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17-010 O'Grady Paving, Inc., 2017 Pavement Maintenance Project No. 2017-104Project No . 2017-104 DOCUMENT 00650 AGREEMENT AND RELEASE OF ANY AND ALL CLAIMS THIS AGREEMENT AND RELEASE OF ANY AND ALL CLAIMS ("Agreement and Release"), made and entered into this I 81h day of April, 2018, by and between the City of Cupertino ("City"), and O'Grady Paving Inc. ("Contractor"), whose place of business is at 2813 Wyandotte Sh·eet, Mountain View, CA 94043. RECITALS A. City and Contractor entered into Contract Number 2017-376 (the "Contract"). B. The Work under the Contract has been completed. Now, therefore, it is mutually agreed between City and Contractor as follows : AGREEMENT l . Contractor will not be assessed liquidated damages except as detailed below: Original Contract Sum Modified Contract Sum Payment to Date Liquidated Damages Payment Due Contractor $3,352,709.00 $3,573,585.04 $3,404,767.76 $0.00 $168,817.28 2. Subject to the provisions of this Agreement and Release, City will f01ihwith pay to Contractor the sum of$ One Hundred Sixty-Eight Thousand, Eight Hundred Seventeen Dollars and Twenty -Eight Cents ($168,817.28) under the Contract, less any amounts withheld under the Conh·act or represented by any Notice to Withhold Funds on file with City as of the date of such payment. 3. Contractor acknowledges and hereby agrees that there are no unresolved or outstanding claims in dispute against City arising from the Contract, except for the claims described in paragraph 4 of this Document 00650. It is the intention of the parties in executing this Agreement and Release that this Agreement and Release shall be effective as a full, final and general release of all claims, demands, actions, causes of action, obligations, costs, expenses, damages, losses and liabilities of Contractor against City, and all if its agents, employees, consultants (including without limitation Consulting Cupe1iino), inspectors, representatives, assignees and transferees except for the Disputed Claims set forth in paragraph 4 of this Document 00650. Nothing in this Agreement and Release shall limit or modify Contractor's continuing obligations described in paragraph 6 of this Document 00650. 4. The following claims are di s puted (hereinafter, the "Disputed Claims") and are specifically excluded from the operation of this Agreement and Release: Claim No. Date Submitted Description of Claim Amount of Claim City of Cupertino Agreement and Release of Any and All Claims 2017 Pavement Maintenance Phase 1 Project 00650 -1 Project No. 2017-104 5. Consistent with California Public Contract Code Section 7100, Contractor hereby agrees that, in consideration of the payment set forth in paragraph 2 of this Document 00650, Contractor hereby releases and forever discharges City, and all of its agents, employees, consultants, inspectors, assignees and transferees from any and all liability, claims, demands, actions or causes of action of whatever kind or nature arising out of or in any way concerned with the Work under the Contract 6 . Guarantees and warranties for the Work, and any other continuing obligation of Contractor, shall remain in full force and effect as specified in the Contract Documents. 7. Contractor shall immediately defend, indemnify and hold harmless the City of Cupertino, Santa Clara County, its Architect, any of their Representatives, and all of their agents, employees, consultants, inspectors, assignees and transferees, from any and all claims, demands, actions, causes of action, obligations, costs, expenses, damages, losses and liabilities that may be asserted against them by any of Contractor's suppliers and/or Subcontractors of any tier and/or any suppliers to them for any and all labor, materials, supplies and equipment used, or contemplated to be used in the performance of the Contract, except for the Disputed Claims set forth in paragraph 4 of this Document 00650. 8. Contractor hereby waive,s the provisions of California Civil Code Section 1542, which provides as follows: A general release does not extend to claims that the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him, must have materially affected his settlement with the debtor. 9. The provisions of this Agreement and Release are contractual in nature and not mere recitals and shall be considered independent and severable, and if any such provision or any part thereof shall be at any time held invalid in whole or in part under any federal, state, county, municipal. or other law, rnling, or regulation, then such provision, or patt thereof shall remain in force and effect only to the extent permitted by law, and the remaining provisions of this Agreement and Release shall also remain in full force and effect, and shall be enforceable. 10. Contractor represents and warrants that it is the true and lawful owner of all claims and other matters released pursuant to this Agreement and Release, and that it has full right, title and authority to enter into this instrument. Each party represents and warrants that it has been represented by counsel of its own choosing in connection with this Agreement and Release. 11. All rights of City shall survive completion of the Work or te1mination of the Contract, and execution of this Agreement and Release. City of Cupertino Agreement and Release of Any and All Claims 2017 Pavement Maintenance Project Phase J 00650 -2 ***CAUTION: THIS IS A RELEASE-READ BEFORE EXECUTING*** THE CITY OF CUPERTINO, a Municipal Corporation of the State of California ATTl!§_T, ~ ~ t2 ~,Ji- [City Clerk) f CONTRACTORJ By: ~-o ~V- Name: _C=-e---=--{ /h--'t!..,.......,___...Q~, J_..0'-""-c.J....,_,rq=--V)_.__ Its: __ S_e"--if'~_f Ti_.__r__,t~f--'_· __ ~v~ [City A ·neyl ___,4e..;_f_fl_l L,_3o ____ , 20 f<J END OF DOCUMENT Project No. 2017-104 City ofCupettino Agreement and Release of Any and All Claims 2017 Pavement Maintenance Phase 1 Project 00650 -3 RECORDING 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 23873698 Regina Alcomendras Santa Clara County -Clerk-Recorder 02/22/2018 01:30 PM Titles: 1 Fees: 10.00 Taxes: 0 Total: 0 .00 Pages: 3 (SP ACE ABOVE THIS LINE FOR RECORDER'S USE) NOTICE OF COMPLETION CITY PROJECT NAME: 2017 Pavement Maintenance Phase 1 City Project No. 2017-104 ,~ Original D For Fast Endorsement 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: _ Fee Ownership Lessee _x_ Other: Right-of-Way 5. Construction work on the project performed on the owner's behalf is generally described as follows: 2017 Pavement Maintenance Phase 1, (City project No. 2017-104) 6. The name of the original contractor for the project is: O'Grady Paving Inc. 7. The project was completed on: February 2, 2018. 8. The project is located at: Various locations throughout the City: Cupertino, CA. Verification: In signing this document, I, 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 this notice, and that the facts stated in this notice are true ~nd comw z!n/,,, ;SantaClaraCounty · ~~ Date and Place Signa ' ' 1:':o {Z Timm Borden Director of Public Works and City Engineer "NO FEE" City of Cupertino NOTICE OF COMPLETION is hereby given in order to corn.ply with the provisions of Section 27283 of the Government Code. This is to certify that the Notice of Completion dated February 22, 2018 for CITY PROJECT NAME: 2017 Pavement Maintenance Phase 1 City Project No. 2017-104 and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on February 22, 2018 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: By: February22, 2018 ·-j,) 0 O)(J)l/AI~_· --- t'auren Sapudar Senior Office Assistant DOCUMENT 00520 CONTRACT Project No. 2017-104 THIS CONTRACT, dated this ( ')-r day of J Crv'-, 2017 , by and between O'GRADY PAVING INC. whose place of business is located at 2313 Wyandotte Street, Mountain, View CA 94043-2314 ("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 ! "v ~ay of j~ , 2017 awarded to Contractor the following Project : PROJECT NUMBER 2017-104 2017 PAVEMENT MAINTENANCE PROJECT NOW , THEREFORE, in consideration of the mutual covenants hereinafter set forth , Contractor and City agree as follows: Article l. 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, Public Works -Maintenance, 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: I 0300 Torre 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. The City anticipates issuing a notice to Proceed on or after May I , 2017. 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 Payment in accordance with Section 00700 (General Provisions) within 80 working days as provided in Document 00700 (General Provisions). All work on streets near schools shall be complete prior to August 11, 2017 . See Attachment A for a list school streets. 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 City of Cupertino 00520 -l Contract 2017 Pavement Maintenance Project No.2017-104 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 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 . l $1,500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Substantial Completion as specified above. 3 .2.2 $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. 3.2.3 $250 per day per location for failure to adjust utility facilities as required per Document 0850 section 6. 3.2.4 $500 per day for failure to place temporary pavement markers as required by Document 850 Section 7. 3.2.5 $150 per day for failure to place final traffic striping as required by Document 0850 , Section 7. 3.2.6 $100 per day per traffic loop not replaced as required by Document 0850 , Section 8. 3.2.7 $100 per day per location for failure to clean any and all tracked tack coat as required by Document 0850 Section 2. 3.2.8 $5,000 for each occurrence of a violation of Document 00800, Section 1.7 WORK DAYS AND HOURS. 3.2.9 $500 per street per day for failure to complete work within time specified in paragraph 3.1. 3.2.10 Three Months Salary for each Key Personnel named in Contractor's SOQ pursuant to Article 2.G of Document 00450 (Statement of Qualifications for Construction Work) who leaves the Project and /or Contractor replaces at any point before Final Completion, for any reason whatsoever, that Co ntractor can demonstrate to City's satisfaction is beyond Contractor's control. 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. 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, attached hereto: See Exhibit "A" attached 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 City of Cupertino 00520 -2 Contract 2017 Pavement Maintenance Project No. 2017-104 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 Contracto r 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 determination set forth in these Documents and Document 00700 (General Provisions) 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 contiguo us 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 Provisions); and no additional examinations, investigations, explorations, tests, reports, studies or similar information or data are or will be required by Contractor for such purposes. 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 dis crepancies 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 Jaw, 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 vio late 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 : City of Cupertino Document 00002 Signature Page Document 00003 Project Directory Document 00012 Caltrans/City Cross-Reference Table Document 00100 Advertisement For Bids Document 00200 Instructions to Bidders Document 00210 Indemnity and Release Agreement Document 00400 Bid Form Document 00411 Bond Accompanying Bid Document 00430 Subcontractors List Document 00450 Statement of Qualifications Document 00481 Non-Collusion Affidavit Document 00482 Bidder Certifications Document 00520 Contract 00520 -3 20 I 7 Pavement Maintenance Contract Document 00530 Insurance Forms 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 C laims Document 00660 Substitution Request Form Document 00700 General Conditions Document 00800 Special Conditions Document 00820 Traffic Control Requirements Document 00821 In surance Document 00822 Apprenticeship Program Document 00850 Technical Specifications Document 00860 General Requirements Attachment A Work Hour Restrictions Addenda(s) Drawings/Plans Project No. 2017-104 6.2 There are no Contract Documents other than those listed in this Document 00520, Article 6. The Contract Documents may only be amended, modified or supplemented as provided in Document 00700 (General Provisions). Article 7. Miscellaneous 7.1 Terms use d in this Contract are defined in Document 00700 (General Provisions) 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 a ll causes of action it may have under Section 4 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 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 oflndustrial 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 .g ov/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 City of Cupertino 00520 - 4 Contract 2017 Pavement Maintenance Project No. 2017-104 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 va lid 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. City of Cupertino 00520 -5 Contract 20 17 Pavement Maintenance Project No. 2017-104 IN WITNESS WHEREOF the parties have executed this Contract in quadruplicate the day and year first above written. 2017 PAVEMENT MAINTENANCE PROJECT CITY: CITY OF CUPERTINO, a Municipal Corporation of the State of California Attest: City Clerk: Grace Schmidt [ _ 2._fu -( f Approved as to form by City Attorney: City Attorney: £...PN -bO L (' it S . CONTRACTOR: Craig E. Young [Please print name here] Title: _VP~---------------- [lf Corporation: Chairman , President, or Vice President] By c~o J)'==-----.: [Signature] Celine 0 . Duran I here by certify, under penalty of perjury, that David Brandt, [Please print name here] City Manager of the City of Cupertino was duly authorized to execute this document. Title: _S_ec_t_./_T_re_a_. _____________ _ [Tf Corporation: Secretary, Assistant Secretary, Designated Representative: Name: Roger Lee Title: Assistant Director of Public Works - Address: I 0300 Torre Ave, Cupertino, CA 95014 Phone:408-777-33 54 Facsimile: 408-777-3333 AMOUNT: 3,352,709.00 ACCOUNT#: 270-85-821-900-92 l ACCOUNT#: Chief Financial Officer, or Assistant Treasurer] 201696 A,Cl2 State Contractor's License No. Classification 12/31/17 Expiration Date Taxpayer ID No.~9_4~-1_4~9~36~9~2 ________ _ Name: Craig E. Young Title: _V_P ______________ _ Address: 2513 Wyandotte St. Mountain View, CA 94043 Phone: (650) 966-1926 Facsimile : (650) 966-1946 NOTARY ACKNOWLEDGEMENT IS REQUIRED. IF A CORPORATION, CORPORATE SEAL AND CORPORATE NOTARY ACKNOWLEDEMENT AND FEDERAL TAX lD ARE REQUIRED. IF NOT A CORPORATION SOCIAL SECURITY NO. IS REQUIRED City of Cupertino END OF DOCUMENT 00520 -6 Contract 2017 Pavement Maintenance CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 • 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 SaYJ ±tl CJa Y--(1. On Sa n . D 5 , 2011 before me, Date s r1GA Lopez.. C,.o(±e,z.,. 1\bto r y 'Pub l,1'c., Here Insert Name and Title of the Officer personally appeared _CK __ Ov..~'q,, ___ £_._~~D~U~nD-:~~O=rd-.~C,e~\~iY\.Q,__~~C ...... J~.~1)~\)~'{=a~Y)_,__ __ 0 U Name(s) of Signer(s) 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 acknowledged to me that he/she/they executed the same in his/her/their 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 instrument. Place Notary Seal Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature_-'C""-'"-~=..