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17-161 Nema Construction, Sports Center Upgrades - East Courts Light Conversion, Project No. 2017-19.01
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 23867926 Regina Alcomendras Santa Clara County -Clerk-Recorder 02/14/2018 11:43 AM Ti lles: 1 Fees : 10 .00 Taxes : 0 Total : 0.00 Pages: 3 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NOTICE OF COMPLETION CITY PROJECT NAME: Remove, Dispose and Replace Existing East Court Lights with New LED Lights According to Plans, Specifications, and Project Manual 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 February 12, 2018 for CITY PROJECT NAME: Remove, Dispose and Replace Existing East Court Lights with New LED Lights According to Plans, Specifications, and Project Manual and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on February 12, 2018 and the grantee consents to recordation thereof by its duly authorized officer. I certify under Penalty of Perjury under the laws of the State of California that the foregoing paragraph is true and correct. Dated: February 14, 2018 By: Senior Office Assistant Recording Requested By: The City of Cupertino When Recorded Ma il To: Michael Zimmermann , CIP Program Manager Cupertino City Hall 10300 Torre Avenue Cupertino , CA 95014 EX EMPT 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 , Cupert ino , CA 95014 . 4 . The nature of City 's interest in the Project is : ~ Fee Ownership Lessee Other : _______ _ 5. Constr uction work on the Project performed on City 's behalf is generally described as follows: REMOVE , DISPOSE AND REPLACE EX ISTING EAST COURT LIGHTS WITH NEW LED LIGHTS ACCORDING TO THE PLANS , SPECIFICATIONS, AND PROJECT MANUAL , 6 . The name of the original Contractor for the Project is: Nema Construction . 7. The Project was completed on: January 25,2018 8. The Project is located at: Cupertino Sports Center 21111 Stevens Creek Boulevard Cupertino , CA 95014 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. z(t?/(~ C1.1 ec-b~ ~ Date and Place "i f Timm Borden Public Works Director City of Cupertino SPORTS CENTER UPGRADES -EAST COURTS 2017 -19 .02 NOTICE OF COMPLETION Page 2 Contract This public works contract ("Contract ") is entered into by and between the City of Cupertino ("City"), a municipal corporation, and Nema Construction ("Contractor"), for work on the SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION, PROJECT NO. 2017-19.01 , Project ("Project"). The parties agree 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 Exhibit A to perform the Work to construct the Project. On October 17 , 2017 , City author ized award of th is 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 Wa rr anty 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 Deta ils ; and 2.14 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 all 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 str ict accordance with the terms and conditions of the Contract Documents , City will pay Contractor$ 220,000 . (the "Contract Price ") for all of Contractor's direct and indirect costs to perform the Work , including all labor, materials , supplies , equipment, ta xes , 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 on or before January 15 , 2018. 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 une xcused delay in completion , 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. SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 CONTRACT Page 1 7 .1 General. This Contract is subject to all applicable requirements of Chapter 1 of Part 7 of Division 2 of the 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 online 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 reg istered 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 certifies 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 will comply with such provisions 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 re lation 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 Documents 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 Phone: (408) 777-3354 Attn: Director of Public Works Email: alexa@cupertino.org Copy to: Alex Acenas Contractor: Name : Nema Construction SPORTS CENTER UPGRADES-E AST COURTS LIGHT CONVERSION 2017-19.01 CONTRACT Page 2 Address: 555 Pierce Street #1005 City/State/Zip: Albany , CA 94706 Phone : 510 525-2398 Attn: Mr. Ali Farahani Email : nema@post.com Copy to: Mr. Ali Farahani 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; Seve rability. This Contract and the Contract Documents incorporated herein , including authori zed amendments or Change Orders thereto , constitute the final , complete , and exclusive terms of the agreement between City and Contractor. If any provi sion of th e 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.] SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017 -19.01 CONTRACT Page 3 The parties agree to this Contract as witnessed by the signatures below: CONTRACTOR NameAI , a Title Owner Date }(YI 2 6/ 11 By __________ ~ CITY _,P~UPERTINO 12'.;por)t__ &vid Brandt C ity Manager / ·-/ T Date J(I -~ cl· I ,. I . APPROVED AS TO FORM: Name_________ • , I Tit le_________ d Av":'.\ Date __________ \f Randolph S. Hom City Attorney j . J Date I 1 9--_ t }:: ATTEST: -")~ ~c,J;btv/ft Grace Schmidt City Clerk Date /( -]-/ 7 Contract Amount: $220 ,000 .00 P.O. No. ?1)1 9 · 2>;2 6 Account No. 420-99-017-900-905-SPCT 004-03-01 END OF CONTRACT SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 CONTRACT Page 4 ATTACHMENT A Bid Proposal SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION JROJECT NO. 2017-19.01 /tlffiU:JJ ~6r/r,1!%,1 & V' ("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, insuranc and all overh d for the fo~ice (" ase Bid"): $ "2..1..0 DOC • I 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: Addendum: #05 #06 #07 #08 Date Received: 3. Bidder's Warranties. By signing and submitting this Bid Proposa l, Bidder warrants the following: 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 limitation s of Public Contract Code section 1104. 3.2 Examination of Workslte. 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 Responslblllty 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 Bidder, Bidder wi ll 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 pertormanoo bond, each for 100% of the Contract Price, using the bond forms provided and in accordance with the requirements of the Contract Documents; and SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19 .01 BID PROPOSAL Page 13 Bidder's Name: a/lJJ1{2 ~G/;11tflJ,p J/1 4.3 Insurance Requirements. Submit to City the insurance certificate(s) and endorsement(s) as required by the Contract Documents. 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 \n the amount of ten percent of \ts 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 $ __________ _ A bid bond, using the Bid Bond form included with the Contract Documents, payable to City and executed by a surety li censed to do bus iness in the State of Ca li fornia. This Bid Proposal is hereby submitted on $ e pi t \'3, tx.. I 20IJ.. Signature I /,:{, 1 @11/)f bRJA I /dita YI~ . Name/Title (If Corporation : Chairman, President or Vice President) -, ·~ 1cg ,~ -B -c. LO' -Z.o lC\ License #, Expiration Date, and Classification 5ss ·p,'erc:::e. & ,,(!''if# /r;,# 5 Address ,4. \kar.1.f 1 u'c,, f4 706 City, State, Zip ~ (()' -5 z; 5 -2 3 q 8' Contact Phone Date Signature=:::::;, ::> Name/Title (If Corporation : Secretary, Assistant Secretary, Chief Financial Officer or Assistant Treasurer) ·\o~~ao 8sicr DIR Registration # Phone ¥1--l' ~/Y) ~J"( I 1 / (ltd{ H tf2-./ . Contact Namerritle /Jt!/Y/0 t2 &;sf &fl- Contact Email END OF BID PROPOSAL SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 BIO PROPOSAL Page 14 Bidder's Name: Btd Schedule This Bid Schedu le must be comp leted in ink and included with the sealed Bid Proposa l. Pricing must be provided for each Bid Item as indicated . Items marked "(SW)" are Specialty Work that must be performed by a qua lified Subcontractor. The lump sum or unit cost for each item must be inclusive of all costs, whether direct or indirect, including profit and ove rhead . The sum of all amounts entered in the "Extended Total Amount" column must be identical to the Base Bid price entered ln Section 1 of the Bid Proposa l Form. LS= Lump Sum SF= Square Feet EA= Each LF = Linear Foot CY= Cubic Yard LB = Pou nds TON = Ton (2000 lbs) AL = A ll owance BID EST. UNIT ITEM ITEM DESCRIPTION UNIT NO. QTY. COST SPORTS CENTER UPGRADES- EAST COURTS LIGHT 1 CONVERSION, PROJECT 2017-1 LS $ 19.01 ACCORDING TO THE PLANS AND PROJECT MANUAL $ TOTAL BASE BID: Items 1: $ '2-'l..O O Q 0 SY=Square Yard EXTENDED TOT AL AMOUNT $ ~?..0000 $ 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. END OF BID SCHEDULE SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 BID SCHEDULE Page 15 .. I t .• 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 descripUon of the Work, the name of the Subcontractor, its California contractor license number , the location OT \ts place OT business, its DIR registration number, and the portion of the Work that the Subcontractor is performing based on a percentage of the Base Bid price . Bidder may not list more than one Subcontractor for each such portion of the Work listed by Bidder below . END OF SUBCONTRACTOR LIST 1 For street or highway construction this requirement appl ies to any subcontract of $10,000 or more. SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19 .01 SUBCONTRACTOR UST Page 16 Bidder's Name: ~4 (k;111zt uJlr~ · Noncolluslon Declaration TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID The undersigned declares: I am the (l'µ(l'l-t.R-[titleJ of Afett1a &11-GiCttL_<f;~ [business name]. the party making the foregoing bid. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not dlrectly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. The bidder has not In any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. The bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid and will not pay, any person or entity for such purpose. This declaration is intended to comply with California Public Contract Code section 7106 and Title 23 U.S.C section 112 . I declare under penalty of perjury under the laws of the State of California that the foregoing is true and c rrect and that this declaration is executed on q .._ lct -l 'l [date], at ---A:-{.-.11:a~~jL-------[city], & [state]. Name [print] END Of NONCOLLUSION DECLARATION SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 NONCOLLUSlON DECLARATION Page 17 Bid Bond NEMA Construction ("Bidder") has submitted a bid, dated September 19 , 20 17 ("Bid"), to City of Cupertino ("City") for work on the SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION, PROJECT NO. 2017-19.01, Project ("Project"). Under this duly executed bid bond ("Bid Bond"), Bidder as Principal and Merchants Bonding Company (Mutual) , its surety ("Surety"), are boLmd to City as obligee in the penal sum of ten percent of the maximum amount of the Bid (the "Bond Sum "). Bidder and Surety bind themselves and their respective heirs, executors, administrators , successors and assigns, jointly and severally, as follows: 1. General. ff Bidder is awarded the Contract for the Project, Bidder will enter into the Contract with City in accordance with the terms of the Bid. 2. Submlttals. Within ten days following issuance of the Notice of Award to Bidder , Bidder must submit to City the following : 2.1 Contract. The executed Contract, using the form provided by City in the Project contract documents ("Contract Documents"); 2.2 Payment Bond. A payment bond for 100% of the maximum Contract Price, executed by a surety licensed to do business in the State of California using the Payment Bond form included with the Contract Documents; 2.3 Performance Bond. A performance bond for 100% of the maximum Contract Price, executed by a surety licensed to do business in .the State of California using the Performance Bond form included with the Contract Documents ; and 2.4 Insurance. The insurance certificate(s) and endorsement(s) required by the Contract Documents , and any other documents required under the Instructions for Bidders . 