, if Surety's obligations defined in paragraph 6,below, exceed the Balance of
the Contract Sum,then Surety shall pay to City the amount of such excess;or
4.4 Waive its right to perform and complete, arrange for completion, or obtain a new contractor and with
reasonable promptness under the circumstances, and, after investigation and consultation with City,
determine in good faith its monetary obligation to City under paragraph 6, below, for the performance
and completion of the Construction Contract and, as soon as practicable after the amount is determined,
tender payment therefor to City with full explanation of the payment's calculation. If City accepts
Surety's tender under this paragraph 4.4, City may still hold Surety liable for future damages then
unknown or unliquidated resulting from the Contractor Default. If City disputes the amount of Surety's
tender wider this paragraph 4.4, City may exercise all remedies available to it at law to enforce Surety's
liability under paragraph 6,below.
5.If Surety does not proceed as provided in paragraph 4, above, then Surety shall be deemed to be in default on
this Bond ten days after receipt of an additional written notice from City to Surety demanding that Surety
perform its obligations under this Bond. At all times City shall be entitled to enforce any remedy available to
City at law or under the Construction Contract including,without limitation,and by way of example only,rights
to perform work, protect work, mitigate damages, advance critical work to mitigate schedule delay, or
coordinate work with other consultants or contractors.
6.Surety's monetary obligation under this Bond is limited by the Amount of this Bond identified herein as the
Penal Sum. This monetary obligation shall augment the Balance of the Contract Sum. Subject to these limits,
Surety's obligations under this Bond are commensurate with the obligations of Contractor under the
Construction Contract. Surety's obligations shall include,but are not limited to:
6.1 The responsibilities of Contractor under the Construction Contract for completion of the Construction
Contract and correction of defective work;
6.2 The responsibilities of Contractor under the Construction Contract to pay liquidated damages, and for
damages for which no liquidated damages are specified in the Construction Contract, actual damages
caused by non-performance of the Construction Contract including, but not limited to, all valid and
proper backcharges,offsets,payments,indemnities,or other damages;
6.3 Additional legal, design professional and delay costs resulting from Contractor Default or resulting from
the actions or failure to act of the Surety under paragraph 4,above(but excluding attorney's fees incurred
to enforce this Bond).
7.No right of action shall accrue on this Bond to any person or entity other than City or its successors or assigns.
City of Cupertino
Service Center Roof Project 00610-2 Construction Performance Bond
8.Surety hereby waives notice of any change, alteration or addition to the Construction Contract or to related
subcontracts, purchase orders and other obligations, including changes of time. Surety consents to all terms of
the Construction Contract, including provisions on changes to the Contract. No extension of time, change,
alteration, modification, deletion, or addition to the Contract Documents, or of the work required thereunder,
shall release or exonerate Surety on this Bond or in any way affect the obligations of Surety on this Bond.
9.Any proceeding, legal or equitable, under this Bond shall be instituted in any court of competent jurisdiction
where a proceeding is pending between City and Contractor regarding the Construction Contract, or in the
courts of the County of Santa Clara, or in a court of competent jurisdiction in the location in which the work is
located. Communications from City to Surety under paragraph 3.1 of this Bond shall be deemed to include the
necessary contracts under paragraph 3.2 of this Bond unless expressly stated otherwise.
10. All notices to Surety or Contractor shall be mailed or delivered(at the address set forth on the signature page of
this Bond), and all notices to City shall be mailed or delivered as provided in Document 00520 (Contract).
Actual receipt of notice by Surety,City or Contractor,however accomplished,shall be sufficient compliance as
of the date received at the foregoing addresses.
11. Any provision in this Bond conflicting with any statutory or regulatory requirement shall be deemed deleted
herefrom and provisions conforming to such statutory requirement shall be deemed incorporated herein.
12. Definitions.
12.1 Balance of the Contract Sum: The total amount payable by City to Contractor pursuant to the terms of the
Construction Contract after all proper adjustments have been made under the Construction Contract, for
example, deductions for progress payments made,and increases/decreases for approved modifications to
the Construction Contract.
12.2 Construction Contract: The contract between City and Contractor identified on the signature page of this
Bond,including all Contract Documents and changes thereto.
12.3 Contractor Default: Material failure of Contractor, which has neither been remedied nor waived, to
perform or otherwise to comply with the terms of the Construction Contract including,but not limited to,
default" or any other condition allowing a termination for cause as provided in Document 00700
General Conditions).
12.4 City Default: Material failure of City, which has neither been remedied nor waived, to pay Contractor
progress payments due under the Construction Contract or to perform other material terms of the
Construction Contract, if such failure is the cause of the asserted Contractor Default and is sufficient to
justify Contractor termination of the Construction Contract.
END OF DOCUMENT
City of Cupertino Construction Performance Bond
Service Center Roof Project 00610-3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A Notary Public or other officer completing this certificate verifies only the
identity of the individual who signed the document to which this certificate
is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Contra Costa
On November 18, 2015before me, L. Byas-Barnett, Notary Public
Date Here Insert Name end Title of the Officer
personally appeared John Daley
Name(s)or Signer(s)
S
A—who proved to me on the basis of satisfactory evidence toa:.
y
L. BYAS BARNETT --h
ff" J _ Commission #2001260
h1-be the person(s).whose name*is/-eye subscribed to the
ci:t•.y c 1.,• i1:, Notary Public-California z within instrument and acknowledged to me that
ti.Tr_.
Contra Costa County he7,ey executed the same in his/her/613x authorizedMyCommExpiresJan13,2017 capacity(ies}, and that by his/her/their signatures} on theMyComm
instrument the persons} or the entity upon behalf of
h"' which the person® acted,executed the instrument.
L. BYAS BARNETT
Commission#2001280 I certify under PENALTY OF PERJURY under the laws
Notary Public-California z I of the State of California that the foregoing paragraph ist.
c Contra Costa County true and correct.
tt `y Comm Expires Jan 13,2017 I
WITNESS .• r • and official se
ir'Place Notary Seal Above 011Signa 7signatureo otary Public
OPTIONAL
7hough/e information belay is not required by law, it mayprove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment ofthis form to another document
Description of Attached Document
Title or Type of Document Bond Number: 070019523
Document Date: November 18, 2015 Number of Pages: Three (03)
Slgner(s)Other Than Named Above! N/A
Capacity(ies) Claimed by Signer(s)
Signer's Name: John Daley Signer's Name:
Individual Individual
Corporate Officer-Title(s): Corporate Officer—Title(s):
Partner Limited —General RIGHT THUMBPRINT Partner —Limited —General RIGHT THUMBPRINTXAttorneyinFactOF.SIGNER Attorney in Fact OF SIGNER
TrusteeTop of thumb here
Trustee Top of thumb here
Guardian or Conservator Guardian or Conservator
Other Other:
Signer Is Representing:Signer Is Representing:
The Ohio Casualty
Insurance Company
2007 Nationai Notary Association•9350 be Solo Ave..,P.0 20x 2402'Chatsworth,CA.81313-2402•www,NatlonalNotary,org Item#5907 Reorder.Cat Tot-Free 1-800-676-6627
THIS POWER OF ATTORNEY IS NOT VALID UNLESS,IT-IS PRINTEDON-RED BACKGROUND.
