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17-148 DMZ Builders, Retaining Wall Replacement - Regnart Rd Project No. 2017-12' RECORDING REQUESTED BY City of Cupertino WHEN RECORDED MAIL TO City Clerk's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 NO FEE IN ACCORDANCE WITH GOV. CODE 27283 23832571 Regina Alcocmentl"'Ya~ Clerk-Recorder Santa Clara oun 12/21/2017 09:58 AM Pages: 3 Titles: 1 Fees: 10.00 Taxes: 0 Total: 0 .00 ,L 11111 1111 W)f,1tl.l~~~,~1«~i~ It '!Ill: tM~ Nl~\ll lUI" ~•~~ i\11 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NOTICE OF COMPLETION CITY PROJECT NAME: Removal and Replacement of an Existing Wood Retaining Wall with a Pier Supported Concrete Retaining Wall at Regnart Road at Regnart Canyon Drive ~ Original D For Fast Endorsement "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 December 18, 2017 for CITY PROJECT NAME: Removal and Replacement of an Existing Wood Retaining Wall with a Pier Supported Concrete Retaining Wall at Regnart Road at Regnart Canyon Drive and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on December 18, 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: December 21, 2017 By: ~!l,l:.;~~ar=· =-::::::_-__ _ Senior Office Assistant Recording Requested By: The City of Cupertino When Recorded Mail To: John Raaymakers, Project Manager Cupertino City Hall 10300 Torre Avenue Cupertino, CA 95014 EXEMPT FROM RECORDING FEES PER GOVERNMENT CODE§§ 6103, 27383 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 the City of Cupertino ("City") 3. City's address is 10300 Torre Avenue, Cupertino, CA 95014. 4. The nature of City's interest in the Project is: __x_ Fee Ownership Lessee Other: -------- 5. Construction work on the Project performed on City's behalf is generally described as follows: removal and replacement of an existing wood retaining wall with a pier supported concrete retaining wall. 6. The name of the original Contractor for the Project is: DMZ Builders 7. The Project was completed on: December 15, 2017 8. The Project is located at: Regnart Road at Regnart Canyon Drive, Cupertino, California 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. 11-/;¢2 SwA~ !!v,;,-,1 c---,,,:::~::::::;~2;~. ':s;=='-------- D'Zte and Place Slgffature Retaining Wall Replacement -Regnart Road Project No. 2017-12 NOTICE OF COMPLETION Page 1 Contract This public works contract ("Contract") is entered into by and between the City of Cupertino ("City"), a municipal corporation , and DMZ Builders ("Contractor"), for work on the Retaining Wall Replacement -Regnart Road, Project No. 2017-12 , Project ("Project "). The parties ag ree as follows: 1. Award of Contract. In response to the Notice Inviting Bids , Contractor has submitted a Bid Proposal and accompanying Bid Schedule , a copy of which is attached for convenience as Ex hibit A, to perform the Work to construct the Project. On October 3, 2017 , City authorized award of this Contract to Contractor for the amount of Contractor's bid. 2. Contract Documents . The Contract Documents incorporated into this Contract include and are comprised of all of the following: 2.1 Notice Inviting Bids; 2.2 Instructions to Bidders ; 2 .3 Addenda, if any; 2.4 Bid Proposal and attachments thereto; 2 .5 Contract ; 2.6 Payment Bond , Performance Bond and , if required , a Warranty Bond; 2. 7 General Conditions; 2.8 Special Conditions ; 2.9 Project Drawings and Specifications; 2.10 Change Orders , if any; 2.11 Notice of Award; 2.12 Notice to Proceed; 2.13 City of Cupertino Standard Details ; and 2.14 The following : No other documents 3. Contractor's Obligations. Contractor agrees to perform all of the Work required for the Project , as specified in the Contract Documents. Contractor must provide , furnish , and supply all things necessary and incidental for the timely performance and completion of the Work, including au necessary labor, materials , supplies, tools , equipment , transportation , and utilities, unless otherwise specified in the Contract Documents. Contractor must use its best efforts to complete the Work in a professional and expeditious manner and to meet or exceed the performance standards required by the Contract Documents . 4. Payment. As full and complete compensation for Contractor's timely performance and completion of the Work in strict accordance with the terms and condit ions of the Contract Documents, City will pay Contractor $343,133 .00 (the "Contract Price ") for all of Contractor's direct and indirect costs to perform the Work, including all labor, materials , supplies , equipment , taxes, insurance , bonds and all overhead costs , in accordance with the payment provisions in the General Conditions . 5. Time for Completion. Contractor will fully complete the Work for the Project within 40 calendar days from the commencement date given in the Notice to Proceed ("Contract Time "). By signing below , Contractor expressly waives any claim for delayed early completion . 6. Liquidated Damages. If Contractor fails to complete the Work within the Contract Time , City will assess liquidated damages in the amount of $1 ,000 .00 per day for each day of unexcused delay in complet ion , and such liquidated damages may be deducted from City's payments due or to become due to Contractor under this Contract. 7. Labor Code Compliance. 7 .1 General. This Contract is subject to all applicable requirements of Chapter 1 of Part 7 of Division 2 of th e Labor Code, including requirements pertaining to wages , working hours and workers ' compensation insurance. 7.2 Prevailing Wages. This Project is subject to the prevailing wage requirements applicable to the locality in which the Work is to be performed for each craft, classification or type of worker needed to perform the Work, including employer payments for health and welfare, pension, vacation , apprenticeship and similar purposes . Copies of these prevailing rates are available on line at http ://www.dir.ca .gov/DLSR . 7.3 DIR Registration. City will not enter into the Contract with a bidder without proof that the bidder and its Subcontractors are registered with the California Department of Industrial Relations to perform public work under Labor Code section 1725.5 , subject to limited legal exceptions. 8. Workers' Compensation Certification. Under Labor Code section 1861, by signing this Contract, Contractor cert ifi es as follows : "I am aware of the provisions of Labor Code section 3700 which require every employer to be insured against liability for workers ' compensation or to undertake self-insurance in accordance with the provisions of that code, and I w ill comply with such prov isions before commencing the performance of the Work on this Contract." 9. Conflicts of Interest. Contractor, its employees , Subcontractors and agents , may not have , maintain or acquire a conflict of interest in relation to this Contract in violation of any City ordinance or policy or in violation of any California law, including under Government Code section 1090 et seq . and under the Political Reform Act as set forth in Government Code section 81000 et seq. and its accompanying regulations. No officer, official, employee , consultant , or other agent of the City ("City Representative") may have , maintain, or acquire a "financial interest" in the Contract, as that term is defined under the Political Reform Act (Government Code section 81000 , et seq ., and regulations promulgated thereunder); or under Government Code section 1090, et seq .; or in violation of any City ordinance or policy while serving as a City Representative or for one year thereafter. Any violation of this Section constitutes a material breach of the Contract. 10. Independent Contractor. Contractor is an independent contractor under this Contract and will have control of the Work and the means and methods by which it is performed . Contractor and its Subcontractors are not employees of City and are not entitled to participate in any health , retirement, or any other employee benefits from City. 11. Notice. Any notice, billing , or payment required by or pursuant to the Contract Do cuments must be made in writing, signed, dated and sent to the other party by personal delivery, U.S. Mail, a reliable overnight delivery service, or by email as a PDF (or comparable) file . Notice is deemed effective upon delivery unless otherwise specified . Notice for each party must be given as follows : City: Name : City of Cupertino Address : 10300 Torre Avenue City/State/Zip: Cupertino, CA 95014 2 Phone: 408-777-3354 Attn : Director of Public Works Email : johnr@cupertino .org Copy to: John Raaymakers Contractor: Name : Richard Zito Address: 1717 Solano Way# 19 City/State/Zip: Concord , CA 94520 Phone : (925)826-5387 Attn : Richard Zotp Email: rzito@dmzbuilders.com 12. General Provisions. 12.1 Assignment and Successors. Contractor may not assign its rights or obligations under this Contract , in part or in whole, without City's written consent. This Contract is binding on Contractor's and City's lawful heirs , successors and permitted assigns . 12.2 Third Party Beneficiaries. There are no intended third party beneficiaries to this Contract except as expressly provided in the General Conditions or Special Conditions . 12.3 Governing Law and Venue . This Contract will be governed by California law and venue will be in the Superior Court of Santa Clara County, and no other place . 12.4 Amendment. No amendment or modification of this Contract will be binding unless it is in a writing duly authorized and signed by the parties to this Contract. 12.5 Integration; Severability. This Contract and the Contract Documents incorporated herein, including authorized amendments or Change Orders thereto, constitute the final, complete , and exclusive terms of the agreement between City and Contractor. If any provision of the Contract Documents, or portion of a provision , is determined to be illegal, invalid, or unenforceable, the remaining provisions of the Contract Documents will remain in full force and effect. 12.6 Authorization. Each individual signing below warrants that he or she is authorized to do so by the party that he or she represents , and that this Contract is legally binding on that party. If Contractor is a corporation, signatures from two officers of the corporation are required pursuant to California Corporation Code section 313. [Signatures are on the following page.] 3 The parties agree to this Contract as witnessed by the signatures below: CITY OF CUPERTINO 60 or;_n __ David Brandt , City Manager Date ---------- APPROVED AS TO FORM : i)M ~andolph S . Hom, City Attorney Date ----------- ATTEST: race Schmid/' Ci z_g ler~ Date CJ -,-( ] Contract Amount: $343 ,133.00 P.O. No . c;H)l Y-?;t> i Account No . 420-99-G4.Q.-ST 020-03-01 o'fl q ~,qlls- END OF CONTRACT 4 ATTACHMENT A Bidder's Name: DMZ Bu ilders Bid Proposal RETAINING WALL REPLACEMENT -REGNART ROAD ______________ D_M_Z_B_u_i_ld_e_rs _____ ("Bidder") hereby submits this Bid Proposal to the City of Cupertino ("City") for the above-referenced project ("Project") in response to the Notice Inviting Bids and in accordance with the Contract Documents referenced therein . 