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18-213 American Custom Marble Inc., Replacing the Countertops at Community Hall
CITY OF a PUBLIC WORKS CONTRACT $45,000 OR LESS CUPERTINO 1. PARTIES This public works contract ("Contract") is made and entered into on October 22, 2018 ("Effective Date") by and between the City of Cupertino, a municipal corporation ("City"), and American Custom Marble Inc. , a Corporation ("Contractor") for replacing the countertops at Community Hall. 2. SCOPE OF WORK Contractor will perform and provide all labor, materials, equipment, supplies, transportation and any other items or work necessary to perform and complete the work required for the Project ("Work"), as required in the Scope of Work, attached here and incorporated as Exhibit A, and in accordance with the terms and conditions of this Contract. 3. TIME FOR COMPLETION 3.1 Term. This Contract begins on the Effective Date and ends on March 29, 2019 ("Contract Time") unless terminated earlier as provided herein. Contractor's Work shall begin on the date shown on a written Notice to Proceed ("NTP") and must be fully completed within the Contract Time or on the date specifically provided in the Notice to Proceed. The City Engineer will not issue a NTP until the Contract is fully executed by both parties and City has received satisfactory proof of insurance and any performance and payment bonds that may be required. 3.2 Time is of the essence for Contractor's performance and completion of the Work. Contractor must have sufficient time, resources , and qualified staff to deliver the work on time. 3.3 Liquidated damages of$ 200.00 will be charged for each day of unexcused delay , or City may deduct the amount from Contractor's payments. Liquidated damages are based on reasonably foreseeable consequences of delay and may include intangible losses which the Parties agree may be difficult to ascertain , such as loss of public confidence in City and its contractors, interference or loss of use of public facilities, and extended disruption to the public. 4. COMPENSATION 4.1 Maximum Compensation. City will pay Contractor for satisfactory performance of the Work an amount that will based on actual costs but that will be capped so as not to exceed $18,104.00 ("Contract Price"), for all of Contractor's direct and indirect costs , including all labor, materials, supplies, equipment, taxes , insurance, bonds and all overhead costs. 4.2 Invoices and Payments. Contractor must submit an invoice on the first day of each month, describing the Work performed during the preceding month, itemizing labor, materials, equipment and Public Works Project Community Hall -Restroom Countertop Replacements Public Works Contract $45 ,000 /Rev. May 22, 2018 P age 1 of 11 any incidental costs incurred. Contractor will be paid 95% of the undisputed amounts billed within 30 days after City receives a properly submitted invoice. Any retained amounts will be included with Contractor's final payment within 60 days of City's acceptance of the Work as complete. 5. INDEPENDENT CONTRACTOR 5.1 Status. Contractor is an independent contractor and not an employee of City. Contractor is solely responsible for the means and methods of performing the Work and for the persons under this employment. Contractor is not entitled to worker's compensation or any other City benefits. 5.2 Contractor's Qualifications. Contractor warrants on behalf of itself and its subcontractors that they have the qualifications and skills to perform the Work in a competent and professional manner and according to the highest standards and best practices in the industry. 5.3 Perm its and Licenses. Contractor warrants on behalf of itself and its subcontractors that they are properly licensed, registered, and/or certified to perform the Work as required by law, and have procured a City Business License. Contractor shall possess a California Contractor's License in good standing for the following classification(s): C-61 , which must remain valid for the entire Contract Time. 5.4 Subcontractors. Only Contractor's employees are authorized to work under this Contract. Prior written approval from City is required for any subcontractor, and the terms and conditions of this Contract will apply to any approved subcontractor. 5.5 Tools, Materials and Equipment. Contractor will supply all tools , materials and equipment required to pe1form the Work under this Contract. 5.6 Payment of Taxes. Contractor must pay income taxes on the money earned under this Contract. Upon City's request, Contractor will provide proof of payment and will indemnify City for violations pursuant to the indemnification provision of this Contract. 