The URL can be used to link to this page

17-027 JJR Construction Inc., Sidewalk Renovation - Stevens Creek Boulevard, Project No. 2017-21RECORDING REQUESTED BY City of Cupertino WHEN RECORDED MAIL TO City Clerk's Office City of Cupertino 10300 Torre A venue Cupertino, CA 95014-3255 NO FEE IN ACCORDANCE WITH GOV. CODE 27283 23639827 Regina Alcomendras Santa Clara County -Clerk-Recorder 05/03/2017 02:34 PM Till es: 1 Fees : $0 .00 Taxes: $0 Total : $0.00 Pages: 3 1111 ~,1~ .. ~11']H~·,,~-v.1,, ,I, N ~ ~,~,~·~j \1 •1!11:,,'i'~~1~1'i~1~ ,t,,,J, 11111 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NOTICE OF COMPLETION CITY PROJECT NAME: SIDEWALK RENOVATIONS -STEVENS CREEK BLVD. (CITY PROJECT NO. 2017-21) l!J"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, Cal ifornia . 3 . Owner's address is : City Hall , 10300 Torre Ave ., Cupertino , CA 95014 . 4. The nature of owner's interest in the project is : l Fee Ownership Lessee Other: __________ _ 5 . Construction work on the project performed on the owner's behalf is generally described as follows : City Project Name: Sidewalk Renovations-Stevens Creek Blvd (City Project No .: 2017-21) Removal and disposal of existing pavers and installation of appro x imately 1600 lineal feet of concrete walkway. 6 . The name of the original contractor for the project is : JJR Construction Inc . 7. The project was completed on : April 25 , 2017 . 8 . The project is lo ca ted at: St evens Creek Boulevard between Stelling and De An za . 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 and correct. April 26, 2017; Santa Clara County Date and Place ~ Signature --=-- Timm Borden Director of Public Works and City En gi neer++ "NO FEE" City of Cupertino NOTICE OF COMPLETION is hereby given in order to comply with the provisions of Section 27283 of the Government Code. This is to certify that the Notice of Completion dated April 26, 2017 for CITY PROJECT NAME: SIDEWALK RENOVATIONS -STEVENS CREEK BL VD. (CITY PROJECT NO. 2017-21) and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on April 25, 2017 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: May 3, 2017 ~µ Grace Schmidt City Clerk Project No . 2017-21 DOCUMENT 00650 AGREEMENT AND RELEASE OF ANY AND ALL CLAIMS SIDEWALK RENOVATION-STEVENS CREEK BOULEVARD PROJECT NUMBER 2017-21 THIS AGREEMENT AND RELEASE OF ANY AND ALL CLAIMS ("Agreement and Release"), made and entered into this 5th day of May, 2017, by and between the City of Cupertino ("City"), and JJR Construction, Inc. ("Contractor"), whose place of business is at 1120 Ninth Avenue, San Mateo, CA 94402. RECITALS A. City and Contractor entered into Contract Number 2017-7 (the "Contract"). B. The Work under the Contract has been completed. Now, therefore, it is mutually agreed between City and Contractor as follows: AGREEMENT 1. Contractor will not be assessed liquidated damages except as detailed below: 2. 3. Original Contract Sum Modified Contract Sum Payment to Date Liquidated Damages Payment Due Contractor $179,795.00 $172,091.70 $ 163,487.12 $0 $8,604.59 Subject to the provisions of this Agreement and Release, City will forthwith pay to Contractor the sum of Eight Thousand, Six Hundred and Four Dollars and Fifty-Nine Cents ($8,604.59) under the Contract, less any amounts withheld under the Contract or represented by any Notice to Withhold Funds on file with City as of the date of such payment. Contractor acknowledges and hereby agrees that there are no unresolved or outstanding claims in dispute against Ci!Y arising from the Contract, except for the claims_des_cnbe_d_in_paragrapb_4_of.thisJ)ocument-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 Cupertino), inspectors, representatives, assignees and transferees except for the Disputed Claims set forth in paragraph 4 of this Document 00650. Nothing in thjs Agreement and Release shall limit or modify Contractor's continuing obligations described in paragraph 6 of this Document 00650. City of Cupertino 00650 -I Agreement and Release of Any and All Claims Sidewalk Renovation-Steven s Creek Blvd Project No . 2017-21 4. The following claims are disputed (hereinafter, the "Disputed Claims") and are specifically excluded from the operation of this Agreement and Release: Claim No. Date Submitted Descri ption of Claim None Amount of Claim 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, anq 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 waives 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, ruling, or regulation, then such provision, or part 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 termination of the Contract, and execution of this Agreement and Release. City of Cupertino 00650 - 2 Agreement and Release of Any and All Claims Sidewalk Renovation-Stevens Creek Blvd Proj ect No. 2017-21 * * * CAUTION: nns IS A RELEASE -READ BEFORE E XECUTING * * * THE CITY OF CUPERTINO, a Municipal Corporation of the State of California ATTEST: ~ 6o_ G / 'JJ---City Clerk ) ---/ J -; 1 JJR CONSTRUCTION, INC. By:-------------- Name: _____________ _ Its : ______________ _ REVIEWED AS TO FORM: City Attorney ____ s_·_\ __ 9_\~ .. 20 \~ END OF DOCUMENT City of Cupertino 0 0650 -3 Agreement and Release of Any and All Claims Si dewalk Renovation-Stevens Creek Blvd I' Project No. 2017-21 DOCUMENT 00520 C cM-fl t>-c)-E¾-~ l '.'.t--1- ();) ~,Z.0 1 '1 -'(~ 1-- CONTRACT THIS CONTRACT, dated this 1,,1,--day of ~ , 20 l3::_, by and between JJR CONSTRUCTION, INC. whose place of business is located at 1120 Ninth Avenue, San Mateo, CA 94402 ("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 23rd day of February, 2017 awarded to Contractor the following Project: PROJECT NUMBER 2017-21 SIDEWALK RENOVATION-STEVENS CREEK BOULEVARD NOW, THEREFORE, in consideration of the mutual covenants hereinafter set forth, Contractor and City agree as follows: Article 1. Work I. I Contractor shall complete all Work spec ified in the Co ntract Documents, in accordance with the Specifications, Drawings, and all other terms and conditions of the Contract Documents. Article 2. Agency and N otices to City 2.1 C ity ha s designated John Raaymakers to ac t as City's Authorized Representative, who will represent City in performing C ity 's duties and responsibilities and exercising City 's rights and authorities in Co ntract Documents. City may change th e individual(s) acting as C ity 's Authorized Representative(s), or delegate one or more specific functi o ns to one or more specific Ci ty's Repre se nt at ives, including without limitation engineering, architectural , inspection and general ad mini strative functions , at any time with notice and without liability to Contractor. Each City's Representative is the beneficiary of al l Contractor obligations to C it y, including without limitation , all releases and indemnities. 2.2 City has des ignated HMH Engineers, Inc. as the Design Consultant. City ma y change the identity of the Design Consultant at any time with notice and without liability to Contractor. 2.3 All notices or demands to City under the Contract Documents shall be to City's Authorized Representative at: 10300 Torre Avenue, Cupertino, California 95014 or to such other person(s) and address(es) as City shall provide to Con tractor. Article 3. Contract Time and Liquidated Damages 3.1 Contract Time. The Contract Time will commence to run on th e date indicated in the Notice to Proceed. City may give a Notice to Proceed at any tim e within 30 Days after the Notice of Award. Contractor shall not do any Work at the Site prior to the date on which th e Contract Time commences to run. Contractor s hall achieve Final Completion of the e ntire Work and be ready for Final Payment in accordance with Section 00700 (General Co ndition s) by 55 calendar days following the effective date of the Notice to Proceed. City of Cupert in o 00520 -I Co nt ract Sidewalk Renovation-Stevens Creek Blvd 3 .2 Project No. 20 I 7-21 Liquidated Damages. City and Contractor recognize that time is of the essence of this Contract and that City will suffer financial loss in the form of contract administration expenses (such as project management and consultant expenses), if all or any part of the Work is not completed within the times specified above, plus any extensions thereof allowed in accordance with the Contract Documents. Consistent with Document 00700 (General Conditions), Contractor and City agree that because of the nature of the Project , it would be impractical or extremely difficult to fix the amount of actual damages incurred by City because of a delay in completion of all or any part of the Work. Accordingly, City and Contractor agree that as liquidated damages for delay Contractor shall pay City: 3 .2 .1 $2,000 for each Calendar Day that expires after the time specified herein for Co ntractor to achieve Final Completion of the entire Work as specified above. 3 .2.2 $3,000 for each occurrence of a violation of Document 00800 , Section 1.7 WORK DAYS AND HOURS. 3.2.3 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 Contractor 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 s uffered by City res ulting from delay in completion of the Work. Co ntractor s hould be aware that California Department of Fish and Game, a nd other State and Federal agencies, may also levy fines and penalties for the harming, harassing or killing of protected wildlife and endangered species . Contractor hereby agrees to become familiar with and adhere to wildlife and endangered species protection requirements. 3.3 Liquida ted damages for delay sha ll only cover administrative, overhead, interest on bonds, and general lo ss of public use damages s uffered 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 re presentations and warranties: 5.1 Contractor has visited the Site and has examined thoroughly and understood the nature and extent of the Contract Documents, Work, Site, locality, actual conditions, as-built conditions, and all local conditions, and federal , state and local laws and regulations that in any manner may affect cost, progress, performance or furnishing of Work or which relate to any aspect of the means, methods, techniques, sequences or procedures of construction to be employed by Contractor and safety precautions and program s incident thereto. 5.2 Contractor has examined thoroughly and understood all reports of exploration and tests of subsurface conditions, as-built drawings, drawings, products specifications or reports, available for Bidding purposes, of physical conditions, including Underground Facilities, which are identified in Document 00320 (Geotechnical Data, Hazardous Materials Surveys and Existing Conditions), or which ma y appear in the Drawings. Contractor accepts the determination set forth in the se Documents and Document 00700 (General Conditions) of the City of Cupertino 00520 - 2 Contract Sidewalk Renovation-Stev ens Creek Blvd Project No. 2017-21 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 sha ll not rely on any other information contained in such reports and drawings. 