1. Base Bid. Bidder proposes to perform and fully complete the Work for the Project as specified in the Contract Documents, within the time required for full completion of the Work, including all labor, materials, supplies, and equipment and all other direct or Indirect costs including, but not limited to, taxes, insurance and all overhead for the following price ("Base Bid"): $ 3Y'22. lo;), oo · . / 2. Addenda. Bidder agrees that it has confirmed receipt of or access to, and reviewed, all addenda issued for this Bid. Bidder specifically acknowledges receipt of the following addenda: Addendum: #01 #02 #03 #04 Date Received : 08 -24-'17 Addendum : #05 #06 #07 #08 Date Received: 3. Bidder's Warranties. By s igning and submitting thi s Bid Proposal, Bidder warrants the follo wing: 3.1 Examination of Contract Documents. Bidder has thoroughly examined the Contract Documents and represents that, to the best of Bidder's knowledge, there are no errors, omissions, or discrepancies in the Contract Documents, subject to the limitations of Public Contract Code section 1104 . 3.2 Exam ination of Worksite. Bidder has had the opportunity to examine the Worksite and local conditions at the Project location. 3.3 Bidder is Qualified. Bidder is fully qualified to perform the Work. 3 .4 Responsibility for Bid. Bidder has carefully reviewed this Bid Proposal and is solely responsible for any errors or omissions contained in Its completed Bid. 4. Award of Contract. By signing and submitting this Bid Proposal , Bidder agrees that if Bidder is awarded the Contract for the Project, within ten days following issuance of the notice of award to Bidd er, Bidder will do all of the following: · 4.1 Execute Contract. Enter into the Contract with City in accordance with the terms of this Bid Proposal, by signing and submitting to City the Contract prepared by City using the form included with the Contract Documents; 4.2 Submit Required Bonds. Submit to City a payment bond and a performance bond, each for 100% of the Contract Price, using the bond forms provided and in accordance with the requirements of the Contract Documents ; and 4.3 Insurance Requirements. Submit to City the insurance certificate(s) and endorsement(s) as required by the Contract Documents. Retaining W a ll Replacement -Regnart Ro ad Project No . 2017-12 BID PROPOSAL Page 9 ATTACHMENT A Bidder's Name: ~D~M~Z_B~ui~ld~e~rs _____ _ 5. Bid Security. As a guarantee that, if awarded the Contract, Bidder will perform its obligations under Section 4 above, Bidder is enclosing bid security in the amount of ten percent of its maximum bid amount in one of the following forms (check one): A cashier's check or certified check payable to City and issued by _____________ [Bank name] in the amount of $ ___________ _ ___x_ A bid bond, using the Bid Bond form included with the Contract Documents, payable to City and executed by a surety licensed to do business in the State of California. This Bid Proposal is hereby submitted on Signature ~ l lces,&&lrC Name!Tltle (If Corporation : Chairman, President or Vice President) 986594 09/30/17 A B, C-10, C-21 License#, Expiration Date, and Classification 1717 Solano Way #19 Address Concord, CA 94520 City, State, Zip 925 826-5387 Contact Phone September 19 , 2011, Name!Tltle . If Corporation: Secretary, Assistant Secretary, Chief Financial Officer or Assistant Treasurer) 1000006023 DIR Registration # 925 826-5387 Phone Richard Zito/ President Contact Name/Title rzito@dmzbuilders.com Contact Email END OF BID PROPOSAL Retaining Wall Replacement -Regnart Road Project No. 2017-12 BID PROPOSAL Page 10 ATTACH MENT A Bidder's Name: DMZ Builders Bid Schedule This Bid Schedule must be comp leted in ink and included w ith the sealed Bid Proposal. Pricing must be prov ided for each Bid Item as indicated. Items marked "(SW)" are Specialty Work that must be performed by a qualified Subcontractor. The lump sum or un it cost for each item must be inclus ive of all costs, whether direct or indirect, inc luding profit and overhead. The sum of all amounts entered in the "Extended Total Amount" column must be identical to the Base Bid price entered in Section 1 of the Bid Proposal Form. LS= Lump Sum SF = Square Feet EA= Each LF = Linear Foot CY= Cubic Yard LB = Pounds TON = Ton (2000 lbs) AL = Allowance BID ITEM ITEM DESCRIPTION NO. 1 Mobilization 2 Fie ld EnAlneering & Survey Work 3 Traffic Control & Construction Area Signage 4 Temporary Water Pollution Control 5 Utility Location 6 Roadway Excavation 7 Clearino & Grubbino 8 Remove Tree 9 Remove Existing Retaining Wall 10 Hot Mix Asphalt (Type A) 11 AC Dike (Type A) 12 Concrete Barrier -Type 60 13 Concrete Barrier -Type 60D 14 12x12 DI With 8" PVC Down Drain 15 Jute Erosion Control B l anket/Netting 16 Structural Excavation (So l dier PIie Wall) 17 Structural Backfill (Soldier Pile Wall) 18 Concrete Backfill (Soldier Pile Wall) 19 Lean Concrete Backfill 20 lnstalied Drilled Piers 21 Structura l Concrete, Retaining Wall 22 Bar Reinforcement Steel (RetaininQ Wall) 23 Retaining Wall Gutter Retaining Wall Replacement -Regnart Road Project No. 2017-12 EST. UNIT QTY. UN IT COST 1 LS $ 32. D0D 1 LS $ \ Y?, onn 1 LS $ ?J'S-, Oco 1 LS $\5"10DCJ 1 LS $ 2>, l)() D 1 LS $ \ 3 IJOO 1 LS $,ry,1.)0\j 2 EA $ 5' 00 L) 1 LS $ <:/, D00 14 TON $ ytplj 20 LF $ \ 00 20 LF $ 500 102 LF $ 2.00 2 EA $ 1, aOO 20 SY $ I '2,!J 42 CY $ ' 2,1:5 $ 1?0 4 CY $ l\ 06 31 CY 13 CY $ 200 380 LF $ 190 25 CY $1)~00 $ \, g 0 3,670 LB 102 LF $ ID D TOTAL BID SY = Square Yard EXTENDED TOTAL AMOUNT $'~2.,000 $ \. i I OOcJ $ 3-S-, oou $ I !?/0 ob $ 3, O Du $ \~,ooo $ \S-, C>O O $ 10, 000 $ i,ooo $ V) ;:5) () $ 2, OOC> $ I l> [) OD $ 20,YOD $ '5 I OOCl $ 2; 5""()0 $ 5) 2,~() $ Lti DD $ \2,Lju6 $ 2./ (p60 $ I 2-260 $ ?>7; 5""00 $ lt>,C!l3 $ \D,'2.,00 $ :\'-1·~ \ 62i, OD .., B ID SCHEDULE Page 11 ATTACHMENT A Bidder's Name: --'D-'M_Z_B_u;_il--'-d-'-er--"-s _____ _ TOTAL BASE BID: I terns 1 through 23 inclusive : $ __ 3...,_'-1-'--"3.__,_/--+-\ _·eiL.1.3.,,_-.....,0"'-""()'------ Note: The amount entered as the "Total Base Bid" should be identical to the Base Bid amount entered in Section 1 of the Bid Proposal form. BIDDER NAME: ---=D--'-M=Z~B=-u=i=ld=er=s-------------------- END OF BID SCHEDULE Retaining Wall Replacement -Regnart Road Project No. 2017 ~12 BID SCHEDULE Page 12 ATTACHMENT A Bidder's Name: ------------ Subcontractor List For each Subcontractor that will perform a portion of the Work in an amount in excess of one-half of 1 % of the Bidder's total Contract Price, 1 the bidder must list a description of the Work, the name of the Subcontractor, .its California contractor li ce nse number, the location of its place of business, its DIR registration number, and the portion of the Work that the Subcontractor is performing based on a percentage of th e Base Bid price. Bidder may not list more than one Subcontractor for each such portion of the Work listed by Bidder below. Dr i \I\ n '1 END OF SUBCONTRACTOR LIST 1 For street or highway co ns truction th is requirement appli es lo any subcontract of $10,000 or rnore. Retaining Wall Replacement -Regn art Road Project No. 2017-12 SUBCONTRACTOR LIST Page ·13 3.0 Executed in Duplicate Performance Bond Bond No . 57BCSHM6344 Premium: $4,046.00 The City of Cupertino ("City ") and DMZ Builders ("Contractor") have entered into a contract, dated October 3 , 20.l.Z..__ ("Contract") for work on the Retaining Wall Replacement -Regnart Road, Project No. 2017-12, Project ("Project"). The Contract is incorporated by reference into this Performance Bond ("Bond "). 1. General. Under this Bond, Contractor as Principal and Hartford Fire Insurance Company , its surety ("Surety"), are bound to City as obligee for an amount not less than $ 343,133.00--------------. By executing this Bond. Contractor and Surety bind themselves and their respective heirs , executors. administrators . successors and assigns . jointly and severally. to the provisions of this Bond. 2. Surety's Obligations; Waiver. If Contractor fully performs its obligations under the Contract. including its warranty obligations under the Contract , Surety's obligations under this Bond will become null and void upon recordation of the notice of completion, provided Contractor has timely provided a warranty bond as required under the Contract. Surety waives any requirement to be notified of and further consents to any alterations to the Contract made under the applicable provisions of the Contract Documents , including changes to the scope of Work or ex tensions of time for performance of Work under the Contract. Surety waives the provisions of Civil Code sections 2819 and 2845. 3. Application of Contract Balance. Upon making a demand on this Bond, City will make the Contract Balance available to Surety for completion of the Work under the Contract. For purposes of this provision , the Contract Balance is defined as the total amount payable by City to Contractor as the Contract Price minus amounts already paid to Contractor, and minus any liqu idated damages, credits , or backcharges to which City is entitled under the terms of the Contract. 4. Contractor Default. Upon written notification from City that Contractor is in default under Article 13 of the Contract General Conditions , time being of the essence, Surety must act within the time specified in Article 13 to remedy the default through one of the following courses of action : 4.1 Arrange for completion of the Work under the Contract by Contractor, with City 's consent, but only if Contractor is in default solely due to its financial inability to complete the Work ; 4.2 Arrange for completion of the Work under the Contract by a qualified contractor acceptable to City , and secured by performance and payment bonds issued by an admitted surety as required by the Contract Documents, at Surety's expense ; or 4.3 Waive its right to complete the Work under the Contract and reimburse City the amount of City 's costs to have the remaining Work completed . 5. Surety Default. If Surety defaults on its obligations under the Bond, City will be entitled to recover all costs it incurs due to Surety's default , including legal , design professional, or delay costs . 6. Notice. Any notice to Surety may be given in the manner specified in the Contract and delivered or transmitted to Surety as follows: Attn : Lindsay Machacek, Hartford Fire Insurance Company Address : 595 Market St.. 5th Fl. Retaining Wall Replacement -Regnart Road Project No . 2017-12 PERFORMANCE BOND Page 1 City/State/Zip : San Francisco, CA 94 105 Phone : (800) 248 -5999 Fax: (866) 780-9956 Email : liodsay machacek@thehartford .com Bond No . 57BCSHM6344 7. Law and Venue. This Bond will be governed by California law, and any dispute pursuant to this Bond will be venued in the Superior Court for Santa Clara County in which the Project is located, and no other place. Surety will be responsible for City's attorneys ' fees and costs in any action to enforce the provisions of this Bond . 8. Effective Date; Execution. This Bond is entered into and effective on October 5 , 201.L_. SURE~TY : fartford Fire Insurance Company s/ ~'f!;ut;_ l Nancy L. Hamilton. Attorney-in-Fact Name/Title [print] (Acknowledgment with Notary Seal for Surety and Surety's Power of Attorney must be attached.) Name/Title /JRA v'11vD DuvvuR.u ,. Name/Title C ·FO APPROVED BY CITY OF CUPERTINO : sf Name/Title END OF PERFORMANCE BOND Retaining Wall Replacement -Regnart Road Project No. 2017-12 PERFORMANCE BOND Page 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 ~~~~~~..&~~il:i"'"~--~-;W,!-~--~~~~~~~ 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 San Francisco On __ o_c_to_b_e_r _5,_2_0_1 _7 ___ before me, __ Y_vo_n_n_e_R_o_n_c_ag_l_io_lo_,_N_o_ta_r_y_P_u_b_lic_-_--_--_--_---_--_--_--_--_--_--_---_--_--_--_--_--, Date Here Insert Name and Title of the Officer personally appeared Nancy L . Hamilton------------------------------------------------------------------------------------------- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s). whose name~ is/are- subscribed to the within instrument and acknowledged to me that -!