This Power of Attorney limits,the acts of those'named herein,and they,have no authority to bind the Company except in the-manner and to the extent herein stated.
CertificateNo.-686as90
American Fire and Casualty Company Liberty Mutual Insurance Company`
c = - - -:-- The Ohio Casualty Insurance Company West American Insurance Company=
POWER OF ATTORNEY
KNOWN ALL PERSONS BY-THESE'PRESENTSsTfiatAmerican Fire&Casualty Company and The Ohio Casualty Insurance Company are corporations duly under the laws of; -
the State of New Hampshire;that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and WestAmerican Insurance Company -
is a corporation duly organized ud'er the laws of the State of Ihdiana(herein collectively calledthe"Companles);pursuantto and byauthonty herein set forth;,does hereby name;constitute. =
and appoint, -John:DaleviKenneth Goodwin LindiByas-Barnett;TeaganiChastain 1-:-.5-_- - _ c - ^ -. _ _
all of the cityof-Keene- state of;NH = a each individuallyif there be more than one named Its true and lawful attorneyinfact to make;execute seal acknowledge
and deliver,focend on its behalf.as surety and as its act and deed;any and.all undertakings,bonds recognizancesand'other.surety obligationstin pursuance.of these presents and shall _ -
be as binding upon the Companies as if they,have duly signed by the president and attested by the secretaryof theCompanies in their own proper persons. -
IN WITNESS WHEREOF this Power of Attorney has been subscribed-byan authorized-officer or official the Compo inendtsahecorp`te_seals of the Companies have been affixed'IN
this =-dayof -March- =.c 2015:o--;- -
ANN CgSG SYINSU INSUq - INSU American Fire and Casualty Company L
a 9p, > °'cit, F ° arF, - -a "°"corp, The Ohio Casually Insurance Company u)6 .Liberty Mutual Insurance Company - m
a190fi o O 1919_ n 1912 1991-
y
s 3 : _y a West merican Insurance_Company_ _ i e
UJ _'d.,
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9R4MUS' 12 1lMD PNP" F=
1 * *
BY' 74-.`- -
c_:STATE OF PENNSYLVANIA _ ss- _ - David M.Carey`AssistanfSecretary m
1- "COUNTY-OF.MONTGOMERY__ - _, -
0-pf Op this 4th- day of-March- - z 20157 before me personally:appeared David M-Carey,who,acknowledged himself to be the Assistant_Secretary of American Fire-and 10 O
0 d Casualty Company Liberty Mutual Insurance Compang-The Ohio Casualty.lnsur`ance'Cbmpany,and West American Insurance Company,and that he,as such,being authorized do,->>'W1-32 execute the foregoing instrument for the purposes therein contained by signing-on behalf of the corporations by himself as-a duly authorizedofficer
ay? IN WITNESS WHEREOF,I-1 have h_ereuntosubscribedmyname and affixed_mynoterial seal at Plymouth Meeting,Pennsylvania,on the day andyear first above written. _ o 0.
y.co - -
P pqs\ .- - -COMMONWEALTH OF PENNSYLVANIA - 0
tie
wl
Notarial Seal w;
i- o - s q Teresa Pasteila Notary Public g ;-h"-'•""" O
0.` Plymouth Twp..Montgomery County Y
TeresaPastella Notary'Public 02
My Commission Expires Merolla.2017
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Member,PennsylvaniaAssodabonof Notaries o:E0.
c `- This PowerofAttomey is Made-and executed pursuant to and byauthorityof the following By-laws andAuthorizations of American Fire and Casualty Company,The Ohio Casualty Insurance •fn:0
ar - Company Liberty.Mutual Insurance Company,and:WestAmerican Insurance Company which resolutionsare now:in full force and effect reading as follows: - - r 0.o
It "ARTICLE IV-OFFICERS_Section 12 Power of Attorney;Any officer or other official of theCorporation authorized for that purpose in writing by the Chairman or the President,and subject 05c
to such limitation as the.Chairman or the President may,prescribe shalllappoint such attorneys-in-fact;as maybe necessary to act in behalf of.the Corporation to make,execute,seal, r
o E -acknowledge and defiler ea surety any and all undertakings,bonds,recognizances and othersuretyobligations.-Such attorneys-in-fact subject to the limitations set forth in theirrespective :5-3E. .powers of attorney,shall have fil power to bind the Corporation by their signature and execution of anysuchlinstruments and to attach thereto the seal ofaf:the Corporation. When so
0 W executed,such instruments shall be as binding ass' i- by the President and attested to by the Secretary My power-or authority granted to any representative or attorney-in-fact under >oTthe, provisions of this article may be revoked at any-bme by the'Board,the Chairman,the President or by the officer or officers granting such power or authority:L.fl
rpy2_:ARTICLE XIII-Execution of Contracts,SECTION 5 Surety Bonds and Undertakings Any office?of the Company authorized for that purpose in writing by the chairman or the president, E F.2 and subject to such limitations as the chairman or the president may prescribe,,shall appoint such attorneys-In-fact;-as may be necessaryto act in-behalf of the Company.to make,execute,-. 1.M
0, seal,acknowledge and-deliver as'surety.any-and all undertakings,-bonds recognizances and other surety obligations.,Such attorneys in-factsubject to the limitations-set forth in their !Pit
Z-(1;,respective powers of attorney,`sshall havefull ower_to bind theCompany by theirsignatureand execution of.any.suchlnstrumentiand toattacfi thereto the seal of:the Company. When so' 0:o
5' executed such instruments shall:be as binding as if signed by.the-president and attested by thesecretary m
1 iCertificateofDesignation"-ThePresident of theCompanyacting pursuant to the Bylaws of the_Company authorizes David M.Carey Assl ntSecretaryto appoint such attorneys-in
fact as may.be:necessary.toeaton behalfoft eeCompany to_Make-ete,seal,acknowledgeand deliver as surety anyand all undertakingi}bonds,recognizances'.and other suretyxecu-
Authorization-By unanimous consent oftheCmpany'sBand of Directors the Company consents that facsimlleor mechanically reproducedsig l re of any assistant secretary of the-
Com "panywherever appearing:upon a'ceNfied copy of enypower of atterneyCompanyissuedbythe in cona tion with s`uretybonds,shill bevalid and binding;upon the Companywith, -
the same force and effectas:though manually.affxed,
I,_Gregbry W;:Davenport the undersigned'Assistat Secretary,of American'Fire eedCasualit_empany The'Oh1O Casualty Insurance Companyliberty Mutual Insurance.Company,and
West American Insurance Company do hereby certify that the onginal"power of attorney of which.the foregoing is-a full tine and CorrrectCopy of the Power ofAttorney executed by said
Companies Is infull force and'effect and has not been revoked.: - _
l+
y ' _ -1_ ,,'
IN TESTIMONYWHEREOF,I have hereunto set my hand and affixed.the seals ofsaid Companies this 12 _day of W IO A 1:G ( _ - 20-1 5 . .