5 .3 Contractor has conducted or obtained and has understood al l such examinations, investigations, explorations, tests , reports and studies (in addition to or to supplement those referred to in Section 5.2 of this Document 00520) that pertain to the subsurface conditions, as-built conditions, underground facilities, and all other physical conditions at or contiguous to the Site or otherwise that may affect the cost, progress, performance or furnishing of Work, as Contractor considers necessary for the performance or furnishing of Work at the Contract Sum, within the Contract Time and in accordance with the other terms and conditions of the Contract Documents, including specifically the provisions of Document 00700 (General Conditions); and no additional examinations, investigations, exp lorations, 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 al l such observations, examinations, investigations, explorations , tests , reports and studies with the terms and conditions of the Contract Documents. 5.5 Contractor has given City prompt written notice of all conflicts, errors, ambiguities, or discrepancies that it has discovered in or among the Contract Documents and as-built drawings and actual conditions and the written resolution thereof through Addenda issued by City is acceptable to Contractor . 5 .6 Contractor is duly organized, existing and in good standing under applicable state law, and is duly qualified to conduct business in the State of California. 5. 7 Contractor ha s duly authorized the execution, delivery and performance of this Contract , the other Contract Documents and the Work to be performed herein . The Contract Documents do not violate or create a default under a ny instrument, contract, order or decree binding on Contractor. 5.8 Contractor has list ed Subcontractors pursuant to the Subcontractor Listing Law, California Public Contra ct ing Code §4 100 et seq . in document 00430 (Subcontractors List) Article 6. Contract Documents 6.1 Contract Documents consist of the following documents, including all changes, addenda, and modifications thereto : C ity of C up e rtin o Document 00400 Bid Form Document 00430 Subcontractors List Document 00450 Statement of Qualifications Document 00481 Non-Collusion Affidavit Document 00482 Bidder Certifications Document 00510 Notice of Award Document 00520 Contract Document 00530 Insurance Forms Document 00550 Notice to Proceed Document 00610 Construction Performance Bond Document 00620 Construction Labor and Material Payment Bond Document 00630 Guaranty Document 00650 Agreement and Release of Any and All Claims Document 00660 Substitution Request Form Document 00680 Escrow Agreement for Security Deposit in Lieu of Retention Document 00700 General Conditions Document 00800 Special Conditions Document 00820 Special Environmental Conditions Document 00821 Insurance Document 00822 Apprenticeship Program Technical Specification/Special Provisions 00520 -3 Sidewalk Renovation-Stevens Creek Blvd Co ntract Addenda(s) Drawings/Plans Project No. 2017-21 6 .2 There are no Contract Documents other than those listed in this Document 00520 , Article 6. Document 00320 (Geotechnical Data, Hazardous Material Surveys and Existing Conditions), and the informati on supp li ed therein, are not Contract Documents. The Contract Documents may only be amended , modified or supplemented as provided in Document 00700 (General Conditions). Article 7. Miscellaneous 7.1 Terms used in this Contract are defined in Document 00700 (General Conditions) and w ill 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 emplo yee, agent, or representative of C ity , 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 supp ly goods , services or materials pursuant to a public works contract, Contractor or Subcontractor offers and agrees to assign to the awarding body all rights, title and interest in and to all causes of action it may have under Section 4 of the Clayton Act (I 5 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), ari s ing 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 fu11her acknowledgment by the parties. 7.6 Copies of the general prevailing rates of per diem wages for each craft, classification, or type of worker needed to execute the Contract, as determined by Director of the State of California Department of Industrial Relations, are deemed included in the Contract Documents and on tile at City's office, or may be obtained of the State of Californi a web sit e http ://www.dir.ca.gov/DLSR/PWD/Northern.html and shal l be made ava il ab le 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 emp lo yer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that Code, and Contractor shall comply with such provisions before commencing the performance of the Work of the Contract Documents. 7. 7 Should any part, term or provision of this Contract or any of the Contract Documents, or any document required herein or therein to be executed or delivered, be declared invalid, void or unenforceable, all remaining parts, terms and provisions shall remain in full force and effect and shall in no way be invalidated , impaired or affected thereby . If the provisions of any la w causing such invalidity, illegality or unenforceability may be waived, they are hereby waived to the end that this Contract and the Contract Documents may be deemed valid and binding contracts, enforceable in accordance with their terms to the greatest extent permitted by applicable law. In the event any provision not otherwise in cluded 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 City of Cupertino 00520 -4 Contract Sidewa lk Renovation-Stevens Creek B lvd Proj ect No. 2017-21 waive their rights under California Code of Civil Procedure Section 394 to file a motion to transfer any action or proceeding ari s ing out of the Co ntract Documents to another venue . Contractor accepts th e C laim s Procedure in Document 00 700 , Article I 2, established und er the California Government Code, Title I , Division 3.6 , Part 3, C hapter 5. C ity of C up ertin o 00520 -5 Co nt rac t S id ewalk Ren ovati o n-Stevens C reek Blvd Project No. 20 I 7-21 IN WITNESS WHEREOF the parties have executed this Contract in quadruplicate the day and year first above written. SIDEWALK RENOVATION-STEVENS CREEK BOULEY ARD CITY: CITY OF CUPERTINO, a Municipal Corporation of the State of California Attest: 6~ City Clerk: Grace Schmidt Approved as to form by City Attorney: di &l1 ~ City Attorney: Randolph Stevenson Hom I hereby certify, under penalty of perjury, that David Brandt, City Manager of the City of C upertino was duly authorized to execute this document on behalf of the City of Cupertino. vid Brandt, City Manager of the City of Cupertino, a Municipal Corporation of the State of California Designated Representative: Name: Timm Borden Title: Director of Public Works Address: 10300 Torre Ave., Cupertino , CA 95014 Phone:408-777-3354 Facsimile: 408-777-3333 AMOUNT: $ 179 ,7 95.00 ACCOUNT NUMBER:270-99-046-ST O 15-03-01 ~~ .(),t)/1; CONTRACTOR: JJR CONSTRUCTION, INC. By : ~ £f,IOt,<{)~ [Signature] [Please print name here] Title: J},.,.r,·clu:, 7 [If Corporation: Chairman , President , or Vice Pres ident] Title: ~Crt-T:.9"fv /4~ AJ'Pre [If Corporation: Secretry, 'Ass istant Secretary, Chief Financial Officer, or Assistant Treasurer] A · State Contractor's License No. Classification ~//49 Expiration~el' TaxpayerIDNo. ~'5/.7//Y.2 Name: ~~ ... ~c-..,'<'...,?,..~ ... """"'..c_.~~~=..,e::...!!!'J<....,,'l!J"'--------- Title: __.A'-'-~=---J..,_,·.-.J=:L------------ Address: 1/..U, /n m A,,-,~% k~Te~ 9YY~2. Phone: l.t,,S~~/,/tJ,9 Facsimile : ~ SO i5 '/3 6o2 0 .Z NOT ARY ACKNOLEDGEMENT IS REQUIRED. IF A CORPORATION, CORPORATE SEAL AND CORPORATE NOTARY ACKNOWLEDEMENT AND FEDERAL TAX ID ARE REQUIRED. IF NOT A CORPORATION SOCIAL SECURITY '0. IS REQUIRED END OF DO CUMENT C ity of Cupertino 00520 -6 Co ntract Sidewalk Renovation-Stevens Creek Blvd 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 Califo,,\nia , ib-1'is1l ) County ot..Sf-tf{.) Mn' Lbu' ) On O ~G-i !;_-:; before me, Alex;is Gar~ota . Romanl Notary.,Pub!ic oJte ' Here lnseJ1 Name and Title of the Officer personally appeared CARLOS RAPQSQ i N~me(s)!M Signer(sf' who proved to_ me on 'the basis of satisfactory evidence to be the person(s('whose name is/ar€ subscribed to the within instrument and acknowledged to me that he/sh~th~ executed the same in his/her/tr¢fr authorized capacity(i~. and that by his/hrfthei,signature(s}"b,n the instrument the perso~. or the entity upon behalf of whicH the person(~ 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 ~::~ru. . · Signature~~"'----+-~_,___,'---------- Signature of Notary Public =====~==========oPTIONAl====e=e==========~ Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document, iDescriptioro of Aiitaicheol Document Title or Type of Document: _____________ Document Date: _______ _ Number of Pages: ___ Signer(s) other Than Named Above: ____________ _ <Caipacii:lf{oes) craomed foy Si~~er{s) Signer's Name: ____________ _ Signer's Name: ____________ _ D Corporate Officer -Titl e(s): ______ _ D Corporate Officer -Title(s): ______ _ D Partner -D Limited D General LJ Partner -O Limited O General O Individual D Attorney in °fact D Trustee D Guardian or Conservator D I'ndividua! D Attorney in Fact D Trustee D Guardian or Conservator D other: ______________ _ D Other: _____________ _ Signer Is Representing: _________ _ Signer Is Representing: _________ _ &~"?¥o~~"§G~~~'%~~~~'W<.~~~~~~y.<g,~'§'()~~~W,o.~s~~ ©2014 Nat ional Notary Association • www .NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 EXHIBIT A Contractor's Name: :r:::r(l ~t(tJC fl01(\ ~ DOCUMENT 00400 BID FORM Project No.2017-21 To be submitted as part of Envelope "A" by the time and date specified in Document 00200 (Instructions to Bidders). TO THE HONORABLE CITY COUNCIL OF THE CITY OF CUPERTINO THIS BID IS SUBMITTED BY: J" ·J:, 1(. LonsTfu C.T 10,,, I ~ l-· (Firm/Company Name) Re: PROJECT NUMBER 2017-21 Sidewalk Renovation-Stevens Creek Boulevard I . The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into a contract with the City of Cupertino ("City'') in the form included in the Contract Documents, Document 00520 (Contract), to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Sum and within the Contract Time indicated in this Bid and in accordance with al I other terms and conditions of the Contract Documents. All portions of this Bid Form must be completed and signed before the bid is submitted. Failure to do so will result in the bid being rejected as non-responsive. 2. Bidder accepts al l of the terms and conditions of the Contract Documents, Document 00100 (Advertisement for Bid s), and Document 00200 (Instructions to Bidders), including, without limitation, those dealing with the disposition of Bid Security . This Bid will remain subject to acceptance for 90 Days after the day of Bid opening. 3. 4. 5. 6. 7. 8. 