=le/she/they-executed the same in -Ris/herJtheir-authorized capacity{~. and that by his/her/theil: signature(s}-on the instrument the person(s}, or the entity upon behalf of which the person(s)-acted, executed the instrument. Place Notary Seal Above I certify under PENAL TY OF PERJURY under the laws of the St ate of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: _______ _ Number of Pages: Signer(s) Other Than Named Above: ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: Nancy L. Hamilton D Corporate Officer -Title(s): ______ _ D Partner -D Limited D General D Individual ~ Attorney in Fact D Trustee D Guardian or Conservator D Other:--------------- Signer Is Representing: ________ _ .l(;~~~~~~~~~w.,~·g_.(,'~,,<:l~X,'g{;,~~~~·~,rog,<;~~'Ql:'lt,~,~~~~~~~ ©2014 National Notary Association · www .NationalNotary .org • 1-800-US NOTARY (1-800 -876-6827) Item #5907 POWER OF ATTORNEY Direct Inquiries/Claims to: THE HARTFORD BOND , T-12 One Hartford Plaza Hartford , Connecticut 06155 Bond.Cl a ims@thehartfo rd .com call: 888-266-3488 or fax: 860-757-5835 SAWYER & COMPANY KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: WOODRUFF Agency Code: 57-554795 LI Hartford Fire Insurance Company, a cmpora ti o n dul y o rga ni zed und er th e la ws of th e St ate o f Co nn ec ti cut EJ Hartford Casualty Insurance Company, a cmporati on dul y orga ni zed und er the laws o f th e Sta te of In dia na LI Hartford Accident and Indemnity Company , a co rp ora ti on dul y orga nized und er the laws of th e Sta te of Connec ti c ut D Hartford Underwriters Insurance Company, a co1porati on dul y organi zed und er th e laws of th e State of Conn ec t icut D Twin City Fire Insurance Company, a corp orati o n dul y organ ized und er the laws of th e State of Indi ana D Hartford Insurance Company of Illinois , a corporation d ul y orga ni zed und er the laws of th e State of Illino is D Hartford Insurance Company of the Midwest , a corp orati on dul y orga ni zed und er th e laws of th e State of In dia na D Hartford Insurance Company of the Southeast, a corp orati on dul y orga nized und er the laws of th e State of Fl orida having their home office in Hartford , Connecticut, (hereinafter collectively referred to as the ·companies") do hereby make, constitute and appoint, up to the amount of Un limi te d : Ner i ssa S. Ba rtolome, Lawrence J . Coyne, Alic i a Dass , Joan De Lu ca, Roger C. Dicki n son , Pa t rick R Di ebe l , Na n cy L. Hami lt on, Ke lly Ho l temann , Thomas E. Hu ghes , Stanl ey D. Loa r , Mark M. Munekawa , Yvonne Roncag l iol o, Charl e s R. Shoemaker o f SAN FRANC I SCO , California their true and lawful Attorney(s)-i n-Fa ct , each in their separate capacity if more than one is named above , to sign its name as surety(ies) only as del ineated above by 1:8], and to execute , seal and acknowledge any and all bonds , undertakings , contracts and other written instruments in the nature thereof, on behalf of the Companies in the ir business of guaranteeing the fidelity of persons , guaranteeing the performance of contra cts and executing or guaranteeing bonds and undertakings requ ired or perm itted in any act ions or pro ceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6, 2015 the Companies hav e ca us ed these presents to be signed by its Senior Vice President and its corporate seals to be hereto affi xed , duly attested by its Assistant Se cretary . Further , pursuant to Resolution of the Board of Directors of the Companies , the Companies hereby unambiguously affirm that they are and will be bound by any mechani cally applied signatures applied to this Po wer of Attorney . John Gray , Assi stant Secretary M. Ross Fisher , Senior Vice President STATE OF CONNECTICUT} ss . COUNTY OF HARTFORD Hartford On th is 11th day of January , 2016 , before me personally came M . Ross Fisher , to me known, who being by me duly sworn , did depose and say : that he resides in the County of Hartford , State of Connecticut ; that he is the Senior Vice President of the Compan ies , the corporations described in and which executed the above instrument; that he knows the seals of the said corporations ; that the seals affi xed to the said instrument are such corporate seals ; that they were so affi xed by authority of the Boards of Dire ctors of said corporations and that he signed his name thereto by like authority . CERTIFICATE POA 1016 No ra M. Stranko No tary Publi c My Co mmi ss io n Ex pires Marc h 3 1, 20 18 Kevin Heckman , Assistant Vice President Exec uted in Duplicate Payment Bond Bond No. 57BCSHM6344 Premium : Included in Perf. Bond The City of Cupertino ("City ") and DMZ Builders ("Contractor") have entered into a contract, dated October 3 , 20lZ_ ("Contract") for work on the Retaining Wall Replacement -Regnart Road, Project No. 2017-12 , Project ("Project"). The Contract is incorporated by reference into this Payment Bond ("Bond"). 1. General. Under this Bond , Contractor as principal and Hartford Fire Insurance Company its surety ("Surety"), are bound to City as obligee in an amount not less than $ 343 J 33 00-------------, under California Civil Code sections 9550 , et seq . 2 . Surety's Obligation. If Contractor or any of its Subcontractors fails to pay any of the persons named in California Civil Code section 9100 amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract , or for any amounts required to be deducted , withheld , and paid over to the Employment Development Department from the wages of employees of Contractor and its Subcontractors , under California Unemployment Insurance Code section 13020 , with respect to the work and labor, then Surety will pay for the same . 3. Beneficiaries. This Bond inures to the benefit of any of the persons named in California Civil Code section 9100 , so as to give a right of action to those persons or their assigns in any suit brought upon this Bond . Contractor must promptly provide a copy of this Bond upon request by any person with legal rights under this Bond . 4. Duration. If Contractor promptly makes payment of all sums for all labor, materials , and equipment furnished for use in the performance of the Work required by the Contract, in conformance with the time requirements set forth in the Contract and as required by California law , Surety's obligations under this Bond will be null and void . Otherwise , Surety's obligations will remain in full force and effect. 5. Waivers. Surety waives any requirement to be notified of alterations to the Contract or extensions of time for performance of the Work under the Contract. Surety waives the provisions of Civil Code sections 2819 and 2845 . City waives requirement of a new bond for any supplemental contract under Civil Code section 9550. Any notice to Surety may be given in the manner specified in the Contract and delivered or transmitted to Surety as follows: Attn : Lindsay Machacek, Hartford Fire Insurance Company Address : 595 Market St 5th El City/State/Zip : San Francisco CA 94105 Phone: (800) 248 -5999 Fax: (866) 780-9956 Email : liodsay machacek@tbehartford com 6. Law and Venue. This Bond will be governed by California law, and any dispute pursuant to this Bond will be venued in the Superior Court of Santa Clara County in which the Project is located , and no other place . Surety will be responsible for City 's attorneys ' fees and costs in any action to enforce the provisions of this Bond. Retaining Wall Replacement -Regnart Road Project No. 2017-1 2 PAYMENT BOND Page 1 Bond No . 57BCSHM6344 7. Effective Date; Execution. This Bond is entered into and is effective on October 5 2012. SURETY: Hartford Fire Insurance Company Business Name ~ ~f?~~ Nancy L. Hamilton, Attorney-in-Fact Name/Title (Acknowledgment with Surety's Notary Seal and Surety's Power of Attorney must be attached.) CONTRACTOR : -'D'-'M"""Z=-.c.B...c.u""-ild'-'e'--rs'----~----------------- s/ /2:c&t:.ZN~ _'ki'---t'--=-C H~it""-I-Z----"A~~Z~, 7?)L....>OC._,___.h~g-=--c, b f-Nr Name/Title ' ARAVttJD Du¥vu~o, G·r-o Name/Title APPROVED BY CITY OF CUPERTINO: s/ ___________________ ~ Name/Title END OF PAYMENT BOND Retaining Wall Replacement -Regnart Road Project No. 2017-12 PAYMENT BOND Page 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing th is 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 San Francisco On __ O_c_to_b_e_r_5_, _20_1_7 ____ before me, __ Y_v_o _nn_e_R_on_c_a_g_li_o_lo_, _N_o_ta_r_y _P_u_b_lic_-_--_--_--_--_--_--_--_--_--_--_--_--_---_-_--_--_-, Date Here Insert Name and Title of the Officer personally appeared Nancy L . Hamilton----------------------------------------------------------------------------------------- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s} whose name(g) is/are- subscribed to the within instrument and acknowledged to me that -he/she/they executed the same in -Ris/herl-tl=leir-authorized capacity(ies}, and that by Aislher/theu: signature(s}on the instrument the person(s}, or the entity upon behalf of which the personfst-acted, executed the instrument. Place Notary Sea/ Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature __ vtJ_' -fi:'---.+--'-/":c__ _______ _ / Signature of Notary Public ---------------OPTIONAL --------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: -------------Document Date: _______ _ Number of Pages: Signer(s) Other Than Named Above: ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: Nanc.,_y =L.:.c. H'-=am~ilt=o=n'------- 0 Corporate Officer -Title(s): ______ _ 0 Partner -D Limited O General 0 Individual [1!] Attorney in Fact D Trustee D Guardian or Conservator D Other:--------------- Signer Is Representing: _________ _ .,<,~'Y(;~~~~'§<.~~'{.;'<.'!,,(;l~'®'§<:1~ro~~~'!.,&'g:(;.~~~~~~-y,;.~ ©2014 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 Direct Inquiries/Claims to: THE HARTFORD POWER OF ATTORNEY BOND, T-12 One Hartford Plaza Hartford , Connecticut 06155 Bo nd .Claims@thehartford.com call: 888-266-3488 or fax: 860-757-5835 Agency Name : WOODRUFF SAWYER & COMPANY KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code : 57-554795 LI Hartford Fire Insurance Company, a corp oration duly o rgan ized under th e laws of th e State of Connec ti c ut rK::J Hartford Casualty Insurance Company, a co rp ora ti on duly organ ized und er the laws of the State of Indian a LI Hartford Accident and Indemnity Company , a corp oration duly organized und er the laws of th e State of Conn ec ti cut CJ Hartford Underwriters Insurance Company, a corp oration duly orga ni zed under th e laws of the State of Connect icut CJ Twin City Fire Insurance Company, a co1poration dul y orga ni zed und er the laws of the State of Indiana CJ Hartford Insurance Company of Illinois , a co1porat ion duly orga ni zed und er the laws of the State of Illinois CJ Hartford Insurance Company of the Midwest , a cmp orat ion duly orga ni zed under th e laws of the State of Indi ana CJ Hartford Insurance Company of the Southeast, a corporatio n duly organized und er the laws of the State of Fl orid a having their home office in Hartford , Connecticut, (hereinafter collectively referred to as the "Companies") do hereby make , constitute and appoint , up to the amount of Unlimited : Nerissa S. Ba rt o l ome, Lawrence J . Coyne, Alicia Dass, Joan DeLuca, Roger C. Dickinson, Patri ck R Diebel, Nancy L. Hamilton, Kelly Holtemann, Thomas E. Hughes , Stanley D. Loar, Mark M. Munekawa, Yvonne Roncag l iol o, Charles R. Shoemaker of SAN FRANCISCO , California their true and lawful Attorney(s)-in-Fact , each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by l:8l. and to execute , seal and acknowledge any and all bonds , undertakings , contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons , guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6, 2015 the Companies have caused these presents to be signed by its Senior Vice