3. Enforcement. If Bidder fails to execute the Contract and to submit the bonds and insurance certificates as required by the Contract Documents, Surety guarantees that Bidder forfeits the Bond Sum to City . Any notice to Surety may be given in the manner specified in the Contract and delivered or transmitted to Surety as follows: Attn: Terry Bricker Address: P.O. Box 14498 City/State/Zip: Des Moines IA 50306 Phone: (515)243-8171 Fax: (515)243 -3854 Email: TBRICKER@MERCHANTSBOND ING .COM 4. Duration; Waiver. If Bidder fulfills its obligations under Section 2, above, then this obligation will be null and void; otherwise it will remain in full force and effect for 90 days following award of the Contract or until this Bid Bond is returned to Bidder, whichever occurs first. Surety waives the provisions of Civil Code sections 2819 and 2845. [Signatures are on the following page.] SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 BID BOND Page 18 This Bid Bond is entered into and effective on September 18 , 20_17_. SURETY: Merchants Bonding Compan (Mutual sr-U"G~.- Vanessa Copeland, Attorney-in-Fact Name/Title (Acknowledgement with Notary Seal for Surety, and Surety's Power of Attorney-In-Fact Certificate must be attached.) BIDDER: NamefTitle 1- END OF BID BOND SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 BID BOND Page 19 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attach~d and not the truthfulness, accuracy, or validity of that document. State of California ) ----4-----"'----------) --'-+-'--'"-----1---'------before me, _______ B_._C_o"'"""p_e_Ja_n_d _______ , Notary Public, personally appeared Vanessa Copeland Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s-) whose name(s-) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instmment the person(-s), or the entity upon behalf of which the person(51 acted, executed the instmment. J············i '@" B COPELAND _ . .:_ · · · Notary Public -Ca liforni a f -· ··, Orange County f J . Commission# 2187550 l l u O = = MyConin::;xg::esApiJ!·:1_ [ Place Notary Sen! 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. OPTIONAL Though the information below is not required by law , it may prove valuable to persons relying on the docmnent and could present fraudulent and reattachment of this form to another document. Description of Attached Document Type or Title of Document:------------------------------- Document Date:-----------------Number of Pages:----------- Signer(s) Other Than Named Above: _________________________ _ Capacity(ies) Claimed by Signer(s) Signer's Name : Vanessa Copeland D Individual D Corporate Officer -Title(s): ______ _ D Partner: DLimited D General ~ Attomey in Fact D Trustee D Guardian or Conservator D Other: --------------- Signer Is Representing: _________ _ Capacity(ies) Claimed by Signer(s) Signer's Name : -------------- D Individual D Corporate Officer -Title(s): -------- 0 Partner: OLimited D General 0 Attorney in Fact D Trustee D Guardian or Conservator D Other: --------------- Signer Is Representing : __________ _ Re v, 1 -15 MERCHANTS~ BONDING COMPANYrn POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa (herein collectively ca ll ed the 'Co mpanies") do hereby make , const itute and appoint, Ind ividually, Eric Lowey; Jennifer Grenrood; Karyl A Richter; Kevin Cathcart; Mark Richardson; Shawn Blume; Teresa I Jackson; Vanessa Copeland their true and lawful Attomey(s)-in-Fact, to sign Its name as surety(les) 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. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16 , 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President sha ll have power and autho.rity to appo int Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings ob li gatory In the nature thereof.' "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney" or Certification thereof authorizing the execuUon and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only , It is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the state of Florida Department of Transportation. It is fully understood that consenting to the State ofFlorida Department of Transporta!ion making payment of the flnal estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obllgaUons under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this Instrument ta be signed and sealed this 17th day of April , 2017 1•••1t•••••t • • • • • •••• ~ \0 N.ci/••, ••·,~a Co•. ···~~ ............. ~··· •• ..\.\) ...... 4t,,.• • • ........ pon '• V • (',.-.:' .. PO '•,,.., • /"J/c:,"' -r-9;. .. o '.:. :~".···~~ lj_,;,,-?,,,. •• : ,-.; : c:i (<I.'· -t, : • . '1 ..., ,', ', ~. .;,;e:~ -o-c,',C,• •::;::.e -0-~-• :<:-~-= • ·-o:-• : :,: : i 2:: : ~:. 1933 : a:: : (.) ·. 2003 : .c:, : • ....... : ~. ~ J:•. . .... .," .-~.. .· "::Y • •• V-:.,.'• .• ' •• • ,f. •, .. ~~. STATE OF IOWA COUNTY OF DALLAS ss. '•/''li/""· ..... ·:'r:,~ •• • •• ':IJi;· .. ". '\"\ •• #,#-,. 'Cl , .. ~.~ • • • • ti ••• ,,.......... . .... MERCHANTS BONDING COMPANY (MUTUAL) :::;zNATION7;2: /,,.esident On this this 17th day of April 2017 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he Is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING , INC.; and that the seals affixed to the foregoing Instrument are the Corporate Seals of the Companies ; and that the said instrument was signed and sealed In behalf of the Companies by authority of their respective Boards of Directors. "-.~\Alu>~ 0 J> Z O O O ~ ,-. . . tr,wt- ALICIA K. GRAM Commission Number 767 430 My Commission Expires April 1, 2020 Notary Public {Expiration of notary's commiss ion does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC ., 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 st ill in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 18th day of •• ,......... • ..... "<I •• ···~1, a N,q;"•, • • ~\~G co;,_•. ···~r , ....... , (;,_''• •r,.~ ,•' 'p'o····· ,<> • • •• •'1J .. ·~~t)O~~·· .. o\ .·~~.·~?-Ii~·.-?.,;•. :"-:CJ~ ..,.~ .. ~ .... c;.i ""~·.-~. :.,..:,,,. (<\· .... ~ •C.,:.:;;e -o-r<'• • .. --:~ -o-C,:'-' .. ~,-._ -:-• -<· ·-· •:z:· -a:• : '$ ~ 2003 i 2:: . ,d.:. 1933 :' ....• -,.,· ·0· • ~· ' .... • "" ... .:, : • I?·. . • ~ • .... ~.;.·.... . ... ·:...~ •• • • •• O'jj,,:• ..... ' •i;.,,~ .. '•"'11 ......... 'J...... . ~ ti ' •• '•• •• , i::r ,....... • •••••••• ' ''" .. "' POA 0018 (3/17) September , 2017 P'~~~~. Secretary Insurance Forms Insurance Forms Instructions For Items 2, 3 and 4, the forms provided by the City of Cupertino must be used. Forms other than these will not be accepted. All documents must be originals -submit in triplicate. 1. Certificate of Insurance to the City of Cupertino -must be completed by the insurance agent or must provide a certificate on the company's form . They must contain the same information . 2 . Endorsement of Additional Insured and Primary Insurance and Notice of Cancellation -must be signed by the insurance agent for general liability and automobile liability only. 3. Comprehensive General Liability/Commercial General Liability Endorsement of Aggregate Limits of Insurance Per Project -must be signed by the insurance agent for general liability only. 4 . Waiver of Subrogation Endorsement Worker's Compensation Insurance -must be signed by the insurance agent for worker's compensation only. City of Cupertino Insurance Forms Page 1 of 7 CERTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO This certifies to the City of Cupertino that the following described policies have been issued to the insured named below and are in fo rce at th is time . Insured: Ali Eara baui OB A Ne ma Cau stw ctiau Address : 555 Pierce St #100~5~----------- A lbany. CA 947 06 Description of operations/locations/products insured (show contract name and/or number, if any): SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION WORKER 'S COMPENSATION State Co mp ensa tio n In sura nce Fu nd (name of insurer) * Statutory Min . * Employer's Liability $ 1.000 .000 $ 1.000 .000 $ I QQQ ,QQQ Insurance Company's State License No . __.,'"""·rn......._.?r; _________________ _ Check Policy Type : $ _______ _ COMPREHENSIVE GENERAL LIABILITY [ x J Premises/Operations $ _______ _ [ J Owners & Contractors Protective $ _______ _ [ J Contractual for Specific Contract $ _______ _ [ J Products Liability [ J XCU Hazards [ J Broad Form P.O. $ _______ _ [ J Severability of Interest Clause [ J Personal Injury with $ _______ _ Employee Exclusion Removed or COMMERCIAL GENERAL LIABILITY $ J ,QQQ QQQ ($2 _QQQ _QQQ Benchmark Insurance Company Policy No . a r cso 1G1 9s Date 4/22 /2 01 8 Each Occurrence $1,000 ,000 General Aggregate $2,ooo,oo o (if applicable) Aggregate Personal Injury $!,OO O,OOO Fire Damage (any one fire) $SO,OOO Medical Expense $S,OOO (any one person) Self-Insured Retention (name of insurer) Expiration City of Cupertino Insurance Forms Page 2 of 7 AUTOMOTIVENEHICLE LIABILITY DAMAGE Commercial Form Liability Coverage $ _______ _ California Auto Insurance Co (name of insurer) $ _______ _ Policy No . _BA_o4_0_00_0_00_1_42_3 __ _ BUILDER 'S RISK "ALL RISK" @ BODILY INJURY PROPERTY Each Person Each Accident $ ______ _ Each Accident $ ______ _ or Combined Single Limit $1,000 ,000 Expiration Date 7/10/2018 This is to certify that the following policy has been issued by the below-stated company in conformance with the requirements of the project documents and is in force at this time . (Name of insurer) Policy No . ________ _ Expiration Date _______ _ Limits of Liability: _______ _ Deductible: --------- ( agentsinifui I) A copy of all Endorsements to the policy(ies) which in any way limit the above-listed types of coverage are attached to this Certificate of Insurance. This Certificate of Insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement , term , or condition of any contract or any other document with respect to which this Certificate of Insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. IT IS HEREBY CERTIFIED that the above policy(ies) provide liability insurance as required by the Agreement between the · y and the insured . Attach Certificate of Insurance and Additional Insured Endorsement on company forms . City of Cupertino Insurance Forms Page 3 of 7 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 10/25/2017 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(s). PRODUCER ~2~?CT Marie Rivera Nickerson Insurance Services, Inc . m9NJn Fvt\· (310) 326-6333 I FAX IA/C No\: (310) 326-54 16 LIC #0491589 it1D~~ss,marie@nickersonins.com 2106 West Lomita Blvd. INSURER(Sl AFFORDING COVERAGE NAIC # Lomita CA 90717 INSURER A :Benchmark Insurance Co 41394 INSURED INSURER B :California Au to Insurance Co 38342 Ali Farahani, DBA: Nema Construction INSURER C :StarStone National 25496 555 Pierce St #1005 INSURER D :State Compensation Ins . Fund 35076 INSURER E : Albany CA 94706 INSURER F: COVERAGES CERTIFICATE NUMBER:17-18 GL/C Auto/Exe/WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURAN CE LISTED BELOW HAVE BEEN ISS UED TO THE INSURED NAMED ABOVE FOR THE POLI CY PERIOD IN DI CATED . NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPE CT TO WHICH THI S CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURAN CE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXC LUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MA Y HAVE BEEN REDU CED BY PAID CLAIMS. INSR ADDL SUBR (~~gg~\ 1~2h~%~1 LTR TYPE OF INSURANCE , ... ~n '"",n POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EAC H OCCURRENCE $ 1,000,000 >--~ CLAIMS-MA DE W OCCUR DAMAGE TO RENTED A >--PREMISES (Ea occurrence \ $ 50 ,000 X BIC50 1 6195 4/22/2017 4 /22 /20 10 MED EXP (An y on e pers on) $ 5 ,000 -PERSONAL & ADV INJURY $ 1,000 ,0 00 - GEN"L AGGREGATE LIMIT APP LIE S PER : GENE RA L AGGREGATE $ 2,000,000 ~ POLI CY 0 .l'r8r DLoc PRODUCTS -COMP/OP AGG $ 2,000,000 OTHE R: $ AUTOMOBILE LIABILITY COMBI NED SINGLE LIMIT $ 1,000,000 (Ea accident) - ANY AUTO BODILY IN JURY (Per person ) $ B -ALL OWNED -SCHEDULED AUTOS X AUTOS BA040000007423 7/10 /20 17 7/10 /20 18 BODILY INJURY (Per accidenl) $ --NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) $ - Hired/b orrowed $ 1,000 ,000 X UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ 2 000 000 - C EXCESS LIAB CLA IMS-MAD E AGGR EGAT E $ 2 000 000 DED I I RETE NTI ON $ 78 658Al 70ALI 10/23/20 17 4/22/2018 $ WORKERS COMPENSATION XI ~¥fTuTE I I OTH- AND EMPLOYERS ' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTI VE D N/A E.L. EACH ACC IDEN T $ 1 000 000 OFF ICER/MEMBER EXC LUDED ? D (Mandatory in NH) 908512017 1/1 /20 17 1 /1 /20 18 EL DISEASE -EA EMPLOYEE $ 1 000 000 If yes . describe under DESCRIPTION OF OPERAT IONS be low E.L. DISEASE -POLI CY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101 , Addit io nal Remarks Schedule , may be attached if more space is required) Job : SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION The City of Cupertino, a municipal corporation of the State of California, its City Council, and their employees, representatives, consultants (including without limitation Design Professional), and agents, are additional insureds, but only with respect to General Liability arising out of the activities of the named insured . Primary & Non-contributory wording and Waiver of Subroogation apply. 