__== ......... ......__----=------ Signature of Notary Public ----------------opnoNAL---------------- 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: _____________ Document Date: _______ _ Number of Pages: ___ Signer(s) Other Than Named Above : ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ___________ _ Signer's Name: ___________ _ D Corporate Officer -Title(s): ______ _ [J Corporate Officer -Title(s): ______ _ D Partner -D Limited D General D Partner -[J Limited [l General D Individual lJ Attorney in Fact [J Individual t J Attorney in Fact D Trustee f] Guardian or Conservator [J Trustee L I Guardian or Conservator 0 Other: ______________ _ Cl Other: _____________ _ Signer Is Representing: ________ _ Signer Is Representing: ________ _ ©2 014 National Notary Association • www .NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 Premium ba se d on final contract price and is s ubject to adjustment Project o. 2 017-104 Bond No. 106523338 Premium: $16 ,093.00 Bonds Execut ed in Duplicate DOCUMENT 00610 CONSTRUCTION PERFORMANCE BOND THIS CONSTRUCTION PERFORMANCE BOND ("Bond") is dated Januaiy 4, 20 17 is in the penal sum of Three Mi llion Three Hundred F ifty Two Thousand Seven Hundred Ni ne and N0/100---------------------------------------- -------------------------------------------------------------------Dallars [ which is one hundred percent of the Co ntract Price], and is entered into by a nd between the partie s listed be low to ensure the fa ithful performance of the Co nstru ctio n Co ntract listed below. Thi s Bond consists of thi s page and the Bond Terms and Co ndit io ns, paragraphs 1 through 12, attached to thi s page. Any sing ular reference to O'Grady Paving, Inc. ("Contractor"), Travelers Cas ualty and Surety Co mpany of Ameri ca ("Surety "), the City of Cup ert in o , a M uni cipal Corporatio n of the State of California ("City") or other paity shall be considered plural where applicable. CONTRACTOR: O'Grady Paving, Inc. Name 2513 Wyandotte Street Address Mo untain View, CA 94043 City/State/Zip CONSTRUCTION CONTRACT: at C upertino , California. DA TED January 3 CONTRACTOR AS PRINCIPAL Co mpan y : (Corp . S 1) Name a nd Title: SURETY: Travelers Casualty and Surety Company of America Name 100 California Stre et, STE 3 00 Principal Place of Bu s iness San Francisco CA 94 111 City/State/Zip 2017 PAVEMENT MAINTENANCE PROJE CT PROJECT NUM BER 2017-104 , 20_.ll__ in the Amou nt of$ 3.352 709 .00 -----------------------(the "Penal Sum ") Signature: \ ~ SURETY Travelers Cas ua lty and Surety Company of America Co mpan y:E f rp . Seal) uX Name and T::: L. Wallis Attorn ey -in-Fact BOND TERMS AND CONDITIONS I. Co ntractor and Surety, jointly and severa ll y, bind th emselves, their heirs , executors , administrators, suc cessors and ass igns to City for the complete an d pro per performance of the Co nstru ct io n Contract, whic h is incorporated herein by reference. 2 . If Co ntractor comp lete ly a nd properl y performs all of its o bli gations under t he Co nstr ucti o n Contract, Surety and Contractor sha ll have no o bligation und er this Bond. 3 . If there is no City Default, Surety's obligation und er this Bond shall arise after: 3 .1 City has declared a Co ntractor Default und er the Co nst ruction Contract pursuant to the terms of the Co nstructi on Contract ; and 3 .2 City has agreed to pay the Balance of the Contract Sum : 3.2 .1 To Surety in accordan ce with the terms of thi s Bond and the Con struction Contract; or City of Cupertin o Co nstructio n Performance Bond 20 17 Pavement Maintenance Proj ect 00610 -1 Project o. 2017-104 3.2 .2 To a contractor selected to perform the Construction Contract in accordance with the terms of this Bond and the Construction Contract. 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 acceptab le 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 equiva lent to the bonds issued on the Construction Contract; and , if Surety 's obligations defined in paragraph 6, be low, 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, detennine 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 ex planation 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 di s putes the amount of Surety's tender under this paragraph 4.4 , City may exercise all remedies availab le 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, witho ut limitation, and by way of examp le only, rights to perform work, protect work, mitigate damages, advance criti cal work to mitigate schedule delay , or coordinate work with other consultants or contractors . 6. Surety 's moneta1y obligation under this Bond is lim ited by the Amount of this Bond id entified 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 action s or failure to act of the Surety under paragraph 4, above (but excluding attorney's fees incwTed to enforce this Bond). City of Cupertino Con struction Performance Bond 2017 Pavement Maintenance Project 00610 - 2 Project No. 2017-104 7 . o right of action shall accrue on this Bond to any person or entity other than City or its successors or assigns. 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 comt 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 fo1th 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 th is 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 2017 Pavement Maintenance Project 00610-3 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary pub lic or other officer completing this certificate verifies only the identity of t he ind ividual who signed the document to wh ich th is certificate is attached, and not the truthfulness, accuracy, or va li dity of that document. State of California County of __ S_o_n_o_m_a ________ _ On __ J_a_n_u_a_r~y_4_,_2_0_1_7 __ before me, ___ S_ta_c~y_M_._C_li_nt_o_n,~N_o_ta_ry~P_u_b_lic _________ _ Date Here Insert Name and Title of the Officer personally appeared ________ N_an_c~y_L_. _W_a_ll _is _________________ _ Name(s) of Signer(s) wh o proved to me on the b as is of satisfactory evidence to be the person~ whose nameµir is/~ subscribed to the within instru ment and acknowledged to me that ;(e/she/t~y ex ecuted the same in h~/her/t~ir authorized capacity~, and that by pif;/her/H¢r signature~ on the instrument the person ~, o r the entity upon behalf of wh ich the perso ~ acted, executed t he instrument. Pla ce Notary Sea l A bove I certify under PENAL TY OF PERJURY under the laws of the State of Cali fornia t hat the forego ing paragraph is tru e and correct. WITNESS -------------~--oPnONAL---------------- Though th is 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: _____________ Document Date: _______ _ Number of Pages: ___ Signer(s) Other Than Named Above: ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ____________ _ Signer's Name: ____________ _ D Corporate Officer -Title(s): ______ _ D Corporate Officer -Title(s): ______ _ D Partner -D Limited D General D Partner -D Limited D Genera l D Ind ivi dual 161 Attorney in Fact D Individual D Attorney in Fact D Trustee D G uardian or Conservator D Trustee D Guardian or Conservator D Other: ______________ _ D Other: ______________ _ Signer Is Representing: _________ _ Signer Is Representing: ________ _ ©2014 National Notary Assoc iation • www.Nat ionalNotary.org • 1-800-US NOTARY (1 -8 00 -876-6827) Item #5907 ..... WARNING : THIS POWER OF ATIORNEY IS INVALID WITHOUT THE RED BOR D ER POWER OF ATTORNEY TRAVELERS J Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance C ompany Attorn ey -In Fact No. 230672 St. Paul Mercury Ins ura nce Co mpa ny Tra ve lers Cas ua lty a nd S uret)' Compa ny Trave ler s Cas ua lty a nd S u rety Co mp a ny of Am erica United S tates F id elity a nd G uaranty C ompany Certifica te No. Q Q 6 8 2 4 6 Q 8 K NO W AL L MEN BY THESE PRESENTS : T hat Farmin g to n Casua lty Co mpa ny. St. Paul Fire a nd Marine In surance Company. St. Pau l Guard ian In sura nce Com pa ny, St. Paul Mercury In s ura nce Company, T rave lers C as ualt y and Surety Comp any, Trave lers Casua lt y and S urety Company of America . and U nited States Fide lit y a nd Gu ara nt y C o mpany a re corpo rati o ns dul y orga ni zed und e r th e la ws o f th e State o f Connec ti c ut , th at Fidelity and G uara nt y In sura nce C o mpan y is a corporati o n dul y o rga ni zed unde r th e la ws o f th e State o f Iowa, and that Fid e li ty a nd Guaranty In s ura nce U nd e rwri ters , In c ., is a corporat io n du ly organi zed unde r the laws of the Sta te of W isconsi n (he re in coll ecti vely call ed th e "C o mp ani es"), and th at th e Compani es d o he reby make. cons tit ut e and appoint Catheri ne A. Pinney , Nanc y L. Walli s, K. Dixon Wright , St acy M . Clinton , Kanda ce L. Reeve s, and Natalie Ann Hard er of th e City of Petaluma , Sta te of California , their true and lawfu l Attorn ey(s)-in-Fact , each in th ei r separate ca pacit y if mo re th a n o ne is na med above , to sig n , execut e , seal and ac kn ow ledge any and a ll bonds. recogn izances , cond iti o na l un dertakin gs a nd o th er writin gs obli gato ry in th e nature th e reof o n be ha lf of th e C o m pa ni es in th e ir bu s in ess of g uara nt ee in g th e fi del it y of persons, guaranteeing the pe rfo rm ance of contract s a nd executing or g uara nteein g bonds and un dert ak in gs required o r perm itted in a ny ac ti o ns or proceedings all owed by law. IN WITNESS WHE REOF, the Compani es have caused thi s in strument to be s ig ned a nd th e ir cor porate seals to be hereto affixed. this _____ 6_t_h _____ _ d ay of Jun e 2016 S ta te of Conn ec ti c ut Ci ty of Hartford ss . Farmin gton Casualty Compan y Fidelity and Guaranty Insurance Company Fidelity a nd Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Compan y St. Paul Guardian Insurance Company By : St. Pa ul Merc ury Insura nce Com pany Trave lers Cas ualty and Surety Com pany Tra ve lers Cas ualty and S ure ty Com pa ny of America Unit ed States Fid elit y and Guara nty Co mpany Robert L. Ra ney. Se nior Vi ce Pre sident On th is the __ 6_t_h ______ d ay of __ J_u_n_e ________ _ 20 16 , be fore me persona ll y ap peared Robert L. Ra ney, who ack now ledged him se lf to be th e Se ni o r Vice Pres id e nt of Fa rmin g ton Casualty Co mp any, Fide lit y a nd Gu a ranty In suran ce Co mpa ny, F ideli ty and Guara nty Ins urance Underwrit ers, In c., S t. Paul F ire and Marin e In s ura nce Compa ny, S t. Pa ul G uardi an In s uran ce Compa ny, St. Paul M erc ury In sura nce Co m pa ny. Travelers Casua lty and S urety Com pany, Travele rs Casualty a nd S ure ty Com pany of A me rica , a nd United States Fid e lit y and Guaranty Co mpa ny, and th at he. as such, being authorized so to do , executed the fo rego in g in strume nt for th e purposes th ere in conta in ed by s ig nin g o n be half o f th e corp o rati o ns by himse lf as a dul y auth o ri zed officer. In Witn ess Whereof, I he re unto set m y hand a nd offic ia l seal. My Com mi ss io n expires th e 30th d ay o f June , 202 1. 58440-5-16 Pri nt ed in U .S .A. '-Marie C. Te treault. 1otary Public WARNING: THI S POWER OF ATIORNEY IS IN VALID WITHOUT THE RED BO RDER WARNING : THIS POWER OF ATIORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attorn ey is g ra nt ed und er a nd by the authori ty of the fo ll owin g resoluti ons ado pt ed b y the Boards of Direc tors of Farmin gton Casualt y Compa ny, F id e lit y and Guara nt y In s urance Comp any, F id e lity and G uarant y In sura nce Underwrit e rs, In c ., S t. Pa ul Fire and Marin e Ins ura nce Com pany, S t. Paul G uardi an In suran ce Company, St. Paul Mercury In surance Compan y, Trave le rs Cas ualty and Surety Co mp any, Trave lers Cas ua lt y a nd S urety Comp any of A me ri c a , a nd United States Fidelity and Gu aranty Company, whi ch resoluti o ns are no w in full fo rce a nd e ffect , readin g as fo ll ows : RESOLVED , that th e Cha irm an , th e Pres id ent , any Vice C ha irm an , any Executi ve Vice Presid ent , an y Se ni or Vice Pres id e nt , any Vice Pres id e nt , any Second Vi ce Pres ident , th e Treas ure r, any Ass ista nt Treasurer, th e Cor porate S ec re tary or any Ass istant Sec retary may appo int Attorn eys-in-Fac t and Agents to ac t fo r and on behalf of the Company and m ay g iv e suc h a pp o intee s uch a uthority as hi s o r he r certifi cate o f a uthorit y may presc rib e to s ig n w ith th e Comp any 's name and seal w ith th e Compan y's seal bonds, recog ni zances , co ntrac ts o f ind e mnity, and oth er writin gs o bligatory in th e nature of a bond , recogni zance , or condition a l un dert ak in g , a nd any of said officers or th e Board of Directo rs at an y tim e may re mo ve a n y s uc h a pp ointee and revoke th e po wer g iven him or her ; and it is FURTHER RESOLVED , that th e C ha irman , th e Pres id e nt , a ny Vi ce C ha irm an , an y Executi ve Vi ce Pres id e nt , any Se ni or Vi ce Presid ent or any Vice Pres id e nt may de legate all o r any pa rt of th e fo regoin g a uthority to o ne o r more offi ce rs or e mpl oyees of thi s Compan y, pro v id ed th at each suc h de legation is in wr itin g and a co py thereof is filed in the offi ce o f th e Secreta ry ; a nd it is FURTHER RESOLVED , that any bond, recogni zan ce, contrac t of ind e mnity, or writ ing obligatory in th e nature of a bond , recog ni za nce , or conditiona l undertakin g shall be valid and binding upon th e Company whe n (a) s igned by th e Pres id e nt , any Vi ce Cha irm an , any E xec uti ve Vi ce Pres id e nt , an y Se nior Vice Pres id e nt or an y Vi ce President , an y Second Vice Pres id e nt , th e Treas ure r, a ny Ass istant Treasure r, th e Corporate Secre tary or a ny Assistant Secretary a nd dul y attested a nd sealed w ith th e Company 's seal by a Sec retary or Ass istant Secretary; or (b) dul y execut ed (unde r seal , if required) by one or more Att orn eys-in -Fac t and Age nt s purs uant to th e power prescribed in hi s or her certifi cate o r th e ir certifi ca tes of authority or by o ne or more Company offi cers purs ua nt to a writte n de legation of auth o rit y ; and it is FURTHER RESOLVED , th at th e s ignature of eac h o f th e follo w in g o ffi cers : Pres ident, any Exec uti ve Vi ce Pres id e nt , an y Seni o r Vi ce Pres id e nt , any Vic e Pres id e nt , any Ass istant Vi ce Pre s ident , a ny Secretary, any Ass istant Sec re tary, and th e seal of th e Co mpany ma y be a ffi xed by fa cs imil e to any Po wer of Attorn ey or to any ce rtificate re latin g th e reto appo intin g Res id e nt Vice Pres id e nt s, Res id e nt Ass ista nt Sec re tari es o r Att orn eys-in -Fact fo r purposes onl y of executin g and att estin g bond s and undertakin gs and oth er writings o bli gatory in th e nature th e reo f, and an y s uc h Power of Att orn ey or certifi ca te bearin g s uch facs imil e s ignature or facs imil e sea l shall be valid a nd binding up on the Company and any suc h power so executed and certifie d by s uc h fa csimil e s ignature and facs imil e seal s hall be va lid a nd binding on the Company in th e future with res pect to any bond o r und e rstandin g to whi ch it is attached. I , Kevin E. Hu ghes , the undersigned , Ass istant Secre tary, of F arming to n Casua lt y Company, Fid e lit y and Gu aranty In s ura nc e Co mpan y, Fide lit y and Gu ara nt y In s uran ce Underw riters , In c., St. Paul Fire and M arin e In sura nce Co mp any, St. Paul Guardian In sura nce Compan y, St. Paul M erc ury In surance Co mp any, Trave le rs Casualty and Surety Company, Trave lers Cas ualt y a nd Surety Comp a ny of Ameri ca, and United States Fide lity and Guaranty Comp a ny do here by certify that th e above and fo regoin g is a tru e and correc t c opy of th e Power o f Attorn ey exec ut ed by said Co mpani es, whi c h is in full force and e ffec t and has not been revoked. IN TESTIMONY WHEREOF , I have he re unt o set m y hand and affi xed th e seals of sa id Comp a ni es thi s 4 th cla y of __ J_a_n_u_a_r~y~----' 20 U__. To verify th e auth e nti c it y of thi s Power of Att o rn ey , call 1-8 00-42 1-3880 o r co ntact us at www.trave lers bo nd .com. Pl ease re fer to th e Attorn ey-In -Fact number, th e a bove-n amed indi vidu a ls and th e deta il s of th e bo nd to whi ch th e power is att ac hed . WA RNIN G: THI S POWER OF ATIORNEY IS INVALID WITHOUT THE RED BORDER Bonds Executed in Duplicate DOCUME T 00620 CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND Project No. 2017-104 Bond No . 