9. Bidder has visited the Site and performed all tasks, research, investigation, reviews, examinations, and analysis and given notices, regarding the Project and the Site, as set forth in Document 00520 (Contract), Article 5. Bidder has given City prompt written notice of all conflicts, errors, ambiguiti es, or discrepancies that it has discovered in or among the Contract Documents and as-built drawings and actual conditions and the written resolution thereof through Addenda issued by City is acceptable to Con tractor. Bidder attended the non-mandatory Pre-Bid Meeting. / YES NO Subcontractors for work included in all Bid items, in accordance with the criteria in the Public Contract Code, are listed on the attached Document 00430 (Subcontractors List). The undersigned Bidder und erstands that City reserves the right to reject this Bid. If written notice of the acceptance of this Bid, hereinafter referred to as Notice of A ward, is mailed or delivered to the undersigned Bidder within the time described in paragraph 2 of this Document 00400 or at any other time thereafter before it is withdrawn, the undersigned Bidder will execute and deliver the documents required by Document 00200 (Instructions to Bidders) within the times specified therein. These documents include, but are not limited to , Document 00520 (Contract), Document 00610 (Construction Performance Bond), and Document 00620 (Constmction Labor and Material Payment Bond). Notice of Award or request for additional information may be addressed to the undersigned Bidder at the address set forth below on the signature page. City of Cupertino Bid Form Sidewalk Renovation-Stevens Creek Blvd 00400 -I EXHIBIT A Contractor's Name: J~R. Cm~Truc.r' O'Y) I ;D,c.. Project No.2017-21 10. The undersigned Bidder herewith encloses cash, a cashier's check, or certified check of or on a responsible bank in the United States, or a corporate surety bond furnished by a surety authorized to do a surety business in the State of California, in form specified in Document 00200 (Instructions to Bidders), in the amount of ten percent (10%) of the total of Base Bid and made payable to the "City of Cupertino". 11. The undersigned Bidder agrees to commence Work under the Contract Documents on the date established in Document 00700 (General Conditions) and to comp lete all work within the time specified in Document 00520 (Contract). The undersigned Bidder acknowledges that City has reserved the right to delay or modify the commencement date . The undersigned Bidder further acknowledges City has reserved the right to perform independent work at the Site, the extent of such work may not be determined until after the opening of the Bids, and that the undersigned Bidder will be required to cooperate with such other work in accordance with the requirements of the Contract Documents . 12. The undersigned Bidder agrees that, in accordance with Document 00700 (General Conditions), liquidated damages for failure to complete all Work in the Contract within the time specified in Document 00520 (Contract) shall be as set forth in Document 00520 (Contract). City of Cupertino Bid Form Si dewalk Renovation -Stevens Creek Blvd 00400 • 2 EXHIBIT A Contractor's Name: ,I, J, I< L,CIY)51YUCTI C1}'.) I :!ht Project No.2017-21 SCHEDULE OF BID PRICES All Bid items, including lump sums and unit prices, must be filled in completely. Quote in figures only, unless words are specifically requested. ITEM SPEC DESCRIPTION UNIT EST UNIT TOTAL REF QTY PRICE 1 General TRAFFIC CONTROL AND LS 1 !I. 10,oo0.~ ijio ()0 Conditions 6.9 CONSTRUCTION AREA SIGNS ,()()().- 2 Cupertino Std. TREE PROTECTION LS 1 & 1,.,,nJr1. •.! 4, °klN'X.1 .o Detail 6-4 ' ...... 3 Plan Sheet TEMPORARY WATER POLLUTION LS 1 ''°o.o~ 'SGo-~ EC01 CONTROL 4 Caltrans 15-REMOVE CURB LF 2 "('o -~ 6 loo.~ 1.038 5 REMOVE AND DISPOSE OF SF 8,100 1!::5° ·~,.~~~ EXISTING PAVERS 6 Sheet DT01- I Vt,, o_!., • ; 1 f,()().bjl) Detail A REMOVE AND RESET EXISITNG SF 2,350 Caltrans 26-PAVERS I 1.02B 7 Sheet DT01 -INSTALL PAVER SLOPE REPAIR LF 60 ~ -i,. o_g ~ l.~io. ~ Detail B 8 Plan General CONSTRUCT SIDEWALK SF 8,300 ,7.1.£ -t;/{ ; 2,S-,ji. Note 10 9 TOPSOIL CY 1 ' ?,/)() • ..: "'U>o. ~ 10 Caltrans 15-REMOVE EXISTING CONCRETE SF 400 .. 'f. {e 1~.~.~ 1.038 DRIVEWAY AND SIDEWALK 11 Cupertino Std . INSTALL CITY OF CUPERTINO SF 250 '\1...~ ·~(01<. ~ Detail 1-20 STANDARD DRIVEWAY TOTAL BID I ~\1"lr7Cf~~ Total bid in words DIA'(, \A""" cla .. ,J. ~~1 MIii(., ~"',v~-cl. 4Jev~ ~"'""'J;~J Unit Legend LS= Lump Sum EA= Each LF = Linear Feet TON = Ton or 2,000 Pounds CY = Cubic Yards LB::; Pounds City of Cupertino Sidewalk Renovation-Stevens Creek Blvd n,l..,.~'J f',·v, +i,"'~cl 4 w, c~. AL = Allowance SF = Square Feet 00400 -3 Bid Fonn EXHIBIT A Contractor's Name : J • J"' 12 · (Ol'\ST t" lJ ( T1 l1'h I Ji,{· Project No.2017-21 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUMS Bidder herby acknowledges receipt and examination of all Contract Documents and the following Addenda: Addendum No. Addendum Date g5 r Bidder proposes and agrees to fully perform the Work within the time stated and in strict accordance with the Contract Documents for the sums of money listed in this Bid Form. NAME oF BIDDER: JJR co:nsrrucr,cm , Tht. Licensed in accordance with an act for the registration of Contractors, and with license number: lo'2.5',4S Expiration Date: 3/3 I /l 1 . DIR Registration No.: 1tOOOQO ':I l 18:'. ' I A Where incorporated, if applicable I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. ~ ~ ~ p')e/' Signature of Bidder NOTE: If Bidder is a c01poration, set forth the legal name of the cmporation, state where incorporated, together with the signature of the officer or officers authorized to sign contracts on behalf of the corporation. If Bidder is a partnership, set forth the name of the firm together with the signature of the partner or partners authorized to sign contracts on behalf of the p artnership. Business Address: ;('JR, &,,,,srr(,IC.7/011, ..Ll1 l • //J.O /,/,-,,-,,, Aa, ' Officers authorized to sign co ntracts: Telephone Number(.s): Typed Full Name: '150d~36/t:J9 :, Fax Number(s): E-Mail Address: END OF DOCUMENT City of Cupertino Bid Form Sidewalk Renovation -Stevens Creek Blvd 00400 -4 EX ECUTED IN DUPLICATE Bond No. 1603042 Premium: $2877.00 Project No. 2017-21 DOCUMENT 00610 CONSTRUCTION PERFORM.ANCE BOND THIS CONSTRUCTION PERFORMANCE BOND ("Bond") is dated ~e?r.u ary 2~,~?l ?, is in the penal sum of One hundred seven tr nine. thousand,s eve n hund r edninety five d ollars andN0/100 _($179,795.002 ___ _ ....... ··········-------······· ···-----··· ···········-····-------·--··· [which is one hundred percent of the Contract Price], and is entered into by and between the parties listed below to ensure the faithfu l performance of the Construction Contract listed below. This Bond consists of this page and the Bond Terms and Conditions, paragraphs 1 through 12 , attached to this page. Any singular reforence to _J1R _ _(;_QJ}§JJµ<::_t\QD.0 l..!1£,__ ------··--·-· ("Contractor"), Great A_l)1E!r/c:<111 I11_SU@.~C:f! C::()r11p3:11y ________ _ ("Su rety"), the City of Cupertino, a Municipal Corporation of the State of California ("City") or ot her party shall be considered p lural where applicable. CONTRACTOR : _llR Construction, Inc. ·--- Name 1120 Ninth Ave nue_··--------·------- Address _ San Mateo, California 94402 .. --·--·----- City/State/Zip CONSTRUCTION CONTRACT: SURETY: . Great American Insurance Company __ Name 1255 Treat Blvd., Suite 8 10 ------·--··------·---···------- Principal Place of Business Walnut Creek, C alifornia 94597 ---- City/State/Zip SIDEWALK CONSTRUCTION-STEVENS CREEK BOULEVARD PROJECT NUMBER 2017-21 at Cupertino, California. DATED _ February 23 ____ , 20 _lZ_ in the Amount of$ ___ 179,79 5.00 ···-------(the "Penal Sum") CONTRACTOR AS PRINCIPAL Company: (Corp. Seal) Signature :~£~e:2,L----·· Name and Title : ~ados Raposo --·-·······-----President ·---- SURETY :C~~ A'_ ,d ? ~ :.:::::::/~.--~ Name and Title:_ Mark C. John s()r:i ________ _ A ttorney -in~-f-ac-t ____ _ BOND TER.'\-1S AND CONDITIONS l . Contractor and Surety, j ointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to City for the complete and proper performance of the Constmction Contract, which is incorporated herein by reference. 2. If Contractor completely and proper ly performs all of its obligations under the Construction Contract, Surety and Co n tractor shall have no obligation tmder this Bond. 3 . If there is no C ity Default, Surety's obligation under this Bond shall arise after : 3.1 City has declared a Contractor Default under the Construction Contract pursuant to the terms of the Construction Contract; and 3.2 City has agreed to pay the Balance of the Contract Sum: 3 .2.1 To Surety in accordance with the tenns of this Bond and the Construction Contract; or City of Cupertino 00610 -I Con struct ion Perfonnancc Bond Side walk Renovation-St evens Creek B lvd Project No. 2017-21 3.2 .2 To a contractor selected to perform the Construction Contract in accordance with the tenns 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 Constrnction Contract itself, through its agents or through independent contractors; provided, that Surety may not sele.ct Contractor as its agent or independent contractor without City's consent; or 4 .3 Undertake to perform and complete the Construction Contract by obtaining bids from qualified contractors acceptable to City for a contract for performance and completion of the Construction Contract, and, upon determination by City of the lowest responsible bidder, arrange for a contract to be prepared for execution by City and the contractor selected with City's concurrence, to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the Construction Contract; and, if Surety's obligations defined in paragraph 6, below, exceed the Balance of the Contract Sum, then Surety shall pay to City the amount of such excess; or 4.4 Waive its right to perfonn 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 explanation of the payment's calculation. If City accepts Surety's tender under this paragraph 4.4 , City may still hold Surety liable for future damages then unknown or un li quidated resulting from the Contractor Default. If City disputes the amount of Surety's tender under this paragraph 4.4, City may exercise all remedies available to it at law to enforce Surety's liability under paragraph 6, below. 5. If Surety does not proceed as provided in paragraph 4, above, then Surety shall be deemed to be in default on this Bond ten days after receipt of an additional written notice from City to Surety demand ing that Surety perfonn its obligations under this Bond. At all times City shall be entitled to enforce any remedy available to City at law or under the Construction Contract including, without limitation, and by way of example only, rights to perform work, protect work, mitigate damages, advance critical work to mitigate schedule delay, or coordinate work with other consultants or contractors. 6. Surety's monetary obligation under this Bond is limited by the Amount of this Bond identified herein as the Penal Sum. This monetary obligation shall augment the Balance of the Contract Sum . Subject to these limits, Surety's obligations under this Bond are commensurate with the obligations of Contractor under the Construction Contract. Surety's obligations shall include, but are not limited to: 6.1 The responsibilities of Contractor under the Construction Contract for completion of the Construction Contract and correction of defective work; 6.2 The responsibilities of Contractor under the Construction Contract to pay liquidated damages, and for damages for which no liquidated damages are specified in the Construction Contract, actual damages caused by non-performance of the Construction Contract including, but not limited to, all valid and proper backcharges, offsets, payments, indemnities, or other damages; 6 .3 Additional legal, design professional and delay costs resulting from Contractor Default or resulting from the actions or failure to act of the Surety under paragraph 4. above (but excluding attorney's fees incurred to enforce this Bond). 