30 day notice of cancellation/10 dau notice for non-payment of premium . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10300 Torre Avenue ACCORDANCE WITH THE POLICY PROVISIONS . Cupertino, CA 95014 AUTHORIZED REPRESENTATIVE Sarah Kelly/MR ~~ © 1988-2014 ACORD CORPORATION . All rights reserved . ACORD 25 (2014/01) INS025 1?0 1ao 11 The ACORD name and logo are registered marks of ACORD ENDORSEMENT PRIMARY BLANKET ADDITIONAL INSURED I ENDT. NO. I 6 I G0103 (ed 09/24/09) IT IS AGREED COVERAGE IS PROVIDED TO THE ADDITIONAL INSURED(S) AS FOLLOWS: 1. SECTION II OF THE POLICY (WHO IS AN INSURED) IS AMENDED TO INCLUDE ANY PERSON OR ORGANIZATION THAT THE NAMED INSURED HAS AGREED IN AN INSURED CONTRACT TO NAME AS AN ADDITIONAL INSURED PROVIDED THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT AND THE BODILY INJURY OR PROPERTY DAMAGE ARISES FROM YOUR WORK PERFORMED DURING THE POLICY TERM. 2. PARAGRAPH 6 .0. IS HEREBY ADDED TO SECTION IV, COMMERCIAL GENERAL LIABILITY CONDITIONS, OF THE POLICY , AS FOLLOWS: D. NOTWITHSTANDING ANYTHING TO THE CONTRARY IN PARAGRAPHS 6.A., 6.B., OR 6.C. HEREOF, THE INDEMNITY PROVIDED BY THIS INSURANCE IS PRIMARY AND NONCONTRIBUTORY FOR ANY PERSON OR ORGANIZATION THAT IS AN ADDITIONAL INSURED UNDER THIS POLICY AND THAT YOU HAVE AGREED , IN AN INSURED CONTRACT , TO PROVIDE PRIMARY ADDITIONAL INSURED COVERAGE . 3 THE APPLICABLE LIMIT OF THE COMPANY'S LIABILITY SHALL NOT BE INCREASED BY THE INCLUSION OF ANY NUMBER OF ADDITIONAL INSUREDS . 4 OTHER THAN AS EXPRESSLY MODIFIED HEREIN, COVERAGE FOR THE ADDITIONAL INSURED IS GOVERNED BY THE TERMS AND CONDITIONS OF THIS POLICY, INCLUDING THE INSURING AGREEMENTS. 5 THE COVERAGE PROVIDED FOR THE ADDITIONAL INSURED IS ONLY TO THE EXTENT OF DAMAGES FROM BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE NEGLIGENCE OR STRICT LIABILITY OF THE NAMED INSURED . NO COVERAGE IS PROVIDED FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF ACTS , ERRORS OR OMISSIONS OF THE ADDITIONAL INSURED . 6. NO COVERAGE IS PROVIDED TO AN ADDITIONAL INSURED FOR DAMAGES BECAUSE OF BODILY INJURY TO AN EMPLOYEE OF THE NAMED INSURED , WHETHER SUIT IS BROUGHT OR CLAIM IS MADE BY THE EMPLOYEE OR THE PARENT, SPOUSE , CHILD OR SIBLING OF SUCH EMPLOYEE , OR ANY ENTITY SEEKING DAMAGES BECAUSE OF INJURY TO SUCH EMPLOYEE. Po licy Number BIC5016195 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Insured Ali Farahani OBA Nema Construction Effective 04/22/2017 BENCHMARK INSURANCE COMPANY Cou nte rsiqnature of Authorized Repres entative © 2009 WESTCAP ENDORSEMENT I ENDT. NO. I 7 I G0905 ( ed 09/24/09) WAIVER OF SUBROGATION-BLANKET IT IS AGREED, FOR AN ADDITIONAL PREMIUM OF$ lnclnM&D , THAT THE TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS) IS AMENDED AS FOLLOWS: WE WAIVE ANY RIGHT OF RECOVERY WE MAY HAVE AGAINST ANY PERSON OR ORGANIZATION THAT QUALIFIES AS AN ADDITIONAL INSURED PURSUANT TO THE TERMS OF ENDORSEMENT NUMBER 6 BECAUSE OF PAYMENTS WE MAKE FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF (i) YOUR WORK PERFORMED DURING THE POLICY PERIOD UNDER AN INSURED CONTRACT WITH THAT PERSON OR ORGANIZATION, PROVIDED THAT THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT, OR (ii) YOUR PRODUCT MANUFACTURED OR SOLD DURING THE POLICY PERIOD UNDER AN INSURED CONTRACT WITH THAT PERSON OR ORGANIZATION, PROVIDED THAT THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT. Policy Number BIC5016195 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Insured Ali Farahani OBA Nema Construction Effective 04/22/2017 Countersignature of Authorized Representative BENCHMARK INSURANCE COMPANY © 2009 WESTCAP ENDORSEMENT I ENDT. NO . I DESIGNATED CONSTRUCTION PROJECT($) GENERAL AGGREGATE LIMIT Designated Construction Project: Each Project of the Named Insured as Required by Insured Contract Designated Construction Project General Aggregate Limit:$ 2,000,000 The combined maximum we will pay for all projects covered by Designated Construction Project Aggregate Limits is $5,000,000 13 I G0907 (ED 10/14/16) It is agreed that, for a flat fully earned additional premium of$ 250.00 , this endorsement modifies insurance provided under the Commercial General Liability Coverage Form. A. For all sums which you become legally obligated to pay as tort damages for bodily injury or property damage to which this insurance applies caused by occurrences under Coverage A , and for all medical expenses covered under Coverage C, which can be attributed only to your ongoing operations at a single Designated Construction Project shown in the schedule above : 1. A separate Designated Construction Project General Aggregate Limit applies to each Designated Construction Project, and that limit is as set forth in the schedule above . 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of bodily injury or property damage included in the products-completed operations hazard, and for medical ex penses under Coverage C, regardless of the number of: a . Insureds, b. Claims made or suits brought, or c . Persons or organizations making claims or bringing suits. 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate limit for that Designated Construction Project. Such payments shall not reduce the Aggregate Limit shown in the declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other Designated Construction Project shown in the schedule above . 4. The limits shown in the declarations for each occurrence and medical payments continue to apply . However, instead of being subject to the Aggregate Limit shown in the declarations , such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. Poli cy Number BIC5016195 (page 1 of 2) ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Insured Ali Farahani OBA Nema Construction Effective 10/23/2017 BENCHMARK INSURANCE COMPANY Counters io nature of Authoriz ed Representa ti ve © 2008 WESTCAP ENDORSEMENT ENDT . NO. 13 G0907 (ED 10 /14/16) B . For all sums which you become legally obligated to pay as tort damages for bodily injury or property damage to which this insurance applies caused by occurrences under Coverage A , and for all Medical Ex penses covered under Coverage C, which cannot be attributed only to ongoing operations at a single Des ignated Construction Project shown in the schedule above : 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the Aggregate Limit shown in the declarations ; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability aris ing out of the products-completed operations hazard is provided , any payments for damages because of bodily injury or property damage included in the products- completed operations hazard will reduce the products-completed operations Aggregate Limit , and not reduce the General Aggregate Lim it nor the Des ignated Construct ion Proj ect General Aggregate Limit. D. If the applicable Designated Construction Project has been abandoned , delayed , or abandoned and then restarted, or if the authoriz ed contracting parties deviate from plans , blueprint s, designs , specifications or timetables, the project will still be deemed to be the same construct ion project. E . The provisions of Limits Of Insurance not otherwise modified by th is endorsement shall continue to apply as st ipulated . Poli cy Nurrber B1C5016195 (page 2 of 2 ) ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED . Ins ured Ali Farahani DBA Nema Construction Ef fective 10/23/2017 BENCHMARK INSURANCE COMPANY Coun ters ignature of A utho ri zed Repr esentativ e © 2008 WESI'CAP ENDORSEMENT 30 DAY NOTICE OF CANCELLATION ENDT . NO. 14 G0908 (Ed 03/0 1/08) IT IS AGREED THAT IN THE EVENT OF CANCELLATION , PRIOR TO THE E XPIRATION DATE THEREOF, A 30-DAY NOTICE OF CANCELLATION (10 DAYS FOR NON -PAYMENT OF PREMIUM) WILL BE ISSUED AS RESPECTS THIS SCHEDULE . City of Cupertino, its directors 10300 Torre A venue Cupertino, CA 95014 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Polic y Number BIC5016195 Ins ured Ali Farahani OBA Nema Construction Eff ecti ve 10/23/2 017 BENCHMARK INSURANCE COMPANY Co unter s ig na tur e o f Autho ri zed Representative © 2008 WESfCAP I ST~TE-ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BROKER COPY COMF'eNSATION INSU~ANCe FU 1 ND 9085120-17 RENEWAL SC HOME OFFICE SAN FRANCISCO 5-01-72-79 PAGE 1 OF 1 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME EFFECTIVE OCTOBER 26, 2017 AT 12.01 A.M. AND EXPIRING JANUARY 1, 2018 AT 12.01 A.M. NEMA CONSTRUCTION 555 PIERCE ST APT 1005 ALBANY, CA 94706 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF CUPERTINO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, NEMA CONSTRUCTION IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03 %. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER , WAIVE OR EXTEND ANY OF THE TERMS , CONDITIONS, AGREEMENTS , OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED . NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER , WAIVE OR LIMIT THE TERMS , CONDITIONS , AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~:::::!?i..,q, OCTOBER 27, 2017 PRES IDEN T A ND CEO SC IF FO RM 102 17 (REV.7-20 14) 2570 O LO DP 217 Dear Policyholder: BROKER COPY PLEASE KEEP THIS ENDORSEMENT WITH YOUR POLICY These endorsements amend and are part of your policy. Please keep them with your documents for future reference. 9085120-17 RENEWAL SC If you have any questions concerning these endorsements, Please contact your local State Fund office. Ali Farahani Nema Construction BA040000007423 07 /10 /201j -07 /10 /201& THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following : BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The following is added to the Section II -Liability Coverage, Paragraph A.1. Who Is An Insured Provision : Any person or organization that you are req uired to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the "bodily _injury" or "property damage" occurs and that is in effect during the policy period is an "insured " for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II . MCA20480711 Al i Farahan i Ne ma Co nst r u c ti o n BA0 4 00000074 23 07/1 0/20 17 -07/1 0/20 1 8 COMMERCIAL AUTO CA00011013 BUSINESS AUTO COVERAGE FORM Various prov1s1ons in this policy restrict coverage . Read the entire policy carefully to determine rights , duties and what is and is not covered . SECTION I -COVERED AUTOS Item Two of the Declarations shows the "autos" that are covered "autos " for each of your coverages . The following numerical symbols describe the "autos" that may be covered "autos". The symbols entered next to a coverage on the Declarations designate the only "autos" that are covered "autos". Throughout this pol icy the words "you" and "your" refer to the Named Insured shown in the Declarations . The words "we", "us" and "our" refer to the company providing this insurance . Other words and phrases that appear in quotation marks have special meaning . Refer to Section V - Definitions . A. Description Of Covered Auto Designation Symbols Symbol Description Of Covered Auto Designation Symbols 1 Any "Auto" 2 Owned "Autos" Only those "autos" you own (and for Covered Autos Liability Coverage any Only "trailers" you don't own while attached to power units you own). This includes those "autos" you acquire ownership of after the policy beqins. 