p,NOcgs4 ' QY INSp _ 1,1NSUq tNSe
j0 0_ 1919 n r ?
Y`''
1912 -o 1991, s By:'
2a 96\1Hnu`.tea° kNiAcH0,= \3 „.am,nNP t -
Gregory W.DavenPon.AssisfantSecretary
93 of 200 _
LMs_12813 122013
Bond Number:070019523
Executed in Duplicate Premium: Included in Performance Bond
DOCUMENT 00620
CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND
THIS CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND("Bond")is dated November 16,2015,is in the
penal sum Seventy Eight Thousand Eight Hundred and No/100 78,800.00)
one hundred percent of the Contract Price], and is entered into by and between the parties listed below to ensure the
payment of claimants under the Construction Contract listed below. This Bond consists of this page and the Bond Terms
and Conditions, paragraphs 1 through 14, attached to this page. Any singular reference to
Pioneer Contractors, Inc.Contractor"), The Ohio Casualty Insurance Company
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:
Pioneer Contractors, Inc. The Ohio Casualty Insurance Company
Name Name
1485 Armstrong Avenue 71 Stevenson Street, Suite 600
Address Principal Place of Business
San Francisco, CA 94124 San Francisco, CA 94105
City/State/Zip City/State/Zip
CONSTRUCTION CONTRACT:
2015 SERVICE CENTER ROOF PROJECT
at Cupertino,California.
DATED November 18 2015 in the Amount of$78,800.00 the"Penal Sum")
CONTRACTOR AS PRINCIPAL Pioneer Contractors, Inc. SURETY:The Ohio Casualty Insurance Company
Company:Co . Seal) Company: (Corp. Seal)
nnCtylSignature: . Signature: l J1
Name and Title: 'erbert Li, President Name and Title:John Daley,Attorney-in-Fact
BOND TERMS AND CONDITIONS
1.Contractor and Surety,jointly and severally, bind themselves, their heirs, executors, administrators, successors
and assigns to City and to Claimants, to pay for labor, materials and equipment furnished for use in the
performance of the Construction Contract,which is incorporated herein by reference.
2.With respect to City,this obligation shall be null and void if Contractor:
2.1 Promptly makes payment,directly or indirectly, for all sums due Claimants;and
2.2 Defends,indemnifies and holds harmless City from all claims,demands,liens or suits by any person or
entity who furnished labor, materials or equipment for use in the performance of the Construction
Contact, provided City has promptly notified Contractor and Surety (at the address set forth on the
signature page of this Bond) of any claims, demands, liens or suits and tendered defense of such
claims,demands,liens or suits to Contractor and Surety,and provided there is no City Default.
3.With respect to Claimants,this obligation shall be null and void if Contractor promptly makes payment,directly
or indirectly through its Subcontractors, for all sums due Claimants. If Contractor or its Subcontractors,
City of Cupertino Construction Labor and Material Payment Bond
2015 Service Center Roof Project 00620- 1
Project No.2015-22
however, fail to pay any of the persons named in Section 3181 of the California Civil Code, or amounts due
under the Unemployment Insurance Code with respect to Work or labor performed under the Contract, or for
any amounts required to be deducted, withheld, and paid over to the Employment Development Department
from the wages of employees of Contractor or Subcontractors pursuant to Section 13020 of the Unemployment
Insurance Code, with respect to such Work and labor, then Surety shall pay for the same, and also, in case suit
is brought upon this Bond,a reasonable attorney's fee,to be fixed by the court.
4.Consistent with the California Mechanic's Lien Law, Civil Code§3082,et seq.,Surety shall have no obligation
to Claimants under this Bond unless the Claimant has satisfied all applicable notice requirements.
5.Surety's total obligation shall not exceed the amount of this Bond,and the amount of this Bond shall be credited
for any payments made in good faith by Surety under this Bond.
6.Amounts due Contractor under the Construction Contract shall be applied first to satisfy claims, if any, under
any Construction Performance Bond and second, to satisfy obligations of Contractor and Surety under this
Bond.
7.City shall not be liable for payment of any costs, expenses, or attorney's fees of any Claimant under this Bond,
and shall have under this Bond no obligations to make payments to,give notices on behalf of,or otherwise have
obligations to Claimants under this Bond.
8.Surety hereby waives notice of any change,including changes of time,to the Construction Contract or to related
subcontracts,purchase orders and other obligations. Surety further hereby stipulates and agrees that no change,
extension of time, alteration or addition to the terms of the Construction Contract, or to the Work to be
performed thereunder,or materials or equipment to be furnished thereunder or the Specifications accompanying
the same, shall in any way affect its obligations under this Bond, and it does hereby waive any requirement of
notice or any such change, extension of time, alteration or addition to the terms of the Construction Contract or
to the Work or to the Specifications or any other changes.
9.Suit against Surety on this Bond may be brought by any Claimant,or its assigns, at any time after the Claimant
has furnished the last of the labor or materials, or both, but,per Civil Code §3249,must be commenced before
the expiration of six months after the period in which stop notices may be filed as provided in Civil Code
3184.
10. All notices to Surety or Contractor shall be mailed or delivered(at the address set forth on the signature page of
this Bond), and all notices to City shall be mailed or delivered as provided in Document 00520 (Contract).
Actual receipt of notice by Surety, City or Contractor,however accomplished, shall be sufficient compliance as
of the date received at the foregoing addresses.
11. This Bond has been furnished to comply with the California Mechanic's Lien Law including,but not limited to,
Civil Code §§3247, 3248, et seq. Any provision in this Bond conflicting with said statutory requirements shall
be deemed deleted herefrom and provisions conforming to such statutory or other legal requirements shall be
deemed incorporated herein. The intent is that this Bond shall be construed as a statutory bond and not as a
common law bond.