President and its co rporate sea ls to be hereto affixed , duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies , the Companies hereby unambiguously affirm that they are a nd will be bound by any mechanically applied signatures applied to this Power of Attorney . John Gray , Assistant !Secretary STATE OF CONNECTICUT} ss. Hartford COUNlY OF HARTFORD M. Ross Fisher , Senior Vice President On this 11th day of January, 2016, before me personally came M. Ross Fisher , to me known , who being by me duly sworn , did depose and say: that he resides in the County of Hartford , State of Connecticut ; that he is the Senior Vice President of the Companies , the corporations described in and which executed the above instrument ; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals ; that they were so affi xed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. CERTIFICATE Nora M. Stranko Notary Publi c My Comm ission Expires Marc h 3 1, 20 18 I, the undersigned , Assistant Vice President of the Companies , DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies , which is still in full force effective as of October 5, 2 o 1 7 . Signed and sealed at the City of Hartford . Kevin Heckman , Assi st ant Vice President POA2016 ACO R D ® C E RTIFICATE OF UABi U TY INSURANCE I DATE (MM /DDNYYY) ~ 10/10/2017 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED , the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement/sl. PRODUCER CONTAC T Cass Hamann NAME : Woodruff-Sawyer & Co . ;f,9N,I, "-"· 415-402-654 7 I f fi~ •T A I • 415-989-9923 50 California Street, Floor 1 2 ~;.,M~~~~-c hamann@wsandco .com S a n Francisco CA 94111 INSURER(S) AFFORDING COVERAGE NAIC # 1NsuRERA:Hartford Fire Ins urance Company 19682 INSURED DMZBUIL-01 INSURER B, Trumbull Insurance Comoa nv 2 71 2 0 DMZ Builders INSURER c ,Aspen American Insurance Company 43460 4070 Nels on Ave ., Su ite A 1NsURER D ,Sentinel Insurance Comoanv , Ltd . 11000 Concord C A 9452 0 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER· 1924687103 REVISION NUMBER· THIS IS TO C ERTIFY TH AT TH E P OLI C IES OF INSURA N C E LISTED B E LOW HAVE BEEN IS S UED T O THE IN S URED NA MED AB OVE FOR THE POLI CY PERI O D INDICATED. NOTWITH ST A NDIN G A NY RE Q U IREMENT, TERM OR CO NDITION OF A NY CONTRACT O R OTH ER DOC UMENT WITH RESPECT T O WHICH T HIS C ERTIFI CATE MAY BE ISS UED OR M AY PERTA IN , THE IN S URA NC E A FFORDED BY THE PO LI C IES DESC RIBED HE R EIN IS S U BJECT TO A LL THE TERM S, EXCLUS IO N S A ND CONDITIONS OF SU C H POLI C IES . LIMITS S HOWN MAY HAVE BEEN REDUCED BY P A ID CLA IMS. INSR TYPE OF INSURANCE IADUL ':SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER IMM/DDNYYYl IMM/DD/YYYY) LIMITS A X COM MERCIA L GENERAL LIABILITY y y 57U EAFM2680 2/1/2 0 17 2/1/201 8 EACH OCCURRENCE $2,00 0 ,000 -D CLA IMS -MADE [iJ OCC UR DAMAGE TO RE NTED f--PREMISES /Ea occurrence l $300 ,0 00 ,__ MED EX P (Any one perso n) $5,000 PERSO NAL & ADV IN JU RY -$2,000,000 GE N'L AG GREG ATE LIMI T APP LIE S PER: GENE RA L AGGREG ATE $4 ,000 ,000 Fl [Z:j PRO-D LOC $4,000,000 POLICY JE CT PRODUCTS -COMP/OP AGG OTH ER: $ B AUTOMOBILE LIABILITY y y 57UEA FM268 1 ,__ 2/1120 17 2/1/20 18 COM BI NED SINGLE LIM IT (Ea accident) $1,000,000 X ANY AUTO BOD IL Y INJURY (Per perso n) $ --AL L OWNED SC HEDUL ED AUTOS AUTOS BODI LY INJU RY (Per accide nt) $ -NON-OWNED PROPERTY DAMA GE X HIR ED AUTOS X AUT OS /P er accidentl $ ,__ - $ C UMBRELLA LIAB M OCC UR y y CX00 57417 2/1/20 17 2/1/2018 EA CH OCCURRE NCE $4,00 0 ,00 0 f-- X EXCESS LIAB CLAIMS -MADE AGGREGATE $4 ,000,000 DED I I RETEN TI ON$ $ D WORKERS COMPENSATION y WEAZU3 126 2/1/2017 2/1/2 01 8 I PE R I I OT H- AND EMPLOYERS' LIABILI TY X STATUTE ER Y /N ANY PROPR IETOR/PARTNER/EXECU TIVE D N /A E.L. EAC H ACC ID EN T $1,000,000 OFFIC ER/M EMBER EXC LUDED? (M anda tory in NH) E.L. DISEASE -EA EMPL OYEE $1,0 00,000 If yes , desc ri be unde r $1,0 00 ,000 DESC RIP TION OF OPERATIONS be low E.L. DISEASE -PO LI CY LI MIT DESCRIPTION OF OPERATI ON S/ LOC ATIONS/ VEHICLES (ACORD 101 , Addition al Remarks Sch edul e, may be attached if more space is required) Retaining wall project. The City of Cupertino ("City") and its directors , office r s, engineers , a g e nts and e mploye es , and all public a g e ncies fro m whom permits will b e obta ine d and their directors, officers, engineers , agents and employees , and the State of California, and its office r s , agents and employe es a re additional insured per the attached . Covera g e is primary & non-contributory per the attached . Per project aggregate a pplies per the a ttached . A waive r of s ubroga tion applies p e r the atta ched . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City o f Cup ertin o , Dept of Publ ic Wo rks THE EXPIRATIO N DATE THEREOF, NOTICE WILL BE DELIVERED IN 10 300 Torre Ave ACCORDANCE WITH THE POLICY PROVISIONS. Cup ertin o CA 95 01 4 AUTHORI ZED REPRESEN TA TIVE O.....f6., •• • I © 1988-20 14 A CORD CORPORATION. All rights r es erve d. ACOR D 25 (2 0 14/0 1) T he AC O RD n a me a n d logo ar e re gistered marks o f AC ORD Policy No. 57 UEAFM2681 COMMERCIAL AUTOMOBILE HA9916 0312 TH IS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO MOBIL E BROAD FORM E NDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations The Named Insured shown in the Declarations is amended to incl.ude: (1) Any legal business entity other than a partnership or joint venture, formed as a subsidiary in which you have an ownership interest of more than 50% on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an '"insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture, (b) That is an "insured" under any other policy, (c) That has exhausted its Limit of Insurance under any other po l icy, or (d) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident'' that occurred before you formed or acquired the organization . B. Emp loyees as Insureds Paragraph A.1. -WHO IS AN INSURED -of SECTION II -LIABILITY COVERAGE is amended to add: d. Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A.1. -WHO IS AN INSURED -of Section II -Liability Coverage is amended to add: e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. D. Additional Insured if Required by Contract (1) Paragraph A.1. -WHO IS AN INSURED -of Section II -Liability Coverage is amended to add: f. When you have agreed, in a written contract or written agreement, that a · person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for "bodily injury" or "property damage" caused by the conduct of an "insured" under paragraphs a. or b. of Who Is An Insured with regard to the ownership, maintenance or use of a covered "auto." Form HA 9916 0312 © 2011, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission.) Page 1 of 5 The insurance afforded to any such additional insured applies only if the "bodily injury" or "property damage" occurs: (1) During the policy period, and (2) Subsequent to the execution of such written contract, and (3) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured. (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on you r policy, the most we will pay on behalf of such additional insured is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Pa rt that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non- contributory with the additional insured's own insurance. (4) Duties in The Event Of Accident, Claim, Suit or Loss If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the additional insured shall be required to comply with the provisions in LOSS CONDITIONS 2 . -DUTIES IN TH E EVENT OF ACCIDENT, C L AIM , SUIT OR LOSS -OF SECTION IV - BUSINESS AUT O CONDITIONS, in the same manner as the Named Insured. E. Primary and Non~Contributory if Required by Contract Only with respect to insurance provided to an additional insured in 1.D. -Additional Insured If Required by Contract, the · following provisions apply: (3) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance 5.d. (4) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from t hat other insurance . Paragraphs (3) and (4) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insu re d against that "suit". If no othe r insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance . We will share the remaining loss, if any, by the method described in Other Insurance 5.d. 2. AUTOS RENTED BY EMPLOYE ES Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire. The OTHER INSURANCE Condition is amended by adding the following: Form HA 991 6 0312 © 2011, T he Hartford (Includes copyrighted material of ISO Properties, Inc ., with its permission.) Page 2 of 5 . tf an "employee's" personal · insurance also applies on an excess basis to a covere d "auto" hired or rented by your "employee" on you r behalf and at your direction , this insurance will be primary to the "empl oyee's" personal insurance. 3. A MENDED FELLOW EM PL OYEE EXC LU S IO N EXCLUS ION 5. -FELL OW EMPLOY EE -of SECTION II -LIABILITY COVERAGE does not apply if you have workers' compe n sation in surance in-force covering all of you r "employees". Coverage is excess over any other co ll ectible in surance. 4 . H IRED AU TO PHYS ICAL DAMAG E COVE RAG E tf hired "autos" are covered "autos" for Liab ility Coverage and if Comprehensive, Specified Causes of L oss, or Collision coverages are provided under this Coverage F orm for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $100 ,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property, whi chever is smallest, minus a deducti b le. T he deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning . Hired Auto Physical Damage coverage is excess over any other col l ectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident" .. This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liabi lity company), or members of their households. 5 . PHYS ICAL DAMAGE ADD IT IONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A .4.a. of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1,000. 6. LOAN /LE A SE GA P COVERAGE Under SECTION 111 -PHYS ICAL DAMAGE COVE RAGE , in the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of th e "auto" at the time of the "loss" and the "outstanding balance" of the loan/lease . "Ou tstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees; security deposits not returned by the lessor; costs for extended warranties, credit life Insurance, health, accident or disability insurance pu rchased with the loan or lease ; and carry-over balances from previous loa ns or leases. 7. A IRBAG COVERAG E Under Paragraph B. EXCLUS IONS -of SECTION Ill PHYS ICAL DAMAGE COVERAGE, the following is added: The exclusi on relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 8. ELECTRON IC EQU IPMENT -BROADENED CO V ERAGE a. The exceptions to Paragraphs 8.4 EXCLUSIONS -of SECTION Ill -PHYSICAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto"; (2) Removable from a housing unit wh ich is permanently installed in or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or Form HA9916 0312 © 2 011 , T he Hartford (I ncludes cop yrighted material of ISO Properties, Inc ., with its permission.) Page 3 of 5 (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. b.Section Ill -Version CA 00 01 03 10 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C.2 and Version CA 00 01 10 01 of the Business Auto Coverage Form, Physical Damage Coverage, Li mit of Insurance, Paragraph C are each amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sou nd, and accessories used with such equipment) that reproduces, receives or transmits audio , visual or data signals which, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto" in a housing , opening or othe r location that is not normally used by the "auto" manufacturer for the install ati on of such equipment; (2) Re movable from a permanently installed housing unit as described in Paragraph 2 .a . above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace · damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 9. EXTRA EXPENSE BROADENED COVERAGE Under Paragraph A -COVERAGE -of SECTION Ill -PHYSICAL DAMAGE COVERAGE, we will J:BY for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR -WAIVER O F DEDUCTIBLE Under Paragraph D. -DEDUCTIBLE -of SECTION Ill -PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced . 11 . TWO OR MORE DEDUCTIBLES Under Paragraph D. -DEDUCTIBLE -of SECTION Ill -PHYSICAL DAMAGE COVERAG E, the following is added: If another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage fo rm app lies to the same "accident", the following applies: (1) If the deductible under this Business Auto Coverage Form is t he smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Busi n ess Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible . 12 . AMENDED DUT IES IN THE EVENT OF ACC IDENT, CLA IM, SU IT OR LOSS Th e requ irement in LOSS CONDI T IONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT,C LAIM, SUIT OR L OSS -of SECT ION IV -BU SINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You , if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company ; or (4) An executive officer or insu rance manager, if you are a corporation. 13 . UN INTENTIONAL FAILURE TO D ISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 14 . HIR ED AUTO -COVERAG E TERR ITO RY Paragraph e. of GENERAL CONDI T IONS 7. - POLICY PERIOD, COVERAGE TERRITORY - of SECTION IV BUSINESS AUTO CONDITIONS is replaced by the following: e. For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the '"Jnsured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "suit" is brought in the United States of America , the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 15. WAIVER OF SUBROGATION TRANSFER OF . RIGHTS OF RECOVERY AGAINST OTHERS TO US -of SECT ION IV - BUSINESS AUTO CONDITIONS is amended by adding the following: Form HA 99 16 03 12 © 2011, The Hartford (Includes copyrighted material of ISO Properties, Inc ., with its permission.) Page 4 of 5 We waive any right of recove ry we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. 16 . RESULTANT MEN TAL ANGU ISH COVERAG E The definition of "bodily inju ry" in SECTI ON V- DEFINITIONS is replaced by the following : "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death resulting from any of these. 17. EXTENDED CANCELLATION COND IT ION Paragraph 2. of the COMMON POL ICY CONDITIONS -CANCELLAT ION -applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. 18. HYBRID, ELEC T R IC, O R NATURAL GAS VEH ICLE PAYMEN T COVERAGE In the event of a total loss to a "non-hybrid" auto fo r which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended as follows: a. If the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natural gas, we will pay an additional 10%, to a maximum of $2,500, of the "non-hybrid" auto's actual cash value or replacement cost, whichever is less, b.The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," c. Regardless of the number of autos deemed a total loss, the most we will pay under this Hybrid , Electric, or Natural Gas Vehicle Payment Coverage provision for any one "loss" is $10,000. For the purposes of the coverage provision, a.A "non-hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas. b .A "hybrid" auto is defined as an auto with an internal combustion engine and one or more electric motors; and that uses the internal combustion engine and one or more electric motors to move the auto, or the internal combustion engine to charge one or more electric motors, which move the auto. 19 . VEH ICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended to add the following: In addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage provision for any one "loss" is $5,000 . For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. Form HA 99 16 0312 © 2011, T he Hartford (Include s copyrighted material of ISO Properties , Inc., wi t h its permission.) Page 5 of 5 have all you r ri ghts and duties unde r th is Cove rage Part . e. Unnamed Subsidiary Any subsidiary, and subsidiary thereof, of yours which is a legally incorporated entity of w h ich you own a financial interest of more than 50% of the voting stock on the effective date of the Coverage Part. The insu rance affo rded herein for any subsidiary not named in this Coverage Part as a named insured does not app ly to injury or damage with respect to wh ich an insured under t his Coverage Part is also an insured under another policy or would be an insured under such policy but for its termination or the exhaustion of its limits of insurance . 3 . New ly Acquire d or F ormed Organization Any organization you newly acquire or form , other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if t here is no other simila r insurance available to that organization. However : a . Coverage under this provis ion is afforded only until the 180th day afte r you acqu ire or fo rm the organi zation or the end of the policy p eriod , whichever is earlier; b . Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or fo rmed the organiz ation ; and c . Coverag e B do es n ot app ly to "p ersonal an d advertising injury" aris ing out of an offense committed before you acquired or formed the organization. 4 . Mob i le Equi p m e nt With respect to "mobile equipment" registered in your name under any motor veh icle registration law, any person is an insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liab ility arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to : a. "Bodily injury" to a co -"employee" of the person driving the equipment; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured unde r this provision . Page 10 of 18 P olicy Number: 57U E A FM 2680 5 . Non owned Waterc raft With respect to water craft you do not own t hat is less than 51 feet lon g and is not be ing used t o carry persons for a charge, any p erson is an insu red while operating such watercraft with your permission. Any other person or organi zation responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no othe r insurance of any kind is available to that person or organi zation fo r th is liability. However, no person or orga n ization is an insured with respect to: a . "Bodily injury" t o a co -"employee" of the person operating the wate r craft; o r b . "Property damage" to property owned by, rented to , in the charge of or occupied by you or the employer of any person who is an insured under this provision . 6. Additi o nal In s ureds Wh en R e quired By W ritten Contrac t, Written Agreement Or Permit The following person(s) or organization(s) are an additional insured when you have agreed, in a written cont ract, written agreement or because of a permit issued by a state or political subdivision, that such person or organi zation be added as an additional insured on your policy, provided the injury or damage occu rs subsequent to the execution of the contract or agreement. A person or organization is an additional insured under this provision only for t ha t per iod of time required by the contract or agreemen t. However, no such person o r organization is an insured under this provision if such person or organization is included as an insured by an endorsement issued by us and made a part of this Coverage Part. a. Ve ndo rs Any person(s) or organization(s) (referred to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products - completed operations hazard". (1) The insurance afforded the vendor is subject to the following additional exclusions: This insurance does not apply to: (a) ''Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the cont ract or agreement; HG 00 010605 (b ) Any express warranty unauthori ze d by you; (c ) Any physical or chemical change in the product made intentionally by the ve n do r; (d ) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and t hen repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed t o make or normally undertakes to make in the usual cou rse of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, serv1cmg o r repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h ) "Bodily injury" or "prope rty damage" arising out of the sole negligence of the vendor for its own acts or omissio ns or th ose of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Sub- . paragraphs (d) or (f); or (ii ) Such inspections, adjustments, tests or servicin g as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution o r sale of the products. (2 ) This insurance does not apply to any insured person or organization, from whom you have acqui red such products, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessors of E quipment (1) kly person or organization . from whom you lease equipment; but only with respect to their Hability for "bodily injury", "property damage" or "personal and advertising injury" caused, iri whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization . (2) With respect to the insurance afforded to these additional insureds this insurance does not apply to any "occurrence" which takes place after the equipment lease expires . HG 00 01 06 05 Policy Number : 57 UEAFM2680 c. Lessors of Land or Premises Any person or organiz ation from whom you lease land or premises, but only with respect to liability arising out of the ow ners hip , maintenance or use of that part of the land or premises leased t o you. With respect to the insurance afforded th ese additional insureds the following additional exclusions apply: This insurance does not apply t o: 1. Any "occurrence " which takes p lace after you cease to lease that land; or 2 . Structural alterations, new construction or demolition operations performed by or on behalf of such person or organi zation . d. Architects, Engineers or Survey ors Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury", "p roperty damage" or "personal and advertising injury" caused , in whole or in part, by your acts or omissions or the acts or omissio ns of those acting on you r behalf: (1) In connection with your premises; or (2) In the performance of you r ongoing operati ons performed by you o r on your behalf. With respect to the insurance affo rded these addition al insureds, the following add iti onal exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" ar ising out of the rendering of or the fai lure to rende r any professional services by or fo r you, includ in g : 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orde rs or drawings and specifications; or 2 . Supervisory, inspection, arc hitectural or engineering activities. e. P ermits Is s ued By State Or Po litica l Subdivisions kly state or political subdivis ion , but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. With respect to the insurance afforded these additional insureds, this insurance does not app ly to: (1) "Bodily injury", "p roperty damage" or "personal and advertising injury" arising out of operatio ns performed for the state or municipality; or (2 ) "Bodily injury" or "property damage" included within th e "products -completed operatio ns hazard". Page 11 of 18 f. Any Other P a rty Any othe r person or organi z ation who is not an insured unde r Paragraphs a. through e. above , but only with respect to liab ility for "bodily injury", "property damage" or "pe rsonal and advertising injury" caused , in whole or in part, by your acts or omissions or t he acts or omissions of those acting on your behalf: (1) In the performance of you r ongoing operations ; (2) In connecti on with you r premises owned by or rented to you; or (3 ) In connection with "your work" and included with in the "products-completed operations hazard", but only if (a) Th e written contract or ag reement requires you to provide such cove rage to such additional insured; and (b) This Coverage Part provides coverage for "bodily injury" or "property damage" included within t he "products-completed operations hazard". With respect to the insurance afforded t o these additional insureds, this insurance does not apply to: "B odily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying serv ices, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings , opinions , reports, surveys, field or de rs, change orders or drawings and specifications; or (2 ) Supervisory, inspection, architectural or enginee ring activities. The limits of insurance that apply to additional insureds unde r this provision is described in Section Ill -Limits Of Insu rance. How this insuran ce applies when other insurance is available to the additional insured is described in the Other Insurance Condition in Section IV -Commercial General Liability Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company t hat is not shown as a Named Insured in the Declarations. SECT ION Ill -LIM ITS OF INSURANCE 1. The Most We will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the numbe r of: a. Insureds ; b . Claims made or "suits" brought; or Page 12 of 18 Policy Number: 57UEAFM2680 c . Pers ons or organizations making cla ims o r bringing "suits". 