3 Owned Private Only the private passenger "autos" you own . This includes those private Passenger passenger "autos " you acquire ownership of after the policy begins . "Autos" Only 4 Owned Only those "autos" you own that are not of the private passenger type (and for "Autos" Other Covered Autos Liability Coverage any "trailers" you don't own while attached to Than Private power units you own). This includes those "autos" not of the private passenger Passenger type you acquire ownership of after the policy begins. "Autos" Only 5 Owned "Autos" Only those "autos" you own that are required to have no-fault benefits in the state Subject To where they are licensed or principally garaged. This includes those "autos" you No-fault acquire ownership of after the policy begins provided they are required to have no- fault benefits in the state where they are licensed or principally !'.jara!'.jed . 6 Owned "Autos" Only those "autos" you own that because of the law in the state where they are Subject To A licensed or principally garaged are required to have and cannot reject Uninsured Compulsory Motorists Coverage. This includes those "autos" you acquire ownership of after the Uninsured policy begins provided they are subject to the same state uninsured motorists Motorists Law requirement. 7 Specifically Only those "autos" described in Item Three of the Declarations for which a Described premium charge is shown (and for Covered Autos Liability Coverage any "trailers" "Autos" you don't own while attached to any power unit described in Item Three). 8 Hired "Autos" Only those "autos" you lease , hire , rent or borrow. This does not include any "auto" Only you lease , hire , rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. 9 Non-owned Only those "autos" you do not own, lease, hire , rent or borrow that are used in "Autos" Only connection with your business . This includes "autos" owned by your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of the ir households but only while used in your business or your personal affairs. CA 00 01 10 13 © Insurance Services Office , Inc ., 2 011 Page1of12 19 Mobile Equipment Subject To Compulsory Or Financial Responsibility Or Other Motor Vehicle Insurance Law Only Only those "autos" that are land vehicles and that would qualify under the definition of "mobile equipment" under this policy if they were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where they are licensed or principally garaged . B. Owned Autos You Acquire After The Policy Begins 1. If Symbols 1, 2, 3, 4, 5, 6 or 19 are entered next to a coverage in Item Two of the Declarations , then you have coverage for "autos" that you acquire of the type described for the remainder of the policy period . 2. But , if Symbol 7 is entered next to a coverage in Item Two of the Declarations, an "auto" you acquire will be a covered "auto" for that coverage only if: a. We already cover all "autos" that you own for that coverage or it replaces an "auto" you previously owned that had that coverage; and b. You tell us within 30 days after you acquire it that you want us to cover it for that coverage. C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos If Covered Autos Liability Coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Covered Autos Liability Coverage: 1. "Trailers" with a load capacity of 2 ,000 pounds or less designed primarily for travel on public roads . 2. "Mobile equipment" while being carried or towed by a covered "auto". 3. Any "auto" you do not own while used with the permission of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its : a. Breakdown ; b. Repair ; C. Servicing ; d. "Loss"; or e. Destruction. SECTION II -COVERED AUTOS LIABILITY COVERAGE A. Coverage We will pay all sums an "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies , caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto". We will also pay all sums an "insured" legally must pay as a "covered pollution cost or expense" to which this insurance applies, caused by an "accident" and resulting from the ownership , maintenance or use of covered "autos". However , we will only pay for the "covered pollution cost or expense" if there is either "bodily injury" or "property damage" to which this insurance applies that is caused by the same "accident". We have the right and duty to defend any "insured" against a "suit" asking for such damages or a "covered pollution cost or expense". However, we have no duty to defend any "insured" against a "suit" seeking damages for "bodily injury" or "property damage" or a "covered pollution cost or expense" to which this insurance does not apply . We may investigate and settle any claim or "suit" as we consider appropriate. Our duty to defend or settle ends when the Covered Autos Liability Coverage Limit of Insurance has been exhausted by payment of judgments or settlements . 1. Who Is An Insured The following are "insureds": a. You for any covered "auto". b. Anyone else while using with your permission a covered "auto" you own , hire or borrow except: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. Page2of12 © Insurance Services Office , Inc., 2011 CA00011013 (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household . (3) Someone using a covered "auto" while he or she is working in a business of selling , servicing , repairing, parking or storing "autos" unless that business is yours . (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company) or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership) or a member (if you are a limited liability company) for a covered "auto" owned by him or her or a member of his or her household. c. Anyone liable for the conduct of an "insured" described above but only to the extent of that liability. 2. Coverage Extensions a. Supplementary Payments We will pay for the "insured": (1) All expenses we incur. (2) Up to $2,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds . (3) The cost of bonds to release attachments in any "suit" against the "insured" we defend, but only for bond amounts within our Limit of Insurance . (4) All reasonable expenses incurred by the "insured" at our request , including actual loss of earnings up to $250 a day because of time off from work. (5) All court costs taxed against the "insured" in any "suit" against the "insured" we defend. However, these payments do not include attorneys' fees or attorneys' expenses taxed against the "insured". (6) All interest on the full amount of any judgment that accrues after entry of the judgment in any "suit" against the "insured" we defend, but our duty to pay interest ends when we have paid , offered to pay or deposited in court the part of the judgment that is within our Limit of Insurance . These payments will not reduce the Limit of Insurance. b. Out-of-state Coverage Extensions While a covered "auto" is away from the state where it is licensed , we will: (1) Increase the Limit of Insurance for Covered Autos Liability Coverage to meet the limits specified by a compulsory or financial responsibility law of the jurisdiction where the covered "auto" is being used . This extension does not apply to the limit or limits specified by any law governing motor carriers of passengers or property . (2) Provide the minimum amounts and types of other coverages, such as no- fault, required of out-of-state vehicles by the jurisdiction where the covered "auto" is being used . We will not pay anyone more than once for the same elements of loss because of these extensions . 8. Exclusions This insurance does not apply to any of the following : 1. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". 2. Contractual Liability assumed under any contract or agreement. But this exclusion does not apply to liability for damages: a. Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement; or b. That the "insured" would have in the absence of the contract or agreement. 3. Workers' Compensation Any obligation for which the "insured" or the "insured's" insurer may be held liable under any workers' compensation, disability benefits or unemployment compensation law or any similar law. CA 00 01 10 13 © Insurance Services Office , Inc., 2011 Page 3 of 12 4. Employee Indemnification And Employer's Liability "Bodily injury" to: a. An "employee" of the "insured" arising out of and in the course of: (1) Employment by the "insured"; or (2) Performing the duties related to the conduct of the "insured's" business ; or b. The spouse , child, parent , brother or sister of that "employee" as a consequence of Paragraph a. above. This exclusion applies : (1) Whether the "insured" may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury . But this exclusion does not apply to "bodily injury" to domestic "employees" not entitled to workers' compensation benefits or to liability assumed by the "insured" under an "insured contract". For the purposes of the Coverage Form, a domestic "employee" is a person engaged in household or domestic work performed principally in connection with a residence premises . 5. Fellow Employee "Bodily injury" to: a. Any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business ; or b. The spouse , child , parent, brother or sister of that fellow "employee" as a consequence of Paragraph a. above . 6. Care, Custody Or Control "Property damage" to or "covered pollution cost or expense" involving property owned or transported by the "insured" or in the "insured's" care, custody or control. But this exclusion does not apply to liability assumed under a sidetrack agreement. 7. Handling Of Property "Bodily injury" or "property damage" resulting from the handling of property : a. Before it is moved from the place where it is accepted by the "insured" for movement into or onto the covered "auto"; or b. After it is moved from the covered "auto" to the place where it is finally delivered by the "insured". 8. Movement Of Property By Mechanical Device "Bodily injury" or "property damage" resulting from the movement of property by a mechanical device (other than a hand truck) unless the device is attached to the covered "auto". 9. Operations "Bodily injury" or "property damage" arising out of the operation of: a. Any equipment listed in Paragraphs 6.b. and 6.c. of the definition of "mobile equipment"; or b. Machinery or equipment that is on , attached to or part of a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged . 10. Completed Operations "Bodily injury" or "property damage" arising out of your work after that work has been completed or abandoned. In this exclusion , your work means : a. Work or operations performed by you or on your behalf; and b. Materials , parts or equipment furnished in connection with such work or operations. Your work includes warranties or representations made at any time with respect to the fitness, quality, durability or performance of any of the items included in Paragraph a. or b. above. Your work will be deemed completed at the earliest of the following times : (1) When all of the work called for in your contract has been completed ; (2) When all of the work to be done at the site has been completed if your contract calls for work at more than one site ; or (3) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project . Page 4 of 12 © Insurance Services Office , Inc , 2011 CA00011013 Work that may need service, maintenance , correction , repair or replacement , but which is otherwise complete , will be treated as completed . 