12. Upon request by any person or entity appearing to be a potential beneficiary of this Bond, Contractor shall
promptly furnish a copy of this Bond or shall permit a copy to be made.
13. Contractor shall pay to persons performing labor in and about Work provided for in the Contract Documents an
amount equal to or more than the general prevailing rate of per diem wages for(1) work of a similar character
in the locality in which the Work is performed and(2)legal holiday and overtime work in said locality. The per
diem wages shall be an amount equal to or more than the stipulated rates contained in a schedule that has been
ascertained and determined by the Director of the State Department of Industrial Relations and City to be the
general prevailing rate of per diem wages for each craft or type of workman or mechanic needed to execute this
City of Cupertino Construction Labor and Material Payment Bond
2015 Service Center Roof Project 00620-2
Contract. Contractor shall also cause a copy of this determination of the prevailing rate of per diem wages to be
posted at each Site.
14. Definitions.
14.1 Claimant: An individual or entity having a direct contract with Contractor or with a Subcontractor of
Contractor to furnish labor, materials or equipment for use in the performance of the Contract, as
further defined in California Civil Code §3181. The intent of this Bond shall be to include without
limitation in the terms "labor, materials or equipment"that part of water, gas, power, light, heat, oil,
gasoline, telephone service or rental equipment used in the Construction Contract, architectural and
engineering services required for performance of the Work of Contractor and Contractor's
Subcontractors, and all other items for which a stop notice might be asserted. The term Claimant shall
also include the Unemployment Development Department as referred to in Civil Code§3248(b).
14.2 Construction Contract: The contract between City and Contractor identified on the signature page of
this Bond,including all Contract Documents and changes thereto.
14.3 City Default: Material failure of City, which has neither been remedied nor waived, to pay the
Contractor as required by the Construction Contract,provided that failure is the cause of the failure of
Contractor to pay the Claimants and is sufficient to justify termination of the Construction Contract.
END OF DOCUMENT
City of Cupertino Construction Labor and Material Payment Bond
2015 Service Center Roof Project 00620-3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A Notary Public or other officer completing this certificate verifies only the
identity of the individual who signed the document to which this certificate
is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Contra Costa
On November 18, 2015before me, L. Byas-Barnett, Notary Public
Date Here Insert Name end Title of the Officer
personally appeared John Daley
Name(s)or Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(*whose name(*is/•ete• subscribed to the
within instrument and acknowledged to me that
he/t14®/they executed the same in hisfkef/41eir authorized
capacity(3es}, and that by his/her/their signature* on the
instrument the person(*, or the entity upon behalf of
which the person(s) acted,executed the instrument.
L.BYAS BARNETT I certify under PENALTY OF PERJURY under the laws41y?•. Commission#2001280
s 1' .
Notary Public-California z of the State of California that the foregoing paragraph is
z ' °: `"r - Contra Costa County -.
I
true and correct.
La:°-• My Comm.Expires Jan 134.2_0;771 WITNESS my h 11,. d official seal.
S1PlaceNotarySealAboveSignature1,si naureo leary mu.lc
OPTIONAL
Though Ute information belay is not required by law,, it nrayprovevaluable to persons relying on the document
and could prevent fraudulent removal and reattachment of this tam to another document
Description of Attached Document
Title or Type of Document Bond Number:070019523
Document Date: November 18, 2015 Number of Pages: Three (03)
Signer(s)Other Than Named Above! N/A
Capacity(ies) Claimed by Signer(s)
Signers Name: John Daley Signers Name:
Individual Individual
Corporate Officer–Meg Corporate Officer—Title(s):
Partner _Limited —General RIGHT THUMBPRINT Partner —Limited_General IGHT THUMBPRINT
X Attorney in Fact OF SIGNER Attorney in Fact OF SIGNER
Trustee Top of thumb here
Trustee Top of thumb here
Guardian or Conservator Guardian or Conservator
Other Other.
Signer Is Representing:Signer Is Representing:
The Ohio Casualty
Insurance Company
2007 National Notary Association•9350 be Soto Ave..,P.O/Ox 2402'Chatsworth,CA.'81313-2402•www,NatlonalNotary,org llama 5907 Reorder.Call Toll-Free 1-600-676-6627
THIS.POWER OFATTORNEY ISNOT VALID UNLESS IT IS PRINTED ON:RED.BACKGROUND -...- -
This Powe ofAftorney limitithe acts of those named herein,and they have no authority to bind the Co_mpany:exc_ept in the manner and to the_ extent herein`stated. _ -- - -
Certi_firateNo, 6893996
American Fire and Casualty:Company Liberty Mutual Insurance Company
it _ - - - _ The Ohio Casualty Insurance Company West American Insurance Company= -. -
POWER-OF ATTORNEY-
KNOWNALLPERSONSBYTHESEPRESENTS:-That American Fire&CasualtyCompanyand The Ohio Casualty Insurance Company-are Corporations
di-
lib/organizeduntlerthe laws of _
r the Stateof New Hampshire,that LibertyWithal lnsurance Company is a corporationdulyorganized untlerthe laws of the State of Massachusetts;and WestArnericanInsurance;Company;-_- _
iso corporation dulyorganized untlerthe laws of the Stateof Indiana(herein Icole_ctivelyoalledthe"Companies);'pursuantto and,byauthontyhereinset forth,does herebyhame,constitute-
and appoint-'--John:Daley;KeennettcGoodivitt:LindaByas-Barnett;Teaaih-Chastain 3_ -_ - = _ _ _ - - -
ii - - - = -- -
i - - - tip.-'----' = -=:i- - - --
all of the cityof:"Keene - - _ state of.NH each individually If there be more than one named,its trueand lawful attorney in fact to make,execute seal acknowledge; .
Viand deliver,forand on its behalf as surety:andas its Lit and deed;any andall,undertakings binds recognizances and other surety obligations;in pursuance of these presents and_shall--_ =-_
be as bindmg.upon the Companies as if they:havebeen"duly signeff_by.the president and attested by the secretary of the Companies in theirownproper persons: . - -
r
IN WITNESS WHEREOF this'Power of Attomeyhas been subscribed by an:'aut_honzedrofhcer or official-of the Companies and,the corp tmoasealsoftheCompanieshavebeenaffixed
thereto this'aih - -" day of-March - 2015
PNo cqs° _ tv[Asp, msuRa N1Nsua ``- American Fire and Casualty Company. -
ctr 0.:.Thgi^ `"irCi-
m
tsPwci' lo^ w'pev2 r^ The Ohio Casualty Insurance Company" in
o o Llbeit Mutual insurance Company m
1906 oo'
1919 ; • --7912
2
19,91, a West merican InsuranceCompany -,_N
j - & ",nrvgle `\ a:3 e),'0acause- '' Mbinen -t=
4
e 'STATE OF PENNSYLVANIA Is _David
Mi.