6. CHANGE ORDERS Amendments and change orders must be in writing and signed by City and Contractor. Contractor's request for a change order must specify the proposed changes in the Work, Contract Price, and Contract Time. Each request must include all the supporting documentation, including but not limited to plans/drawings, detailed cost estimates, and impacts on schedule and completion date. 7. ASSIGNMENTS; SUCCESSORS Contractor shall not assign, hypothecate, or transfer this Contract or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do so will be null and void. Any changes related to the financial control or business nature of Contractor as a legal entity is considered an assignment of the Contract and subject to City approval , which shall not be unreasonably withheld. Control means fifty percent (50%) or more of the voting power of the business entity. This Contract is binding on Contractor, its heirs , successors and permitted assigns Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000 /Rev. May 22, 2018 Page 2 of 11 8. PUBLICITY/ SIGNS Any publicity generated by Contractor for th e Project during the Contract Time, and for one year thereafter must credit City contributions to the Project. The words "C ity of Cupertino" must be displayed in a ll pieces of publicity , flyers , press releases , posters, brochures , interviews, public service announcements and newspaper articles. No signs may be posted or displayed on or about City property , except signage required by law or this Contract, without prior written approval from the City . 9. SUBCONTRACTORS 9.1 Contractor must perform all the Work with its own forces, except that Contractor may hire qualified subcontractors to perform up to 25 % of the Work, provided that each subcontractor is required by contract to be bound by the provisions of this Contract. Contractor must provide City with written proof of compliance with this provision upon request. 9.2 City may reject any subcontractor of any tier and bar a subcontractor from performing Work on the Project, if City in its sole discretion determines that subcontractor 's Work falls short of the requirements of this Contract or constitutes grounds for rejection under Public Contract Code Section 4107 . If C ity rejects a subcontractor, Contractor at its own expense must perform the subcontractor's Work or hire a new subcontractor that is acceptable to City. A Notice of Completion must be recorded within 15 days after City accepts the Work if the Contract involves work by subcontractors. 10. RECORDS AND DAILY REPORTS 10.1 Contractor must maintain daily repo1ts of the Work and submit them to City upon request and at completion of Project. The reports must describe the Work and specific tasks performed, the number of workers, the hours, the equipment, the weather conditions, and any circumstances affecting performance. City will hav e ownership of the reports, but Contractor w ill be permitted to retain copies. 10.2 If applicable, Contractor must keep a separate set of as -built drawings showing changes and updates to the Scope of Work or the original drawings as changes occur. Actual locations to scale must be identified for all major components of the Work, including mechanical , electrical and plumbing work; HVAC systems; utilities and utility connections; and any other components City determines should be included in the final drawings of the Project. Deviations from the original drawings must be shown in detail, and the location of all main runs, piping, conduit, ductwork , and drain lin es must be shown by dimension and elevation. 10.3 Contractor must maintain complete and accurate accounting records of it s Work, in accordance with generally accepted accounting principles, which must be available for City review and audit, kept separate from other records, and maintained for four years from the date of City's final payment. Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000 /Rev . May 22, 2018 Page 3 of 11 11. INDEMNIFICATION 11.1 To the fullest extent allowed by law, and except for losses caused by the so le and active negligence or willful misconduct of City personnel, Contractor shall indemnify, defend , and hold harmless City, its City Council , boards and commissions, officers, officials , employees, agents, servants, volunteers and consultants ("lndemnitees"), through legal counsel acceptable to City , from and against any and all liability , damages, claims, stop notices, actions, causes of action, demands , charges, losses and expenses (including attorney fees, legal costs and expenses related to litigation and dispute resolution proceedings), of every nature arising directly or indirectly from this Contract or in any manner relating to any of the following: (a) Breach of contract, obligations, representations or warranties; (b) Performance or nonperformance of the Work or ofany obligations under the Contract by Contractor, its employees, agents, servants, subcontractors or subcontractors; (c) Payment or nonpayment by Contractor or its subcontractors or sub-subcontractors for Work performed on or off the Project Site; and (d) Personal injury, prope1ty damage, or economic loss resulting from the work or performance of Contractor or its subcontractors or sub-subcontractors. 11.2 C ontractor must pay the costs City incurs in enforcing this provision. Contractor must accept a tender of defense upon receiving notice from City of a third-party claim, in accordance with California Public Contract Code Section 9201 . At City 's request, Contractor will assist City in the defense of a claim, dispute or lawsuit arising out of this Contract. 