2 . G e n er a l Aggregate Limit The General Agg regate Lim it is the most we will pay for the sum of: a . Medical expenses under Coverage C ; b . Da mages under Coverage A, except damages because of "bodily inju ry" or "property damage" included in the "products-completed operations hazard"; and c . Dam ages under Coverage B . 3. Products-Completed Operations Aggregate Li mit The Products -Completed Operations Aggregate Limit is the most we w ill pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard". 4 . Person a l and Adve rtising Injury Limit Subject to 2 . above, the Per so nal and Advertising Injury Li mit is the most we will pay under Coverage B fo r the sum of all damages because of all "personal and advertising injury" sustained by any one person or organizati on . 5. Each Occurrence Limit Subject t o 2. or 3. above, whichever applies, the Ea ch Occu rrence Limi t is the most we will pay for the sum of: a . Damages under Coverage A ; and b . Medical expenses u n der Coverage C because of all "bodily injury" and "property damage" ari sing out of any one "occurrence". 6. Damag e To Premises Rented To You Limit Subject to 5. above, the Damage To Premises Rented To You Li mit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these. 7. M e dica l Expense Limit Subject to 5. above , the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person . 8. How Limits App ly To Additiona l Insureds If you have agreed in a written contract or written agreement that another person or organi zation be HG 00 01 06 05 added as an addit ional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: a. The limits of insurance specified in the written contract or written agreement; or b . The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. The Limits of Insurance of this Coverage Pa rt apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV -COMMERC IAL GENERAL LIAB ILITY COND ITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, C la im Or Suit a. Not ice Of Occurrence Or Offense You or any additional insured must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a daim . To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. Notice Of Claim If a claim is made or "suit" is brought against any insured, you or any additional insured must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You or any additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. Assistance And Cooperation Of The Insured You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; HG 00 01 06 05 Policy Number: 57U E A FM2680 (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4 ) Assist us, upon our request, in t he enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply . d . Obligations At The Insureds Own Cost No insured will , except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. e. Additiona l Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance. f. Knowle dge Of An Occurrence, Offense, C la im Or Suit Paragraphs a. and b. apply to you o r to any additional insured only when such "occurrence", offense , claim or "suit" is known to: (1 ) You or any additional insured that is an individual; (2 ) My partner, if you or an additional insured is a partnership; (3) My manager, if you or an additional insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation; (5) My trustee , if you or an additional insured is a trust; or (6) My elected or appointed official , if you or an additional insured is a political subdivision or public entity . This duty applies separately to you and any additional insured . 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with . A person or organization may sue us to recove r on an agreed settlement or on a final judgmen t against an insured ; but we will not be liable for damages that are not payable under the terms of this Coverage Part or Page 13 of 18 that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative . 4 . Oth er In suran ce If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Prim ary Insura nce This insurance is primary except when b . below applies . If other insurance is also primary, we will share with all that other insurance by the method described in c. below. b. Excess Insuran ce This insurance is excess over any of the other insurance, whether primary , excess, conti n gent or on any other basis: · (1) Your Work That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (2) Premises Rente d To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occup ied by you with permission of the owner; (3) Tenant Liabi lity That is insurance purchased by you to cover you r liability as a tenant for "property damage" to prem ises rented to you or temporarily occupied by you with permission of the owner; (4 ) Aircraft, Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I -Coverage A-Bodily Injury And Property Damage Liability; (5) Prop erty D amage to Borrowed Equipment Or Use Of E levators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion j. of Section I -Coverage A -Bodily Injury And Property Damage Liability; (6) When You Are Added As An Additiona l Insu red To Other Insu ran ce Any other insurance avai lable to you covering liability for damages arising out of the premises or operations, or products and completed operations , for which you have been added as an additional insured by that insurance; or Page 14 of 18 Policy Number: 57UEAFM2680 (7) When You Add Others A s A n Addit io na l Insured To This Insurance Any other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this coverage part. (a ) Primary Insuranc e Wh en Required By · Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that othe r insurance by the method described in c. below. (b) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement, or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek cont ribution from that othe r insurance. Paragraphs (a) and (b) do not apply to othe r insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any othe r insurer has a duty to defe nd the insured against that "sui t". If n o other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. · When this insurance is excess over othe r insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2 ) The total of all deductible and self-insu red amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part . c. Method Of Sh aring If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. HG 00 01 06 05 Professiona l serv ices includ e: (1) The preparing , app roving, or failing to prepa re or approve, maps, shop drawings, opinions, reports, surveys, field orders , change orders, or drawings and specificat ions; and (2) Supervisory or i nspection activities performed as a part of any relate d arch itectural or engineering activitie s. This exclusion applies even if the claims against any insured allege negl igence or other wrongdoing in the supervision, hiring, employment, train i ng or monitoring of others by that insured, if the "occurrence" which caused the "bodi ly injury" or "property damage", o r the offense which caused the "personal and advertising injury", involved the rendering of or fai lure to render any professional services by you with respect to your prov iding engineering , arch itectu ral or survey ing services in your capacity as an engineer, architect or surveyor. This exclusion does not apply to your operations in connection with construction work performed by you or on your behalf. However, this exception to the exclusion will not apply if you are in the business or profession of providing the profess io na l services described above independent from the construction work performed by you or on your beha lf. In the event this insurance applies to any injury, damage , loss, cost or expense covered by Professional liability ins urance issued by a company unaffiliated with us, then the insurance afforded under th is Coverage Part is excess over such other valid and collectible Professional Liability insurance (including any deductible or self-insured retention portion thereof), and any · other valid and collectible insurance available to the insured whether primary, excess, con t ingent or on any other bas is. 4. PER PROJECT AND PER LOCATION GENERAL AGGREGATE LIMITS OF INSURANCE A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I -Coverage A, and for all medical expenses caused by accidents under Sect ion I -Coverage C, which can be attributed only to ongoing operations at a single "p roject" or a sing le "location"; 1. A separate Per Project General Aggregate Limit or a separate Per Location General Aggregate Limit applies to each "project'' or "location ", whichever is applicab le. The Per Project Genera l Aggregate limit and Per Locat ion Aggregate Limit is equal to the amo unt of the General Aggregate Limit shown in the Declarations. Page2of6 Po li cy Number: 57UEAFM2680 2. The Per Project Genera l Aggregate Limit or the Per Location General Aggregate Limit, wh ichever appl ies, is the most we will pay for the sum of all damages under Coverage A. except dama ges because of "bodi ly in jury" or "property damage" i ncluded in the "products -comp leted operat ions hazard", and for medical exp enses under Coverage C regardless of the number of; a. Insureds; b. Cla ims made or "su its" brought; or c. Persons or organizations making clai ms or br inging "su it s". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall redu ce the Per Project General Aggregate Lim it for that "proj ect" or the Per Lo catio n General Aggregate for that "location ", whichever applies. Such payments shall not reduce the General Aggregate limit shown in the Dec larations, the Per Project General Aggregate Lim it for any other "project", or the Per Locat ion General Aggregate Limit for any other "location". 