AareyassistantSecretary _ _ C
COUNTY OF MONTGOMERY
2 pl On this 4th. =day of March-I , 2015.,beforemepersonally appeared David M.Carey,whoacknowledged himself to Se the Assistant Secretary of American'Fire and ci F
w.3 Casualty Company,Liberty Mutual Insurance Company The Ohio Casualty Insurance Company,and ncaWestAmen Insurance Company;and that he:as such,being;authorized so to'do >,W
p 2 execute the foregoing instrument for the purposestherein contained by signing on behalf of the corporationsby himself as a duly authorized 2:
11;:_>.d=> IN WITNESS WHEREOF:have fiereuntosubscribedmy name and affixed'-rimy notarial sealat Plymouth Meeting,Pennsylvania;.o n the dayandyear first above wniten.0 0-
I-ai+ {p- P PqB.COMMONWEALTH OF PENNSYLVANIA
0 lsouw
F„. - Notarial Seal- yam-•
CM
C.71) - hi 9Q- -
y v Teresa Pastella Notary Public By:. N'u-^`___'- 2"u` O.0"
C,a,
L.
OF Plymouth Twp.,Montgomery county Teresa_Pastella Notary Public' - -5.c@MyCommission'Expires March 28,2017 d C
CN. Q°l3vt`1. 4 Member,Pennsylvania Assocaeonof Notaries
a
c co This Powerbiktorney is made and exalted pursuant M and by authority of the folloivingB)if-laws andAuthbrizations of American Fire and Caeuany CemPanyTheOhip Casualty Insurance, yo
y y Company Liberty.Mutual Insurance Company;and WestAmencan Insurance Company which resolutions are now in fulpfo ce and effect-reading as follows:: -2.9
cr2 ARTICLE IV'-.OFFICERS Sinai'12-Power ofAttorney:Any officer or otheroficial of the Corporation authorized for that purpose in writing by the Chairman or the President,.and subject O c
1 2 to such limitabohas the Chairman or the President may prescribe,shall appoint such attorneys-in-fact as may be necessary to act in behalf of the Corporation to make execute seal,. «'a'
0;E, acknowledgeanddeliver issurety:any and all undertakings,bonds,-recognizances and other surety obligations.-Such attorneys-in-fact,subject tothe limitationsset forth in their respective: :5--s?.E-.-y powers of attorney,shall have full-power tobind the Corporation-by their signature and-execution of any such instruments and to attach.thereto the seal.of:the Corporation.-When so: To d
p,` executed such instruments shall be as binding'as if signed by the President and attested to by the Secretary Any power or authority granted to any representative orattomey in fact under' >
11
the provisions of this article may be revoked at any time by theiBoard the Chairman.the President or by the bffiCer or officers granting such power or authority: - - - - L,.7,
o,c ARTICLE XIII Execution of Contracts=SECTION 5.Surety Bonds and Undertakings Any officer of the Company authorized for that purpose in writing by the chairman or the president, ET_
w `: and subjectto such limitationses the chairman or the president may prescribe,.shall appoint suchettorneys-in-fict,.as may tie necessary to act in behalf of the Company to make;execute, _'M
O-7 ,seal,acknowledge'and deliver as surety any,and all undertakings,bonds,recognizances and other surety.obligations. Such attorneys in fact'subject to the limitations.set forth in theif c oo
Z y :respectivepowersofattorneyshall havefullpgwertobind the;CompanybytheirSiggnet-deand'execution of any such instruments and to attach thereto the seal of the Company:When:so= 0.01
executed suchinstmments shall be as bmdingas if signed by.the presideht and atteited by the ae`cretary - - - -.^- m
Certif Designation-ThePresident of the-Company',actingpursuant to the Bylaws of:the Company authorizes David.Mficateo Carey Assistant Secretaryto appoint such attorneys-in-
fact as may be necessaryto_act oh behalf of the Company.to make exectite,seal acknowledge and deliver-as surety any and all undertakings;bonds„recognizances and other surety -
obligations _
Authorization=By unanimous consent of.the C mopan's Board of Dnectors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company,whereverappearing upon a certified coy of any power of attorney issued by the lCompanyin connebton with sorery:bonds,shall be:v-andand binding upon the Company with _
the sameforceand effect as though manually affded.-%---
I,:GregoryW:.Davenport,the undersigned Assistinn-Secretary of American Fire and Casually`"Company TheChib-Casualty Insurance Company,:LibertyMutual Insurance Company,and -
3 -West American Insurance Company,do hereby certify that the-original power of altoney of which the foregoing is-A full,true.and'cofrectxopy of.the Power of Attorney executed:by said -
Companies.is in full force and effect and has not been revoked.. _ - r - -
IN TESTIMONY WHEREOF,.I hire hereunto set my hand and affixed the seals of said.Companies this.' qday of IHV VW W1. 201 5' .
toa-59%
44esU - O_cc(INSSpA -Iv INSUR,4 `
onNSUR1,y
v,--
a.
dWv°
oau\\
mc`:rp"°ouarFo G
ifa19060 '0 1919 n i isin 0 a 1991 a By:
a
e o g aa w Gregory.W.Davenport,Assistant Secretary
lybMANN'# _ ',i 11.i? Si SsAcnos T2 3 enieNY Y .
189 of 200
LMS 12873-122013
DOCUMENT 00530
INSURANCE FORMS
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.
City of Cupertino
Service Center Roof Project 00530-1 Insurance Forms
CITY OF
CUPERTINO 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 alloperations, 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
MI 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.
City of Cupertino
Service Center Roof Project 00530-2 Insurance Forms
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.
General Liability- commercial general liability; Combined single limit of$2.0 million per
including provisions for contractual liability, occurrence; $4.0 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.
PiD neer Contracfors , the . By:
Contractor's Name)
Dated: IJovei'11bey 23 2015
City of Cupertino
Service Center Roof Project 00530-3 Insurance Forms
r
CITY OF
CUPERTINO
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: Plbhezr CvVYknttbr .1 (TIC•
Address: igc /Irmctroyt hveli"
Sc+n Frgnci s co I CA- 44124
Description of operations/locations/products insured (show contract name and/or number, if any):
WORKER'S COMPENSATION * Statutory Min.