11.3 Contractor 's duties under this entire Section are not limited to Contract Price, Workers' Compensation or other employee benefits, or the insurance and bond coverage required in this Contract. Nothing in the Contract shall be construed to give rise to any implied right of indemnity in favor of Contractor against City or any other lndemnitee. 11.4 Contractor's payments may be deducted or offset to cover any money the City lost due to a claim or counterclaim arising out of this Contract, a purchase order or other transaction . 12. INSURANCE Contractor shall comply with the Insurance Requirements, attached and incorporated here as Exhibit B. Contractor must provide satisfactory proof of insurance and maintain it for the Contract Time or longer as required by City . City will not execute the Contract until City has approved receipt of satisfactory certificates of insurance and endorsements evidencing the type, amount, class of operations covered, and the effective and expiration dates of coverage. Failure to comply with this provision may result in City, at its sole discretion and without notice, purchasing insurance at Contractor's expense, deducting the costs from Contractor's compensation, or terminating the Contract. Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000/Rev. May 22, 2018 Page 4 of 11 13. COMPLIANCE WITH LAWS 13.1 General Laws. Contractor shall comply with all laws and regulations applicable to this Contract. Contractor will promptly notify City of changes in the law or other conditions that may affect the Project or Contractor's ability to perform. Contractor is responsible for verifying the employment status of employees pe rfonning the Work , as required by the Immigration Reform and Control Act 13.2 Labor Laws. (a) Contracts of $1,000 or more are subject to the requirements of the California Labor Code , including but not limited to: (i) Prevailing wage laws under Labor Code Section 1775 , which require Contractor to pay prevailing wages applicable in Santa Clara County for each craft, classification, or type of worker needed to perform the Work , including health, pension and vacation. The prevailing wage rates are on file with the City Engineer's office and are available online at http://v,,ww.dir .ca.gov/DLSR ; (ii) Apprenticeship requirements under Labor Code Section 1777 .5 for Contacts $30,000 or more ; (iii) Maintain certified payroll records in accordance with Labor Code Sections 1776 and 1812, and electronically submit them to the Labor Commissioner as required by the regulations of California, Department oflndustrial Relations ("DIR"); (iv) Comply with DIR Monitoring , Enforcement and Registration requirements of Labor Code Section 1725.5 . (b) Contractor must compensate workers who are paid less than prevailing wages or required to work more than a legal day's work . Contractor will also be required to pay City a penalty of $ 200.00 per worker for each day of violation. ( c) As required by Labor Code Section 1861 , by signing this Contract Contractor certifies as follows: "I am aware of Labor Code Section 3700 which requires 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 Work on this Contract." 13.3 Discrimination Laws. Contractor shall not discriminate on the basis of race , religious creed , color, ancestry, national origin, ethnicity, handicap , disability , marital status , pregnancy , age, sex, gender, sexual orientation , gender identity , Acquired -Immune Deficiency Syndrome (AIDS) or any other protected classification. Contractor shall comply with all anti-discrimination laws , including Gov ernment Code Sections 12900 and 11135 , and Labor Code Sections 1735 , 1777 and 3077.5. Consistent with City policy proh i biting hara ssment and discrimination, Contractor understands that harassment and discrimination directed toward a job applicant , an employee , a City employee , or any other person , by Contractor or Contractor's employe es or sub-contractors will not be tolerated. Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000 /Rev . May 22, 2018 Page 5 of 11 13.4 Conflicts o fl nte rest. Contractor, its employees, subcontractors , servants and agents, may not have , maintain or acquire a conflict of interest in relation to this Contract in violation of law , including Government Code section 1090 and Government Code section 81000 and their 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 by state law, or in violation of a City ordinance or policy while se rving as a City Representative or for one year thereafter. Contractor, its employees , subcontractors, servants and agents warrant they are not employees of City or have any relationship with City officials, officers or employees that creates a conflict of interest. Contractor may be required to file a conflict of interest form if it makes certain governmental decisions or serves in a staff capacity , as defined in section 18700 of the California Code of Regulations . Contractor agrees to abide by City rules governing gifts to public officials and employees. 13.5 Remedies. Any violation of Section 13 constitutes a material breach and may result in City suspending payments, requiring reimbursement, or terminating the Contract. City reserves all rights and remedies under the law and this Contract, including seeking indemnification . 