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply . However, instead of being subject to the Genera l Aggregate Limit shown in the Dec larations, such limits will be subject to the applicable Per Project Genera l Aggregate Limit if attributable only to ongoing operations at a single "project'' or the Per Location Genera l Aggregate if attributable on ly to ongoing operations at a single "location". B. For all sums . which the insured becomes legally obligated to pay as damages caused by "occurrences " under Section I -Coverage A and for all med ical expenses caused by accidents under Section r -Coverage C , which cannot be attributed only to ongoing operations at a single "project" or a single "location"; 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall re duce the amount available under the General Aggregate limit or the Products- Completed Operations Aggregate Limit, whichever is applicab le; and 2. Such payments shall not reduce any Per Project General Aggregate Limit or any Per Location General Aggregate Limit. Form HS 245012 14 C. When covera ge for liability arisin g out of the "pr oducts-completed operations hazard " is provided, any payments for damages because of "bodily inj ury" or "property damage" included in the "products-completed operations hazard" will reduce the Products- Completed Operations Aggregate Limit , and not reduce the General Aggregate Lirnit,or any Per Project General Aggregate Limit or any Per Locat ion General Agg regate Limit. D. The provisions of Section Ill -Limits Of Insurance not otherwise mod ified by t his endorsement shall continue to apply as stipulated. E. The following is added to Section V - Definitions: "Project" means a premises an insured d oes not own o r rent and where such insured performs construction-related operation s. Each "project'' involving the same or connecting lots, or premises whose connect ion is separated by a street, roadway, waterway or right-of-wayrailroad shall be considered a single "project''. If a "proj ect" has been abandoned and then restarted, or if the al.lthorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the "project" shall be considered a single "project". "Project" does not include a premises that is a "location". "Location" means a premises an insured owns or rents and w here such insu red performs business operations other than construction - related operations . Each "location" involving the same or connecting lots, or prem ise s Whose connection is separated by a street, roadway, waterway or right-of-way railroad shall be considered a single "location." "Location" does not include a premises that is a "project". This provision does not apply if the Per Project and the Per Location General Aggregate Limit has been otherwise modified by endorsement. 5. MOTOR VEHICLE LAWS The following are added to Sect ion IV - Commercial General Liability Cond itions: 1. When this Coverage Part is certified as proof of financial responsibility fo r the future under the provisions of any motor vehicle financial responsibility law, the insurance provided by the coverage part for Bodily Injury Liability or Property Damage Liability will comply with the provisions of the law to the extent of the coverage and limits of insurance re quired by that law. 2. With respect to "mobile equ ipment" t o wh ic h this insurance app lies, we will provide any Form HS 24 50 12 14 Policy Number: 57UEAFM2680 liability, u ninsured motorists, underinsu red motorists , no-fault or other coverages requi red by any motor ve hicle insurance law. We will provide the require d limits for those coverages. 6. MEDICAL PAYMENTS COVERAGE INCLUDING PRODUCTS-COMPLETED OPERATIONS Para g raph 1.a. of the Insuring Agreement - Coverage C is replaced by the fo ll owing : 1. Insuring Ag re ement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On prem ises you own or rent; {2) On ways next to premises you own or rent; {3) Because of your operations; or (4) Included within the definition of the "products-completed op erat ions hazard;" provided that (1) The acciden t takes place in the "coverage territory" and dur ing t he policy period; (2) The expenses are incurred and reported to us within three years o f the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. 7. INSURED CONTRACT -CONSTRUCTION OPERATIONS AND MUNICIPAL WORK Paragraph d. of the definition of "insured contract" in Section V -Definitions is deleted and replaced by the following: d . An obligation, as required by ordinance, to indemnify a municipality. 8. INJURY TO EMPLOYEE'S REPUTATION WITH RESPECT TO INCIDENTAL MEDICAL MALPRACTICE A. The following is added to paragraph 1.e. of the Insuring Agreement -Coverage A: (3) With respect to incidental medical malpractice, "bodily injury" includ es damages claimed for injury to emotions or reputation of an "employee" arising out of the rendering or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic services. Paae3of6 If any of the other insurance does not per mit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on t he ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5 . Premium Audit a . We will compute all premiums for this Coverage Part in accordance with our rules and rates. b . Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned p remium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6 . Re pre s entations a. When You Accept This Po licy By accepting this policy, you agree: (1 ) The statements in the Declarations are accurate and complete; (2 ) Those statements are based upon representations you made to us; and · (3 ) We have issued this policy in reliance up on your representations. b . Unintenti o n al F a i lure To Disclose H azards If unintentionally you should fail to disclose all hazards relating to the conduct of your business that exist at the inception date of this Coverage Part, we shall not · deny coverage under this Coverage Part because of such failure. 7 . Sepa rati o n Of In sureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separate ly to each insured against whom claim is made or "suit" is brought. 8 . Tran sfer Of Ri g h ts Of R ecovery Against Oth e rs To Us a. T ra nsfer of Ri ghts Of Re covery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our reque st, the HG 00 01 06 05 Policy Number : 57UEAFM2680 insu red will bring "suit" or tr ansfer those rights to us and help us enforce them. b . Waiver Of Rights Of R ec ov e ry (Waiver Of Subrogation ) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of . recove ry against such person or organization in a contract, agreement or permit that wa~ executed prior to the injury or damage. 9. When We Do Not Re n ew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 d~ys before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTI ON V -DEFIN IT IONS 1 . "Advertisement" means the widespread public dissemination of information or images that has the pu rpose of inducing the sale of goods, products or services through: a . (1) Radio; (2 ) Television ; (3) Billboard; (4) Magazine; (5) Newspaper; or b . Any other publication that is given widesp read public distribution. However, "advertisement" does not include: a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods or products; or b . An interactive conversation between or among persons through a computer network. 2 . "Advertising idea" means any idea for an "advertisement". 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4 . "Auto" means a land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 5. "Bodily injury" means physical: a . Injury; b . Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at any time . Page 15 of 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA Policy Number: 57WEAZU3126 Endorsement Number: Effe ctive Date: Q/011 20 17 Effecti ve hour is the sa me as stated on the Inform ation Page of the po li cy . Named In sured and Address: DMZ B uilders 17 17 Solano W ay , Sui te 19 Con cord , CA 94 5 20 We have the right to recover our pay m ent s from anyone liable f o r an injury covered by this po licy. W e will not enforce ou r right agai nst the pe rson or organization named in the Schedule. (Th is ag reement appli es only to the extent that you perfor m work under a writte n cont ract that requ ires you to obt ai n this agreement fro m us.) You m ust mainta in payroll reco rd s accu rately segregating t he remuneration of yo ur emplo yees w hile engaged in t he work described in t he S ch edule. The additi on al premium for t his endorsement shall be premium otherwise d ue on such remuneratio n. SCHEDULE Person or Organ ization ANY PER SON OR ORGANIZAT I ON FROM WHOM °¥OU ARE RE QU IRED BY WRI TT EN CONTRACT OR AGRE EMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US. Fonn WC 04 03 06 Process Date; (1) Printed in U.S.A. ALL 2 % of the C alifornia workers' compensat ion Job Desc ription A uth orized Re prese nt ative Policy Expiration Date: CITY OF a CUPERTINO DATE: 12/4/2017 Contractor: DMZ Builders 1717 Solano Way #19 Concord, CA 94520 Retaining Wall Replacement-Regnart .Road PROJECT NO. 2017-12 CONTRACT CHANGE ORDER CCO# 1 P.O.# 20l8-308 Acct.# 420-99-041-900-905-ST 021-03-01 The following changes are hereby approved, notwithstanding language in any attachment to the contrary, Contractor agrees that the amount paid pursuant hereto is full and complete compensation for the work described herein for each and every entity involved in the project who is being compens!;lted hereunder and that each and every claim for any cost for schedule impact such as a delay, impact, inefficiency, acceleration, extended overhead, increased supervision, compression and all other factors affecting cost arising from the subject of this Change Order is hereby released and waived by all such Subcontractors and suppliers at all tiers. Change City Authorization No. Type and No. 1 Description In order to recify a survey control issue, additional coordination, re-calculation, and re~ establishment of control points Cost $5,016.00 Page 1 Change Order 1-Regnart Ret Wall CITY OF fl Retaining Wall Replaccment-Reguart Road PROJECT NO. 2017-12 CONTRACT CHANGE ORDER CUPERTINO Total Change Order No.1 Total Project: Original Contract Change Order No.I Revised Contract Schedule Impact: 0 calendar days Project Final Completion Date: 16-Dec-17 REVIEWED BY: ty of Cupertino ohn Raaymakers City Project Manager Date: ~ Nourdin Khayata Construction Manager Date: Page 2 $5,016.00 $343,133.00 $5,016.00 $348,149.00 APPROVED BY: ~~., ::-_ City of Cupe1iino Tinun Borden Director of Public Works Date: 11-/5:/t 7 ~ Tyle1· Hoffinan Project Manager Date: Change Order 1-Regnart Ret Wall DMZ Builders CORI: 01 PtoJacl : Retaining Wall Replacement. Regnart Road Work Porfom1ad Fo,: ctty or Cupertino Work Petformtd By : DMZ Bllilclllrs / RSE lne. DoscrlpUon of Work : SUIV6y Control Issue• ldantily problem, coordinata with RSE and Designer, 1a-c81G1Jlate survey and re-Install Work Data : 1 lll -11110/17 Today's Date: 30-Nov-17 Employee Oescflpllon Crall Code or ~14irihl.1Ntnt.in6 D 0 D 0 0 0 DescripUon {Company/ Jovofce #) Ouc:npUon (~any I Invoice II) 0 0 0 0 Description {Company/ IIIYOlce Ill RSE Inc •• AddiUonal Costs Incurred {Reference attached) COST MARKUP SUBTOTAL LABOR $0.00 so.oo so.oo LABOR Rate Houi s Per Hr s s $ $ $ $ s $ s s MATERIALS Qty EQUIPMENT Code Qly SUBCONTRACTORSffRUCKING Qly 1 MATERIAL $0.00 S0.00 so.oo $5,016.00 · Fringe Tctal PerHr Wages/Hr . s . s $ . s s $ $ . $ . s . s Subtolal $ Unit Unit Cost s $ s s $ s Tex $ Subtotal s Unll Unlt Cost . s $ $ . $ s . $ s s Subtotal $ Unit Unit Coal $ LS s 4,560.00 s $ $ $ $ $ s $ Subtotal $ EQUIPMENT $0.00 S0.00 so.co Total Burden 20% Amount 27.00Y, Markup $ . s . . s . $ . . $ . s . . $ . s . s . $ . . s . $ . o.oov, 16% Amount Markup . $ . . s . s . $ . . $ $ . . $ . . $ . 15% Amounl Markup . $ . $ . . s . . s . $ . 10% Amount Markup $ . 4,860.00 $ 456.00 s . $ . s . . s . . $ . . s . . s . 4,560,00 $ 468,00 SUBCONTRACTORS $4,650.00 $456.00 $5,016.00 RSE Inc. RFI Additional Reestabl ish Additional Restake Revise Total Subtotal Bid Item Description Unit Preparation Coordination Control Calculat ions Wall CUtsheet Hours 1 2-Man Field <:rew $240.00 2 2 8 2 14 $3,360.00 2 Office Engineer, PE $140.00 2 2 2 6 $840.00 3 Survey Manager, LS/PE $180.00 1 1 2 $360.00 Grand Total $4,560.00 CITY OF fl CUPERTINO DATE: 12/18/2017 Contractor: DMZ Builders 1717 Solano Way#19 Concord, CA 94520 Retaining Wall Replacement-Regnart Road PROJECT NO. 2017-12 CONTRACT CHANGE ORDER CCO# 2 P.O.