Employer's
Ct prtss IvlSct-velnte 6+11p14 Liability
name of insurer)
i1D001000.00 $ 110001000.0D $ 1100D1000.00
Insurance Company's State License No.
Check Policy Type: Each Occurrence I i DDD 1000.0 D
COMPREHENSIVE GENERAL
LIABILITY
Premises/Operations General Aggregate 21 Duo, D00• DD
if applicable)
Owners &Contractors
Protective Aggregate
4 Contractual for Specific
Contract Personal Injury
Products Liability
XCU Hazards
Broad Form P.D. Fire Damage (any one fire) $
Severability of Interest
Clause
Personal Injury with Medical Expense
Employee Exclusion Removed any one person)
or Self-Insured
COMMERCIAL GENERAL LIABILITY Retention
Lep Mr Company
name of insurer)
Policy No. O1zY91tl,4 12 Expiration Date 5/I/ 2oIt,
City of Cupertino
Service Center Roof Project 00530-4 Insurance Forms
AUTOMOTIVE/VEHICLE LIABILITY BODILY INJURY PROPERTY DAMAGE
Commercial Form Each Person Each Accident
Liability Coverage
Each Accident
Parks& Insurance COM p4R )
name of insurer) 1
or
Combined Single Limit $ IIO0D l bOD.DD
Policy No. Mato 't% Expiration Date_ 57!f 201IP
BUILDER'S RISK"ALL RISK"
This is to certify that the following policy has been issued by the below-stated company in
conformance with the requirements of the project documents and is in force at this time.
N/A
Name of insurer)
Policy No. Expiration Date
Limits of Liability: Deductible:
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:Dated:20
Attach Certificate of Insurance and Additional Insured Endorsement on company forms.
City of Cupertino
Service Center Roof Project 00530-5 Insurance Forms
CITY OF
ADDITIONAL INSURED ENDORSEMENT
and
CUPERTINO ENDORSEMENT OF PRIMARY INSURANCE
and
NOTICE OF POLICY
CANCELLATION ENDORSEMENT
Project Title: 20IS SEP/i(2 Cthkh I4DF gvlea
In consideration of the policy premium and notwithstanding any inconsistent statement in the policy
to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as
follows:
The City of Cupertino ("City") and its directors, officers, engineers, agents and employees,
and all public agencies from whom permits will be obtained and their directors, officers, engineers,
agents and employees, and the State of California, and its officers, 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 insured(s) 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: LCK•I 1gkh 114314r'ii1 to CowlpAh y
Olt2. Insurance Policy Number: S4 tt 341-3
ff
3. Effective Date of this Endorsement: 20
4. Insured: PIoi1.tfr eohkI1'1apirs, l0( •
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, 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.
City of Cupertino
Service Center Roof Project 00530-6 Insurance Forms
Signature of Authorized Representative:
Original signature required on all Endorsements furnished to the District)
Names of
Agent/Agency: Title:
Address: Telephone:
Facsimile:
City of Cupertino
Service Center Roof Project 00530-7 Insurance Forms
CITY OF
COMPREHENSIVE GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
7,0.1 Pt,ENDORSEMENT OF AGGREGATE LIMITS OF
CUPERTINO INSURANCE PER PROJECT
Project Title: talg Set'Ulit CC.I1'kr RODE Pinta
In consideration of the policy premium and notwithstanding any inconsistent statement in the policy
to which this Endorsement is attached or any other Endorsement attached thereto,it is 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 INFORMATION
1. Insurance Company: 1.2KI119i'DY1' IitSuvtlh[t LO%n )1.9
2. Insurance Policy Number: 0 GS41P3 4T3
3. Effective Date of this Endorsement: 20
4. Insured: SW r Co%tYc1 c4ir5 r lNG-
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, 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: Title:
Address: Telephone:
Facsimile:
City of Cupertino
Service Center Roof Project 00530-8 Insurance Forms
CITY OF
I //.
yr
WAIVER OF SUBROGATION ENDORSEMENT
WORKER'S COMPENSATION INSURANCE
CUPERTINO
Project Title: 2,0 IS. Servs ce Celltrr "Rauf Project
In consideration of the policy premium and notwithstanding any inconsistent statement in the policy
to which this Endorsement is attached or any other Endorsement attached thereto,it is agreed as follows:
It is agreed that with respect to such insurance as is afforded by the policy, the Insurance Company
waives any right of subrogation 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: Ctjpr tSS lnErtl ra itct Coil)pafly
2. Insurance Policy Number: P1W C./ (y DD'RC4
3. Effective Date of this Endorsement: 20
4. Insured: PION/h CDWIT4I-DYSI inc..
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 Tone Avenue;
Cupertino, California 95014.
I, 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: Title:
Address: Telephone:
Facsimile:
City of Cupertino
Service Center Roof Project 00530-9 Insurance Forms
DOCUMENT'00630
GUARANTY
TO THE CITY OF CUPERTINO,a Municipal Corporation of the State of California("City"),for construction of
2015 SERVICE CENTER ROOF PROJECT
CUPERTINO,CALIFORNIA
The undersigned guarantees all construction performed on 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
specified in the Contract Documents,its unconditional warranty of the quality and adequacy of all of the Work including,
without limitation, all labor, materials and equipment provided by Contractor and its Subcontractors of all tiers in
connection with the Work.
Neither final payment nor use or occupancy of the Work performed by the Contractor shall constitute an acceptance of
Work not done in accordance with this Guaranty or relieve Contractor of liability in respect to any express warranties or
responsibilities for faulty materials or workmanship. Contractor shall remedy any defects in the Work and pay for any
damage resulting therefrom, which shall appear within one year, or longer if specified, from the date of Final
Acceptance.
If within one year after the date of Final Acceptance, or such longer period of time as may be prescribed by laws or
regulations, or by the terms of Contract Documents, any Work is found to be defective, Contractor shall promptly,
without cost to City and in accordance with City's written instructions, correct such defective Work. Contractor shall
remove any defective Work rejected by City and replace it with Work that is not defective, and satisfactorily correct or
remove and replace any damage to other Work or the work of others resulting therefrom. If Contractor fails to promptly
comply with the terms of such instructions,or in an emergency where delay would cause serious risk of loss or damage,
City may have the defective Work corrected or the rejected Work removed and replaced. Contractor shall pay for all
claims,costs,losses and damages caused by or resulting from such removal and replacement. Where Contractor fails to
correct defective Work, or defects are discovered outside the correction period,City shall have all rights and remedies
granted by law.