14 . BONDS For contracts of $25 ,000 or more, Contractor must obtain a payment bond and a performance bond, each in the penal sum of 100% of the Contract Price , using the Bond Forms attached and incorporated here as Exhibit C. Each bond must be issued by a surety admitted in California, with a financial rating from A.M. Best Company of Class A -or higher , or as otherwise acceptable to City. If an issuing surety cancels a bond or becomes insolvent, Contractor must provide a substitute bond from a surety acceptable to City within seven calendar days after written notice from City. If Contractor fails to do so , City may in its sole discretion and without prior notice, purchase bonds at Contractor's expense , deduct the cost from payments due C ontractor, or terminate the Contract. City will not execute the Contract nor issue the NTP until the required bonds are submitted. 15 . UTILI TIES, T RENCHI NG AND EXCAVATION 15.1 Contractor must call the Underground Service Alert ("USA") 811 hotline and request marking of utility locations before digging or commencing Work. For underground service ale11s for street lighting and traffic signal conduits, City 's Service Center must be called at (408) 777-3269 . Government Code Section 4215 requires Contractor to notify City and Utility in writing if it discovers utilities or utility facilities not identified in the Contract. 15.2 Pursuant to Government Code Section 7104, Contractor must stop work, notify City in writing, and wait for instructions if one of the conditions below is found at the worksite. City will work with Contractor to amend the Contract or issue a change order if the discovered conditions materially change the Wark/Performance , Contract Time or Contract Price. (a) Material believed to be hazardous waste under Health and Safety Code Section 25117 , and which requires removal to a Class I, Class II , or Class llI disposal site pursuant to law; (b) Subsurface or latent physical conditions at the Project worksite differing from those indicated by information about the worksite made available to Contractor; and Public Works Project Community Hall -Countertop Replacement Public Works Contract $45 ,000 !Rev. May 22, 2018 Page 6 o f 11 (c) Unknown physical conditions at the Project worksite of any unusual nature, materially different from those ordinarily encountered and from those generally recognized as inherent in the character of the Work. 15.3 For contracts $25,000 or higher that require excavation or involve trenches five feet or more in depth, Contractor must submit a detailed plan for City approval, per Labor Code Section 6705 prior to commencing work. The plan must show the design of shoring, bracing, sloping and other provisions for worker protection from caving ground and other hazards. The protective system must comply with all Construction Safety Orders. If the plan varies from shoring system standards, it must be prepared by a registered civil or structural engineer. 16. URBAN RUNOFF MANAGEMENT 16.1 All Work must fully comply with federal, state and local laws and regulations concerning storm water management. Contractor must avoid creating excess dust when breaking asphalt or concrete and during excavation and grading. If water is used for dust control, Contractor will use only the amount of water necessary to dampen the dust. Contractor wi II take all steps necessary to keep wash water out of the streets, gutters and storm drains. Prior to the start of the Work, Contractor will implement erosion and sediment controls to prevent pollution of storm drains, and must upgrade and maintain these controls based on weather conditions or as otherwise required by City. These controls must be in place during the entire Contract Time and must be removed at the end of construction and completion of the Work. Such controls must include, but will not be limited to, the following requirements: (a) Install storm drain inlet protection devices such as sand bag barriers, filter fabric fences, and block and gravel filters at all drain inlets impacted by construction. During the annual rainy season, October 15 through June 15, storm drain inlets impacted by construction work must be filter-protected from onsite de-watering activities and saw-cutting activities. Shovel or vacuum saw-cut slurry and remove from the Work site; (b) Cover exposed piles of soil or construction material with plastic sheeting. Store all c.onstruction materials in containers; (c) Sweep and remove all materials from paved surfaces that drain to streets, gutters and storm drains prior to rain and at the end of each work day. When the Work is completed, wash the streets, collect and dispose of the wash water offsite in lawful manner; (d) After breaking old pavement, remove debris to avoid contact with rainfall/runoff; ( e) Maintain a clean work area by removing trash, 1 itter, and debris at the end of each work day and when Work is completed. Clean up any leaks, drips, and other spills as they occur. 