106523338 Premium: Included in performance bond THJS CONSTRUCTION LABOR AND MATERIAL PAYMEN T BOND ("Bond") is dated Januaty 4, 2017 , is in the penal sum Three Million Three Hundred Fifty Two Thousand Seven Hundred Nine Dollars and 0 /100 ------------------ [ one hundred percent of the Contract Price], and is entered into by and between the parties listed below to ensure the payment of c laimants under the Construction Contract listed below . This Bond consists of this page and the Bond Terms and Conditions, paragraphs I through 14, attached to this page. Any singular reference to O'Grady Paving, Inc. ("Contractor"), Travelers Casualty and Surety Company of America ("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: O 'Grady Paving, Inc. Travelers Casualty and Surety Company of America Name Name 2513 Wyandotte Street 100 California Street, STE 300 Address Principal Place of Business San Francisco, CA 941 l l Mountain View CA 94111 City/State/Zip City/State/Zip CONSTRUCTION CONTRACT: 2017 PAVEMENT MAINTENANCE PROJECT PROJECT NUMBER 2017-104 at Cupertino , California. DATED Janua1:y 3 , 20 _ll_ in the Amount of$ 3 352 709 .00 ----------------------(the "Penal Sum ") CONTRACTOR AS PRINCIPAL SURETY Travelers Casualty and Surety Company of America Company: Company: ( orp . Seal) _ ~ ~ Signature: -Hl.-"",c..:,..ce::i,,:::.->=~~....:::....-=------==--- L. Wallis 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 fo11h 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. 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, however, fail to pay any of the persons named in Section 3 I 81 of the California Civil Code, or amounts due City of Cupertino Construction Labor and Material Payment Bond 2017 Pavement Maintenance Project 00620 - I Project No. 201 7-104 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 emp loyees of Contractor or Subcontractors pursuant to Section 13020 of the Unemp loyment 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 applicab le 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 c laims , 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 perfo1med 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 term s 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 a ny Claimant, or its assigns, at any time after the Claimant has furnished the la st 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 §3 184 . 10. All notice s 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 , Civi l 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 lega l 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 benefi ciary 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 simi lar character in the locality in which the Work is performed and (2) lega l 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 determ ined by the Director of the State Department of Indu stria l 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 Contract. Co ntractor shall also cause a copy of this determination of the prevailing rate of per diem wages to be po sted at each Site . City of Cupertino Construction Labor and Material Payment Bond 2017 Pavement Maintenance Project 00620 -2 Project 1o. 2017-104 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 §3 18 I. The intent of thi s 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 se1vices 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 2017 Pavement Maintenance Project 00620 -3 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVI L CODE § 11 89 A notary public or other officer completing this certificate verifies onl y the identity of the individual who signed t he document to which this certificate is attached, and not the truthfu lness, accuracy, or val idity of that document. State of California County of Sonoma On __ J_a_n_u_a_r _y_4_, _2_0_1_7 __ before me, ___ S_ta_c_,__y_M_._C_li_nt_o_n,'-N_o_ta_ry~P_u_b_lic _________ _ Date Here Insert Name and Title of the Officer personally appeared ________ N_an_c...,__y_L_. _W_a_ll_is _________________ _ Name(s) of Signer(s) who proved to me on the bas is of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the with in instrument and acknowledged to me that he/she/they ex ecuted the same in his/her/t heir au t horized capacity(ies), and that by his/her/their signature(s) on the instr ument the person(s), or the entity upon behalf of which the person(s) acted , ex ecuted the instrument. STACY M. CLINTON ,. Commission # 2129252 ~ ; ~.. Notary Public -California ~ z · '.,.,., Sonoma County ~ l. ~··: ·;· • • Ml sozi~· zxeir;s 4Ngv J,}~1; l Place Notary Seal Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS ---------------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 Do cument Title or Type of Document: ------~------Document Date: _______ _ Number of Pages: ___ Signer(s) Other Than Named Above: ____________ _ Capacity(ies) C laimed by Signer(s) Signer's Name: ____________ _ Signer's Name: ____________ _ D Corporate Officer -Title(s): ______ _ D Corporate Officer -Title(s): ______ _ D Partner -D Lim ited D General D Partner -D Limited D General D Individual l6l Attorney in Fact D Individual D Attorney in Fact D Trustee D Guardian or Conservator D Trustee D Guardian or Conservator D Other: ______________ _ D Other: ______________ _ Signer Is Representing: _________ _ Signer Is Represent ing : ________ _ • ©2014 Nationa l Notary Assoc iat ion· www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 ~ TRAVELERS J WARNING : THIS POWER OF ATIORNEY IS INVALID WITHOUT THE RED BOR DE R POWER OF ATTORNEY Attorney -In Fact No. Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters , Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company 230672 St. Paul M ercury In s ur ance Compan y Travelers Ca s ualt y and S ur ety Compan y Trav ele rs Ca s ualty a nd Sure ty Compan y of America United States Fid elity and Guaranty Company Certificate No. Q Q 6 8 2 4 61 Q K N OW A LL M EN BY THESE PRESENTS: That Farming to n C asua lt y C o mp a ny, St. Pa ul Fire and Marin e In s ura nce Company. St. Pa ul G uardian In surance Comp any. St. Paul M e rc ury In suran ce Company, Tra vele rs C asualty and Sure ty C ompany, T rave lers Casualt y and S ure ty Company of A merica . and Unite d States Fide lit y a nd Gu arant y Company a re corporation s dul y org anized und er the law s o f the State of Connecti c ut , th at Fide lit y and G uarant y In s ura nce Company is a corp o rat io n dul y o rga ni zed und e r th e la ws o f th e State of Iowa, a nd that Fide lit y and Guaranty In surance Und e rwriters, In c., is a corporat io n dul y o rganized unde r th e laws of the S tate of Wi scons in (here in coll ec ti ve ly call ed th e "Compani es"), and th at th e C o mpani es do he reby ma ke , consti tu te and appo int Catherine A. Pinney, Nan cy L. Wa ll is , K. Dixon Wright, Stac y M . C linton , Kandace L. Reeves, and Nata lie Ann Horder of th e C it y of _ __,P,_e=ta~l~u~rn=a~------------' St ate of _____ C_a_l_ir_o_r_n_i_a __________ , thei r true and lawful Atto rn ey(s)-in -Fact , ea c h in th e ir se parate ca pacity if mo re th an o ne is named a bo ve, to s ig n , execute, seal and ackn o w led ge any and all bo nds, recog ni za nces, conditio nal und e rtakin gs and o th er w ri tin gs o bli gato ry in th e nature th e reof o n be hal f o f the Co mpa ni es in th e ir bu s in ess of g uarant eein g th e fide lity of perso ns . g uara nteei ng th e pe rfo rm ance o f contracts and exec uting o r g uara nt eein g bo nd s a nd un dert ak in gs required o r pe rmitted in a ny ac ti o ns o r proceedi ngs a ll owed by law. 6th IN WIT NES S WHER EOF , th e Compani es have cau sed thi s in strument to be sig ned a nd th e ir corp o rat e sea ls to be hereto affixed, this ___________ _ d ay of June 2016 Sta te of Conn ecti c ut City of Hart fo rd ss . Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company S t. Paul Guardian Insurance Company By : St. Paul Mercu ry Ins uran ce Co mp an)' Tra ve lers Cas ualt y and Surety Co mpany Tra velers Cas ualt y and Sur ety Comp an)' of A merica United State s Fidelity and Guaranty Company Robert L. Ra ney. Senior Vice Pres ide nt On thi s th e __ 6 _th ______ d ay of __ J_u_1_1e ________ _ 2 0 I 6 , be fore me persona ll y a p pea red Robert L. Ra ney. who acknow ledged him se lf to be th e Seni o r Vice Pres id e nt o f Farmin g to n Cas ualty Compa ny, Fid e lit y and Guaranty In s uran ce Company, Fide lity and G uara nt y In sura nce Un de rw rit e rs, In c ., St. Paul F ire and Marin e In s ura nce Company, St. Paul Gu ardi an In s uran ce C o mp any, St. Pa ul M e rc ury In s ura nce Co m pa ny. T rave lers Casualty a nd Sure ty Com pany. Travelers Cas ualt y a nd S ure ty Company of A me ri ca, a nd United States Fide lit y a nd Guarant y Company, a nd th at he. as such , being authorized so to do . exec ut ed th e fo rego in g in strume nt for th e purposes th e re in conta in ed by s ig nin g o n behalf of th e corporati o ns by him self as a dul y a uth orized officer. In Witne ss Whereof, I he re unto set m y ha nd and o ffi c ial seal. M y Co mm iss io n ex pires th e 30th cl ay o f Jun e, 20 2 1. 58440-5 -1 6 Printed in U.S.A. c.j~ '-Mar ie C. Tetreau lt . 1otary P ubli c WARNING : THIS POWER OF ATIORNEY IS INVALID WITHOUT THE RED BO RDER WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attorney is grant ed under and by th e authorit y of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty In surance Und erwri ters , In c ., St. Pau l Fire and Marine Insurance Company, St. Paul Guardian In surance Company, St. Paul Mercury In surance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of Ame ri ca , an d United States Fidelity and Guaranty Company, which reso lution s are now in full force and effect , re adin g as follows: RESOLVED , that th e Chairman, the President , a ny Vice Chairm a n , any Exec uti ve Vice President , any Senior Vice Pres ident , any Vice President , any Second Vice President, th e Treasurer, any Ass istan t Treasurer, the Corporate Secretary or a ny Assistant Secretary may appoint Attorneys-in-Fact and Agents to ac t for a nd on behalf of the Compan y an d may give s uch appo intee s uch a uth orit y as his or her certifi cate of authority may prescribe to s ign w ith the Company 's name and sea l with the Company's seal bonds, recogni za nc es, contracts of ind e mnity, and other writing s obligatory in th e nature of a bo nd , recognizance, or conditional undertaking, and any of sa id officers or the Board of Direc tors at any tim e may remove any s uch appointee and revoke the power g iven him or her ; and it is FURTHER RESOLVED , th at th e Chairman, th e President , any Vice Chairman , a ny Exec uti ve Vice Pres id e nt , any Senior Vice President or any Vice President may delegate all or any part of th e fo rego in g authority to o ne or more officers or em pl oyees of thi s Company, provided that each suc h delegation is in writin g and a copy thereof is filed in the office of th e Secretary; and it is FURTHER RESOLVED , that any bond , recog ni zance , contract of inde mnit y, or writing obli gatory in th e nature of a bond , recogni za nc e , or conditional undertaki ng shall be valid and binding upon th e Company when (a) s ig ned by th e Presid e nt , any Vi ce Chairman , any Executive Vi ce Pres ident , any Senior Vi ce Pres id e nt or any Vi ce President , any Second Vice Pres id e nt , th e Treas urer, any Assistant Treasurer, th e Corporate Secretary or any Assistant Secre tary a nd duly atte sted a nd sealed with th e Company's seal by a Secretary or Ass istant Secretary; or (b) duly exec ut ed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power presc ribed in hi s or her certifi cate or th e ir certifi ca tes of a uthorit y or by one or more Company officers pursuant to a writt e n delegation of authority; and it is FURTHER RESOLVED , that the signature of each of the fo ll owing officers: Pres id e nt , any Executive Vice Pres id e nt , any Seni or Vic e Presid e nt , any Vice Pres ident , any Assistant Vi ce Pres ident , a ny Secretary, any Assistant Sec reta ry, and th e sea l of the Company may be affixed by facsimi le to any Powe r of Attorney or to any certificate rel atin g there to appointing Res id e nt Vice Presidents, Resident Assis tant Secretaries or Attorn eys-i n-Fact for purposes only of exec uting and att es tin g bonds and unde rtakin gs and other writin gs o bli gatory in th e nature thereof, a nd any suc h Power of Attorney or certifi ca te bearing suc h facsimile s ig nature or facsimile sea l s ha ll be va li d a nd binding upon th e Company and any such po wer so exec uted and ce11ified by s uc h facs imil e s ig na ture and facsimile seal s hall be va lid and binding on the Company in the future wi th res pect to any bond or unde rstandin g to wh ic h it is attached. I , Kevin E. Hu ghes, th e undersig ned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guarant y In surance Company, Fidelity and Guaranty In suran ce Underwriters, In c., St. Paul Fire a nd Marine In surance Com pany, St. Pa ul Guardian Ins urance Company, St. Paul Mercury Ins urance Company, Trave le rs Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fide ]jty and Guaranty Company do hereby certify th at th e above a nd foregoing is a true and correct copy of th e Power of Attorney executed by sa id Companies , wh ich is in full force and effect a nd has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my ha nd and affixed th e seals of sa id Companies thi s 4th day of _J_a_n_u_a_r_y~-----' 20 1 7 To verify th e a uth e nti c it y of th is Power of Attorney, ca ll 1-8 00-42 I -3880 or co nt act us at www.trave le rsbo nd.com . Pl ease refer to th e Attorney-In-Fact number, th e above-named individuals and th e details of the bond to whi ch th e power is attached. WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER DOCUMENT 00630 GUARANTY Project No. 20 17-104 TO THE CITY OF CUPERTINO, a Municipal Corporation of the State of California ("City"), for construction of 2017 PAVEMENT MAINTENANCE 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 lon ger 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, lo sses and damages caused by or resulting from such removal and replacement. Where Co ntractor 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 oflimitation, 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. I (i Address Mru a±a i n View, CA q L:f9':B City /State /Zip City of Cupertino 2017 Pavement Maintenance Project Ton . D51 2017 Date END OF DOCUMENT 00630 -I Guaranty CITY OF g Project No. 2017-104 CUPERTINO CERTIFICATE OF INSURANCE TO THE C ITY 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: 0 1 lSr~ fo.u(~ , l nc.. Address: :z...S: I ~J CV"'\ do+k,. S·hr~,t- fY\'v..