Inspection of the Work shall not relieve Contractor of any of its obligations under the Contract Documents. Even though
equipment,materials,or Work required to be provided under the Contract Documents have been inspected,accepted,and
estimated for payment, Contractor shall, at its own expense, replace or repair any such equipment, material, or Work
found to be defective or otherwise not to comply with the requirements of the Contract Documents up to the end of the
guaranty period.
All abbreviations and definitions of terms used in this Agreement shall have the meanings set forth in the Contract
Documents,including,without means of limitation,Section 00700(General Conditions).
The foregoing Guaranty is in addition to any other warranties of Contractor contained in.the Contract Documents, and
not in lieu of,any and all other liability imposed on Contractor under the Contract Documents 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 terms of this Guaranty and any warranty or obligation of the Contractor under the Contract
Documents or at law, such inconsistency or conflict shall be resolved in favor of the higher level of obligation of the
Contractor.
Omar Covttrach rr
Contractor's Name
HIS Owlet ron9 kvenLieAddress
San Mrinci`scol c qz 4 11123)-ufc
City/State/Zip Date
END OF DOCUMENT
City of Cupertino 00630-1 Guaranty
2015 Service Center Roof Project
281679
A®® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMJDD1/
SYY)
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(les) 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 CONTACTNAME:
Construction and Real Estate Practice PHONE FAx
A/C.No,Eat): A/C,No):(866)358-1487
Wells Fargo Insurance Services USA,Inc.-CA Lic#:OD08408 E-MAIL o.comtrtReenesswellsfarADDRESS: Cq @ 9
959 Skyway Rd.,2nd Floor INSURERISI AFFORDING COVERAGE NAIC tt
San Carlos,CA 94070 INSURER A: Lexington Insurance Company 19437
INSURED INSURERS: Peerless Insurance Company 24198
Pioneer Contractors,Inc.
INSURER c: Navigators Insurance Company 42307
1485 Armstrong Avenue INSURER 0: Cypress Insurance Company 10855
INSURER E:
San Francisco,CA 94124 INSURER F
COVERAGES CERTIFICATE NUMBER: 9826106 REVISION NUMBER: See below
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 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTRNSR
TYPE OF INSURANCE
ADDL SUER POLICY EFF POLICY EXP
LIMITSINSDWVDPOLICYNUMBERMM100TYYYY) (MMIDD/YYYY)
A X COMMERCIAL GENERAL LIABILITY 065463473 5/1/2015 5/1/2016 EACH OCCURRENCE 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000
MED EXP(My one person) $
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY X JECOT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER:
B AUTOMOBILE LIABILITY BA8848478 5/1/2015 5/1/2016 COM(
EaBIaccidNEDSINGLEent]
LIMIT $ 1,000,000
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $AUTOS AUTOS
X HIRED AUTOS X
AUTOS
ED PROPERTY DAMAGE
AUTOS Per accident)
UMBRELLA LIAB X OCCUR SFI5EXC75109OV 5/1/2015 5/1/2016 EACH OCCURRENCE 4,000,000
X EXCESS LIAB CLAIMS-MADE AGGREGATE 4,000,000
DED RETENTION$
D AND EMPLOYERS'YERS'LIAILIT X P1WC600964 1/1/2015 1/1/2016 X STATUTE
PER EERH
ANY PROPRIETOR/PARTNER/EXECUTIVEAR
NITY
ANY
OFFCEFUMEMBERIECUDEXECUTIVE
YIN
E.L.EACH ACCIDENT $ 1,000,000
Mandatory NH)
R EXCLUDED? N(A
1,000,000in(
fyes,
doryNH)
E.L.DISEASE-EA EMPLOYEE $
Oyes,describe under 1,000,000DESCRIPTIONOFOPERATIONSbelowE.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if mere space is required)
CG 20 10 10 01,GECA7010107,WC 99 04 10A(07-07)Certificate Holder is named as additional insured as respects general liability and automobile
liability per endorsements attached.
WAIVER OF SUBROGATION: AS RESPECTS WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY,THE RIGHT OF SUBROGATION IS
HEREBY WAIVED.
CERTIFICATE HOLDER CANCELLATION
City of Cupertino SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
10300 Torre Ave
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Cupertino,CA 95014
AUTHORIZED REPRESENTATIVE
9r1.—
The ACORD name and logo are registered marks of ACORD 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01)
This certificate replaces e<NGrales 9826020 issued an 1124120151
POLICY NUMBER: 065463473 ENDORSEMENT# COMMERCIAL GENERAL LIABILITY
CG 20 10 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSWED- DMERS, LESSEES OR
CONTRACTORS - SCI-EDItED PERSON OR
ORGANZA11ON
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Cl lents of the Named Insured's where required
by written contract.
If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
A. Section II - Who Is An Insured is amended to 111 All work, including materials, parts or
include as an insured the person or organization equipment furnished in connection with
shown in the Schedule, but only with respect to such work, on the project (other than
liability arising out of your ongoing operationsservice, maintenance or repairs) to be
performed for that insured. performed by or on behalf of the additional
B. With respect'to the insurance afforded to these.
insuredlsl at the site of the covered
additional insureds, the following exclusion is
operations has been completed; or
added: 2)That portion of "your work" out of which
2. Exclusions the injury or damage arises has been put
to its intended use by any person or
This insurance does not apply to "bodily in-organization other than another contractor
jury" or "property damage" occurring after: or subcontractor engaged in performing
operations for a principal as a part of the
same project.
CG 20 1010 01 ISO Properties, Inc., 2000 Page 1 of 1
LX9605
COMMERCIAL AUTO GOLD ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SECTION II-LIABILITY COVERAGE
A. COVERAGE
1. WHO IS AN INSURED
The following is added:
d. Any organization, other than a partnership or joint venture,over which you maintain ownership or
a majority interest on the effective date of this Coverage Form, if there is no similar insurance
available to that organization.
e. My organization you newly acquire or form other than a partnership or joint venture, and over
which you maintain ownership of a majority interest. However, coverage under this provision
does not apply:
1) If there is similar insurance or a self-insured retention plan available to that organization;or
2) To "bodily injury" or "property damage" that occurred before you acquired or formed the
organization.
f. Any volunteer or employee of yours while using a covered "auto"you do not own, hire or borrow
in your business or your personal affairs. Insurance provided by this endorsement is excess over
any other insurance available to any volunteer or employee.
g. Any person, organization, trustee, estate or governmental entity with respect to the operation,
maintenance or use of a covered"auto"by an insured,if:
1) You are obligated to add that person,organization,trustee,estate or govemmental entity as
an additional insured to this policy by:
a)an expressed provision of an"insured contract",or written agreement;or
b)an expressed condition of a written permit issued to you by a govemmental or
public authority.