7. No right of action shall accrue on this Bond to any person or entity other than City or its successors or assigns. City of Cuperiino 00610 -2 Construction Performance Bond Sidewalk Renovation-Stevens Creek Blvd Project No. 2017-21 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 cowt of competent jurisdiction where a proceeding is pending between City and Contractor regarding the Construction Contract, or in the courts of the County of Santa Clara, or in a court of competent jurisdiction in the location in which the work is located. Communications from City to Surety under paragraph 3. I of this Bond shall be deemed to include the necessary contracts under paragraph 3.2 of this Bond unless expressly stated otherwise. 10. All notices to Surety or Contractor shall be mailed or delivered (at the address set forth on the signature page of this Bond), and all notices to City shall be mailed or delivered as provided in Document 00520 (Contract). Actual receipt of notice by Surety, City or Contractor, however accomplished, shall be sufficient compliance as of the date received at the foregoing addresses. 11 . Any provision in this Bond conflicting with any statutory or regulatory requirement shall be deemed deleted herefrom and provisions conforming to such statutory requirement shall be deemed incorporated herein. 12. Definitions. 12.1 Balance of the Contract Sum: The total amount payable by City to Contractor pursuant to the terms of the Construction Contract after all proper adjustments have been made under the Construction Contract, for example, deductions for progress payments made, and increases/decreases for approved modifications to the Construction Contract. .12.2 Construction Contract: The contract between City and Contractor identi fied on the signature page of this Bond, including all Contract Documents and changes thereto. 12.3 Contractor Default: Material failure of Contractor, which has neither been remedied nor waived, to perform or otherwise to comply with the terms of the Construction Contract including, but not limited to, "default" or any other condition allowing a termination for cause as provided in Document 00700 (General Conditions). 12.4 City Default: Material failure of City, which has neither been remedied nor waived, to pay Contractor progress payments due under the Constrnction Contract or to perform other material tenns of the Construction Contract, if such failure is the cause of the asserted Contractor Default and is sufficient to justify Contractor tennination of the Construction Contract. END OF DOCUMENT City of Cupertino 006)0 -3 Construction Perfonnance Bond Sidewalk Renovaiion-Srevens Creek Blvd CALIFORNIAALL-PURPOSEACKNOWLEDGMENT 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 val idity of that document. STATE OF CALIFORNIA County of Co ntra Costa } On February 24, 2017 Date before me, ----~C=a=th=-.y~A~, s=h=ar-p=ai~·d __________ , Notary Public, Insert Name of Notary exactly as it appears on the official seal personally appeared Mark C. Johnson a CATHY A. SHAPARD Commlstlon # 2134146 -z i Notary Public -California i z Contra Costa County -J. 0 0 0 • .'1 ~o~ ~rts peg 14r,2&1tl Place Notary Seal Above Name{s) of Signer{s) who proved to me on the basis of satisfactory evidence to be the person w_ whose name(~ is.Lare-subscribed to the within instrument and acknowledged to me that he/sf:ie~hey executed the same in his/hei:ltheir authorized capacity(i ~, and that by his/hei=/t-l,eir signature (v) on the instrument the person(J(\, or the entity upon behafrof which the person(~ acted, e)cecuted the instrument . I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature ~ /'.L ~ Signatureofoary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal ana reattachment of the form to another document. Description of Attached Document Title or Type of Document: Construction Performance Bond Document Date: February 23, 2017 ------~------------Number of Pages: _...cc3 ______ _ Signer(s) Other Than Named Above: __________________________ _ Capacity(ies} Claimed by Signer(s) Signer's Name : Mark C. Johnson D Individual D Corporate Officer -Title(s): ________ _ D Partner D Limited D General IX] Attorney in Fact D Trustee D Guardian or Conservator D Other: _______ _ Si_gner is Representing : Great American Insurance Compan y RIGHT THUMBPRINT OF SIGNER Top of thumb here Signer's Name: _____________ _ D Individual D Corporate Officer -Title(s): ________ _ D Partner D Limited D General D Attorney in Fact D Trustee D Guardian or Conservator D Other: -------- Signer is Representing: RIGHT THUMBPRINT OF SIGNER Top of thumb here EXECUTED IN DUPLI CATE DOCUMENT 00620 Bond No . 160 3 042 Premium: Included in Performance Bond Project No . 2017-21 CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND THIS CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND ("Bond") is dated February 23, 20_1_~ is in the penal sum __ QIJe h1Jndred seve n.t:Y-nir:ieJh9 1J.El.!1_4_,...§eve11 h11114r~4_11i_!l_e_ty five doll ars and .1-::l:QDQQ ($179,795.00) __ _ [one hundred percent of the Contract Price], and is entered into by and between the parties listed below to ensure the payment of claimants under the Construction Contract listed below. This Bond consists of this page and the Bond Terms and Conditions, paragraphs 1 through 14, attached to this page. Any singular reference to .. ng__Constri.::!i_o_i::,}11:: .. ----------(''Contractor''), G.r~c1~ /\1:11<:.1]CaJ!J nsuranc~_c:;:g~p~1~y_ -------- ("Surety"), the City of Cupertino , a Municipal Corporation of the State of California ("City") or other party shall be considered plural where applicable. CONTRACTOR: SURETY: .... JJR Construction, Inc. Name Great American In surance company --- 1120 Ninth Aven u e Name 1255 Treat Blvd ., Suite 810 ·----- Address San Mateo, California 94402 Principal Place of Business Walnut Creek, California 94597 City/State/Zi p City/State/Zip CONSTRUCTION CONTRACT: SIDEWALK RENOVA TI ON-STEVENS CREEK BOULEVARD PROJECT NUMBER 2017-21 at Cupertino, California. DATED February 23 ____ , 20 17 in the Amount of$ 179,795 .00 __ _ _ _____ (the "Penal Sum") CONTRACTOR AS PRINCIPAL Company: (Corp . Seal) Signature: CZ., lrfl~ .. ,<.<!.~~PJ- Name and Title: __ Carlos Raposo President Name and Title: Mark C. Joh SQ!l ------····-·· Attorney-in -fa ct BOND TERMS AND CONDITIONS I. Contractor and Sun,1-y, jointly and severally, bind themse lves, their heirs, executors, adm in istrators, 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, d.irectly 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 lab or, materials or equipment for use in the performance of the Construction Contact, provided City has prompt ly notified Contractor and Surety (at the address set forth on the signature page of this Bond) of any claims, demands, liens or suits and tendered defense of such c laims, demands, liens or suits to Contractor and Surety, and provided there is no City Default. 3. With respect to Claimants, this obligation shall be null and void if Contractor promptly makes payment, directly or indirectly through it s Subcontractors, fo r all sums due Claimants. lf Contractor or it s Subcontractors, however, fail to pay any of the persons named in Section 3181 of the California Civil Code, or amounts due under the Unemployment Insurance Code with resp ect to Work or labor performed under the Contract, or for City of Cupertino 00620 -1 Construction Labor and Material Payment Bond Side walk Renovation-Stevens Creek Blvd Project No . 2017-21 any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of Contractor or Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to such Work and labor, then Surety shall pay for the same, and also, in case suit is brought upon this Bond, a reasonable attorney's fee, to be fixed by the court. 4. Consistent with the California Mechanic's Lien Law, Civil Code §3082, et seq., Surety shall have no obligation to Claimants under this Bond unless the Claimant ha5 satisfied all applicable notice requirements. 5. Surety's total obligation shall not exceed the amount of this Bond, and the amount of this Bond shall be credited for any payments made in good faith by Surety under this Bond. 6. Amounts due Contractor under the Construction Contract shall be applied first to satisfy claims, if any, under any Construction Performance Bond and second, to satisfy obligations of Contractor and Surety under this Bond. 7 . City shall not be liable for payment of any costs, expenses, or attorney's fees of any Claimant under this Bond, and shall have under this Bond no obligations to make payments to, give notices on behalf of, or otherwise have obligations to Claimants under this Bond. 8. Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purcha'le orders and other obligations. Surety further hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Construction Contract, or to the Work to be performed thereunder, or materials or equipment to be furnished thereunder or the Specifications accompanying the same, shall in any way affect its obligations under this Bond, and it does hereby waive any requirement of notice or any such change, extension of time, alteration or addition to the tenns of the Construction Contract or to the Work or to the Specifications or any other changes. 9. Suit against Surety on this Bond may be brought by any Claim.ant, or its assigns, at any time after the Claimant has furnished the last of the labor or materials, or both, but, per Civil Code §3249, must be commenced before the expiration of six months after the period in which stop notices may be filed as provided in Civil Code §3184 . 10. All notices to Surety or Contractor shall be mailed or delivered (at the address set forth on the signature page of this Bond), and all notices to City shall be mailed or delivered as provided in Document 00520 (Contract). Actual receipt of notice by Surety, City or Contractor, however accomplished, shall be sufficient compliance as of the date received at the foregoing addresses. 