16.2 These requirements must be used in conjunction with the California Stormwater Quality Association and California Best Management Practices Municipal and Construction Handbooks, local program guidance materials from municipalities, and any other applicable documents on stormwater quality controls for construction. Contractor's failure to comply with this Section will result in the issuance of noncompliance notices, citations, Work stop orders and regulatory fines. Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000 !Rev. May 22, 2018 Page 7 of 11 17. PR OJECT COORDINATION City Project Manager. City assigns Bill Bodene as the City representative for all purposes under this Contract, with authority to require compliance with the Scope of Work. City may substitute Project Managers at any time and without prior notice to Contractor. Contractor Project Manager. Subject to City approval , Contractor assigns _P_a_t _S_h_ar~p ___ _ -------------------as its single representative for all purposes under this Contract, with the responsibility to ensure progress with the Work. Contractor's Project Manager is responsible for coordinating and scheduling the Work and must regularly update the City Project Manager about the status and any delays with the Work, consistent with the Scope of Work . Any substitutions must be approved in writing by City. 18. ABANDONMENT AND TERMINATION 18.l City may abandon or postpone the Project or parts therefor at any time. Contractor will be compensated for satisfactory Work performed through the date of abandonment and will be given reasonable time to close out the Work. With City's pre-approval in writing, the time spent in closing out the Work will be compensated up to 10% of the total t ime expended in performing the Work. 18.2 City may terminate the Contract for cause or without cause at any time . Contractor will be paid for satisfactory Work rendered through the termination date and will be given reasonable time to close out the Work. 18.3 Final payment will not be made until Contractor delivers the Work and provides records documenting the Work, products and deliverables comp leted. Nothing in the Section below is intended to delay , abridge or bar City's right under this Section. 19. GOVERNING LAW, VENUE AND DISPUTE RESOLUTION This Contract is governed by the laws of State of California. Venue for any legal action shall be the Superior Cou1t of the County of Santa Clara, Califo rnia. The dispute resolution procedures of Public Contract Code Section 20 I 04, incorporated here by reference, apply to this Contract and Contractor is required to continue the Work pending resolution of any dispute. Prior to fi ling a lawsuit, Contractor must comply with the claim filing requirements of the California Government Code. If the Parties elect arbitration, the arbitrator 's award must be supported by Jaw and substantia l evidence and include detailed written findings of law and fact. 20. ATTORNEY FEES If City initiates legal action , files a complaint or cross-complaint, or pursues arbitration, appeal, or other proceedings to enforce its rights or a judgment in connection with this Contract, the prevailing party will be entitled to reasonable attorney fees and costs. Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000/Rev. May 22, 2018 Page 8 of 11 21. SIGNS/ADVER TISEMENT No signs may be displayed on or about City's property, except signage which is required by law or by the Contract, without City's prior written approval as to size , design and location. 22. THIRD PARTY BENEFI CIARIES There are no intended third party beneficiaries of this Contract. 23. WAIVER Neither acceptance of the Work nor payment thereof shall constitute a waiver of any contract provision . City waiver of any breach shall not constitute waiver of another provision or breach. 26. WARRANTY Contractor warrants that materials and equipment used will be new, of good quality , and free from defective workmanship and materials, and that the Work will be free from material defects not intrinsic in the design or materials. All Work, materials and equipment should pass to City free of claims, liens or encumbrances. Contractor warrants the Work and materials for one year from the date of City's acceptance of the Work as complete ("Warranty Period"), except when a longer guarantee is provided by a supplier, manufacturer or is required by this Contract. During the Warranty Period, Contractor wil l repair or replace any Work defects or materials, including damage that arises from Contractor's Warranty Work , except any wear and tear or damage resulting from improper use or maintenance . 27. ENTIRE CONTRACT This Contract and the attachments, documents, and statutes attached, referenced , or expressly incorporated herein , including authorized amendments or change orders constitute the final and complete contract between City and Contractor with respect to the Work and the Project. No oral contract or implied covenant will be enforceable against City. lf any attachment or incorporated provisions conflict or are inconsistent with the terms of this Contract, the Contract terms will control. 