2) The"bodily injury"or"property damage"is caused by an"accident"which takes place after:
a)You executed the"insured contract"or written agreement;or
b)the permit has been issued to you.
CECA 701(01/07) Includes copyrighted material of Insurance Services Offices,Inc.with Its permission Page 1 of 4
2. COVERAGE EXTENSIONS
a. Supplementary Payments.
Subparagraphs(2)and(4)are amended as follows:
2)Up to $2500 for cost of bail bonds (including bonds for related traffic law violations) required
because of an"accident"we cover. We do not have to fumish these bonds.
4)All reasonable expenses incurred by the"Insured"at our request, including actual loss of earning
up to$500 a day because of time off from work.
SECTION III-PHYSICAL DAMAGE COVERAGE
A. COVERAGE
The following is added:
5. Hired Auto Physical Damage
a. Any "auto"you lease, hire, rent or borrow from someone other than your employees or partners
or members of their household is a covered"auto"for each of your physical damage coverages.
b. The most we will pay for"loss"in any one"accident"is the smallest of:
1) $50,000
2) The actual cash value of the damaged or stolen property as of the time of the"loss";or
3) The cost of repairing or replacing the damaged or stolen property with other property of like
kind and quality.
If you are liable for the"accident",we will also pay up to$500 per"accident"for the actual loss of
use to the owner of the covered"auto".
c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by
an amount that is equal to the amount of the largest deductible shown for any owned "auto"for
that coverage. However, any Comprehensive Coverage deductible shown in the Declarations
does not apply to"loss"caused by fire or lightning.
d. For this coverage, the insurance provided is primary for any covered "auto" you hire without a
driver and excess over any other collectible insurance for any covered"auto"that you hire with a
driver.
6. Rental Reimbursement Coverage
We will pay up to$75 per day for up to 30 days,for rental reimbursement expenses incurred by you
for the rental of an "auto" because of "loss" to a covered "auto". Rental Reimbursement will be
based on the rental of a comparable vehicle, which in many cases may be substantially less than $75
per day, and will only be allowed for a period of time it should take to repair or replace the vehicle
with reasonable speed and similar quality, up to a maximum of 30 days. We will also pay up to$500
for reasonable and necessary expenses incurred by you to remove and replace your materials and
equipment from the covered"auto".
GECA 701(01107) Includes copyrighted material of Insurance Services Offices,Inc.with its permission Page 2 of 4
If"loss" results from the total theft of a covered "auto" of the private passenger type, we will pay
under this coverage only that amount of your rental reimbursement expenses which is not
already provided under paragraph 4.Coverage Extension.
7. Lease Gap Coverage
If a long-term leased "auto" is a covered"auto"and the lessor is named as an Additional Insured -
Lessor, In the event of a total loss, we will pay your additional legal obligation to the lessor for any
difference between the actual cash value of the "auto" at the time of the loss and the "outstanding
balance"of the lease.
Outstanding balance"means the amount you owe on the lease at the time of loss less any amounts
representing taxes;overdue payments;penalties,interest or charges resulting from overdue
payments;additional mileage charges;excess wear and tear charges;and lease termination fees.
B. EXCLUSIONS
The following is added to Paragraph 3
The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not
apply to the accidental discharge of an airbag.
Paragraph 4 is replaced with the following:
4. We will not pay for"loss"to any of the following:
a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with
audio,visual or data electronic equipment.
b.Equipment designed or used for the detection or location of radar.
c.Any electronic equipment that receives or transmits audio,visual or data signals.
Exclusion 4.c does not apply to:
1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered"auto"at the time of the"loss"and such equipment is designed to be solely operated by
use of the power from the"auto's"electrical system,in or upon the covered"auto";or
2)Any other electronic equipment that is:
a)Necessary for the normal operation of the covered"auto"or the monitoring of the
covered"auto's"operating system; or
b)An integral part of the same unit housing any sound reproducing equipment described in (1)
above and permanently installed in the opening of the dash or console of the covered "auto"
normally used by the manufacturer for installation of a radio.
D. DEDUCTIBLE
The following is added: No deductible applies to glass damage if the glass is repaired rather than
replaced.
GECA 701(01/07) Includes copyrighted material of Insurance Services Offices,Inc.with its permission Page 3 of 4
SECTION IV.BUSINESS AUTO CONDITIONS
A. LOSS CONDITIONS
Item 2.a.and b. are replaced with:
2. Duties In The Event of Accident,Claim,Suit,or Loss
a. You must promptly notify us. Your duty to promptly notify us is effective when any of your
executive officers, partners, members, or legal representatives is aware of the accident, claim,
suit", or loss. Knowledge of an accident, claim, "suit", or loss, by other employee(s) does not
imply you also have such knowledge.
b. To the extent possible,notice to us should include:
1) How,when and where the accident or loss took place;
2) The names and addresses of any injured persons and witnesses;and
3) The nature and location of any injury or damage arising out of the accident or loss.
The following is added to 5.
We waive any right of recovery we may have against any additional insured under Coverage A. 1.
Who Is An Insured g.,but only as respects loss arising out of the operation, maintenance or use of
a covered"auto"pursuant to the provisions of the"insured contract",written agreement,or permit.
B. GENERAL CONDITIONS
9. is added
9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Your unintentional failure to disclose any hazards existing at the effective date of your policy will not
prejudice the coverage afforded. However, we have the right to collect additional premium for any
such hazard.
COMMON POLICY CONDITIONS
2.b.is replaced by the following:
b.60 days before the effective date of cancellation if we cancel for any other reason.
LECA 701(01/07) Includes copyrighted material of Insurance Services Offices,Inc.with its permission Page 4 of 4
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10A(Ed 07-07)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
BLANKET BASIS
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule. (This agreement applies only to the extentt hat you
perform work under a written contract that requires you to obtain this agreement from us.)
The additional premium for this endorsement shall be 2.00 %of the total policy premium otherwise due on such
remuneration.
The minimum premium for this endorsement is$ acn nn
Schedule
Person or Organization Job Description
ALL ORGANIZATIONS FOR WHOM THE WAIVER OF SUBROGATION IS ALL CALIFORNIA OPERATIONS
ISSUED
This endorsement changes the policy to which it is attached and is effective on the date Issued unless otherwise stated.
The Information below Is required only when this endorsement is Issued subsequent to preparation of the policy.)
Endorsement Effective 1/1/2015 Policy No PIWC600964 Endorsement No. 2
Insured Pioneer.Contractors,Inc.
9(44-4-1-
Premium$
Insurance Company Countersigned by
Cypress Insurance Company
WC 99 0410A
Ed 07-07)