>rv-tcL\:I'\ \Jc _ , cA "!i.fo'-/-3 Description of operations/locations/products insured (show contract name and/or number, if any): ,2.o I q-pa. 0 c....«l '1../\. ..(-rY\ a..<.{) ~a/\ "-L--If-I A-oa 3 WORKER'S COMPENSATION ,:, Statutory Min. ,:, Employer's :'.2:0rt'cJA A.rf'Q:rlt'CA,/\_, \ins. Co. Liability (name of insurer) $ 1 , ooa, ~oo $ I , o~, ;)c,c:, Insurance Company's State License No. -=O ..... t .... iS...._...,.';,'-q-'-'-1 & _____________ _ Check Policy Type: COMPREHENSIVE GENERAL LIABILITY [ X:J Premises/Operations [X ] Owners & Contractors Protective [ ] Contractual for Specific Contract $ _______ _ Each Occurrence General Aggregate (if applicable) Aggregate Personal Injury $ I I ~ ( 'b':)(.:) [ ~] Products Liability [')(.] XCU Hazards [ J Broad Form P.D. Fire Damage (any one fire) $ 3 DO, DDo [ ] Severability of Interest Clause [ ] Personal Injury with Medical Expense $ 15 l Cf"...:::,r:;i Employee Exclusion Removed (any one person) or Self-Insured COMMERCIAL GENERAL LIABILITY Retention $ O / fl -~-4, ......... ---- (name of insurer) Policy No. "'le>'2..· 1:.'tl · ~S~ 5t3 -D~(, City of Cupertino 2017 Pavement Maintenance Project Insurance Forms 00530 - 4 Expiration Date o.q. / o\ / ( 4" I ------------------------ AUTOMOTIVENEHICLE LIABILITY Commercial Form Liability Coverage =t:.ur;<.:.,k., ~(~ lf'ISJ(uf\LL c~. (name of insurer) BODILY INJURY Each Person $ ______ _ Each Accident Project No . 2017-104 PROPERTY DAMAGE Each Accident $ ______ _ $_______ or Combined Single Limit $ I I O OD , 0 ao Policy No. Mf> Dl=t3 (o?fj · ~2.ExpirationDate o*/01 / 13: I I 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. NIA (Name of insurer) Policy No._________ Expiration Date ______ _ Limits of Liability: Deductible: ________ _ Jnt's initial) A copy of all Endorsements to the policy(ies) which in any way 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, tenn, 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: 0~o:tikA& I rf'g. 5Ct-l\ Dated:. ___ o-'-t _,_/-=o:....:5:::.__ __ __:20 _G:_ I Attach Certificate of Insurance and Additional Insured Endorsement on company forms. City of Cupertino 2017 Pavement Maintenance Project Insurance Forms 00530-5 -u-·--•-•·--·=--=•~·----·-----------·----------------------- C I TY O F a CUPERTINO ADDITIONAL INSURED ENDORS EMENT and ENDORSEMENT OF PRIMARY INSURAN CE and NO TI CE OF POLICY CANCEL LATI ON ENDORSEMENT "2..c.:>\~ Project No. 20 17-104 Project Title and Nwnber: !q:v~mQ../\+ /V\°'-.~'n f-U\a..0GL.. tt-(:too°?) , 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 pennits 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 insu rance , and no add itional insurance held or owned by the designated additional insured(s) shall be called upon to cover a loss under said addi t ional policy. Cance llatio n No tice. The insurance afforded by th is poli cy shall not be suspended, vo ided, canceled, reduced in coverage or in limi t s, 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. POLI CY INF ORMA TI ON 1. Insurance Company: u b Q)\*c=,m .... :dv9:R... f {/\..Q_ Ins Jru.f'\CA_ 2. InsurancePolicyNumber: ll~'2..· ~91 Y.S'1 S\3 · of~ 3. Effective Date of this Endorsement: ________ ()_~__,/_\t::,_\ _____ 20 ~ I 4. Insured: p l ('""'r o...d...] f c.t.vCf\lf , \ () L · 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 T orre Avenue; Cupertino, California 95014 . I, __ ,..._J+· """'j""'o ...... t..i...:(..:..~'-.....::~ff-'''---a....::~-<t_tl..--=-___________ (print/type name) City of Cupertino 2017 Pavement Maintenance Project Insurance Fonns 00530 · 6 Project No. 2017-104 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: J ~ CL~ ~a.. s.a&, (Original signature required on all Endorsen( nts fumishe<!I to the District) Names of Agent/Agency: At,b lflSu(a.Ace_ 9 G'/\((/\u·cJ.. SC/u1 {.J1tle: Acc.o...>/\+ C0orch/\a.N Address: 3 wa.+Q/s. f cJL -p,,,.J't.. ii. I oo Sq_~ fY'lll. fe..o r CA 1 lf l/-o 3 City of Cupertino 2017 Pavement Maintenance Project Insurance Forms 00530 -7 Telephone: "rlS ~(~ Ss'~( 4 Facsimile: ~~ <2fl "t --,... --M,O•t ... M. ., _,.. __ ·• ,t· -~ --·---.,,-on:.,,.n:• -·-. ··-·-' -------··---··· ---.. _, ----·------------·----- C ITY O F m CUPERTINO COMPREHENSIVE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ENDORSEMENTOFAGGREGATELIMITSOF INSURANCE PER PROJECT 2'-=>14- Project Title and Number: Po..v~ /Y\µ.tt\:t~/lCl,'\CL 1¼ l?r oc 3 Project No . 20 I 7-104 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 2.o \ '.:!--pcu . ..JS:-,:y\Qv\.:t: '{Y\U...:_I"'\. kA.a.~ POLICY INFORMATION I. Insurance Company: Lt'k,cd l:3= M -J""' CL.Q.._ f\' A.CL l f"\5, J ra. f\Q 2. Insurance Policy Number: TB1..· cC\\. 4:S9 '5(3 . ~Y--~ 3. Effective Date of this Endorsement: ________ 0_1""_.....,/r-0_l _____ 20J.h_ 4 . Insured: 0 16co.cl'r Po..u~"W-(r1c...... 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 A venue; Cupertino, California 95014. rCt.sCt.cl Signature of Authorized Representative: ~ ~o.._fi,a.. SQ&... (Original signature required on all Endorsemtsfurnished~the District) Names of Agent/Agency: Aeib lf\S\.l(Q.I\Q_ <ti r\l\Q(\(J.·c,..Q >erl-l'te) Title: ALl..~A.k" ~o~/ ~C"\.a..+w Address: 3 \.1-Jq,+v....c:, PoJ\.t.. 't,/i->~ #-/c::f.) Telephone:..±ls_...'.±l.1-. 'B~l "I 5c..v, f}'.\9.±ed , CA °1':f':/:o"?:, Facsimile: ~ 4l'\ €,(('(°{ City of Cupertino 2017 Pavement Maintenance Project Insurance Forms 00530 -8 ----------. ----------~-------------------------------------· -·- C I TY OF a CUPERTINO WAIVER OF SUBROGATI ON ENDORSEMENT WORKER'S COMPENSATION I NSURANCE Project No. 2017-104 Project Title and Number: '"J..O\ ':\-:pa.. JC(y\Q/l+ r:Y\D...l'o:k"'.'\CV\U-.. # I :+~Yu 3 In consideration of the policy premium and notwithstanding any inconsistent statement in the policy t o 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, ari sing out of the performance of the above-referenced Contract. POL ICY INFORMATION I. Insurance Company: '2:urlciA. f\t!Y'V-. \1CJ-V\...,, / r\Sul'o..A<:..L.-L:::sl)A.(:>4.~ 2. Insurance Policy Number: IN L o ( ~ :3 b 4-o -0 '2- 3. Effective Date of this Endorsement: ______ O_=t-....,__+/-'i:::>_,_\ _______ .20 _Llg 4 . Insured: __ O_'_~...c....:.(':....c.o.._..;;:d.--'ff':;.F=>--+f -~..,_\J_~(\c....o...,n'q.· -'-,-_,_/.,_o....,L."""'-'."------------- 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. r ~ o ... C\ (print/type name) to bind the below listed Insurance Company and by my signature hereon do Signature of Authorized Representative: 'sdY~C......"3,..~Q.\: ct.c.\ (Original signature required on all Endorsemehts furnished the District) Names of Agent/Agency: ABD \>'"\suraf\Q a ~f\Q/\U'~ S<!t~lU'fitle: A ~u/4:: (_o::::,/d,.C,\o..: Address: 3 Wcch.J\s. fo,'\lc_ i'Vi J'Q..... ,t:t:.. l DD T elephone: ·t.f\S '4-l'l ~ l(( 4 S°'-1"\ rna..fe..o , ~ '11{-l{-03 Facsimile: ~_fil 8~('1 City of Cupertino 2017 Pavement Maintenance Project Insurance Forms 00530 - 9 -··----------··---··----------------- ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM /DD/YYYY) ~ 1/5/2017 THIS CERTIFICATE IS ISSUED AS A MATIER 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 ~~~?CT Luiza Watkins ABD Insurance & Financial Services id~gN.,~ Extl· (650) 488-8565 I FAX /A/C Nol: (650) 488-8566 3 Waters Park Drive ~t1l~~ss : luiza@theabdteam.com Suite 100 INSURER(S) AFFORDING COVERAGE NAIC # San Mateo CA 94403 INSURER A :Liberty Mutual Fire Insurance 23035 INSURED INSURER B :Zurich American Insurance Company 16535 O'Grady Paving Inc. INSURER c :Starr Indemnity and Liability 38318 2513 Wyandotte Street INSURER D :Illinois Union Insurance Companv 27960 INSURER E : Mountain View CA 94043 INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 Liab REVISION NUMBER: THIS IS TO CER TIF Y TH AT THE POLICIES OF IN SURA NCE LI STED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOV E FO R THE POLI CY PERIOD INDI CATED . NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI S CERTIF ICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AF FORDED BY THE POLICI ES DES CR IBED HEREIN JS SUBJECT TO ALL THE TERM S, EXCLUSIONS AND CO NDITIONS OF S UCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDU CED BY PAID CLAIMS . IN SR ADDL SUBR POLICY EFF POLIC Y EXP LTR TYPE OF INSURANCE INSn wvn POLI CY NUMBER /MM/DD/YYYY l /MM /DD/YYYY l LIMITS X COMMERCIAL GENERAL LIABILITY EAC H OCCURRE NCE s 1 ,000,000 t---~ CLAIMS-MAD E [iJ OCCUR DAMAGE TO RENTED A PREMISES /Ea occurrence! s 300,000 t--- X TB2-Z91-45 9513-046 7/1 /20 16 7 /1 /2 017 MED EXP (Any one person) s 5,000 ~ ~ x ,c & U Included PERSONAL & ADV INJURY s 1 ,000,000 GEN'L AGGREGATE LI MIT APPLIES PER: GEN ER AL AGGREGATE s 2,0 00 ,000 ~ 0PRO-DLOC PRODUCTS -COMP/OP AGG $ 2 ,000,000 POLICY JE CT OTHER: $ AUTOMOBILE LIABILITY ~OMBINED SINGLE LIMIT Ea accident) $ 1 ,000,000 - X ANY AUTO BODILY INJURY (Per person) s B ~ ALL OWNED -SCHEDULED AUTOS AUTOS X BAP 017 3639-02 7/1/20 16 7/1 /20 17 BODILY INJURY (Per acciden l) S ~ -NON-OWNED iP~?~tcfle~l~AMAGE X HIR ED AUTOS X AUTOS $ ~ Hired Au lo Phvsical Damaoe s 1 ,000,000 X UMBRELLA LIAB M OCCUR EACH OCCURRENCE s 10 000 000 - C EX CESS LIAB CLA IMS-MADE 1000022 841 7/1/2 016 7/1 /20 17 AGGREGATE s 10 000 000 OED I X I RETENTION s N/A s WORKERS COMPENSATION I PER I I OTH- AND EMPLO YERS ' LIABILITY X STATUTE ER YI N ANY PROPRIETOR/PART NER/EXECUTIVE w N/A E.L. EAC H ACC IDENT $ 1 000 ,000 OFFICER/MEMBER EXCLUDED? B (Mandatory in NH) y we 0113640-02 7/1/2016 7/1 /20 17 E.L. DISEASE -EA EMPLOYEE s 1 ,000 000 II yes, describe under DESCRIPT ION OF OPERATIONS below E.L. DISEASE -POLICY LI MIT s 1 000 000 D Pollution Liability CPY G2454039A 006 7/1/2016 7/1/20 17 Per Pollulion Per Condi ti on/Agg $1,000 ,000 A Contractors Equipment YM2-Z91-459513-026 7/1/2016 7/1/2017 Limi l $6 ,395 ,594 DESCRIPTION OF OPERATIONS/ LO CATIONS / VEHICLES (A COR D 101 , Addition al Remarks Schedule , may be attached if more space is required) Re: Project #2017-104, Job #17003 -2017 Pavement Maintenance . 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 , e ngineers, agents and employees and the State of California and its officers, agents and employees are hereby declared are additional insureds to General Liability and Automobile Liability where required b y written contract or agreement per attached endorsement. Primary wording applies to General Liability and Automobile Liability where required by written contract or agreement per attached endorsement . Per Project Aggregate applies CERTIFICATE HOLDER City o f Cupertino 10300 Torre Ave. Cupertino, ACORD 25 (2014/01) INS025 1?n14n11 CA 95014 CANCELLATION SHOULD ANY OF THE ABOVE DESCR IBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR IZ ED REPRESENTATIVE Rod Sockolov/ERICA ~~ © 1988-2014 ACORD CORPORATION. All rights reserved . The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS to General Liability policy as per written contract or agreement per attached endorsement . Waiver of Subrogation applies to Workers Compensation where required by written contract or agreement per attached endorsement . OFREMARK COPYRIGHT 2000, AMS SERVICES INC. Policy No.: TB2-Z91-4595013-046 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEM:NTCHANGES·THE POLICY. PLEASE READ IT CAREFULLY. COtvM:ROAL GENERAL LIABILITY ENHANCEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILllY COVERAGE PART Index of modified items: tte·m 1. Item 2 . Item 3. Item 4. Item 5. Item 6 . Item 7. Item 8. Item 9 . Item 10. Item 11. Item 12. Item 13. Item 14. Item 15. Item 16. Item 17. Item 18. Reasonable Force Non-Owned Watercraft Extension Oamag~ To Premises Rented To You -Expanded Coverage Bodily Injury To Co-Employees Health Care Professionals As Insureds Knowledge Of Occurrence Notice Of Occurrence Unintentional Errors And Omissions Bodily Injury Redefinition Supplementary Payments -Increased Limits Property In Your Care, Custody Or Control M::>blle Equipment Redefinition Newly Formed Or Acquired Entitles BlanketAddltlonal Insured Where Required By Written Contract Lessors of l eased Equipment Managers .or Lessors of Premises Mortgagees, Assignees or Receivers Owners, Lessees or Contractors · Architects, Engineers or Surveyors Any Person or Organization Blanket Additional Insured -Grantors Of Permits Waiver Of Right Of Recovery By Written Contract Or Agreement Other Insurance Amendment Contractual Liability-Railroads Item 1. Reasonable Force Exclusion a. of Section I -Coverage A -Bodily Injury And Property Damage Liability is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" ot "property damage" resulting from the use of reasonable force to protect persons or property. Item 2 . Non-Owned Watercraft Extension Paragraph (2) of Exclusion g. of Section I -Coverage A -Bodily Injury And Property Damage Liability is replaced by the following : (2) A watercraft you do not own that is: LC04 43 0512 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted materia l of Insurance Services Office, Inc., with its permission. Page 1 of 9 (a) Less than 55 feet long; and (b) Not being used to carry persons or property for a charge; Item 3. Damage To Premises Rented To You -Expanded Coverage A. The final paragraph of 2. Exclusions of Section I -Coverage A -Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion or subsequent damages resulting from such fire , lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with perm ission of the owner. A separate limit of insurance applies to this coverage as described in Section 111-Limits Of Insurance. B. Paragraph 6. of Section Ill -Limits Of Insurance is replaced by the following : 6 . Subject to Paragraph S. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage• to any one premises, while rented to you, or in the case of damage by fire , lightning , explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner. The Damage To Premises Rented To You Limit is the greater of: a. $300,000; or b. The Damage To Premises Rented To You limit shown on the Declarations. C. Paragraph 9.a. of the definition of "insured contract" in Section V -Definitions is r eplaced by the following: a. A contract for a tease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire , lightning, explosion or subsequent damages resulting from such fire, lightn ing or explosion including water damage to premises wh il e rented to you or temporarily occupied by you with permission of the owner is not an "insured contract". D. The paragraph immediately following Paragraph (6) of exclusion j . of Section I -Coverage A -Bodily Injury And Property Damage Liability is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage• (other than damage by fire, lightning or explosion or subsequent damages resulting from such fire, lightning or explosion including water damage) to prem ises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days . A separate limit of insurance applies to Damage To Premises Rented To You as destribed in Section Ill-Limits of Insurance. Item 4. Bodily Injury To Co-Employees A. Paragraph 2. of Section 11-Who Is An Insured is amended to include: Each of the following is also an insured: Your supervisory or management "employees" (other than either your 0 executive officers" (if you ar e an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company)) are insureds while in the course of their employment or while performing duties related to the conduct of your business with respect to "bodily injury·: (1) To you: (2) To your partners or members (if you are a partnership or joint venture); LC04 43 OS 12 © 2012 l.Jberty Mutual Insurance. All rights reserved . Includes copyrighted material of Insurance Services Office , Inc ., with its permission . Page 2 of 9 (3) To your members (if you are a limited liability company); or (4) To a co-"employee· or "volunteer worker" while that co-"employee· or "volunteer worker" is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities sponsored by you). Your "employees" (other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company)) or "volunteer workers" are insureds while in the course of their employment or while performing duties related to the conduct of your business for a Good Samaritan Act that results in "bodily injury": (1) To you; (2) To your partners or members (if you are a partnership or joint venture); (3) To your members (if you are a limited liability company); or (4) To a co-"employee" or "volunteer worker" while that co-"employee" or "volunteer worker" is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities sponsored by you). A Good Samaritan Act means an attempt to rescue or aid a person in imminent or serious peril. provided the attempt is not recklessly made. However, none of these "employees" (including supervisory or management "employees; or "volunteer workers· are Insureds for the providing or failure to provide professional health care services. B. The insurance provided by this Item 4. will not apply if the injured person's sole remedy for· such injury is provided under a workers' compensation law or any similar law. C. Other Insurance The insurance provided by this Item 4. is excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis. Item 5. Health care Professionals As Insureds A. Paragraphs 2.a.(1)(a) and (d) of Section 11 -Who Is An Insured do not apply to "bodily injury" or "personal and advertising injury" arising out of the providing of or failure to provide professional health <:are services by any •employee" or ·volunteer" of the Named Insured who is a "designated health care provider" if the "bodily injury• or "personal and advertising injury• occurs in the course and scope of the "designated health care provider'sa employment by the Named Insured. B. With respect to "employees" and •volunteer workers" providing professional health care services, the following exclusions are added to Paragraph 2. ·Exclusions of Section I -Coverage A -Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I -Coverage B -Personal And Advertising Injury Liability: This insurance does not apply to: (1) Liability assumed under an "insured contract" or any other contract or agreement; (2) Liability arising out of the providing of professional health care services in violation of law; (3) Liability arising out of the providing of any professional health care services while in any degree under the influence of intoxicants or narcotics; · (4) Liability arising out of any dishonest, fraudulent. malicious or knowingly wrongful act or failure to act; or LC0443 0512 © 2012 Liberty Mutual Insurance . All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with Page 3 of 9 · its permission. (5) Punitive or exemplary damages, fines or penalties. C. The following definition is added to Section V -Definitions: "Designated health care provider" means any •employee• or "volunteer worker· of the Named Insured whose duties include providing professional health care services, including but not limited to doctors, nurses, emergency medical technicians or designated first aid personnel. D. Other Insurance The insurance provided by this Item 5. is excess over any other valid and collecilble insurance available to the insured, whether primary, excess, contingent or on any other basis. Item 6. Knowledge Of Occurrence Knowledge of an "occurrence" by your agent, servant or "employee" will not in itself constitute knowledge by you unless your "executive officer" or "employee• or other third party designated by you to notify us of "occurrences" has knowledge of the "occurrence". Item 7. Notice Of Occurrence For purposes of Paragraph 2.a. of Section N -Conditions, you refers to an "executive officer" of the Named Insured or to the "employee" designated by the insured to give us notice. Item 8. Unintentional Errors And Omissions Unintentional failure of the Named Insured to disclose all hazards existing at the inception of this policy shall not be a basis for denial of any coverage afforded by this policy. However, you must report such an error or omission to us as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. Item 9. Bodlly Injury Redefinition The definition of "bodily injury· in Section V -Definitions is replaced by the following: "Bodily injury'' means: a. Bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time; and b. Mental anguish, shock or humiliation arising out of injury as defined in Paragraph a. above. Mental anguish means any type of mental or emotional illness or distress. Item 10. Supplementary Payments -Increased Limits Paragraphs 1.b. and 1.d. of Section I -Supplementary Payments -Coverages A And B. are replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodny Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or •suit" including substantiated loss of earnings up to $500 a day because of time off from work. LC04 430512 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 9 Item 11. Property In Your Care, Custody Or Control A. Paragraphs (3) and (4) of exclusion j. of Section I -Coverage A-Bodny Injury and Property Darn age Liability only apply to: 1. "Property damage" to borrowed equipment, or 2. "Property damage" to property in your care, custody and control while in transit. B. This insurance does not apply to any portion of a loss for which U,e insured has available any otlier valid and collectible insurance, whetlier primary, excess, contingent, or on any other basis, unless such oU,er insurance was sp~cifically purchased by the insured to apply in excess of this policy. C. limits of Insurance Subject to Paragraphs 2., 3., and 5. of Section Ill -Limits Of Insurance, the most we will pay for Insurance provided by Paragraph A., above is: $10,000 Each Occurr.ence limit $25,000 Aggregate Limit · The Each Occurrence Limit for this coverage applies to all damages as a result of any one "occurrence" regardless of the number of persons or organizations who sustain damage because of that "occurrence". The Aggregate Limit is U,e most we will pay for the sum of all damages under this Item 11. Item 12. Mobile Equipment Redefinition The definition of "Mobile Equipment" in Section V -Definitions is amended to Include self.propelled vehicles with permanently attached equipment less than 1000 pounds gross vehicle weight that are primarily designed for: (1) Snow removal; (2) Road Maintenance, but not construction or resurfacing; or (3) Street cleaning. Item 13. Newly Formed Or Acquired Entities Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization. other than a partnership or joint venture, you newly acquire or form and over which you maintain majority ownership or majority interest will qualify as a Named Insured if there is no other similar insuran'ce available to that organization. a. Coverage under this provision is afforded only until: (1) The 180th day after you acquire or.form the organization; (2) Separate coverage is pµrchased for the organization; or (3) The end of the policy period. whichever is earlier. b. Coverage A does not apply to "bodily injury" or "prop·erty damage" that occurred before you acquired or formed the organization; and LC0443 0512 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 9 c. Coverage B does not apply to "personal and advertising Injury• arising out of an offense committed before you acquired or formed the organization. Item 14. Blanket Additional Insured Where Required By Written Contract Paragraph 2. of Section ll -Who Is An Insured is amended to add the following: e. Additional Insured by Written Contract or Written Agreement The following are insureds under the policy when you have agreed in a written contract or written agreement to provide them coverage as additional insureds under your policy: (1) Lessors of Leased Equipment: The person(s) or organization(s) from whom you lease equipment, but only with respect to liability for "bodily injury•, "property damage" or "personal and advertising injury• caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). (2) Managers or Lessors of Premises: Any manager or lessor of premises leased to you in which the written lease agreement obligates you to procure additional insured coverage . The coverage afforded to the additional insured is limited to liability in connection with the ownership, maintenance or use of the premises leased to you and caused, in whole or in part, by some negligent acts or omissions of you, your "employees", your agents or your subcontractors. There is no coverage for the additional insured for liability arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured, except as provided below. If the written agreement obligates you to procure additional insured coverage for the additional insure d's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if the applicable law would allow you to indemnify the additional insured for liability arising out of the additional insured's sole negligence. This insurance does not apply to: (a) Any "occurrence" which takes place after you cease to be a tenant in that premises or to lease that land; or (b) Any premises for which coverage is excluded by endorsement (3) Mortgagees, Assignees or Receivers: Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership. maintenance or use of your premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. (4) Owners, Lessees or Contractors: any person(s) or organization(s) to whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injury•, "property damage· or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of your "employees·, your agents, or your subcontractors, in the performance of your ongoing operations. This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury• arising out of ·your work" included in the "products-completed operations hazard" unless you are required to provide such coverage for the additional insured by the written agreement. and then only for the period of time required by the written agreement and only for liability caused. in whole or in part, by your acts or omissions or the acts or omissions of your "employees·, your agents, or your subcontractors. There is no coverage for the additional insured for liability arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured, except as provided below. LC 04 43 0512 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc .• with · its permission. Page 6 of 9 If the written agreement obligates you to procure additional insured coverage for the additional insured's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if the applicable law would allow you to indemnify the additional insured for liability arising out of the additional insured's sole negligence. This insurance does not apply to "bodily injury•, "property damage• or "personal and advertising injury" arising out of the rendering of, or the fa~ure to render, any professional architectural, engineering or surveying services, including: . (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports. surveys, field orders, change orders or drawings and specifications: or (b) Supervisory, inspection, architectural or engineering activities. (5) Arc:hitec:ts, Engineers or Surveyors: any architect, engineer, or surveyor engaged by you but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury• caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; or (b) In the performance of your ongoing operations. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury• arising out of the rendering of or the failure to render any professional services by or for you, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports , surveys, field orders. change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. (6) Any Person or OrganlzaUon Other Than a Joint Venture: Any person or organization (other than a joint venture of which you are a member) for whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injury", "property damage " or "personal and advertising injury" caused, in whole or in part. by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing op_erations; or (b) In connection with premises owned by you. This insurance does not apply to: 1. Any construction, renovation, demolition or installation operations performed by or on behalf of you, or those operating on your behalf; 2. Any person or organization whose profession. business or occupation is that of an architect, surveyor or engineer with respect to liability arising out of the preparation or approval of maps, drawings, opinions, reports, surveys, change orders. designs, specification or the performance of any other professional services by such person or organization; or 3. Any person or organization more specifically covered in Paragraphs e.(1) through (5) above. The insurance afforded to any person or organization as an insu·red under this Paragraph 2.e .: (1) Applies only to coverage and minimum limits of insurance required by the written agreement or written contract, but in no event exceeds either the scope of coverage or the limits of insurance provided by this policy; LC 04430512 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 9 (2) Does not apply to any person or organization for any "bodily injury•, "property damage " or "personal and advertising injury" if any other additional insured endorsement attached to this policy applies to that person or organization with regard to the "bodny injury ", "property damage" or "personal and advertising injury"; (3) Applies only if the "bodily injury• or "property damage" occurs. or offense giving rise to "personal and advertising injury" is committed. subsequent to the execution of the written agreement; and (4) Applies only if the written agreement is in effect at the time the "bodily injury" or "property damage " occurs , or at the t ime the offense giving rise to the "personal and advertising injury " is committed . Item 15. Blanket Additional Insured -Grantors Of Permits Paragraph 2. of Section II -Vv'ho Is An Insured is amended to add the following : Any state. municipality or political subdivision with respect to any operations perfonn ed by you or on your behalf, or in connection with premises you own, rent or control and to which this insurance applies, for which the state , municipality or political subdivision has issued a permit. However, this insurance does not apply to: 1. "Bodily injury", "property damage " or "personal and advertising injury• arising out of operations performed for the state, municipality or political subdivision ; 2. Any "bodily injury• or "property damage" included within the "products-completed operations hazard", except when required by written contract or agreement initiated prior to loss; or 3. "Bodily injury•, "property damage " or "personal and advertising injury •, unless negligently caused , in whole or in part, by you or those acting on your behalf. Item 16. Waiver Of Right Of Recovery By Written Contract Or Agreement The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery because of payments we make under this policy for injury or damage arising out of your ongoing operations or "your work" included in the "products-completed operations hazard" that we may have against any person or organization with whom you have agreed in a written contract or agreement to waive your rights of recovery but only if the "bodily injury• or "property damage • occurs, or offense giving rise to "personal and advertising injury" is committed subsequent to the execution of the written contract or agreement. Item 17. Other Insurance Amendment If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent. o~ any other basis for any person or organization that qualifies as an additional insured on th is policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV-Conditions will not apply. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV -Conditions will govern. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same "occurrence•, claim or •suit ". Item 18. Contractual Llabflity-Railroads Paragraph 9. of Section V ~ Definitions is replaced by the following: 9. "Insured Contract· means: LC 04 43 0512 © 2012 Liberty Mutual Insurance . All rights reserved . Includes copyrighted material of Insurance Services Office , Inc., with its permission. Page 8 of 9 a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporanly , occupied by you with permission of the owner is not an "insured contract•; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; · e. An elevator maintenance agreemen~ f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that vvould be imposed by law in the absence of any contract_ or agreement. · Paragraph f. does not include that part of ~~y contract or agreement: (1) That indemnifies an arcMect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or faHing to prepare or approve maps, shop drawings. opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or tamng to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured; if an architect. engineer or surveyor, assumes liability for an injury or damage arising out of the insure d's rendering or failing to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engine _ering activities. LC 04 43 OS 12 © 2012 Liberty Mutual Insurance . All rights reserved . Includes copyrighted material of Insurance Services Office, Inc., with its perm_ission. Page 9 of 9 0212014000194000 46 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The following sections modify the insurance provided under the Commercial General Liability Coverage Part Per Project and Per Location Combined Aggregate Limits-With Optional Capped Limits Endorsements Per Project and Per Location Combined Aggregate Lim its Coverage A_ For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences " under Coverage A (Section I), and for all medical expenses caused by accidents under Coverage C (Section I), which can be attributed only to ongoing operations at a single construction project or a single "location": 1. A separate Designated General Aggregate Limit applies to each construction project and to each "location",and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury " or "property damage" included in the "products-completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or 1:. Persons or organizations making claims or bringing "suits". 3 . Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated General Aggregate Limit for that construction project or "location". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated General Aggregate Limit for any other construction project or "location". 4. The limits shown in the Declarations for Each Occurrence , Fire Damage and Medical Expense continue to apply . However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated General Aggregate Limit. B . For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Coverage A (Section l), and for all medical expenses caused by accidents under Coverage C (Section l). Which cannot be at tributed only to ongoing operations at a single construction project or "location": 1 . An y payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available und er the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is appl icable ; and 2 . Such payments shall not reduce any Designated General Aggregate Li mi t . C. When coverage for li ability arising out of the "products-completed operations hazard" is provided, any payments for dam ages because of "bodily injury" or "property damage" included in the "products-completed op eration s hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggreg ate Limi t nor the Designated General Aggregate Limit. L.G 31 78 05 05 Pag e 1 of 2 021201400019400047 D. If the applicable construction project has been abandoned, delayed, or abandoned and then n=started,or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. For the purposes of this endorsement, the Definitions Section is amended by the addition of the following definition : "Location" means any premise that you occupy for permanent operations as part of your business, but does not include any premises at which you are performing operations as part of a construction project . All premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "location". F. The provisions of Limits Of hlsurance (Section Ill) not otherwise modified by this endorsement shall continue to apply as stipulated. PER PROJECT AND PER LOCATION COMBINED AGGREGATE LIMITS-CAPPED LIMITS (X) Jf this box is checked , l he Per Project and Per Location Aggregate limits as provided above in will be capped at $ 15,000,000 A. The Project and Location Aggregate Limit shown here: is the most we will pay for tre sum of all damages caused by "occurrences" under Coverage A (Section l) and all medical expenses caused by accidents under Coverage C (Section I) which can be attributed only to ongoing operations at a single construction project or a single "location", regardless of the number of construction projects, locations, "occurrences" or accidents . B. Each Designated General Aggregate Limit is subject to the Project and Location Aggregate Limit. LG 31 78 0505 Page 2 of 2 POLICY NUMBER : BAP O 173 6 3 9 -0 2 COMMERCIAL AUTO CA2048 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organlzatlon(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form . This endorsement does not alter coverage provided in the Coverage Form . This endorsement changes the policy effective on the incept ion date of the policy unless another date Is Indicated below. Endorsement Effective: . 7 / 1 / 2 0 1 6 Namedinsured: 0 1 Grad Pavin. Inc. Name of Person(s) or Organization(s): SCHEDULE -Any person or organization to whom or which you are required to provide additional Insured status or additional Insured status on a primary, non-contributory basis, in a written contract or written agreement executed prior to loss, except where such contract or agreement is prohibited by law. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule Is an '"Insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insu red" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 2048 02 99 Copyright, Hawaii Insurance Bureau, Inc., 1999 Includes copyrighted material of the Insurance Services Office, Inc ., with its permission Copyright, Insurance Services Office, Inc., 1999 CA 1028 (2-99) Page 1 of1 @ Coverage Extension Endorsement ZURICH ~ Policy No. Eff. Date of Pol. Exp . Date of Pol . Eff. Date of End . Producer No . Add'I. Prem Return Prem . BAP0 17 3639 -02 7/1 /2 016 7/1/2017 7 /1 /20 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II -Covered Autos Liablllty Coverage: The following are also "insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you . Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance-Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment -Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II -Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. Includes copyrighted material of Insurance Services Office , Inc., with its permission . U-CA-424-F CW (04-14) Page 1 of6 C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II -Covered Autos Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section II -Covered Autos Liability Coverage : This exclusion does not apply to covered "autos " participating in a driver safety program event, such as , but not limited to, auto or truck rodeos and other auto or truck agility demonstrations . 2. The following is added to Paragraph 2. in the Exclusions of Section Ill -Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV -Physical Damage Coverage of the Motor Carrier Coverage Form : This exclusion does not apply to covered "autos" participating in a driver safety program event, such as , but not limited to, auto or truck rodeos and other auto or truck agility demonstrations . E. Lease or Loan Gap Coverage The following is added to the Coverage Prov ision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and b. Any: (1) Overdue lease or loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties , credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans . F. Towing and Labor Paragraph A.2. of the Physical Damage Coverage Section is replaced by the following: We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: If glass must be replaced, the deductible shown in the Declarations will apply . However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived . You have the option of having the glass repaired rather than replaced . H. Hired Auto Physical Damage -Increased Loss of Use Expenses The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the following : Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: Includes copyrighted material of Insurance Services Office, Inc ., with its permission . U-CA-42 4-F CW (04-14) Page 2 of6 (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to $750 for "loss" to personal effects which are: (1) Personal property owned by an "insured"; and (2) In or on a covered "auto". b. Subject to Paragraph a. above, the amount to be paid for "loss" to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value . c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value . (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones . (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph B.4.a. of Section Ill -Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.2.c. of Section IV -Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an "insured"; and (b) Are in a covered "auto" at the time of "loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such "loss". Includes copyrighted material of Insurance Services Office , Inc., with Its permission. U-CA-424-F CW (04-14) Page 3 of6 K. Airbag Coverage The Exclusion in Paragraph 8.3.a. of Section Ill -Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 8.4.a. of Section IV -Physical Damage Coverage in the Motor Carrier Coverage Form does not apply to the accidental discharge of an airbag. L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you by us, the following applies for each covered "auto" on a per vehicle basis: 1. If the deductible on this policy or Coverage Form is the smaller ( or smallest) deductible, it will be waived ; or 2. If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller ( or smallest) deductible. M. Physical Damage -Comprehensive Coverage -Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss" from any one cause is $5,000 or the deductible shown in the Declarations, whichever is greater. N. Temporary Substitute Autos -Physical Damage 1. The following is added to Section I -Covered Autos: Temporary Substitute Autos -Physical Damage If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following types of vehicles are also covered "autos" for Physical Damage Coverage : Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto" you do own but is out of service because of its : 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss"; or 5. Destruction. 2. The following is added to the Paragraph A. Coverage Provision of the Physical Damage Coverage Section : Temporary Substitute Autos -Physical Damage We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces . O. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following : a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim , "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member {if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any Includes copyrighted material of Insurance Services Office, Inc., with its permission . U-CA-424-F CW (04-14) Page 4 of6 agent, servant or employee of the "insured" to notify us of any "accident", claim , "suit" or "loss " shall not invalidate the insurance afforded by this policy. Include, as soon as practicable : (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought , written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit"; (2) The "insured's" name and address; and (3) To the extent possible , the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you . P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Cond ition : This Condition does not apply to the extent required of you by a written contract, executed prior to any "acc ident" or "loss ", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos -Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance -Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following : For Hired Auto Physical Damage Coverage , the following are deemed to be covered "autos" you own : (1) Any covered "auto" you lease , hire, rent or borrow; and (2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or elected or appointed official with your permission wh ile being operated with in the course and scope of that "employee 's" employment by you or that elected or appointed official's duties as respect their obl igations to you . However, any "auto" that is leased , hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (2) Make an error, omission , improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not prov ided to us prior to the acceptance of th is policy. S. Hired Auto -World Wide Coverage Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, T. Bodily Injury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following : "Bod ily injury" means bodily injury, sickness or disease, sustained by a person including death or mental angu ish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease . Includes copyrighted material of Insurance Services Office, Inc., with Its perm ission . U-CA-424-F CW (04 -14) Page 5 of 6 U. Expected Or Intended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section II -Covered Auto Liability Coverage is replaced by the following: · · · · Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property . V. Physical Damage -Additional Temporary Transportation Expense Coverage Paragraph A.4.a. of Section Ill -Physical Damage Coverage is replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage . We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section: In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or "auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum of $2500 . The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement. To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of propulsion power. The other source of propulsion power must be electric, hydrogen, propane , solar or natural gas, either compressed or liquefied . To qualify as an "auto" powered by an alternative fuel source, the "auto" must be powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source. X. Return of Stolen Automobile The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section: If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto" to you. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. All other terms, conditions, provisions and exclusions of this policy remain the same. Includes copyrighted material of Insurance Services Office, Inc., with its permission . U-CA-424-F CW (04-14) Page 6 of 6 POLICY NUMBER: BAPOl 73 63 9-02 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following : AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below . Narred Insured: O ' Grady Paving, Inc. Endorsement Effective Date: 7 / 1 / 2 o 16 Name(s) Of Person(s) Or Organization(s): SCHEDULE ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY Information reouired to complete this Schedule if not shown above will be shown in the Declarations . The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc ., 2011 Page 1 of 1 WORKERS' COMPENSATJON AND EMPLOYERS' LIABILITY INSURANCE POLICY we 04 os oe (Ed. 4-B4) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA This endorsement changes the policy to which II is attached effective on the Inception date of the pollcy unless a different date is indicated below. (The following .. ltllchlng clause' need be completed only when thll; endor&ement Is ls&uad suba~uent 1o plflpani~on of lha policy.) This endorsement, effective on PollcyNo .WC 0173640-02 7/1/2016 (OAiE) at 12:01 AM. standard time, forms a part of Endorsement No. of the Zurich American Insurance Co. (NAME OF INSURANCE COMPANY) Issued to , 0 Grady Paving, Inc. Premium (rf any) $ ..,.~ Aulhorfzedepresenlruve we have the right to recover our payments from anyone !fable for an Injury covered by this policy. We wnJ not enforce our right against the person or organization named in the Schedule. (Thls agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us,) You must maintain payroll records accurately segregating the remuneration of your employees while engaged In the work described In the Schedule. The additional premium for this endorsement shall be % of the California workers' compensaUon pre- mium otherwise due on such remunerstlon. Schedule Person or Organization Job Description ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNbER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION WC252(,l--8'l) WC 04 03 06 (Ed . +-8-4) Pege 1 of 1 I City of Cupertino 111iMCto r's Oc rnrnr.f'!t : n Pf(J9-tl7 10300 Torre Avenue C<1penino, CA 95 0 l 4 -32 02 CONTRACT CHANGE Tel ephone :408-77 7-3354, Fa, :408 -777 -3 333 ORDER FORM .w/CIVt Change order I TO: O'Grady Grading and Paving PROJECT: 2017 Pa vement Maintenance Project, City Project No. 2017-1 0 4 Change Requested By: City of Cupertino You are he reby directed to make the herein described changes from the plans a nd specificsLion~ or do the following described work not included In the plans and specificati ons on this contract Item No. Description Unit Quantity Unit Cost Total Cost Add itional 1/2" HMA for Sunrise Digouts 3 (116.55) & Add 0.02 feet to Creekline TN 128 .55 $86.00 $11,055 .30 Drive in mill area (12) 5 Keycut A (Deleted on Creekline Drive) LF -258 $1.75 -$451.50 6 Keycut B (added on Creekline Crive) LF 37 $5 .00 $185.0D 44-CCO 1 2" Cold Plane -Various S treets SF 9500 $1 .00 $9,500.00 45-CCO 1 4 inch Cold Plane for Digou ts on Sunrise SF 4662 $3.00 $13 ,986 .00 Drive 46-CCO 1 Additional Cost for 4" Dii}out Placement SF 4662 $3.25 $15,151 .50 47-CCO 1 3" Cold Plane on Creekllne Drive SF 7500 $2.30 $17 ,250.00 48-CCO 1 Add for Fabric on Creekside Drive SF 7500 $0.50 $3,750.00 49-CCO 1 Delayed Grinding on Moretti due to LS 1 $1,352.00 $1,352 .00 Utility Work Note : See attached spreadsheet for quantity breakdown on each street. this change order total: $60,989.50 Previous Change Order Amount: $ - Total Cost This Change Order: $60 ,989.50 Total Changes To Date Including This Change Order: $60,989 .50 Original Contract Amount: $ 3,352,709.00 Revised Contract A m ount:! $3,413,698 .50 Contract Time Adjustment:! 0 Calendar Da11s We, Ille un<lerslgned Conlractor, ha ve given careful consideration to the change proposed end hereby agree, if this propos al ls approved , that we ,.,;11 provide ali equipment. furnish all materials , except as otherv.ise be noted herein. and perform all se rvi ce s necessary for the work above specifi ed, and will accepl as full payment therefore the p,'~~ein. Note: This Change ~f-is-nst_ejf1 live until' proved by the Town Manager. Accepted, Dite: I/Jo JI, ;?,/~( 117, Contractor: \y:--f:;;;::?l / , TIiie: O'Grady Paving and Grading (lei) If the Conlractor does nor sign a~;ance or this Change Order, his attention is directed lo the requirements of lho specifications as to pro c,iedin g with ordered wor1< an d filing a writte1ylo1 t ,.,;1hin th~)!l"'Jeteln specified . ~ /// ~// 7~h,or1 Recommended By: // ';[:;?t,,v(/.1 ~...._ . , 2017 Date: ~~n 72 · ( Approval Recommended : );4d') , 201 7 ""]_,._ · -~ Date: PJ,011,ct Manager Signalure Approval Recommended : . , 2017 Date : Pub li c Wor1<s Oireclor/City Engineer SignallH'e Approved : ' , 2017 Date: City Man ager Signatu re I City o!Tupertino Inspecto r's Document: CIPF09-07 10300 Torre Avenue Cupertino , CA 950 14-32 02 CONT RACT CHANGE Telephone:408-777-3354 , Fax :408-777-3333 ORDER FORM w/ CM . Change Order#: 2 • TO: O'Grady Paving Inc. ------- PROJECT : 2017 Pavement Maintenance Project, City Project No. 2017-104 Change Requested By: City of Cupertino You are hereby directed to make the herein described changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract: Acici ,iison Avenue-Stern to Caivert, ·v·vuncieriicil-,ii son to aarnilari, anci .Scotianci urive-.Squirewooci ·vvay to i\ingsi:Juiy Item No. Description Unit Quantity Unit Cost Total Cost 1 Traffic Control LS 1 $9 ,440 .33 $9,440 .33 2 Leveling Course -No. 4 Hot Mix Asphalt TN 250 .02 $103.00 $25 ,752.06 3 Hot Mix Asphalt, 1/2" Maximum Type A TN 1062.59 $86 .00 $91,382.31 4 Pavement Fabric SY 8759. ii $1.50 $13,138.67 5 Keycut A LF 5528 $1.75 $9,674 .00 6 Keycut B LF r 300 $5 .00 $1 ,500.00 7 Adjust Survey Monument Cover to EA 11 $300 .00 $3,300 .00 11 Adjust Manhole Covers to Finish Grade EA 7 $450.00 $3 ,1 50.00 14 6" White Lines (Thermo) LF 2 $2.00 $4.00 16 12" White Crosswalk/Limit Line LF 100 $ 3 .20 $320.00 21 StripinQ Detail# 22 (Thermo & Markers) LF 90 $ 2.00 $180.00 50-CCO 2 "Ahead Legend" White (Pre-formed EA 1 $ 500.00 $500 .00 Note: See attached spreadsheet for quantity breakdown on each street. this change orde r total : $158 ,341.37 Previous Change Order Amount: $ 60,989.50 Total Cost This Change Order: $158,341 .37 po wtf -h1 o Total Changes To Date Including This Change Order: $219,330.87 Original Contract Amount: $ 3,352,709 .00 Revised Contract Amount:! $3,572,039 .87 Contract Time Adjustment:! 51Working Da~s We, the undersigned Contractor, have given careful consideration to the change proposed and hereby agree , if this proposal is approved , that we wi ll provide all equipment , furnish all m~s otherwise be noted herein, and perform all services necessary for the wor k above spe cifi ed , and will accept as full payment therefore the · s shown ere in. Note : This Change OJ>"'<"' "9V""ective until pproved by the Town Manager. Accepted, Oat( 9 /3o / d , 2017 , Contractor: O'Grady Paving Inc. '-WY <:.E() By: , Title : If the Contractor does no( sigM,tance of this Change Order, his attention is directed to the requirements of the specifications as to proceeding with ordered wo rk and filing a writte pro st within th ~ therein specified. Recommended~ U/~d-, l'v/~ , 2017 Date: Construction Manager: Approval Recommended : , , 2017 Date: Appm,al Recomm c 2 ;;a£-, /&/~ , 2017 Date: Publ ic Wor~ Director/City Engineer Signature 7 App oved: _____., , , 2017 Date: C~nager Signature <- I Lily ol Luprr lin o lu ~f Jf:-C l N':. Document: (lf'~03·0 7 10 300 Ton-~ .-\v~nu,• Cupe nino, C:\ 950 J<J .J20~ CONTRA CT CHANG E Tdq,hon ~:40 8-777 -33 5·1. Fit\ :40X-777-33 J 3 OR ER FOR M w/ CM Change Order#: 2 TO: O 'Grady Paving Inc . PROJ ECT: 2017 Pavement Maintenance Project, City Project No. 2 017-104 Change R eq uested By: City of Cupertino Yo u are h ereby direc l e d lo mal<e lhe h e rei n described ch a ng es from Jh e plans a nd specification s or do lhe followin g d escribed work no l include d in th e plans a nd s pe ci fi ca tion s on thi s con tract: Add Tilson Avenue-Stern lo Calvert: Wunderlich-Tilson l o Barnhart ; and Scolland Drive -Squirewood Way lo J<i n gsbuly Item No. Description Unit Quantity Unit Cost Total Co s t 1 Traffic Control LS 1 $9,440 .33 $9,440.33 2 Leveling Course -No. 4 Hot Mix Asphalt TN 250.02 $103 .00 $25,752 .0G 3 Hot Mix Asphalt, 1/2" Maximum Type A TN 1062.59 $86 .00 $91,382 .74 4 Pavement Fabric SY 8759 .11 $1 .50 $13,138.67 5 l<eycut A LF 5528 $1.75 $9,674.00 6 l<evcut B LF 300 $5 .00 $1,500.00 7 Adiust Survey Monument Cover to EA 11 $300 .00 $3,300.00 11 Adjust Manhole Covers to Finish Grade EA 7 $450.00 $3,150.00 14 6" While Lines (Thermo) LF 2 $2.00 $4.00 16 12" White Crosswalk/Limit Line LF 100 $ 3.20 $320.00 21 StriplnQ Detail# 22 (Thermo & Markers) LF 90 $ 2 .00 $180.00 50-CCO 2 "Ahead Legend" White (Pre-formed EA 1 $ 500.00 $500.00 Note: See attached spreadsheet for quantity breakdown on each street. this change order total : $158,341.80 Previous Change Order Amount: $ 71,778.30 0-M. 4-3 &,, Total Cost This Change Order : $158,341.80 - Total Changes To Dale Including This Change Order: $230,120 .10 ~yvw Origina l Contract Amount: $ 3,352,709.00 Revised Contract Amount:! $3,582,829.10 Contract Time Adjustment:! 5IWorking Da!,'s We , Iha undersigned Contractor, have gi ve n careful consideration to the change proposed and herebi• agree, if Jhis prop osal is approved , thal we will prov ide all equipmenl. furnish all materials, except as otherwise be noted herein . and perform all services nec essary for !he work abo ve specified . an d will accepl as full payment therefore the prices shown herein . No~e : This Change Order Is not effective until approved by tho Town Manager. Accepted, Date : )I 117 , 2017 , Contractor: O'Grady Paving Inc. By: r vi AAA 11 . 0 ']) , Title: S(U;(11Y~ Jr the Contractor does not sign acceptance of this Change Order, his altenlion is directed to the requ irements of the sp ec ification s as lo proc ee ding wi th ordered work and filing a wrillen protest within the lime therein specified . ----, Recommended By: ,.···· ,, .... :;' /-:'g I November 8 I 2017 {__.,,, :;Vt../9 I < ~: .,/' <,Vv,r.. Date: , Approval Recommended : Z 7.n2 ' //~? , 2017 Date : / Pro jec t Manager Signature 7 Approval Recommended : -~ ' , 2017 ·-_k"(9 Date : ,n/r z c:Ptr!SlTc Wo'71rn"Oirector/Cily Engineer Signature I Approved : . ~~. 2017 Date : City Manager Si gnature . \ :iv-'' '~ ·---- fo iet 1-.~~ I C ily ol C 111H·rlino ln ~r c ctm's oow 11 1e nt : O Pfln.01 10:100 T f'm' :\,·rm,,• Cup ,•11in,,. CA 950 1-1-.\202 CO NTRACT CHANG E Tek phv 11e:-10S-77i-J.15 .1. Fa, :-lll~-7i7-}}_IJ ORDER FOR M w/ CM Change Order l TO: O'Grady Paving Inc. PROJECT : 2017 Pavement Maintenance Project, City Project No . 2017 ·104 Change Requested By: City of Cupertino You are hereby directed to make the herei n described chang es fr om th e pla ns and spec ifi ca tio ns or do th e follow in g described work not in clud ed in th e plans and speci fications on this co nlr act: Item No. Description Unit Quantity Unit Cost Total Cost Additional 1/2" HMA for Sunrise Digouts 3 (116.55) & Add 0 .02 fe et to Cre ekline TN 128.55 $86.00 $11 ,055.30 Drive in mill area ( 12) 5 l<eycut A (Deleted on Creekline Drive) LF -258 $1 .75 -S451 .50 6 Keycut B (added on Creekline Crive) LF 37 $5.00 S185 .00 44 -C CO 1 2" Cold Plane • Various Streets SF 9500 $1.00 S9,500 .00 45 -CCO 1 4 inch Cold Plane for Digouts on Sunrise SF 4662 $3 .00 $13,986 .00 Drive 46-CCO 1 Additional Cost for 4" DiQoul Placement SF 4662 $3.25 $15,151.50 47-CCO 1 3" Cold Plane on Creekline Drive SF 7500 $2 .30 S17,250.00 48-CCO 1 Add for Fabric on Creekside Drive SF 7500 $0 .50 $3,750.00 49-CCO 1 Delayed Grinding on Moretti due to LS 1 $1,352 .00 $1,352 .00 Utility Work Note : See al/ached spreadsheet for quantity breakdown on each street . this change order total: $71,778.30 Previous Change Order Amount: $ . Total Cost This Change Order: $71,778 .30 -~.LVvtY CV\ Total Changes To Date Including This Change Order : $71,778.30 (2.,.(...c) .IJ, I Original Contract Amount : $ 3,352,709.00 ~ i.Jf;/i_ 7.8) Revised Contract Amount:! $3,424,487 .30 M.)L 1i ID. 't·l ftfl> Contract Time Adjustment:! OI Calendar Da'is ;i..-:rl) . ~ • 8 z..,\ We, lhe undersigned Contractor. have given careful considerat ion lo tho change proposed and hereby agreo. if this proposal is approved. that we will 1 • 2 it, provide all equipment. furnish all materi als. except as olhe rwise be nol ed herein , and perlorm all services necessary for lh e work above specif ied. aw.I will accepl as full payment th erefore lho prices shown herein . Nole: This Chango Order Is nol effoctivo until approved by tho Town Man ager. Accepted, Date: l \ / I 'f , 2017, Contractor : O'Grady Paving Inc . By: ~ OJ)\ • .Ii~ ~e,c.;r~ II the Co nlr ac lor do es not sign acceptance of this Cha,ige Order. his allenlion is directed lo the requirements of th e specif1calions as lo proce edin;i will · ordered work and filing a wriUen protest within lhe lime lherein specified . .. -----, Recommended By: / _.,,: ;;(7 // ' November 8 • 2017 : --.:uu/ < 0 ,.r1;z,,1:.. Date: t_/• . - Approval Recommended : ~::?z ' /bl , 2017 Date : "Project (<'lanager Signature I Approval Recommended : ~ ' ·\,\/{ 7 • 2017 ---/ >-J Date: tulllie-'I', orks umrc1or/Cily Engin ee r Sign alu re I Approved : . J A ytµJd-NJ]<; , 2017 Date: Cily Manager Signalure --L.l,~ I . I Lit)· ol Cup~rllno 111 ;p!:c ll11·s D(,(um.:-nt: Ul'F0?-07 103(1() Tor r~ ,\,~nuc Cup,·r1in o. L \ •1 501-1-3202 CO NTRAC CH ANGE T d eph,>ne:-lOS -i77-335-I, Fa:1-:-lllS-iii -3333 OR ER FORM w/ CM Cha nge Order#: 3 T O : O'Grady P aving Inc. P ROJ ECT: 2017 Pave me n t M a inte n a n ce P roject, City P roject No . 2 01 7-104 C h a n ge R e queste d By: C ity of C upertino Yo u are he reby dir ec lecJ lo mak e th e here in des cribed change s from l he pl,ms and spec ificalions or clo l he following described work not includ ed in lh e pl ans and specifica l ions on lhis conlr ac l: Add misce ll aneous work ilems and ext ra wo rk cos ls It e m No. D escription Unit Quantitv Unit Cos t Total Cos t 4 P ave m e nt Fa bric (delete o n Upla nd) SY -5 388 $1 .50 / -$8,082.00 4 3 6 " A C Dike LF -4 25 $15.00 / / -$6,37 5 .00 5 1-CCO 3 8" AC Dike LF 759 $20.00 // $15,180.00 52-CCO 3 3" roll ed AC Dike LF 39 $30 .00 II $1,170.00 53-CCO 3 Provide Tack Truck & SS-1h e muls ion LS 1 $5,657.42 ,~ $5 ,65 7'.4 2 54-CCO 3 Chip P a vement away from Curb LS 1 $4,273 .00 -.~ _ $4 ,273.00 -~IC I ill-. ~ ( C/ D._L,_,f t-u. >J +- Not e: See attac/J ed spreadsheet for quantity breakdown on each street. this change order total : $11,823.42 Previous Change Order Amount: $ 230,120 .10 Total Cost This Change Order: -$11,823.42 .-d-qo .~. ~u Total Changes To D a te Including T his Change Order: $241,943.52 "rVU . -- Original Contract Amount: $ 3 ,352,709.00 Revised Contract Amount :! $3,594,652.52 Contract Time Adjustment:! 