# 2018-308 Acct. # 420-99-041-900-905-ST 021-03-01 'The following changes are hereby approved, notwithstanding language in any attachment to the contra1y, Contractor agrees that the amount paid pursuant hereto is full and complete compensation for the work described herein for each and eve1y entity involved in the J>roject who is being compensated hereunder and that each and every claim for any oost for schedule i1npact such as a delay, impact, inefficiency, acceleration, extended overhead, increased supervision, compression and all other factors affecting cost arising from the subject of this Change Order is hereby released and waived by all such Subcontractors and suppliers at all tiers . Change City Authorization Description Cost No. Type and No. 2 $3,278.67 Remove and dispose of concrete foundations Page 1 Change Order 2-Regnart Ret Wall CITY OF II Retaining Wall Replacement-Regna1·t Road PROJECT NO. 2017-12 CONTRACT CHANGE ORDER CUPERTINO Total Change Order No.2 Total Pl'Oject: Original Contract Change Order No.1 Change Order No.2 Revised Contract Schedule Impact: 0 calendar days Project Final Completion Date: 16-Dec-17 REVIEWED BY: Cit of Cupertino APPROVED BY: ~ City of Cupe1tino Timm Borden $3,278.67 $343,133.00 $5,016.00 $3,278.67 $351,427.67 Jo n Raaymakers City Project Manager Director of Public Works Date: 1iJs/;1 . CSG Consultants Nourdin Khayata Construction Manager Date: Page 2 Tyler Hoffman Project Manager Date: Change Order 2-Regnart Ret Wall Retaining Wall Replacement -Regnart Road (Project No. 2017-1~)6/20173:53 PM DMZ Builders Pricing Estimate Summary Sheet Description: Existing Concrete F-oundatlon • Removal and Disposal COR 02 :rn/1(,(c(,1'::r:m;,-,:;1:f____ --------------___ _Ii '11t,Cd1 I Labor Man-hours Rate Craft 18 Supervision Engineer/Estimator '*See Breakdow,-c.n*_• ____ _, $0.00 I OIMan-hours $0.00 . O_ Man-hours Sub-Total Direct Labor Labor Markup Sub-Total Labor 15.00%5 - Materials Materials Material Markup Sub-Total Materials Including Tax 15% Equipment Estimated Equipment Operating Cost (CalTrans Rate) Equipment Markup Sub-Total Equipment Total Direct Estimate Total Mark-Up On Direct Est Included In detail Total Direct Estimate Subcontractors Subcontractors work Mark-up on Subcontractor work Sub-Total Subcontractors work Sub-Total D rects, Contract mar -up, In . Bond will be settled for all CO's at the end of the project. 15% 0% 10% ,, '( (, J _._., _____ ' _,, I ,, .,,r,, I I " --___ _l ~_:____I .' Estimate $ 1 592.43 $ $ I $ 1,592.43 I $ 524.15 $ .·· ·., .. ' T "::.,:•, ·;:, .;·· 3,278.67 .\ c:>il! ( .:. : /: ' . ~~~ nu111nt;J.i 4070 Nelson Ave, Suite A Concord, CA 94520 Office: (925) 826-5387 IIT:E!V!~U~'f.PJ~~::5 :::. ·~·-·:· ... <·,:·: :;~· •:.r ·:·.~:~ .''t,a~~.r:0:'·~c::,:·<Ma~rfcit'-': ·;_ ·F '·'EquiP,irient: .. Remove and Dispose existing concrete at founaation of existing retaining wall. (DEWR 0957) Offhaul and Dispose -existing wall concrete foundation. (DEWR 0959} T otal <;ost IMarKup 1\:;rana I ota1 1::,;~:; AO ORS $ $ $ $ $ $ 1,Q:1-2.20 $ 550.23 $ -$ 1,592.43 $ 236.86 $ 1 ,831.29 $ ~ 0 249.15 $ 455.14 1 $ 275.00 $ 279.30 $ -$ -$ 524.15 $ 734.44 $ 78.62 $ 110.17 $ 602.77 $ 844.61 $ ; §1,1bcpntra~ .· <[ . -TotaFC~t . _$_~~ $ \104.53 $ $ 2,851.02 $ 4z1;s1> $ ·-3-;278.67 DMZ Builders CORI: 02 Project : Relalnlng Wall Replacement· Regnart Road Work Porfonned For : Clly of ~ertlno Work Performed By~ DMZ Bulldore Desc~pllon or Work: Remove ond Dispose existing conccele al fou ndation of existing ralalnlng wall. (OEWA 0957) Work Date: 27-Nov-17 Today's Date: 6-0ec-17 LABOR Employee Descf1pllon c,ettcodeor Raia ftt1 t,ifal.J•11na,n• Hours Per Hr JUAN C. GARCIA (REG) J.GARCIA 2.0 $ 63.20 $ KEVIN FEENEY (REG) l(.FEENEY 2.0 $ 61.04 $ JOSE A. JIMENEZ (REG) JA.JIMENl:Z 3.0 $ S9.25 $ SAUL ANGUIANO (REG) 8.ANGUIANO 1.0 $ 61 .04 $ SANTIAGO BRISENO (REG) S.BRISENO a.a $ 47,82 $ 0 $ $ MATERIALS Description (Company I lnvolco II) Qty Disposal of Broken Conctele-Zanker Landnll 4.63 EQUIPMENT Descf1ptlon (Company / Invoice #) Codo Qty F-260 Pickup T&TIOB-12 3,0 F-150 Plckuo T&TT00-08 2,0 F-150 Plckuo T&TT0().08 2.0 F-160 Pickup T&TT00-06 1.0 Ingersoll Rand 185 CFM CorJ1)ressor PORT 01S.026 3,0 5 CY DUMP TRUCK 2AXL 2.0 PCBB + 2 buckets KOMA9486 3 SUBCONTRACTORS/TRUCK! NG COST MARKUP SUBTOTAL Oescf1ption {Company/ Invoice II) L/\BOR $1,042.20 $166.33 $1,188 .53 $2,008.46 Qlv MATERIAL $249,16 $37,37 $286 .62 F~nge Tolal Per Hr Waaes/Hr 28 .39 $ 81 .59 28,39 $ 79.43 22.22 $ 61.47 28.39 $ 79.43 30.43 $ 78.26 $ - Subtotal Unll Unit Cost Tons $ 55.00 Tax Subtotal Unit Unit Coal Hrs $ 22.78 Hrs $ 18,28 Hrs $ 18,28 Hrs $ 18.26 Hrs $ 17.33 Hrs $ 42.84 Hrs $ 02.63 Subtotal Uril Unit Cosl Subtotal EQUIPMENT $466.14 $68,27 $623.41 Tolal Burden 161', Amounl 27.00% Mll/kuo $ 163.18 $ 44 .06 $ 31.09 $ 168.88 $ 42 .89 $ 30.28 $ 184.41 $ 49.78 $ 36 .13 $ 79.43 $ 21.45 $ 16.13 $ 234 .76 $ 63.38 $ 44.72 $ -$ -$ - $ 820.63 $ 221,67 $ 166.33 0.00% 16% Amount Msrkuo $ 249.16 $ 37.37 $ -$ - $ . $ . $ -$ - $ -$ - $ 249.15 $ 37.37 16% Amounl MerkuP $ 68.28 $ 10.24 $ 38.62 $ 5.48 $ 36.62 $ 6.48 s 18.26 $ 2.74 $ 61 .99 $ 7,80 $ 85.68 $ 12.85 s 157.89 $ 23,08 $ 466.14 $ 08 .27 10% Amount Merkuo $ $ . $ $ - $ $ $ $ - $ $ . $ . $ SUBCONTRACTORS $0.00 $0.00 $0.00 DMZBullders CORI: 02 Project : Relelnlng Wall Replacement· Regn art Road Work Porformed For : City or cuperUno Work Porformed By : DMZ Builders Description of Work : OJfhaul and Dispose ex!sllng woJI cone<elo foun<lallon. (DEWR 0050) Work Date: ao-Nov-17 Today's Date: 6-0eo-17 LABOR Employee DesafpUon CraRCode or Rate fhtinl11Ua.ttn1mt Hours Per Hr JOSE A. JIMENEZ (REG) JA.JIMENEZ 2.0 $ 39.26 JUAN M JIMENEZ (REG) J,JIMENEZ 3,0 $ 29.05 SANTIAGO BRISENO (RE(l) S.BRISENO 2.0 $ 47.82 0 $ . 0 $ . 0 $ . 0 $ . MATERIALS Desc,lpllon (Company I Invoice#) Qlv Dlsvosal or Broken-Concrete -.Zenker Landfil l 6 EQUIPMENT OosC<lpllon (Company I Invoice II) Code Qly 6 CY DUMP TRUCK I 2AXL 3.0 PCBB + 2 buckets KOMA 0<185 2.0 F-250 Pickup T&TI06·12 2.0 0 0 0 0 0 0 Fringe Total Per Hr Wages/Hr $ 22.22 $ 61.47 $ 22.22 $ 51.27 $ 30.43 $ 78.26 $ . $ $ . $ $ . $ . $ . $ . Subtotal Unit Unll Cos! Tons $ 55,00 Tax Subtotal Unit Unll cost Hrs $ 42 .84 Hts $ 62.63 Hrs $ 22,70 $ . $ . $ . $ . $ . $ . Subtolal SUBCONTRACTORS/TRUCKING COST MARKUP SUBTOTAL Oescrlpllon (Company I Invoice II) lABOR $660.23 $82.53 $832.78 $1,270.21 Qfy MATERIAL $276.00 $41.25 $316.25 Unit Unll Cos! Subtolal EQUIPMENT $279.30 $41.00 $321.20 Total Burden 15% Amounl 27.00% Mark\Jp $ 122.04 $ 33,19 $ 23.42 $ 153.81 $ 41.53 $ 29,30 $ 168,60 $ 42.26 $ 29.81 $ $ . $ . $ . $ $ . $ . $ $ . $ $ . $ . $ 433.25 $ 116,98 $ 82.63 0.00% 16% Amounl Ma1kup $ 276 .00 $ 41.25 $ . $ $ -$ - $ . $ . $ -$ . $ . $ . $ 275.00 $ 41.25 15% Amount Markup $ 128.52 $ 19.28 $ 106,26 $ 15.79 $ 46.62 $ 6.83 $ -$ $ . $ . $ -$ $ . $ $ . $ $ . $ . $ 270.30 $ 41,90 6% Amount Marku~ $ . $ $ . $ - $ -$ - $ . $ s $ $ . $ . $ $ SUBCONTRACTORS $0.00 $0.00 $0.00 JIii !' ~ co"""°""'"~ No gll659< DAILY EXTRA WORK REPORT I J ~ J .fit 1717 Sotono Way, #19 Concord, CA 91,51,3 'Ph: (9i5) 826-5387 Fox: (925) 826-5766 Job No . ......,.....,.\ 2-.W ......... _____ _ Date: \I I z.,'7'/ 11:...___ ___ _ lJ ll.UERS Project/ Contract No. ::2ol1--l].... e<?S,V\o/\_. gJ (2_e1 kJ! - Description of Work:·~ Qpvv\rn,f o.,d ol:{\oS: fk'.\ctm.t~ag,cerl f :\j~ C,o~ .a..\: ~iwk.~~ ~ £. Wi:*•Y'.'j ~~~v\.\.:3 _L .. noU. ~ LABOR Reg 1me EOUJ PMEN!( SUPPLIES & MATERIALS SUBCONTRACTOR Description """'lkJ. (2.."di..d~ri,,,,a> 1.1-L .. ,.,nA -·~ ... \i.fC ~"'d-4..'111 -, " __ ... _ -· --- Verification of work perfofmed, labor, equipment, and materials are fisted . Foreman/Supervisor.~ ..... ~-"=-~~------------- Unit Quantity .... Unit Quantity LrA ,1_ --- Slgn•tu~ = Authorized By:_ CIC St-,rt-c_A~c.u ~I ~Hr; ~t-f Signature: ~~ ,__ Distribution: White• Yellow-(' l 9 i:-''i " ,) I ! l I I. Contractor's License No 986594 BUI LUERS 1717 Solono Way, #19 Concord, CA 91151-3 Ph: (915) 8:z6·5~87 FaK: (9,.5) 826-5766 Project/ Contract No. Description of Work: LABOR Name /iJ ("L L ~""'e.re 1 1:T. .. -~-..... An,;,- ~ .~ ... :_ Ci?-~ - "' =-=n - Craft ~h nw:>~.,.. I ,_ . -"' 'Cl ~-~~r EQUIPMENT/ SUPPLIES & MATERIALS Equipment Types/Attachments Hours RegT1me Hours 1- '3 1- 'L._ M.M.~ ~ \ 1nk--'\o.-¥.c..V\J~ ... ~ ?.A (I) 3 ~"' o.,_...,...(\ ~,rvfl~,{ 'L-\'=1)~·n,, ..... u -Al~,..1 .... .•. SUBCONTRACTOR Description . (' l"hl\~ _\)T;.fico~ \ A 1~ ... ~.~\,ur L,,,,r;/ ~ I - - - Vel'lflcatlon ofwork performed, labor, equipment, and materials are listed. Foreman/Supervisor: ~uµ..J?-C..c:.-\\& ........ _......-=v\._..,,c-------- Authorized Sy: ------- Dlstrlbutlom White· Yellow- DAILY EXTRA WORK REPORT Over11me Double Time Suosistance Hours Hours Hours Unit Quantity \ \ 1 --~ Unit Quantity },of __ .:.:1.. - -- -- Slgnaw~/ /, Slgnc1ture: ::2""'""'""',,_.~ ..... -1-,!!H~-¥--~--- :l ;·' I ,I \ 09 59 ii II , I I I j ,, I I i I I I I 1 I CITY OF m CUPERTINO DATE: 1/5/2018 Contractor: DMZ Builders 1717 Solano Way # 19 Concord, CA 94520 Retaining Wall Replacement-Regnart Road PROJECT NO. 2017-12 CONTRACT CHANGE ORDER CCO# 3 P.O.# 2018-308 Acct.# 420-99-041-900-905-ST 021-03-01 The following changes are hereby approved, notwithstanding language in any attachment to the contrary, Contractor agrees that the amount paid pursuant hereto is full and complete compensation for the work described herein for each and every entity involved in the project who is being compensated hereunder and that each and every claim for any cost for schedule impact such as a delay, impact, inefficiency, acceleration, extended overhead, increased supervision, compressio11 and all other factors affecting cost arising from the subject of this Change Order is hereby rele~sed and waived by all such Subcontractors and suppliers at all tiers . Change City Authorization No. Type and No. 3 Change Order Description Quantity Adjustments-Bid Line Items See details on page 3 Page 1 Amount $25,487.67 2017-12 CCO 3 Quantities f i I I f I 1 l I f ! I I I I I ! CITY OF g Retaining Wall Rcplaccmcnt-Regnart Road PROJECT NO. 2017-12 CONTRACT CHANGE ORDER CUPERTINO Total Change Order No.3 $25,487.67 _Total Project: __________________ _ --------------------------·----- . 01iginal Contract ________________________ _ $343,133.00 ------ fhange Order No. I__ _ Additional Survey _______________ _ $5,016.00 Change Order No. 2 Foundation_ ~~!~~.<?''~l __________________ _ Change Order No. 3 Quantities Revised Contract Schedule Impact: 0 calendar days Project Final Completion Date: 12/16/2017 REVIEWED BY: City Project Manager Date: /-g,;g -~~K CS G Consultants Nourdin Khayata Construction Manager Date: //y /;; j } Page 2 APPROVED BY: City of Cupertino Tinm1 Borden $3,278.67 $25,487.67 $376,915.34 Director of Public Works DMZ Builders Tyler Hoffinan Project Manager Date: 1/9/18 2017-12 CCO 3 Quantities CITY OF a Retaining Wall Replacement-Regnart Road PROJECT NO. 2017-12 CONTRACT CHANGE ORDER CUPERTINO Bid Line Orig Revised Item Description Unit Price Quantity Quantity 8 Remove Tree (EA) 5000.00 2.0 4.00 10 Hot Mix Asphalt (TON) 465.00 14.0 18 .40 15 Jute Netting (SY) 125.00 20.0 81.33 17 Structural Backfill (CY) 150.00 4.0 42.50 Total Quantity Adjustment Value Quantity Increase/De Variance crease 2.00 10,000.00 4.40 2,046.00 61.33 7,666.67 38 .50 5,775.00 25,487 .67 Page 3 2017-12 CCO 3 Quantities I i ! i ! I I i I i l I ! ! i ! ft i I I I I ~ ! I ; ., ' I ! I ! ' h I I I i I I i I I i I ! I ' I I, ' I I I I i