11. Pollution "Bodily injury" or "property damage" arising out of the actual , alleged or threatened discharge , dispersal, seepage, migration , release or escape of "pollutants": a. That are , or that are contained in any property that is : (1) Being transported or towed by , handled or handled for movement into , onto or from the covered "auto"; (2) Otherwise in the course of transit by or on behalf of the "insured"; or (3) Being stored , disposed of, treated or processed in or upon the covered "auto"; b. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto"; or c. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered , disposed of or abandoned by the "insured". Paragraph a. above does not apply to fuels , lubricants, fluids , exhaust gases or other similar "pollutants" that are needed for or result from the normal electrical , hydraulic or mechanical functioning of the covered "auto" or its parts if: (1) The "pollutants" escape, seep, migrate or are discharged , dispersed or released directly from an "auto" part designed by its manufacturer to hold, store, receive or dispose of such "pollutants"; and (2) The "bodily injury", "property damage" or "covered pollution cost or expense" does not arise out of the operation of any equipment listed in Paragraphs 6.b. and 6.c. of the definition of "mobile equipment". Paragraphs b. and c. above of this exclusion do not apply to "accidents" that occur away from premises owned by or rented to an "insured " with respect to "pollutants" not in or upon a covered "auto" if: 12. War (a) The "pollutants" or any property in which the "pollutants" are contained are upset , overturned or damaged as a result of the maintenance or use of a covered "auto"; and (b) The discharge , dispersal , seepage , migration, release or escape of the "pollutants" is caused directly by such upset , overturn or damage . "Bodily injury" or "property damage " arising directly or indirectly out of: a. War, including undeclared or civil war ; b. Warlike action by a military force, including action in hinde ri ng or defending aga inst an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or c. Insurrection , rebellion , revolution , usurped power or action taken by governmental authority in hindering or defending against any of these . 13. Racing Covered "autos" while used in any professional or organized racing or demolition contest or stunting activity, or while practicing for such contest or activity . This insurance also does not apply while that covered "auto" is being prepared for such a contest or activity. C. Limit Of Insurance Regardless of the number of covered "autos", "insureds", premiums paid , claims made or vehicles involved in the "accident", the most we will pay for the total of all damages and "covered pollution cost or expense" combined resulting from any one "accident" is the Limit Of Insurance for Covered Autos Liabil ity Coverage shown in the Declarations . CA 00 01 10 13 © Insurance Services Office , Inc ., 2011 Page5of12 All "bodily injury", "property damage" and "covered pollution cost or expense " resulting from continuous or repeated exposure to substantially the same conditions will be considered as resulting from one "accident". No one will be entitled to receive duplicate payments for the same elements of "loss" under this Coverage Form and any Medical Payments Coverage endorsement , Uninsured Motorists Coverage endorsement or Underinsured Motorists Coverage endorsement attached to this Coverage Part . SECTION Ill -PHYSICAL DAMAGE COVERAGE A. Coverage 1. We will pay for "loss" to a covered "auto" or its equipment under: a. Comprehensive Coverage From any cause except: (1) The covered "auto's" collision with another object ; or (2) The covered "auto's" overturn. b . Specified Causes Of Loss Coverage Caused by : (1) Fire , lightning or explosion ; (2) Theft ; (3) Windstorm , hail or earthquake ; (4) Flood; (5) Misch ief or vandalism; or (6) The sinking, burning, coll ision or derailment of any conveyance transport ing the covered "auto". c. Collision Coverage Caused by: (1) The covered "auto's" collision with another object ; or (2) The covered "auto's" overturn . 2. Towing We will pay up to the limit shown in the Declarations for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled . However, the labor must be performed at the place of disablement. 3 . Glass Breakage -Hitting A Bird Or Animal~ Falling Objects Or Missiles If you carry Comprehensive Coverage for the damaged covered "auto", we will pay for the following under Comprehensive Coverage: a. Glass breakage ; b. "Loss " caused by hitting a bird or animal ; and c. "Loss " caused by falling objects or missiles . However , you have the option of having glass breakage caused by a covered "auto's" collision or overturn considered a "loss" under Collision Coverage . 4. Coverage Extensions a. Transportation Expenses We will pay up to $20 per day , to a maximum of $600 , for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type . We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes Of Loss Coverage . We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration , when the covered "auto " is returned to use or we pay for its "loss". b. Loss Of Use Expenses For Hired Auto Physical Damage , we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or agreement. We will pay for loss of use expenses if caused by : (1) Other than collision only if the that provided Declarations indicates Comprehensive Coverage is for any covered "auto "; (2) Specified Causes Of Loss only if the Declarations indicates that Specified Causes Of Loss Coverage is provided for any covered "auto "; or Page6of12 © Insurance Services Office , Inc ., 2011 CA 00 01 10 13 (3) Collision only if the Declarations indicates that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $20 per day, to a maximum of $600. B. Exclusions 1. We will not pay for "loss" caused by or resulting from any of the following . Such "loss" is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the "loss". a. Nuclear Hazard (1) The explosion of any weapon employing atomic fission or fusion ; or (2) Nuclear reaction or radiation , or radioactive contamination, however caused . b. War Or Military Action (1) War, including undeclared or civil war; (2) Warlike action by a military force , including action in hindering or defending against an actual or expected attack , by any government , sovereign or other authority using military personnel or other agents ; or (3) Insurrection , rebellion, revolution , usurped power or action taken by governmental authority in hindering or defending against any of these . 2. We will not pay for "loss" to any covered "auto" while used in any professional or organized racing or demolition contest or stunting activity , or while practicing for such contest or activity . We will also not pay for "loss" to any covered "auto" while that covered "auto" is being prepared for such a contest or activity. 3. We will not pay for "loss" due and confined to : a. Wear and tear, freezing , mechanical or electrical breakdown . b. Blowouts , punctures or other road damage to tires . This exclusion does not apply to such "loss" resulting from the total theft of a covered "auto". 4. We will not pay for "loss" to any of the following : a. Tapes , records , discs or other similar audio, visual or data electronic devices designed for use with audio , visual or data electron ic equipment. b. Any device designed or used to detect speed-measuring equipment , such as radar or laser detectors , and any jamming apparatus intended to elude or disrupt speed-measuring equipment. c. Any electronic equipment, without regard to whether this equipment is permanently installed , that reproduces , receives or transmits audio , visual or data signals . d. Any accessories used with the electronic equipment described in Paragraph c . above . 5. Exclus ions 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 : a. Permanently installed in or upon the covered "auto"; b . Removable from a housing unit which is permanently installed in o r upon the covered "auto "; c. An integral part of the same unit housing any electron ic equipment described in Paragraphs a. and b. above ; or d . Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. 6 . We will not pay for "loss" t o a covered "auto" due to "diminution in value". C. Limits Of Insurance 1. The most we will pay for: a. "Loss" to any one covered "auto" is the lesser of: (1) The actual cash value of the damaged or stolen property as of the time of the "loss "; or (2) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality . b . All electronic equ ipment that rep roduces , receives or transmits audio , v isual or data signals in any one "loss " is $1 ,000 , if, at the time of "loss ", such electronic equipment is: (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installat ion of such equipment ; CA 00 01 10 13 © Insuran ce Se rv ice s Offic e , Inc ., 2011 Page7of12 (2) Removable from a permanently installed housing unit as described in Paragraph b.(1) above ; or (3) An integral part of such equipment as described in Paragraphs b.(1) and b.(2) above . 2. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". 3. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. D. Deductible For each covered "auto", our obligation to pay for, repair , return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning . SECTION IV -BUSINESS AUTO CONDITIONS The following conditions apply in addition to the Common Policy Conditions : A. Loss Conditions 1. Appraisal For Physical Damage Loss If you and we disagree on the amount of "loss", either may demand an appraisal of the "loss". In this event, each party will select a competent appraiser. The two appraisers will select a competent and impartial umpire . The appraisers will state separately the actual cash value and amount of "loss". If they fail to agree, they will submit their differences to the umpire . A decision agreed to by any two will be binding . Each party will : a. Pay its chosen appraiser ; and b. Bear the other expenses of the appraisal and umpire equally . If we submit to an appraisal, we will still retain our right to deny the claim. 2. Duties In The Event Of Accident, Claim, Suit Or Loss We have no duty to provide coverage under this policy unless there has been full compliance with the following duties : a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident" or "loss". Include: (1) How, when and where the "accident" or "loss" occurred ; (2) The "insured's" name and address; and (3) To the extent possible , the names and addresses of any injured persons and witnesses. b. Additionally , you and any other involved "insured" must: (1) Assume no obligation , make no payment or incur no expense without our consent , except at the "insured's" own cost. (2) Immediately send us copies of any request, demand, order , notice, summons or legal paper received concerning the claim or "suit". (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit". (4) Authorize us to obtain medical records or other pertinent information. (5) Submit to examination, at our expense, by physicians of our choice, as often as we reasonably require . c. If there is "loss" to a covered "auto" or its equipment , you must also do the following: (1) Promptly notify the police if the covered "auto" or any of its equipment is stolen . (2) Take all reasonable steps to protect the covered "auto" from further damage. Also keep a record of your expenses for consideration in the settlement of the claim. (3) Permit us to inspect the covered "auto" and records proving the "loss" before its repair or disposition . (4) Agree to examinations under oath at our request and give us a signed statement of your answers. 