11. This Bond has been furnished to comply with the California Mechanic's Lien Law including, but .not limited to, Civil Code §§3247, 3248, et seq . Any provision in this Bond conflicting with said statutory requirements shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirements shall be deemed incorporated herein. The intent is that this Bond shall be construed as a statutory bond and not as a common law bond. 12. Upon request by any person or entity appearing to be a potential beneficiary of this Bond, Contractor shall promptly furnish a copy of this Bond or shall permit a copy to be made. 13. Contractor shall pay to persons performing labor in and about Work provided for in the Contract Documents an amount equal to or more than the general prevailing rate of per diem wages for (1) work of a similar character in the locality in which the Work is performed and (2) legal holiday and overtime work in said locality. The per diem wages shall be an amount equal to or more than the stipulated rates contained in a schedule that has been ascertained and determined by the Director of the State Department of Industrial Relations and City to be the general prevailing rate of per diem wages for each craft or type of workman or mechanic needed lo exe.cute this Contract. Contractor shall also cause a copy of this determination of the prevailing rate of per diem wages to be posted at each Site. City of Cupertino 00620-2 Constrnction Labor and MateriaJ Payment Bond Sidewalk Renovation-Stevens Creek Blvd Project No. 2017-21 14 . .Definitions . 14.1 Claimant: An individua l or entity having a direct contract with Contractor or with a Subcontractor of Contractor to furnish labor, materials or equipment for use in the performance of the Contract, as further defined in California Civil Code §3181. The intent of this Bond shall be to include without limitation in the terms "labor, materials or equipment" that part of water, gas, power, light, heat, oil, gasoline, telephone service or rental equipment used in the Construction Contract, architectural and engineering services required for performance of the Work of Contractor and Contractor's Subcontractors, and all other items for which a stop notice might be asserted. The term Claimant shall also include the Unemployment Development Department as reforred to in Civi l 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 Co nstruction Contract. END OF DOCUMENT City of Cupertino 00620 • 3 Construction Labor and Material Payment Bond Sidewalk Renovation-Stevens Creek Blvd CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA County of Contra Costa } On February 24, 201 7 before me , ----~C=a=th""y~A=·~S=h=a'E'-pa=r=d~---------' Notary Public, Date In sert Name of Notary exactly as it appears on the official sea l personally appeared ______ M_a_r_k_C_._Jo_h_n_s_on _______________________ _ Name(s) of Signer(s) Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(~whose name(OO is/eire-subscribed to the within instrumefit and acknowledged to me that he/&l:lelt.J:iey executed the same in his/heFAAeir authorized capacity(i ~). and that by his/h8f#l-:leir signatureM on the instrument the person ()(), or the entity upon behalf of which the person(~ acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature Slgaa~~P"~ ~ OPTIONAL Though the information below is not required by Jaw1 it may prove valuable to persons relying on the document and could prevent fraudulent removal ana reattachment of the form to another document. Description of Attached Document Title or Type of Document: Construction Labor and Material Payment Bond ------------------~------------- Document Date : February 23, 2017 -----~--------------Number of Pages : __ 3 ______ _ Signer(s) Other Than Named Above : __________________________ _ Capacity(ies) Claimed by Signer{s) Signer's Name: Mark C. Johnson D Individual D Corporate Officer -Title(s): ________ _ D Partner D Limited D General IX] Attorney in Fact D Trustee D Guardian or Conservator D Other: ______ _ Signer is Representing : Great Ainerican Insurance Company RIGHT THUMBPRINT OF SIGNER Top of thumb here Signer's Name: _____________ _ D Individual D Corporate Officer -Title(s): --------- 0 Partner D Limited D General D Attorney in Fact D Trustee D Guardian or Conservator D Other: ______ _ Signer is Representing: RIGHT THUMBPRINT OF SIGNER Top of thumb here GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons a uthori zed by thi s power of attorney is not more than FOUR No. 0 15021 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INS URANCE COMPANY, a corporation organized and ex isting under and by virtue of the laws of the State of Ohio, does hereby nominate , const itute and appoint the person or persons named below, each individually if more than one is nam ed , its true and lawfu l attorney -in-fact, for it and in it s name , place and stead to execute on behalf of the said Company, as surety, any and a ll bonds , undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the sa id Compan y on any such bond , undertaking or contract of suretyship executed under thi s authority s hall not exceed the limit stated below. JOHN F. ARENTS MARK C. JOHNSON Name CECIL A. COLLINS Ill JAMES W . GERVANG Address ALL OF CONCORD , CALIFORNIA Limit of Power ALL $100,000 ,000 .00 This Power of Attorney revokes all previous powers issued on behalf of the attorney(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INS URANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and it s corporate seal hereunto affixed this 21ST day of APRIL , 2016 Attest GREAT AMERICAN INSURANCE COM PANY 4"c e. ~-~"~ //,~ Assistant Secreta,y Divisional Senior Vice Pres ident STATE OF OHIO, COUNTY OF HAMILTON -ss: DAVID c. KITCHIN (877-377-2405) On this 21ST day of APRIL , 2016 , before me personally appeared DAVID C . KITCHIN, to me known , being duly sworn , deposes and says that he resides in C incinn at i, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Com pany, the Company described in and which executed the above instrument; that he knows the seal of the sai d Company; th at the seal affixed to the sa id instrument is such corporate seal; that it was so affixed by authority of his office under the By-Laws of said Company, and that he signed hi s name thereto by like authority. a - This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American In surance Company by unanimous written consent dated June 9, 2008. RESOLVED: Th at the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them , be and hereby is authorized, from time to time , to appoint one or more Attorneys-in-Fact to execute on behalf of the Co mpany , as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in th e nature thereof; to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment al any time . RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secreta,y or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original sea l of the Co mpany, to be valid and binding upon the Company w ith th e same force and effect as though manually affixed. CERTIFICATION I, S TEPHEN C . BERAHA, Assistant Secretary of Great American Insurance Co mpany, do hereby ce1tify that th e foregoing Power of Attorney and the Resolutions of th e Board of Directors of June 9, 2008 have not been revoked and are no w in full force and effect. Signed and sealed this 24th day of February 2017 4"c e. -:E___,,,,,___ _ Assis/ant Secret01 y S 1 029AF (06/15) Project No. 2017 -21 DOCUMENT 00630 GUARANTY TO THE CITY OF CUPERTINO, a Municipal Corporation of the State of California ("City"), for construction of SIDEWALK RENOVATION-STEVENS CREEK BOULEVARD PROJECT NUMBER 2017-21 CUPERTINO, CALIFORNIA The undersigned guarantees all construction performed on this Project and also guarantees all material and equipment incorporated therein . Contractor hereby grants to City for a period of one year following the date of Final Acceptance, or such longer period specified in the Contract Documents, its unconditional warranty of the quality and adequacy of all of the Work including, without limitation , all labor, materials and equipment provided by Contractor and its Subcontractors of all tiers in connection with the Work. Neither final payment nor use or occupancy of the Work performed by the Contractor shall constitute an acceptance of Work not done in accordance with this Guaranty or relieve Contractor of liability in respect to any express warranties or responsibilities for faulty materials or workmanship. Contractor shall remedy an y defects in the Work and pay for any damage resulting therefrom, which shall appear within one year, or longer if s pecified , from the date of Final Acceptance. If within one year after the date of Final Acceptance, or s uch longer period of time as may be prescribed by laws or regulations , or by the term s of Contract Documents, any Work is found to be defective, Contractor shall promptl y, 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 promptl y comply with the terms of such instructions, or in an emergency where delay would cause serious risk of loss or damage, City may have the defective Work corrected or the rejected Work removed and replaced . Contractor shall pay for all claims, costs, losses and damages caused by or resulting from such removal and replacement. Where Contractor fail s to correct defecti ve 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 it s obligations under the Contract Documents. Even though equipment, materials, or Work required to be provided under the Contract Documents have been inspected , accepted , and estimated for payment, Contractor shall, at its own expense, replace or repair any such equipment , material , or Work found to be defective or otherwise not to comply with the requirements of the Contract Documents up to the end of the guaranty period. All abbreviations and definitions of terms used in this Agreement shall have the meanings set forth in the Contract Documents, including, without means of limitation, Section 00700 (General Conditions). The foregoing Guaranty is in addition to any other warranties of Contractor contained in the Contract Documents, and not in lieu of, any and all other liability imposed on Contractor under the Contract Documents and at law with respect to Contractor's duties , obligations, and performance under the Contract Documents . In the event of any conflict or inconsistency between the terms of this Guaranty and any warranty or obligation of the Contractor under the Contract Documents or at law , such inconsistency or conflict shall be resolved in favor of the higher level of obligation of the Contractor . .TJ"~ G.u0 rrvc T/()N', IA. c- Contractor 's Name I 1.a.o,v..,,,r1, Av~nu.e.. Address cf,912 t/4 reo, a '?VV" 2. City/State/Zip ' 3/t ltz Dat~ 1 END OF DOCUMENT City of Cupertino 00630 -I Guaranty Sidewalk Renovatio n-St evens C reek Bl vd CITY OF ll Project No. 2017-21 CUPERTINO INSURANCE AGREEMENT A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker's compensation or undertake self- insurance in accordance with the provisions of that Code, and will comply with such provisions before commencing the performance of the work of this Contract. B. Contractor and all subcontractors will carry worker's compensation insurance for the protection of its employees during the progress of the work. The insurer shall waive its rights of subrogation against the City, the City's officers, agents and employees and shall issue an endorsement to the policy evidencing same. C . Contractor shall carry at all times, on all operations hereunder, commercial general liability insurance, automobile liability insurance and builder's all risk insurance. All insurance coverage shall be in amounts required by the City and shall be evidenced by the issuance of a certificate in a form prescribed by the City and shall be underwritten by insurance companies satisfactory to the City for all operations, sub-contract work, contractual obligations, product or completed