0 Working Days We, th e und ersi gn ed Contractor. have gi ve n care ful co nside rati on lo th e ch ange prop ose d and here by agr ee. if lhi s prop osa l is appro ve d, lhal wo l'lill provid e all equipm en t, furn ish all maleri als, excep l as oth erwi se be noted herein, an d pe rform all serv ice s nece ssary for th e wo rk abov e spec ifi ed, and will acc ept as full paym enl the re for e lh e pri ces sho wn herein . Note : This Change Ord er Is not effective until approved by the Town Ma nager . Accepted, Date : 11 / l Lf , 2017 , Contractor: O 'Gr acJy Paving In c. By : ~OJ). , Title : ~U,1' t Tr eo-- If the Cont rac tor does not sign acce ptan ce of thi s Chang e Order . his all entio n is direc ted to th e req uirements of th e spec ifi ca ti ons as to procee din g l'l it h ord ered work and fil ing a written prot esl within lh e tim e !h erein specifi ed .. . ---. Recommended By : (_, . ------;;, /,"::7 4-' Novem be r8 , 2017 _../ ·p[ .. t'(./" < . __ ... 1,i.,,,;l'i_,,,.., Date : Approval Recommended : £22 ' /~h , 2017 D a t e: '76iccl Manage r Signa ture 7 App r ova l Recom m ended : ,-~--. 11/17 , 20 17 ----./1...l. 1--' ~ D at e: ~orks D,reclo r/Cily Engineer Signature ...... u.06-NJ)~ Approved: . ,~~ ,2017 Dat e: City Manager Signature -,.,,,.Ii' ,,,-,,u c>rtS, ~ > ~ 1f" ~;}. DV+. *" f ~J, ~~.~~ 1-i:) g C ily of C upl'rtinn ln ~p~cto,·~ Oocunw nt : CIPf-09 ·07 I 0300 Torr e /wrnu c Cup ertin o, CA 950 1.J -3~[12 CO N RA C CHA NGE T eleph one:-l{IS-777 -335-1, Fa ., :.JO ~-777-,.,33 ORDER FOR M w/ CM Change O rder#: 4 TO: O 'Grady Paving Inc. PROJECT : 2 01 7 Pavement M a inte n ance Project, City Project No. 201 7-·10 4 Change Requested By: City of C upertino You are here by direc ted to mal:e th e herein d es cr ib ed c hang es fr om th e pl ans ancl spe cifica ti ons or do th e foll owing des cribed work not includ ed in th e plan s a nd specifica ti ons on thi s con tr ac t: Ch ange out wa ter v a lve boxes pe r San Jose W ater Item No. D escription Unit Qua ntity Unit Cost Total Cosl 55-CCO 4 Adjust San Jose Water V a lves EA 11 $6 00 .00 $6,60 0 .00 Note : See attached spreadsheet for quantity /Jreakdown on each street. this c hange order total : $6,600 .00 Previous Change Order Amount : $ 241,943 .52 Total Cost This Change Order: $6,600.00 --CVJ4 C'-<--d- Total Changes To Date Including This Change Order: $248,543 .52 Original Contract Amount: $ 3,352,709.00 Revised Contract Amount:! $3,601 ,252 .52 Contract Time Adjustment:! . OIWorking Days We , th e und ersigned Contractor, have given ca reful considerat io n lo th e change proposed and hereby ogree. if this proposal is approved, that we will provide all equipment, furnish all materials. excep t as otherwise be noted herein , and perform all services necessa ry for the wo rk above spec ifi ed, mid will accept as full payment th ere for e the prices shown herein . Note: This Change Order Is not effective until approved by the Town Manager. Accepted, Date: ll/{4-, 2017, Contractor: O'Grady Paving Inc. By : !JJlM-LV J>--, Title: ~e«t1Y~ If lhe Contraclor doe s nol sign acce pl ance of lhis Chang e Orde r, hi s altenlion is direcled lo lhe requiremenls of lh e specifications as lo proceeding with ordered work and filing a written prot es l wil hin th e time th erein specified. Recommended By: , . . .. · .::; .,:-:, ,,.,,;; . November 8 , 2017 (,., ;-£."<P /-:..:. C-::..'~Ar:/V1'. Date: Approval Recommended : 2 ct72-. /~7 , 2017 Date : PJdfccl Manage r Signa lu re ' Approval Recommended : ~ --. ?t/7 , 2017 "'-, Date : P~ Direcl or/Cily Engineer Signalure ~ Approved : . I 2 0 17 Date: Cily Manager Signature \ ' I L.-• ( )( City ot'Cupcrtino h,spett o r's D0runH:.1 1H: CIP F00 -0 7 I 0300 Torre A ve nu e Cup ertino, CA 9501 4-3202 CONTRACT CHANGE Te lephone:408 -777-3 354 , Fax :408 -777 -3333 ORDE R FORM w/ CM Change Order#: 5 TO: O'Grady Paving Inc. PROJECT: 2017 Pavement Maintenance Project, City Project No. 2017-104 Change Requested By: City of Cupertino You are hereby directed to make the herein described changes from lhe plans and specifications or d o th e following described wor k not included in the plans and specifications on this contract: Change out waler valve boxes per San Jos e Waler Item No. Description Unit Quantity Unit Cost Total Cost 2 Leveling Course -No. 4 Hot Mix Asphalt TN -125.2 $103.00 -$12,895.60 3 Hot Mix Asphalt, 1/2" Maximum Type A TN -1843.13 $86.00 -$'158,509 .18 4 Pavement Fabric SY -5949.11 $1.50 -$8,923.66 5 KeycutA LF -3590 $1.75 -$6,282.50 6 Keycut B LF -2537 $5.00 -$1 2,685.00 56-CC05 3" Misc. Cold Plane and Paving at SF 46431 $2.10 Intersections $97,505.10 57-CC05 Additional Traffic Control Intersections LS 1 $10,500.00 $10,500.00 Note : See attached spreadsheet for quantity breakdown on each street. this change order total: -$91,290.85 Previous Change Order Amount: $ 248,543.52 Total Cost This Change Order: -$91 ,290.85 ~ LJ.td-. -~ Total Changes To Date Including This Change Order: $157,252.68 Original Contract Amount: $ 3,352 ,709 .00 Revised Contract Amount:I $3,509,961.68 Contract Time Adjustment:! 0 Working Da:ts We, the undersigned Contractor, have given carefu l cons ideration to the change proposed and hereby agree, if this proposal Is approved, that we will prov id e all equipment, furni sh all materials, excep t as otherw ise be noted herein, and perform all services necessary for the work above specified, and will acce pt as full payment therefore the prices shown herein . Note: This Change Order is not effective until approved by the Town Manager, Accepted, Date : u Ito , 2017 , Contractor: O'Grady Pavi ng Inc. By: ~-·oJ) , Title: oe c::r J-n--e (A_, If the Contractor does not sign acceptance of this Change Order, his attention is di rec ted lo the requirements of the specifications as to proc ee ding with ordered work and filing a wr itten protest wi thin the time therein specified . . ---~ Recommended By: (;~-;;£~£/ k?' dA/L,14 I November 10 I 2017 Date: Approval Recommended: ~uctio/L ' /~/ , 2017 Date: 'pfd)ect Manager Signature I Approval Recommended : ~~ J ti /J z , 2017 r Date: ework~ctor/City Engin ee r Signat ure '~:.2017 Approved : J Date: City Manager Sig nature "---' \'-N-' r " ~ \ . \ V I City of Cuperti110 l nspcdor's nornrn ent: CI PH19 -07 I 0300 Torre A venue Cupertino, CA 95014-3202 CONTRACT CHANGE Telcphone:408-777-3354, Fax :408-777-JJJJ ORDER FORM w/ CM Change Order#: 6 TO : O'Grady Paving Inc. PROJECT: 2017 Pavement Maintenance Project, City Project No. 2017-104 Change Requested By: City of Cupertino You are hereby directed to make the he re in described changes from the plans and specifications or do the followi ng described work not included in the plans and specifications on this contract: Repair AC around high manholes on Black Oak and Sycamore Streets Item No. Description Unit Quantity Unit Cost Total Cost 58-CCO 6 AC Repari at Manholes -Agreed Lump Sum LS 1 $8 ,321 .37 $8,321.37 Note : See attached spreadsheet for quantity breakdown on each street. this change order total: $8,321.37 Previous Change Order Amount: $ 157,252.68 Total Cost This Change Order: $8,321.37 ./ Total Changes To Date Including This Change Order: $165,574.05 Original Contract Amount: $ 3,352,709.00 Revised Contract Amount:! $3,518,283.05 Contract Time Adjustment:! olworking Oats We, !he undersigned Contraclor, have given careful consideration lo the change proposed and hereby agree, if this proposal is approved, Iha! we will provide all equipment, furnish all mate ria ls, except as otherwise be noted here in, and perform all services necessary for the work above specified, and will accept as full payment therefore the prices shown herein. Note: This Change Order Is not effective unt!J..afl)irovea--iciy the Town Manager. Accepted, Dale/r:J-//f-/7 ___/ ~Contractor: O'Grady Pavi ng Inc. By · ( I , Title: ~o . A - Ir the Contractor does not sign aw~nce of this Change Order, his attenlion is direcled to the requirements of the specifications as lo proceeding with ordered work and filing a wrilten protesl within the time therein specified . ----7 Recommended By: c· -;:;;:;;/ « duA/1.,,, ' December 13, , 2017 Date: Con str uction Manager: Approval Recommended : 9o ~-Q ~~ ' L\ I 2-'ff L ",{ Date: ,. Project Manaer Signature I Approval Recommended: ---··---~ ' i/z1/t ~ , 2017 ~\~-Date: Public Worl<s Dire ctor/City Engineer Signature Approved: ' , 2017 Date: City Manager Signalure · I Cit)' or Cup ertin o ln ,;pci:to r's Oocw ne.1\t : CIPF 0 9-0 7 I 0300 Torre Avenue Ct1/1 cr1 i no , CA 9501 <1-3202 CO NTRA CT CHANGE Tc ephon e:•IO S-777-3354, Fax :408-777-3333 ORDER FOR M w/ CM . Cha ng e Order#: 7 TO: O'Grady Paving Inc. PROJECT: 2017 Pavement Maintenance Project, City Project No. 2017 -104 Change Requested By: City of C upertino You are hereby directed to rnal<e th e herein describ ed cha nges fr om th e plans and speci fi ca ti ons or do the fo llowing described work not included in th e plan s and specifications on this co ntract: Pave trench in Co rp oration Yard Item No. Descriotion Unit Quantity Unit Cost Tota l Cost 59-CCO 6 Trench paving at Corp Yard LS 1 $2 ,942 .00 $2,942.00 Nole: See al/ached spreadsheet for quantity breal<down on each street. th is change order total : $2 ,942 .00 Previous Change Order Amount : $ 165,574.05 Total Cost This Change Order: $2,942 .00 ,/ Total Changes To Date Including This Change Order: $168,516.05 Origin al Contract Amount: $ 3,352,709 .00 Revised Contract Amount:! $3,521,225.05 Contract Time Adjustment:! 0 Working Da:is We, th e undersigned Contractor, have given carefu l cons idera tion to the change propo sed and hereby agree , if th is proposal is approved , that we will prov ide all equipment, furnish all materials, except as otherwi se be noted herein , and perfo rm all services necessary for th e work above specified, and will acoept as full paymen t therefore the price s shown here in. Note: This Change Ord~s-not'l!ffeoll,vo until approved by the Town Manager. Accepted, Dat~@'-/$°-r .J_-) , 2017, Contractor: O'G rady Pav ing Inc. By : ,/ j-/ , Title : ClEo If th e Contra ctor does not sign a;;ti;;~ce of th is Change Order, his atte nlion is directed to the requirem ents of the specifications as to proceeding with ordere d work and filing a written p le I within the time the rein specified . ~ ·7 Recommended By : {,, ::.u~,::7 ~ du,. .. . December 19, , 2017 Date : Construction Manager: Approval Recommend e d : 0 /) a~[] n ~ ;("Vl_. ' ::\ 1 '.ks -i 1 < Date : . ~ager Signature Approval Recommended : ' '-f/z7fa:I r J --, 2017 Date: "l"llblic Works Director/City Engineer Signature App r oved : . I 2017 Date : City Manager Signature I City oH.:upcrlino I 0300 Torre A venue Insp ec tor's Document : CIPF09-07 Cupertino, CA 95014-3202 Tclcphone:408-777-3354, Fa" :408-777-3333 CONTRACT CHANGE ORDER FORM w/ CM Change Order#: 8 TO : O'Grady Paving Inc. PROJECT: 2017 Pavement Maintenance Project, City Project No. 2017-104 Change Requested By: City of Cupertino You are hereby directed to make the herein described changes from the plans and specifications or do the following described work not Included in the plans and specifications on this contract: Repair AC around high manholes on Black Oak and Sycamore Streets Item No . Descriotion Unit Quantitv Unit Cost Various See attached spreadsheet for item LS $52,360.00 quantity adjustments Note: See attached spreadsheet for quantity breal<down on each street. this change order total : Previous Change Order Amount: $ 168,516.04 _______ ......; __ _ Total Cost This Change Order: $52,360.00 i/ Total Changes To Date Including This Change Order: $220,876.04 -----------0 rig in a I Contract Amount: $ 3,352,709.00 .---------------. Revised Contract Amount:! $3,573,585.04-f 6 5 Contract Time Adjustment: l.__ ____ o:.iil1.,_W.,_,o=rk=iow..:9:wD=a,,.,y=s Total Cost $52,360 .00 $52,360.00 We, the undersigned Contractor, have given careful consideration to the change proposed and hereby agree, If this proposal Is approved, that we will provide all equ ipment, furnish all materials, except as otherwise be noted herein. and perform all services necessary for the work above specified, and will accept as full payment therefore the prices shown herein. Note: This Change Order Is not effective until approved by the Town Manager. Accepted, Date : '!!J-/ f ~ , 2018 , Contractor: By : ~ 0 )}.,( IJ O 'µ. , Title: O'Grady Paving Inc. If the Contractor does not sign acceptance of this Change Order, his attention Is directed to the requirements of the specifications as to proceeding wilh ordered work and filing a wrilten protest within the time therein specified. Recommended By : Con st ruction Manager: Approval Recommended : <;p a . @(:L /I ~ _ ,J(I, :vi,&<~ in.n._ < Project M nager Sign /mire Approval Recommended : ~r:,'7"'"~--- ~~ifector/City Engineer Signature Approved: City Ma nager Signature . February 16 Date: , 2018 ' I" \« ':J I \ ]') Date : ' y/21,/; t Date: , 2018 ' Date: , 2018 Wt{" I g ~ ~3,fo?.b.77 Contract Change Order No. 8 -Final Quantity Adjustments tjJU UNIT cco 8 ITEM BID ITEM UNIT PRICE NO. Quantity Cost 4 Pavem ent Fabric SY $1.50 -1517 -$2,275.50 6 keycut B LF $5.00 247 $1,235 .00 7 Adjust Survey Monument Cover to Finish Grade EA $300 .00 -36 -$10 ,8 00.00 9 Lower Manhole Covers Prior to Cold Planing EA $300 .00 3 $900.00 10 Lower Cleanout I Water I Gas Valve Cover Pri or to Cold Planin g EA $200.00 57 $11,400.00 11 Adjust Manhole Covers to Finish Grade EA $450 .00 32 $14,400 .00 12 Adjust Cleanout /Water/ Gas Valve Cover to Finish Grade EA $300.00 108 $32,400.00 13 Install Blue RPM's @ Fire Hydrant EA $16 .00 39 $624.00 14 6" White Lines (Thermo) LF $2.00 178 $356.00 16 12" White Crosswalk/Limit Line (Th ermo) LF $3 .2 0 102 $326.40 17 12" Yellow Crosswalk (Thermo) LF $3 .30 182 $600 .60 18 24" White (Thermo) LF $6 .50 262 $1,703 .00 19 24" Yellow (Thermo) LF $6.50 199 $1,293.50 20 Striping Detai l # 10 (Markers) LF $1.00 -1,060 -$1,060.00 21 Striping Detail# 22 (Thermo & Markers) LF $2 .00 -804 -$1,608 .00 22 Striping Detail # 27B (Thermo) LF $1.00 -552 -$552.00 23 Striping Detail 27B Modified 4'seg with 6' gap) thermo LF $2 .00 56 $112.00 24 Striping Detail# 39 (Thermo) LF $2 .00 -540 -$1,080.00 25 Striping Detail# 39A (Thermo) LF $2.00 -300 -$600.00 26 "Ahead Legend" Yellow (Pre-formed thermo) EA $500.00 -1 -$500 .00 27 "STOP" Legend (Pre-formed Thermo) EA $440.00 13 $5,720.00 28 "SLOW" Legend (Pre-formed Thermo) EA $450.00 2 $900 .00 -29 --"-SGH881:.-"-l:cegend (Pre•formed-T'hermo)----EA--$650:00------2----$1,300:00 30 "XING" Legned (Pre-formed Thermo) EA $450.00 2 $900 .00 31 "25" Legend (Pre-formed Thermo) EA $220.00 1 $220.00 33 "BUMP" Legend (Pre-formed Thermo) EA $450.00 2 $900.00 34 Green Bike Lane (P re-formed Thermo) SF $9 .00 730 $6,570.00 35 Bike Rider Symbol (Pre-formed white on green) EA $400.00 2 $800 .00 36 Bike Rider Arrow (Pre-Formed white on green) EA $400.00 1 $400.00 37 Bike Detection Symbol (Pre-formed white on green EA $300.00 -1 -$300 .00 38 Arrow Type IV (Pre-formed Thermo) EA $220.00 -1 -$220 .00 39 Sharrows (Pre-formed MUTCD figure 9C-9) EA $220.00 2 $440 .00 40 Replace Traffic Signal Loops EA $1,600.00 1 $1,600.00 41 Remove/Install Speed Bump (City detail 17-A) EA $10,000.00 -1 -$10,000.00 43 6" AC Dike LF $15.00 9 $135.00 44-CCO 1 2" Cold Plane -Various Streets (CCO 1) SF $1.00 6,500 $6,500.00 45-CCO 1 4" Cold Plane for Digouts on Sunrise Dr (CCO 1) SF $3 .00 -72 -$216.00 46-CCOl Additional Cost for 4" Digout Placement (CCO 1) SF $3.25 -72 -$234.00 47-CCOl 3" Cold Plan e on Creekline Dr (CCO 1) SF $2.30 400 $920.00 48-CCOl Add Fabric on Creekside Dr (CCO 1) SF $0.50 -7,500 -$3,750.00 50-CC02 "Ahead Leg end" White (Pre-formed Thermo) (CCO 2) EA $500.00 -1 -$500.00 55-CC04 Adjust San Jose Water Valves EA $600.00 -11 -$6,600.00 Total Contract Change Order No. 8 $52,360.00