3. Legal Action Against Us No one may bring a legal action against us under this Coverage Form until: a. There has been full compliance with all the terms of this Coverage Form ; and b. Under Covered Autos Liability Coverage , we agree in writing that the "insured" has an obligation to pay or until the amount of that obligation has finally been determined by judgment after trial. No one has the right under this policy to bring us into an action to determine the "insured's" liability. Page8of12 © Insurance Services Office , Inc., 2011 CA 00 01 10 13 4. Loss Payment -Physical Damage Coverages At our option, we may: a. Pay for, repair or replace damaged or stolen property; b . Return the stolen property, at our expense . We will pay for any damage that results to the "auto" from the theft ; or c. Take all or any part of the damaged or stolen property at an agreed or appraised value . If we pay for the "loss", our payment will include the applicable sales tax for the damaged or stolen property. ~ Transfer Of Rights Of Recovery Agains~ Others To UsJ ff any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us . That person o r. organization must do everything necessary to, secure our rights and must do nothing afte r. "accident" or "loss" to im~air them .J B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the "insured" or the "insured's" estate will not relieve us of any obligations under this Coverage Form . 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form . It is also void if you or any other "insured", at any time , intentionally conceals or misrepresents a material fact concerning : a. This Coverage Form ; b. The covered "auto"; c. Your interest in the covered "auto"; or d. A claim under this Coverage Form . 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the addit ional coverage as of the day the revision is effective in your state . 4. No Benefit To Bailee -Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding , storing or transporting property for a fee regardless of any other provision of this Coverage Form . 5. Other Insurance For any covered "auto" you own, this Coverage Fonn J)rovides J)rirnarY. insurance. For any covered "auto" you don't own , the insurance provided by this Coverage Form is excess over any other collectible insurance. However, while a covered "auto" which is a "trailer" is connected to another vehicle, the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is : (1) Excess while it is connected to a motor vehicle you do not own; or (2) Primary while it is connected to a covered "auto" you own. b. For Hired Auto Physical Damage Coverage , any covered "auto" you lease , hire , rent or borrow is deemed to be a covered "auto" you own . However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". c. Regardless of the provisions of Paragraph a. above , this Coverage Form's Covered Autos Liability Coverage is primary for any liability assumed under an "insured contract". d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary , we will pay only our share . Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis . 6. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began . We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance , if any . The due date for the final premium or retrospective premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due , the first Named Insured will get a refund. b. If this policy is issued for more than one year, the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy . CA 00 01 10 13 © Insurance Services Office , Inc ., 2011 Page9of12 7. Policy Period, Coverage Territory Under this Coverage Form , we cover "accidents" and "losses" occurring: a. During the policy period shown in the Declarations; and b. Within the coverage territory. The coverage territory is : (1) The United States of America ; (2) The territories and possessions of the United States of America ; (3) Puerto Rico ; (4) Canada ; and (5) Anywhere in the world if a covered "auto" of the private passenger type is leased , hired, rented or borrowed without a driver for a period of 30 days or less , provided that the "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the Un ited States of America, the territories and possessions of the United States of America , Puerto Rico or Canada , or in a settlement we agree to. We also cover "loss" to , or "accidents" involving , a covered "auto" while being transported between any of these places . 8. Two Or More Coverage Forms Or Policies Issued By Us If this Coverage Form and any other Coverage Form or policy issued to you by us or any company affiliated with us applies to the same "accident", the aggregate maximum Limit of Insurance under all the Coverage Forms or policies shall not exceed the highest applicable Limit of Insurance under any one Coverage Form or policy . This condition does not apply to any Coverage Form or policy issued by us or an affiliated company specifically to apply as excess insurance over this Coverage Form . SECTION V -DEFINITIONS A . "Accident" includes continuous or repeated ex posure to the same conditions resulting in "bodily injury" or "property damage". B. "Auto" means : 1. A land motor vehicle , "trailer" or semitrailer designed for travel on public roads ; or 2. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged . However, "auto" does not include "mobile equipment". C. "Bodily injury" means bodily injury, sickness or disease sustained by a person , including death resulting from any of these. D. "Covered pollut ion cost or expense" means any cost or expense arising out of: 1. Any request, demand , order or statutory or regulatory requirement that any "insured" or others test for, monitor, clean up, remove , contain, treat, detoxify or neutralize , or in any way respond to , or assess the effects of, "pollutants"; or 2. Any claim or "suit" by or on behalf of a governmental authority for damages because of testing for , monitoring, cleaning up , removing, containing, treating, detoxifying or neutralizing, or in any way responding to , or assessing the effects of, "pollutants". "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge , dispersal , seepage, migration, release or escape of "pollutants": a. That are, or that are contained in any property that is : (1) Being transported or towed by , handled or handled for movement into , onto or from the covered "auto"; (2) Otherwise in the course of transit by or on behalf of the "insured"; or (3) Being stored , disposed of, treated or processed in or upon the covered "auto"; b. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured " for movement into or onto the covered "auto"; or c. After the "pollutants" or any property in wh ich the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered , disposed of or abandoned by the "insured". Page 10 of 12 © Insurance Services Office , Inc ., 2011 CA 00 01 10 13 Paragraph a . above does not apply to fuels , lubricants , fluids , exhaust gases or other similar "pollutants" that are needed for or result from the normal electrical , hydraulic or mechanical functioning of the covered "auto" or its parts , if: (1) The "pollutants" escape , seep , migrate or are discharged, dispersed or released directly from an "auto" part designed by its manufacturer to hold , store, receive or dispose of such "pollutants"; and (2) The "bodily injury", "property damage" or "covered pollution cost or expense" does not arise out of the operation of any equipment listed in Paragraph 6.b. or 6.c. of the definition of "mobile equipment". Paragraphs b. and c. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (a) The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (b) The discharge , dispersal, seepage, migration , release or escape of the "pollutants" is caused directly by such upset, overturn or damage . E. "Diminution in value" means the actual or perceived loss in market value or resale value which results from a direct and accidental "loss". F. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker". G. "Insured" means any person or organization qualifying as an insured in the Who Is An Insured provision of the applicable coverage. Except with respect to the Limit of Insurance, the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or "suit" is brought. H. "Insured contract" means: 1. A lease of premises ; 2. A sidetrack agreement; 3. Any easement or license agreement , ex cept in connection with construction or demolition operations on or within 50 feet of a railroad ; 4. An obligation , as required by ordinance, to indemnify a municipality, except in connection with work for a municipality ; 5. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another to pay for "bodily injury" or "property damage" to a third party or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement; or 6. That part of any contract or agreement entered into, as part of your business, pertaining to the rental or lease , by you or any of your "employees", of any "auto". However, such contract or agreement shall not be considered an "insured contract" to the extent that it obligates you or any of your "employees" to pay for "property damage" to any "auto" rented or leased by you or any of your "employees". An "insured contract" does not include that part of any contract or agreement: a. That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, roadbeds, tunnel, underpass or crossing; b. That pertains to the loan , lease or rental of an "auto" to you or any of your "employees", if the "auto" is loaned , leased or rented with a driver; or c. That holds a person or organization engaged in the business of transporting property by "auto" for hire harmless for your use of a covered "auto" over a route or territory that person or organization is authorized to serve by public authority . I. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". J. "Loss" means direct and accidental loss or damage. K. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: 1. Bulldozers , farm machinery , forklifts and other vehicles designed for use principally off public roads ; 2. Vehicles maintained for use solely on or ne xt to premises you own or rent; 3. Vehicles that travel on crawler treads; CA 00 01 10 13 © Insurance Services Office , Inc ., 2011 Page 11 of 12 4. Vehicles, whether self-propelled or not , maintained primarily to provide mobility to permanently mounted : a. Power cranes , shovels , loaders , diggers or drills ; or b. Road construction or resurfacing equipment such as graders , scrapers or rollers ; 5. Vehicles not described in Paragraph 1., 2., 3. or 4. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: a. Air compressors , pumps and generators , including spraying, welding , building cleaning , geophysical exploration , lighting and well-servicing equipment ; or b. Cherry pickers and similar devices used to raise or lower workers; or 6 . Vehicles not described in Paragraph 1., 2., 3. or 4. above maintained primarily for purposes other than the transportation of persons or cargo . However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": a. Equipment designed primarily for: (1) Snow removal ; (2) Road maintenance, but not construction or resurfacing ; or (3) Street cleaning; b. Cherry pickers and similar dev ices mounted on automobile or truck chassis and used to raise or lower workers; and c. Air compressors , pumps and generators , including spraying , welding , building cleaning, geophysical exploration , lighting or well-servicing equipment. However, "mobile equipment" does not include land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged . Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered "autos". L. "Pollutants" means any solid , liquid, gaseous or thermal irritant or contaminant, including smoke , vapor, soot, fumes , acids, alkalis , chemicals and waste . Waste includes materials to be recycled , reconditioned or reclaimed. M. "Property damage" means damage to or loss of use of tangible property . N. "Suit" means a civil proceeding in which: 1. Damages because of "bodily injury" or "property damage"; or 2. A "covered pollution cost or expense"; to which this insurance applies, are alleged . "Suit" includes : a. An arbitration proceeding in wh ich such damages or "covered pollution costs or expenses" are claimed and to which the "insured" must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in · which such damages or "covered pollution costs or expenses" are claimed and to which the insured submits with our consent. 0. "Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short- term workload conditions. P. "Trailer" includes semitrailer. Page 12 of 12 © Insurance Services Office , Inc ., 2011 CA 00 01 10 13 CITY OF II CUPERTINO ADDITIONAL INSURED ENDORSEMENT and ENDORSEMENT OF PRIMARY INSURANCE and NOTICE OF POLICY CANCELLATION ENDORSEMENT Project Title and Number: SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows : The City of Cupertino ("City") and its directors, officers, engineers, agents and employees, and all public agencies from whom permits will be obtained and their directors , officers, engineers, agents and employees, and the State of California , and its officers, agents and employees, are hereby declared to be additional insureds under the terms of this policy, but only with respect to the operations of the Contractor at or upon any of the premises of the City in connection with the Contract with the City, or acts or omissions of the additional insureds in connection with , but limited to its general supervision or inspection of said operations . The insurance afforded by this policy is primary insurance, and no additional insurance held or owned by the designated additional insured(s) shall be called upon to cover a loss under said additional policy. Cancellation Notice. The insurance afforded by this policy shall not be suspended , voided , canceled, reduced in coverage or in limits, or materially altered , except after thirty (30) days ' prior written notice by certified mail, return receipt requested , has been given to the City of Cupertino ("City"). Such notice shall be addressed to the City as indicated below. POLICY INFORMATION Benchmark Insurance Company 1. Insurance Company: _________________________ _ 2. Insurance Policy Number:_B_rc_5_01_6_1_9s _________________ _ 3. Effective Date of this Endorsement: October 23 , 20_17_ 4. Insured: AJ.i Farahani, DBA: Nema Construction All notices herein provided to be given by the Insurance Company to the City in connection with this policy and these Endorsements, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino , California 95014 . [Signature on following page.] City of Cupertino Insurance Forms Page 4 of 7 I, Sarah Kelly (prinUtype name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company . Signature of Authorized Representative : P~~ (Original signature required on all Endorsementsfum1sf1edothe ity) Names of AgenUAgency :Nickerson Insurance Serv. Inc Title :......._.rr..,..es .... id...,e"'"ot~------- Address: 2016 Lomita Blvd. Lomita. CA 90717 City of Cupertino Insurance Forms Page 5 of 7 Telephone : .ill)_ --32.Q__ 6333 Facsimile : .lli)_.l1.§_ 5416 CITY OF II COMPREHENSIVE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ENDORSEMENT OF AGGREGATE LIMITS OF INSURANCE PER PROJECT CUPERTINO SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION Project Title and Number: _______________________ _ In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto , it is as follows : This Endorsement modifies the insurance provided under the General Liability Coverage part of the below-referenced policy of insurance . The general aggregate limit under LIMITS OF INSURANCE applies separately to the project described as SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION POLICY INFORMATION 1. Insurance Company: Benchmark Insurance Company 2. Insurance Policy Number:_~B~I~C~5~0~1~6~1~9~5 _________________ _ 3. Effective Date of this Endorsement: October 23 20.ll_ 4. Insured: Ali Farahani DEA Nema Construction 5. Additional Insured: City of Cupertino , its directors , officers, agents and employees. All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this Endorsement , shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino , California 95014 . I, Sarah Kelly (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company . Signature of Authorized Representative, ~ (Original signature required on all Er{clorsen,entsf the Crty) Names of Agent/Agency :Nickerson Insurance Serv. Inc. Title : President Address : 2106 Lomita Blvd. Lomita, CA 90717 City of Cupertino Insurance Forms Page 6 of 7 Telephone : ____J_l_O_ll§__ 6333 Facsimile: ...llQ_ __fil_ 5416 CITY OF II CUPERTINO WAIVER OF SUBROGATION ENDORSEMENT WORKER'S COMPENSATION INSURANCE Project Title and Number: SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows : It is agreed that with respect to such insurance as is afforded by the policy , the Insurance Company waives any right of subrogation against the City of Cupertino, and each of its directors, officers, agents , consultants and employees by reason of any payment made on account of injury, including death resulting therefrom , sustained by any employee of the insured, arising out of the performance of the above-referenced Contract. POLICY INFORMATION State Compensation Ins. Fund 1. Insurance Company: _________________________ _ 9 0 851201 7 2 . Insurance Policy Number: ________________________ _ 3. Effective Date of this Endorsement: Octo ber 25 , 20 17 Ali Farahani , DBA: Nema Construction 4 . Insured: ______________________________ _ All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this Endorsement , shall be mailed to or delivered to the City at 10300 Torre Avenue ; Cupertino , California 95014 . I, Sarah Kelly (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative , ~~ (Original signature required on all En '3sementsfumishetohe City) Names of Agent/Agency:Nickerson Insurance Serv. Inc. Title:~P~r~e=s=i=d=e=n-t _____ _ Address: 2106 Lomita Blvd. Telephone: ___llQ _]1.§_ 6333 __ L_o_m_i_t_a_,_, _C_A_9_0_7_1_7 ________ Facsimile: -2.l.Q ..J.1.§_ 5416 END OF DOCUMENT City of Cupertino Insurance Forms Page 7 of 7 Payment Bond Bond No . CAC715642 Premium listed on Performance Bond Execu ted in two originals The City of Cupertino ("City ") and NEMA Construction ("Contractor") have entered into a contract , dated odobe.r 2, 6, , 20 17. ("Contract") for work on the SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION, PROJECT NO. 2017-19.01 , Project ("Project"). The Contract is incorporated by reference into this Payment Bond ("Bond "). 1. General. Under this Bond , Contractor as principal and Merchants Bonding Company (Mutual), its surety ("Surety"), are bound to City as obl igee in an amount not less than Two hundred twenty thousand 001100 $ 220 ,000 .00 , under Cal ifornia 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. Th is Bond inures to the benefit of any of the persons named in Cal ifornia Civil Code section 9100 , so as to give a right of action to those persons or their assigns in any su it brought upon this Bond . Contractor must promptly provide a copy of this Bond upon request by any person with lega l 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 th is Bond will be null and void . Otherwise , Surety's obligations will rema in in full force and effect. 5. Waivers. Surety waives any requirement to be notified of alterations to the Contract or extensions of time fo r performance of the Work under the Contract. Surety waives the provisions of Civil Code sections 2819 and 2845 . Cit y waives requirement of a new bond for any supplemental cont ract under Civil Code section 9550. Any notice to Surety may be g iven in the manner specified in the Contract and delivered or transmitted to Surety as follows : Attn : Terry Bricker , Merchants Bonding Company (Mutual) Address : P.O. Bo x 14498 City/State/Zip : Des Moines IA 50 306 Phone : (515)243-8171 Fa x: (515)243-3854 Ema il: TBRICKER@MERCHANTSBONDING .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. SPORTS CENTER UPGRADES -EAST COURTS LIGHT CONVERSION 2017-19 .01 PAYMENT BOND Page 1 7. Effective Date; Execution. This Bond is entered into and is effective on October 24 , 20J.Z. Kev in Cathcart , Attorney -In-Fact Name/Title (Acknowledgment with Surety's Notary Seal and Surety's Power of Attorney must be attached .) Name/Title z Name/Title c.,p MN~ END OF PAYMENT BOND SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 PAYMENT BOND Page 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 A notary public or other officer completing this ce1iificate verifies only the identity of the indi vidual \-Yl10 signed the document to which this certificate is attached and not the truthfulness , accuracy , or validity of that document. State of California ) County of _O_r_a _ng~e __________ ) On /t)-c9-V-// before me, ________ B_. _C_o_,_p_e_la_n_d _______ , Notary Public, personally appeared Kevin Cathcart Name(s ) ofSigner(s ) wh o proved to m e 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 he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(-&) on the instrument the person(-&), or the entity upon behalf of which the person(s1 acted, executed the instrnment. < ~ @ . . B. COPELAND Notarv Public -California Orange County Commission# 2187550 Mv Comm Expires Apr 19. 2021 Pla ce Notar y Seal Above I certify tu1der PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. OPTIONAL Though the information below is not required by law , it ma y prove valuable to persons rel ying on the doc1m1ent and could present fraudulent and reattachment of this fonn to another docmnent. Description of Attached Document Type or Title of Document:-------------------------------- Document Date: Nwnber of Pages: ----------------------------- Signer ( s) Other Than Named Above: ___________________________ _ Capacity(ies) Claimed by Signer(s) Capacity(ies) Claimed by Signer(s) Signer's Name: Kevin Cathcart Signer 's Name : D h1dividual D Individual D Corporate Officer -Title(s): D Corporate Officer -Title(s): D Partner: OLimited D General D Partner: OLimited D General ~ Attorney in Fact D Attorney in Fact D Trustee D Trustee D Guardian or Conservator D Guardian or Conservator D Other: D Otl1er: Signer Is Representing : __________ _ Signer Is Representing: __________ _ Rev . 1-15 MERCHANTS~ BONDING COMPANY™ POWER OF ATTORNEY Know All Persons By These Presents , that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING , INC ., both being corporations of the State of Iowa (herein collectively called the "Companies") do hereby make , constitute and appoint , individually , Eric Lowey ; Jennifer Grenrood ; Karyl A Richter; Kevin Cathcart; Mark Richardson; Shawn Blume ; Teresa I Jackson ; Vanessa Copeland their true and la wful Attorney(s)-in-Fact , to sign its name as surety(ies) 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 . This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23 , 2011 and amended August 14 , 2015 and adopted by the Board of Directors of Merchants National Bonding , Inc ., on October 16 , 2015 . "The President , Secretary , Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto , bonds and undertakings , recognizances , contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond , undertaking , recognizance , or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only , it is agreed that the power and au! hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation . It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee , shall not relieve this surety company of any of its obligations under its bond . In connection with obligations in favor of the Kentucky Department of Highways only , it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation . In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 17th day of April , 2017 , .......... ., ......... . ···~\ON,q '•, .• ~G C • • . -·~~ ........... { ;;·-. . . ~~\ ..... _q4t~·· /"J .. ··oV.'P o~_/.,: .. o\. ..