operations, all owned vehicles and non-owned vehicles. Said insurance coverage obtained by the Contractor, excepting worker's compensation coverage, shall name the City, its engineer, and each of its directors , officers, agents and employees, as determined by the City, as additional insureds on sa id policies. Insurers must be licensed to do business in the State of California. The Insurers must also have an "A " policyholder's rating and a financial rating of at least Class VII in accordance with the current Best's Guide Rating or that is otherwise acceptable to the City. D. Before Contractor performs any work at, or prepares or delivers materials to , the site of construction, Contractor shall furnish ce11ificates of insurance evidencing the foregoing insurance coverages and such certificates shall provide the name and policy number of each carrier and policy and that the insurance is in force and will not be canceled or modified without thirty (30) days written notice to the City. Contractor shall maintain all of the foregoing insurance coverages in force until the work under this Contract is fully completed. The requirement for carrying the foregoing insurance shall not derogate from the provisions for indemnification of the City by Contractor under this Contract and for the duration of the warranty period. Notwithstanding nor diminishing the obligations of Contractor with respect to the foregoing, Contractor shall maintain in full force and effect during the life of this Contract, the following insurance in amounts not less than the amounts specified and having a Best's Guide Rating of A, Class VII or better or that is otherwise acceptable to the City. Cit y of Cup ertino 00530 - 2 In suranc e Form s Sid ewalk Reno vati on-Stev en s Cree k Bl vd Project No . 2017-21 LIMITS Worker's Compensation & Employers' Liability General Liability -commercial general liability ; in c luding provisions for contractual liability, per so nal injur y, independent co ntractors and products -completed operations hazard. Automobile Liability -comprehensive covering owned, non -ow ned and hired a utomobiles . In accor dance with the Worker's Compensation Act of the State of California-Worker's comp "stat utor y" per CA Law; Employers' Liability $1,000,000 per occurrence. Combined single limit of $2.0 million per occurrence; $4.0 million in the aggregate Combined single limit of $1.0 million per occurrence. J.(f.l(.. CJM,srrv~T/b?J,V'C By: ~£,ya,~ (Contractor 's Name) / Dated: ,3 (p I 20JJ City of Cupert in o 00530 -3 In surance Fo rm s Sidewa lk Re nova tio n-Stevens Creek Blvd JJRCONS-01 JARGUELLO ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 2/24/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 License# 0757776 ~~ijifCT Concord, CA -HUB International Insurance Services Inc. Ft8~~o. Ext): (925) 609-6500 I FAX ( 2300 Clayton Rd. (A/C, No): 925) 609-6550 Concord , CA 94520 ioMl~hs: INSURER/SI AFFORDING COVERAGE NAIC # INSURER A : First Mercurv Insurance Company 10657 INSURED INSURER B, Ohio Casualty Insurance Company 24074 JJR Construction, Inc. INSURER c : RSUI Indemnity Company 22314 1120 9th Avenue INSURER D: State Compensation Insurance Fund of California 35076 San Mateo, CA 94402 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER · REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED . NOTWITHSTANDING ANY REQUIREMENT , TERM OR CONDITION OF AN Y CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERT IFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC IES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MA Y HAVE BEEN REDUCED BY PAID CLAIMS . l~f~ TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF ,f.R~.!C:.U,~f .. LIM ITS ,.,en wvn IMMlnDfYYYYl A X COMMERCIAL GENERAL LIABILITY EACH OCC URREN CE $ 1,000,000 -D CLAIMS-MADE CRJ OCC UR DAMAG E TO RENTED X X WACG L000006045102 01/01/2017 01/01/2018 PR EMISES i Ea nrro rr,anc P\ $ 50 ,000 X Bl/PD Ded: 5,000 MED EXP /Anv one oersonl $ 5,000 - PERSONAL & A DV INJURY $ 1,000 ,000 - G EN'L AGG RE GATE LIMIT APPLI ES PE R: GENERAL AG GREGATE $ 2,000,000 Fl POLICY 0 ffc?i D LOG PRODUC TS -COMP/O P AGG $ 2,000 ,000 OTHE R: Policy Aggregate $ 10,000,000 B AUTOMOBILE L IABILITY -(F~~~~~;~,?NGLE LI MIT $ 1,000,000 X ANY AUTO X X BA055893485 01/01/2017 01/01/2018 BOD IL Y INJURY /Per person ) $ -OW NED ~ SCH EDULED -AUTOS O NLY f--AUTOS BODI LY INJURY /Per accident) $ X HI RED X NO N-OWNE D /p~f~fc%~t?AMAGE $ ~ AUTOS O NL Y f--AUTOS O NLY I I $ C UMBRELLA L IA B M OCC UR EAC H OCC URREN CE $ 5,000,000 ~ NHA241608 01/01/2017 01/01/2018 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000 ,000 DEO I X I RETENTION $ 0 $ D WORKERS COMPENSATION X I n:nJTE I I OTH- AND EMPLOYERS' LIABILITY ER Y/N X 914966817 01/01/2017 01/01/2018 1,000 ,000 A NY PRO PR IET OR/PARTNE R/EXECUTI V E D E.L. EAC H ACCI DENT $ O FFI CER/M EMBE R EXCLU DED ? N/A 1,000,000 (Mandatory in NH) E.L. DI SEASE -EA EMPLOYEE $ If yes, describe under DESC RI PTION O F O PE RAT IONS below E.L. DISEAS E -POLI CY LI MIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 10 1, Additional Remarks Sc hedule, ma y be attac hed if mo re space is required) Re : Project #2017-21, Sidewalk Renovation-Stevens Creek Blvd City of Cupertino, a Municipal Corporation of the State of California, its City Council , and their employees, representatives, consultants (including without limitation Consulting Engineer), and agents , and Engineers, as additional insured as respects to General Liability per attached CG2010-0704, Primary wording applies per attached FMICGL 1002-1015, Waiver of Subrogation applies per attached CG2404-0509, Per Project General Aggregate applies per attached FMICGL2017-0916 and additional insured including Waiver of Subrogation applies to Auto Liability per attached CA8810 -0113, Primary wording applies per attached CA0001-0306. Waiver of Subrogation applies to Workers Compensation per attached WC040306/0484, all as required by written contract. CERTIFICATE HOLDER City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS . A UTHORIZED REPRESENT ATI VE ~~ ~ __ ,l _______________________ __,_ ____________________________ .J ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION . All rights re s e r ved . The ACORD name and logo are registered marks of ACORD POLICY NO. W ACGL000006045102 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oraanization{s): Location{s) Of Covered Operations . As required by written contract signed by both parties All Locations prior to the loss Information reguired to com121ete this Schedule, if not shown above, will be shown in the Declarations . A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury'', "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above . B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply : Th is insurance does not apply to "bodily injury'' or "property damage" occurring after : 1. All 1/v'Ofk, . including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be perfoITTied by or on behalf of the additional lnsured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organ ization other than another contractor or subcontractor en- gaged in perfoITTiing operations for a principal as a part of the same project. CG 2010 0704 @ ISO Properties, Inc., 2004 Page 1 of 1 D THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condrtion and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that : (1) The addrtional insured is a Named Insured under such other insurance ; and (2) You have agreed in wrrting in a contract or agreement prior to the injury or damage that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. However, the insurance provided under this endorsement will not apply beyond the extent required by such contract or agreement. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. This endorsement forms a part of the Policy to which attached , effective on the inception date of the Pol icy unless otherwise stated herein. (The following information is required only when this endorsement is issued subsequent to preparation of the Policy.) 1-1-16 WACGL000006045102 Endorsement effective Policy No. Endorsement No. Named Insured JJR Construction, Inc. Countersigned by _________________ _ FMIC-GL-1002 (10/2015) .I THIS ENDORSEMENT CHANGES THE POLICY . PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT SUBJECT TO A TOTAL POLICY AGGREGATE LIMIT This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: Any project: 1) covered under this policy; and 2) required by written contract with you to be subject to a separate General Aggregate limit. {If no entry appears above , information required to complete th is endorsement w ill be shown in the Declarat ions as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences " under COVERAGE A (SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above : 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount shown in the Declarations of this policy . 2. Subject to the Total Policy Aggregate Limit , the Designated Construction Project 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 ," regardless of the number of: a. Insureds ; b. Claims made or "su its " brought ; or c. Persons or organizations making claims or bringing "suits ." 3. Any payments made under COVERAGE A for damages shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Subject to the Total Policy Aggregate Limit, such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence continue to apply. However, instead of being subject to the General Aggregate Lim it shown in the Declarat ions , such limits will be subject to the applicable Designated Construction Project General Aggregate Limit and the Total Policy Aggregate Limit. FMIC-GL-2017(09/2016) Page 1 of 2 8. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences " under COVERAGE A (SECTION I), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above : 1 . Any payments made under COVERAGE A for damages shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable ; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. 3. Such payments will reduce the Total Policy Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard " is provided , any payments for damages because of "bodily injury " or "property damage " included in the "products-completed operations hazard " will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit or the Designated Construction Project General Aggregate Limit or the Total Policy Aggregate Limit. D. The Total Policy Aggregate Limit scheduled in the Declarations of this policy is the most we will pay for the sum of: (a) all damages covered under this policy and falling within the scheduled Designated Construction Projects(s) General Aggregate Limits described in Paragraph A . of this endorsement; and , (b) all damages covered under this policy and falling within the General Aggregate Limit, as described in Paragraph B. of this endorsement and as set forth in the provisions of Limits of Insurance (SECTION Ill) not otherwise modified by this endorsement. The Total Policy Aggregate Limit applies regardless of the sums indicated in the Declarations for the General Aggregate Limit or Designated Construction Projects(s) General Aggregate Limit, and applies to all locations(s) set forth in the Schedule above. The Total Policy Aggregate Limit applies collectively, rather than separately , to all of your scheduled locations. The Total Policy Aggregate Limit is not reduced by payments for damages covered under this policy and falling within the "products- completed operations hazard ," but such payments will reduce the Products-Completed Operations Aggregate Limit, as described in Paragraph C. of this endorsement. E. The provisions of Limits Of Insurance (SECTION Ill) not otherwise modified by this endorsement shall continue to apply as stipulated . ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. This endorsement forms a part of the Policy to which attached, effective on the inception date of the Policy unless otherwise stated herein. (The following information is required only when this endorsement is issued subsequent to preparation of the Policy.) Endorsement effective 1-1-2017 Policy No . W ACGL000006045102 Endorsement No . Named Insured JJR Construction, Inc Countersigned by ________________ _ FMIC-GL-2017(09 /2016) Page 2 of 2 ,,f' 5. Other Insurance a. For any covered "auto'' you own, this Coverage Form provides primary insurance. For any covered "auto" you don't own, the insurance pro- vided by this Coverage Form is ex- cess over any other collectible insurance. However, while a covered "auto" which is a "trailer" is con- nected to another vehicle, the Liabil- ity Coverage this Coverage Form provides for the "trailer" is : (1) Excess while it is connected to a motor vehicle you do no, own. (2) Primary while it is connected to a covered "auto" you own . b. For Hired Auto Physical Damage Coverage, any covered "auto" you lease , hire, rent or borrow is deemed to be a covered ''auto" you own. However, any "auto" that is leased; hired, rented or borrowed Wtth a driver is not a covered "'auto ''. c . Regardless of t h.e p rovi sions of Para - graph a. ab ove, this Coverage Form 's Liability Co verage is p r¾ma ry for any liab i lity a$sum~d under an "insu red contract ". d. When this Coverage Form and any other Coverage Form or policy cov- ers on the same basis, either excess or primary, we will' pay only our share . Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. 6. Premium Audit a. The estimated premium for this Cov - erage Form is based on the expo- sures you told us you would have when this policy began . We will compute the final premium due when we determine your actual ex- posures . The estimated total premi- um wit! be credited against the final premium due and the first Named Insured will be billed for the balance, if any . If the estimated total premium exceeds the final premium due, the first Named Insured will get a re- fund. BA05589'.r4S-5 ____ - b. If this policy is issued for more than one year, the premium for this Cov- erage Form will be computed annu- ally based on our rates or premiums in effect at the beginning of each year of the policy. 7 . Policy Period, Coverage Territory Under this Coverage Form, we cover "ac- cidents" and "losses" occurring: a. During the policy period shown in the Declarations; -and b. Within the coverage territory. The coverage territory is : a. The United States of America; b. The territories and possessions of the United States bf America; c;. Puerto Rico; d . Canada ; and e. Anywhere i n the wortd if: (1) A covered ''auto " of t he private passenger type is leased, hired, rented or borrowed witho\it a driv er for' a period of 30 days or less'; ahd (2) The "insured's '' responsibility fo pay damages is determined in a "suit" on the merits, in the Unit- ed States of America, the ter- ritories and possessions of the United States of America, Puerto Rico, or Canada or in a settle- ment we agree to. We also cover "loss" to, or "accidents" involving, a covered "auto" while being transported between any of these places . 8. Two Or More Coverage Forms Or Poli- cies Issued By Us If this Coverage Form and any other Cov- erage Form or policy issued to you by us or any company affiliated with us apply to the same "accident ", the aggregate maximum Limit of Insurance under all the Coverage Forms or policies shall not exceed the highest applicable Limit of Insurance under any one Coverage Form or policy. This condition does not apply to any Coverage Form or policy issued by us or an affiliated company specifi- cally to apply as excess insurance over this Coverage Form. CA 00 01 03 06 ©!SO Prope rties, Inc., 2005 Page 10 of 13 POLICY NUMBER: W A-CGL-0000060451-0 2 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule , if not shown above , will be shown in the Declarations . 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 we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above . CG 24 04 05 09 © Insurance Services Office , Inc ., 2008 Page 1 of 1 0 STATE ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS BROKER COPY COMPENSATION JN£URA NCE FUNO HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DA TES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME EFFECTIVE JANUARY 1, 2017 AT 12.01 A.M. AND EXPIRING JANUARY 1,2018 AT 12.01 A.M. JJR CONSTRUCTION, INC. 1120 9TH AVE SAN MATEO, CA 94402 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY . WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION REP 05 9149668-17 NEW SP 1-88-51-03 PAGE 1 OF NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER , WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS , AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER , WAIVE OR LIMIT THE TERMS , CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO : 1::f,ttfi,q:. Ii~-~ _d~<:~ PRESIDENT AND CEO 2572 S CIF F ORM 10 2 17 \RE V.7 -20 141 OLD DP 2 17 1 BA055893485 POLICY NO. COMMERCIAL AUTO CA88100113 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following : BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement , the provisions of the policy apply unless modified by the endorsement COVERAGE INDEX SUBJECT ADDITIONAL INSURED BY CONTRACT , AGREEMENT OR PERMIT ACCIDENTAL AIRBAG DEPLOYMENT AMENDED DUTIES IN THE EVENT OF ACCIDENT , CLAIM , SUIT OR LOSS AMENDED FELLOW EMPLOYEE EXCLUSION AUDIO , VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE BROAD FORM INSURED BODILY INJURY REDEFINED EMPLOYEES AS INSUREDS (including employee hired auto) EXTENDED CANCELLATION CONDITION EXTRA EXPENSE -BROADENED COVERAGE GLASS REPAIR -WAIVER OF DEDUCTIBLE HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) HIRED AUTO COVERAGE TERRITORY LOAN/ LEASE GAP PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) PERSONAL EFFECTS COVERAGE PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EX PENSE COVERAGE RENTAL REIMBURSEMENT SUPPLEMENTARY PAYMENTS TOWING AND LABOR TWO OR MORE DEDUCTIBLES UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION II -LIABILITY COVERAGE is amended as follows 1 . BROAD FORM INSURED PROVISION NUMBER 3 12 19 5 13 1 22 2 23 10 15 6 20 14 16 11 8 9 4 7 17 18 20 SECTION II -LIABILITY COVERAGE , paragraph A.1 . -WHO IS AN INSURED is amended to include the following as an insured : CA 88 10 01 13 d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that: (1) Is a partnership or joint venture ; or (2) Is an insured under any other automobile policy ; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy . e. Any organization you ne wly acquire or form, other than a partnership or joint venture , of wh ich you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation . However , coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization ; © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office , Inc ., with its permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted ; or (3) To "bodily injury " or "property damage " that occurred before you acquired or formed the organization . 2. EMPLOYEES AS INSUREDS SECTION II --LIABILITY COVERAGE , paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured : f. Any "employee" of yours while using a covered "auto " you do not own , hire or borrow , but only for acts within the scope of their employment by you. Insurance provided by this endorsement is excess over any other insurance available to any "employee ". g . An "employee " of yours while operating an "auto " hired or borrowed under a written contract or agreement in that "employee 's" name, with your permission , while performing duties related to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee ". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II -LIABILITY COVERAGE, paragraph A.1 . -WHO IS AN INSURED is amended to include the following as an insured : h. Any person or organization with respect to the operation , maintenance or use of a covered "auto ", provided that you and such person or organization have agreed in a written contract , agreement , or permit issued to you by governmental or public authority , to add such person , or organization , or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured ": (1) Only w ith respect to the operation , maintenance or use of a covered "auto "; (2) Only for "bodily injury " or "property damage " caused by an "accident " which takes place after you executed the written contract or agreement , or the permit has been issued to you ; and (3) Only for the duration of that contract , agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE , Coverage Extensions , 2.a. Supplementary Payments , paragraphs (2) and (4) are replaced by the following : (2) Up to $3 ,000 for cost of bail bonds (including bonds for related traffic 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. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where , by law , fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule , or similar protection , the following provision is added : SECTION II -LIABILITY , exclusion B .5. FELLOW EMPLOYEE does not apply if the "bodily injury " results from the use of a covered "auto " you own or hi re . SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended as follows : 6. HIRED AUTO PHYSICAL DAMAGE CA 88 10 0113 Paragraph A.4 . Coverage Extensions of SECTION Ill -PHYSICAL DAMAGE COVERAGE , is amended by adding the following : If hired "autos " are covered "autos " for Liability Coverage , and if Comprehensive , Specified Causes of Loss or Coll ision coverage are provided under the Business Auto Coverage Form for any "auto " you own , then the Physica l Damage coverages provided are extended to "autos ": a . You hire , rent or borro w; or © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance SeNices Office , Inc ., with its permission . Page 2 of 7 b. Your "employee " hires or rents under a written contract or agreement in that "employee 's" name , but only if the damage occurs while the vehicle is being used in the conduct of your business , subject to the following limit and deductible : A. The most we will pay for "loss " in any one "accident " or "loss " is the smallest of: (1) $50 ,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repair ing or replacing the damaged or stolen property with other property of like kind and quality , minus a deductible . B. The deductible wil l be equal to the largest deductible applicable to any owned "auto " for that coverage . C. Subject to the limit , deductible and excess provisions described in this provision , we will provide coverage equal to the broadest coverage applicable to any covered "auto " you own. D. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto " if it results from an "accident ", you are legally liable and the lessor inc urs an actual financial loss. E. This coverage extension does not apply to : (1) Any "auto" that is hired , rented or borrowed with a driver; or (2) Any "a uto " that is hired , rented or borrowed from your "employee ". For the purposes of this provision, SECTION V -DEFINITIONS is amended by adding the following : "T otal loss" means a "loss " in which the cost of repairs plus the salvage value exceeds the actual cash value . 7. TOWING AND LABOR SECTION Ill -PHYSICAL DAMAGE COVERAGE , paragraph A.2. Towing , is amended by the add ition of the following : We wil l pay towing and labor costs incurred , up to the limits shown below , each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is disabled: a. For private passenger type vehicles , we wil l pay up to $50 per disablement. b. For "ligh t trucks ", we will pay up to $50 per disablement. "Light trucks " are trucks that have a gross vehicle we ight (GV\N) of 10,000 pounds or less . c. For "medium trucks " , we will pay up to $150 per disablement. "Medium trucks " are trucks that have a gross vehicle weight (GV\N) of 10 ,001 -20 ,000 pounds . However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE CA 88 10 01 13 Paragraph A.4.a., Coverage Extension of SECTION Ill -PHYSICAL DAMAGE COVERAGE , is amended to provide a limit of $50 per day and a maximum limit of $1,500 © 2013 Liberty Mutual Insurance In eludes copyrighted material of Insurance Services Office , Inc ., with its permission . Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE , A . COVERAGE , is amended by adding the following: a. We will pay up to $i'5 per day for rental reimbursement expenses incurred by you for the rental of an "auto " because of "accident'' or "loss ", to an "auto " for which we also pay a "loss " under Comprehensive , Specified Causes of Loss or Collision Coverages . We w ill pay only for those ex penses incurred after the first 24 hours following the "accident" or "loss " to the covered "auto .,. b. Rental Reimbursement wi ll be based on the rental of a comparable vehicle , which in many cases may be substantially less than $75 per day , and will only be allo wed for the period of time it should take to repair or replace the vehicle w ith reasonable speed and sim i lar quality, up to a maximum of 30 days . c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos " available for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto " of the private passenger type , we wi ll pay under this coverage only that amount of your rental reimbursement ex penses which is not already provided under Paragraph 4. Coverage Extension . f. No deductible applies to this coverage . For the purposes of this endorsement provision, materials and equipment do not inc lude "personal effects " as defin ed in provision 11 . '10 . EXTRA EXPENSE -BROADENED COVERAGE Under SECTION Ill -PHYSICAL DAMAGE COVERAGE , A. COVERAGE , we wil l pay for the expense of return ing a stolen covered "auto " to you . The ma xi mum amount we will pay is $1 ,000 11. PERSONAL EFFECTS COVERAGE A. SECTION Ill -PH Y SICAL DAMAGE COVERAGE , A . COVERAGE , is amended by adding the follo w ing : If you have purchased Comprehensive Coverage on this policy for an "auto " you own and that "auto" is st ole n, we will pay, without application of a deductible , up to $600 for "personal effects " stolen with the "auto ." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V -DEFINITIONS is amended by adding the following : For the purposes of this provision , "personal effects" mean tangible property that is w orn or carried by an insured." "Personal effects " does not include tools , equipment, jewelry , money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE , B. EXCLUSIONS is amended by adding the follo wi ng: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag . Any insuran ce we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other coverage or warranty . 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE CA 88 10 0113 SECTION Ill -PH YSI CAL DAMAGE COVERAGE , B. EXCLUSIONS , exce ption paragraph a. to exclusions 4.c . and 4.d. is deleted and replaced w ith the followi ng : © 2013 Liberty Mutual Insurance Includes copyrighted material of In surance Services Office , Inc ., w ith its permission . Page 4 of 7 Exclusion 4.c. and 4.d . do not apply to : a. Electronic equipment that receives or transmits audio, visual or data signals , whether or not designed solely for the reproduction of sound , if the equipment is permanently installed in the covered "auto" at the time of the "loss " and such equipment is designed to be solely operated by use of the power· from the "auto 's" electrical system, in or upon the covered "auto " and physical damage coverages are provided for the covered "auto "; or If the "loss" occurs solely to audio , visual or data electronic equipment or accessories used with this equipment , then our obligation to pay for , repair , return or replace damaged or stolen property will be reduced by a $100 deductible . 14. LOAN/ LEASE GAP COVERAGE CA 88 10 01 13 A . Paragraph C ., LIMIT OF INSURANCE of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by adding the following : The most we will pay for a "total loss" to a covered "auto" owned by or leased to you iri any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto " is subject at the time of the "loss " less the amount of: a. overdue payments and financial penalties associated with those payments as of t he date of the "loss ", b. Financial penalties imposed under a lease due to high mileage , excessive use or abnormal wear and tear , c . Costs for extended warranties , Credit Life Insurance , Health , Accident or Disability Insurance purchased with the loan or lease , d . Transfer or rollover balances from previous loans or leases, e . Final payment due under a "Balloon Loan ", f. The dollar _amount of any unrepaired damage which occurred prior to the "total loss " of a covered "auto", g. Security deposits not refunded by a lessor , h . All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended seNice agreement on a covered "auto ", i. Any amount representing taxes, j. Loan or lease termination fees ; or 2 The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. 8. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto " that incurred the loss serves as collateral , or lease written on the covered "auto " that incurred the loss. C. SECTION V -DEFINTIONS is changed by adding the following: As used in this endorsement provision , the following definitions apply: "Total loss " means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value . A "balloon loan" is one with periodic payments that are insuffic ient to repay the balance over the term of the loan , thereby requ i ring a large final payment. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office , Inc ., with its penm ission . Page 5 of 7 15. GLASS REPAIR· WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION Il l -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following : No deductible app l ies to glass damage if the glass is repa i red rather than replaced . 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following The deductible does not apply to "loss " caused by collision to such covered "auto " of the private passenger type or light weight truck with a gross vehicle weight of 10 ,000 lbs . or less as defined by the manufacturer as maximum loaded w eight the "auto " is designed to carry while it is : a. In the charge of an "insured"; b. Legally parked ; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto " must exceed the deductible sho w n in the Declarations . This provision does not apply to any "loss" if the covered "auto " is in the charge of any person or organization engaged in the automobile business . 17. TINO OR MORE DEDUCTIBLES Under SECTION Ill PH Y SICAL DAMAGE COVERAGE , if two or more company policies or coverage forms apply to the same accident , the follo w ing appli es to paragraph D. Deduct ible : a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived ; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of tl1e smaller (or smallest) deductible ; or c . If the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group. SECTION IV-BUSINESS AUTO CONDITIONS is amended as follows: 18 . UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards , exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form , the coverage afforded by this policy w ill not be prejudiced . However, you must report the undisclosed hazard of ex posure as soon as practicable after its discovery , and we have the right to collect additional premium for any such hazard or ex posure . 19. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS CA 88 10 01 13 SECTION IV -BUSINESS AUTO CONDITIONS , paragraph A.2.a. is replaced in its entirety by the following : a. In the event of "accident ", claim , "suit " or "loss", you must promptly notify us when it is known to : 1. You , if you are an individual ; 2 . A partner , if you are a partnership ; 3. Member , if you are a limited liability company ; 4 . An executive officer or the "employee " designated by the Named Insured to give such notice , if you are a corporation . © 2013 Liberty Mu t ual Insurance Includes copyrighted material of Insurance Servi c es Office, Inc ., w ith its perm ission . Page 6 of 7 To the extent possible , notice to us should include: (1) How , when and where the "accident'' or "loss" took place ; (2) The "insureds " name and address ; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS , paragraph A.5., Transfer of Rights of Recovery Against others to Us , is amended by the addition of the following: If the person or organization has waived those rights before an "accident " or "loss ", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period , Coverage Territory, is amended by the addition of the following f. For "autos " hired 30 days or less , the coverage territory is anywhere in the world , provided that the insured 's responsibility to pay for damages is determined in a "suit", on the merits , in the United States , the territories and possessions of the United states of America , Puerto Rico or Canada or in a settlement we agree to . This extension of coverage does not apply to an "auto " hired , leased, rented or borrowed with a driver. SECTION V -DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V -DEFINTIONS , defin ition C. is replaced by the follo w ing : "Bodily injury" means physical injury , sickness or disease sustained by a person , including mental anguish , mental injury , shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION CA 88 10 0113 COMMON POLICY CONDITIONS, paragraph A .-CANCELLATION condition applies except as follows: If we cancel for any reason other than nonpayment of premium , we wil! mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancellation . © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office , Inc ., w ith its permission . Page 7 of 7