~~-·~~PO Ii°;·:~; •• MERCHANTS BONDING COMPANY (MUTUAL) -J....:C., ~·."t--:. • ·'-> ..,.,.,. .. ~. :<:~ -o-c:,:O: :~:c!': -o-r1": : :<: :z: •:;z:;-O;~. -:. ~..... 2003 ... t;): : ~·.. 1933 ... c:::: ":,,"'"' ·• .. .... • .-~.,,. • ":Y. •.($, ·.. ... '.. • ...... ~.. .·~<:::-. STATE OF IOWA COUNTY OF DALLAS ss . '•.~/,,,:···········:·~~--· •• '..:llj,·······\\ •• ,,:_11 {:::[-........ • • • <:t •• 111 111 I I 11 111 • e e. e •• ::~:~!;2 On this this 17th day of April 2017 , before me appeared Larry Taylor, to me personally known , who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING , INC .; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies ; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors . 1>-?-'f\l <l' ALICIA K. GRAM /;' A 't Commission Number 767 430 ~a :-My Commission Expires ,0 wP.. April 1, 2020 Notary Public (Expiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING , INC., 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 and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 24th day of October , 2017 . p'~~/. Secretary POA 0018 (3/17) PREMIUM IS FOR THE CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT BASED ON FINAL CONTRACT PRICE Performance Bond Bond No . CAC715642 Premium: $4 ,300 .00 Executed in two originals The City of Cupertino ("City ") and NEMA Construction ("Contractor ") have entered into a contract, dated e>c.b ba r 7...,(f,,, 20J:l_ ("Contract") for work on the SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION, PROJECT NO. 2017-19.01 , Project ("Project"). The Contract is incorporated by reference into this Performance Bond ("Bond "). 1. General. Under this Bond , Contractor as Principal and Merchants Bonding Company (Mutual) its surety ("Surety"), are bound to City as obligee for an amount not less than Two hundred twenty thousand 001100 $ 220 ,000 .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 extensions 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 liquidated 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: SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19.01 PERFORMANCE BOND Page 3 Attn: Terry Bricker, Merchants Bond in g Company (Mutual) Address: P.O. Box 14498 City/State/Zip : Des Moines IA 50306 Phone : (515)243-81 71 Fa x: (515)243-3854 Email : TBRICKER@MERCHANTSBONDING.COM 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 24 , 20.!I._. Ke vin Cathcart , Att orney-In-Fa ct Name/Title [print] (Acknowledgment with Notary Seal for Surety and Surety's Power of Attorney must b e attached.) A Const ructio n Name/Title s/ ---------------------------- Name/Title s/ Name/Title END OF PERFORMANCE BOND SPORTS CENTER UPGRADES-EAST COURTS LIGHT CONVERSION 2017-19 .01 PERFORMANCE BOND Page 4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 A notary public or other officer completing this ce1iificate ve rifi es only the identity of the indi vi dual who signed th e docum ent to which this certificate is attached and not th e truthfulness , accuracy, or va lidi ty of that document. State of California ) County of _O_r_a_n=g_e __________ ) On /() ---d V-/ J before me, _______ B_._C_o~p_e_la_n_d ______ ~, Notary Public, p ersonall y app eared Kevin Cathcart Name(s ) ofSigner(s ) who pro ve d to me on the b as is of satisfactory ev id enc e to b e the person(s) who se name(s) is /are subscribed to the w ithin instrument a nd acknow ledge d to me th at he/she/they executed the sam e in hi s/her/their authori ze d capacity(ies), and tha t by hi s/her/their signature(s-) on the in stmm ent th e person(-&), or the ent ity upon b ehalf of which the person(s1 acted, execut ed the instmment . 8. COPELAND Notary Pu blic -Ca lifornia Orange County Comm iss icn # 2187550 Mv Comm . Ex~ire s Apr 19. 2021 Place l\"otary Sea l Above t z " > I certify und er PENAL TY OF PERJURY under the laws of the State of California that the foregoing p aragraph is tru e and correct. WITNESS my hand and official seal. 1 OPTIONAL Though the information belo w is not required by law , it may prove val uabl e to persons relying on the do cmn ent and could present fra udulent and reattachment of this form to another document. Description of Attached Document Type or Title of Document:-------------------------------- Document D ate: _________________ Nwnb er of Pages: ___________ _ Si gner(s) Other Than Na.med Above: _________________________ _ Capacity(ies) Claimed by Signer(s) Signer 's Na.me : _K_e_v_in_C_a_th_c_a_rt _______ _ D Individual D Corporate Offi cer -Title(s): ______ _ D Partner: DLimited D Gen eral ~ Attorney in Fa.ct D Tmstee D Guardian or Cons ervator D Other : ---------------- Signer Is R epresenting: __________ _ Capacity(ies) Claimed by Signer(s) Signer 's Na.me: _____________ _ D Individual D Corporate Officer -Title(s): ______ _ D Partner: OLimited D Genera.I D Attorney in Fa.ct D Trustee D Guardian or Conservator D Other: ---------------- Signer Is Representing : __________ _ Re v. 1 -1 5 MERCHANTS~ BONDING COMPANYTM POWER OF ATTORNEY Know All Persons By These Presents , that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING , INC ., both being corporations of the State of Io w a (herein collectively called the "Companies ") do hereby make , constitute and appoint, individually , Eric Lewey ; Jennifer Grenrood ; Karyl A Richter ; Kevin Cathcart ; Mark Richardson ; Shawn Blume ; Teresa I Jackson ; Vanessa Copeland their true and lawful Attorney (s)-in-Fact , to sign its name as surety(ies) and to execute , seal and acknowledge any and all bonds , undertakings , contracts and other written instruments in the nature thereof, on behalf of the Compan ies in their business of guaranteeing the fide li ty of persons , guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings requi red or permitted in any actions or proceedings allowed by law . This Power-of-Attorney is granted and is signed and sealed by fa c simile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual ) on April 23, 2011 and amended August 14 , 2015 and adopted by the Board of Directors of Merchants National Bonding , Inc ., on October 16 , 2015 . "The President , Secretary, Treasurer , or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact , and to authorize them to execute on behalf of the Company , and attach the seal of the Company thereto , bonds and undertakings , recognizances , contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affi xed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the exec ution and delivery of any bond , undertaking , recognizan ce , or other suretyship obligations of the Company , and such signature and seal when so used shall have the same force and effect as though manually fi xed ." In conne ction with obligations in favor of the Florida Department of Transportation only , it is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and /or final estimates on engineering and construction contra cts required by the State of Fl orida Department of Transportation . It is fully understood that consenting to the State of Florida Department of Transportation mak ing payment of th e final estimate to the Contra ctor and/or its assignee , shall not relieve this surety company of any of its obligations under its bond . In connection w ith obligations in favor of the Kentucky Department of Highways only , it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commission e r- Department of Highways of the Common w ealth of Kentucky at least thirty (30) days prior to the modification or revocation . In Wit nes s Whereof, the Companies have caused this instrument to be signed and sealed this 17th day of April , 2017 ,,, .... ····· ........ . ···~\ON,q '•. .• ~G C •. ···~~ ........... ~ iJ··. • • ~<y,\ ..... .f!4t,¢·· /"J .. ··o~PO~,fj',: .. O \ :~~.·~ \\ p O ;9_:;.,11,#· •• :J...: c., {t\··~':. • . c:., ..,,A .. ~. :c::·~ -o-c:>':0: :f:::c!:: -0-ff': : :ct: :i: •z:;-C :3:o .,:. · • •.:1:· 1933 . • ':.()... 2003 :'/i>: •-5-.·. :c::-• ..... ,:J;··. .··, .... •• v·.. .-·~: ·-.~/ .. > ... ··~.·· . ~.:lh:• .... ··\,~. STATE OF IOWA COUNTY OF DALLAS ss . #•.;v .. :&.. . ':>,.,,,.... • •• ry {I ••• ................ , ....... . MERCHANTS BONDING COMPANY (MUTUAL) :~~::r;z On this this 17th day of April 2017 , before me appeared Larry Taylor , to me personally known , who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING , INC .; and that the seals affi xed to the foregoing instrument are the Corporate Seals of the Companies ; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors . ,_.~\A(IS'I" 0 )> Z 0 oo 0 r- • . 'a-NI>- ALICIA K. GRAM Commission Numb er 76 743 0 My Commission Expir es April 1, 2020 Notary Public (E xpiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING , INC., 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 and effect and has not been amended or revoked . In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 24th day of October , 2017 . POA 0018 (3/17) 1tll I 11111 •• •·~~\ON,4 '••,. •• ~t,. ....... (. (;'' .-·~ .·{i,POff,j'·. o\ :J....-·c., ~-.~~ :c::·~ -o-o ·:O: :ct: :-: ·,=.· .;z. ~c.,\ 2003 .. ·)i>: .... fJ,"·. .··, .... .. ~ ·... . .. ·~· .. '• '1t ········ -')~ .... •••••• 1::( ,,,,•' 1 111 I I tl 1 . ··. ~G-co·· . . ~-v\ ....... 4f,¢• :~~.·~ \',PO ;9.;·:t,\ • . c:., ..,_.A·.-~. -~ .. c!:: ff'· • .,-._ -o-o:-• :~:. 1933 :::: • ...-.·. : c::-. • ~· • c'Yo • O:· ·~<:::-• • •• --1~·-.. ,··\, •• • • • ti • ....... p~~~. Secretary Form W-9 Request for Taxpayer Give Form to the requester. Do not (Rev. December 2011) Identification Number and Certification Department of the Treasury send to the IRS. Interna l Revenue Service Name (as shown on your income tax return) Ali Farahani <'-i Business name/disregarded entity name, if different from above QJ NEMA Construction CJ) ro C. Check appropriate box for federal tax classification: C 0 0 Individual/sole proprietor 0 C Corporation 0 S Corporation D Partnership 0 Trust/estate Cl) 1/) Q. § 0 Exempt payee ~ .. 0 Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ... ... (.) 0 2 --------------------------------..... C Vl ·c: .: 0 Other (see instructions) ... a. (.) !E (.) Address (number, street, and apt. or suite no .) Requester's name and address (optional) Qj 555 Pierce Street #1005 Q. u, City, state, and ZIP code QJ QJ Albany,CA 94706 Cl) List account number(s) here (optional) .:F.T • •• Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" lin e I Social security number . . . . . . . . to avoid backup w 1thhold1ng . For 1nd1v1duals , this 1s your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your em ployer identification number (EIN}. If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. I Employer identification number 20-4097122 Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issu ed to me), and 2. I am not subject to backup withholding because: (a) I arri exempt from backup withholding, or (b} I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends , or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U .S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provid e your correct TIN. See the instructions on page 4. Sign Signature of Ali === Here u.s. person... Farahani :::,-;:::,:- General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN} to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued}, 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S . exempt payee. If applicable, you are also certifying that as a U.S . person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. 10/26/17 Note. If a req uester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S . person if you are: • An individual who is a U.S. citizen or U .S . resident alien, • A partnership, corporation , company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign es tate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business . Further, in certain cases w here a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid w ithholding on your share of partnership income. Cat. No. 10231X Form W-9 (Rev. 12-2011) I \ ·: ' ··-~ ~.,-