28. SEVERABILITY/P ARTIAL INVALIDITY If a court finds any term or provision of this Contract to be illega l, invalid or unenforceable, the legal portion of said provision and all other contract provisions will remain in full force and effect. 2 8. SURVIVAL The contract provisions which by their nature should survive the Contract or Completion of Project, including without limitation all warranties, indemnities, payment obligations, insurance and bonds , shall remain in full force and effect after the Work is completed or Contract ends. Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000 !Rev. May 22, 2018 Page 9 of 11 29. INSERTE D PROVI SIONS Each provision and clause required by law to be inserted in this Contract will be deemed to be included and will be inferred herein. Either party may request an amendment to cure mistaken insertions or omissions of required provisions. 30. CAPTIONS The captions , titles , and headings in this Contract are for convenience only and may not be used in the construction or interpretation of the Contract or for any other purpose. 31. COUNTERPARTS This Contract may be executed in counterparts , each of which is an original and all of which taken together shall form one single document. 20. NOTICES All notices, requests , and approvals must be sent in writing to the persons below and will be considered effective on the date of personal delivery , the date confirmed by a reputable overnight delivery service , on the fifth calendar day after deposit in the United States Mail , postage prepaid , registered or certified, or the next business day following electronic submission: To City of Cupertino: 10300 T01Te Avenue, Cupertino CA 95014 Attention: Ken Tanase To Contractor : American Custom Marbl e Inc. Attention : Pat Sharp ---------------------------Copy to: Carl Valdez Copy to: ___________ _ Email: kent@cupertino.org Email: americancustommarble@msn .com 30. VALIDITY OF CONTRACT This Contract is valid and enforceable only if (a) it complies with the purchasing and contract provisions of Cupertino Municipal Code Chapters 3.22 and 3.23, (b) is signed by the City Manager or an authorized designee , and (c) is approved for form by the City Attorney's Office. 32. EX ECUTI ON The persons signing below waiTant they have the authority to enter into this Contract and to legally bind their respective Parties. If Contractor is a corporation, signature s from two officers of the corporation are required pursuant to California Corporations Code Section 313. Public Works Project Community Hall -Countertop Replacement Public Works Contract $45,000 !Rev. May 22, 2018 P age !Oofll IN WITNESS WHEREOF, the parties have caused this Contract to be executed as of the Execution Date first above written. CONTRACTOR American Custom Marble Inc. CITY OF CUPERTINO, a Municipal Corporation By:~5 Timm Borden Title: Project Manager Title: Director of Public Works Signature Date 7L Ji 17 /:J. DI 6 Signature Date: __ [CY_,{'-L_,8",_('--(_g _____ _ STOFORM: ~rj }/J-19 -rt By: v /D~J~---l ~ Cupert o City Attorney ATTEST: By: 6~4tl GRACE SCHMIDT, City Clerk Public Works Project Community Hall -Countertop Rep lacement Public Works Contract $45,000 /Rev. May 22, 2018 Page 11 of 11 EXH I BIT 11 A11 American Custom Marble 806 West Home Street San Jose Ca. 95126 DATE 10/8/2018 NAME / ADDRESS City of Cupertino Service Center 10555 Maty Avenue Cupertino, CA 95014 Revised ITEM CounterR/con Prices submitted by Pat Sharp Phone# ( 408) 292-8873 TERMS Net30 DESCRIPTION One 26 1/4" x 64 1/2" top in Quartz Storm Grey 2cm. thick material 4" splashes and 5" apron ( 2) #816 sinks integral with top Cameo White One 26" x 64 1/2" top in Quartz Storm Grey 2 cm. thick material 7" splashes and 5" apron (2) #816 sinks integral with top Cameo White REP GC Two 35" x 26 1/4" Dressing table tops in Quartz Storm Grey 2 cm . thick material 4" splashes and 4 3/4" front aprons no cut outs All of the above includes, material , template, fabrication and installation . TOTAL Fax# I (408) 298-9408 ESTIMATE NO. 7145 Estimate JoB: Common Hall Counters TOTAL 13,104.00 $13,104 .00 American Custom Marble, Inc. Replacing Countertops at Community Hall Proposal Amount $ 13,104.00 Description replacement of countertops per attached Exhibit "A" Account# Proposal Amount Description Account# Proposal Amount Description Account# Unforeseeables/Extras SUBTOTAL Contingency CONTRACT TOTAL PW Supervisor $ 13,104.00 $ 5,000 .00 $ 18,104.00 Ken Tanase lo ·ll-/8 Date PUBLIC WORKS CONSTRUCTION CONTRACTS Small Projects -$45,000 Insurance Requirements: Exhibit B Contractor shall procure and maintain for the duration of the contract, and for.five years following the completion of the ProjecL , insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of t he work hereunder by Contractor, its agents , representatives, employees or subcontractors. MINIMUM SCOPE AND LIM1T OF INSURANCE Coverage shall be at least as broad as: vi . Commercial General Liability (CGL): Insurance Services Office (ISO) Form CG 00 01 covering CGL on an . . ~ "occurrence" basis, written on a comprehensive general liability form , and must include coverage for liability \:' \'11 arising from Contractor's or Subcontractor 's acts or omissions, including Contractor's protected coverage, blanket contractual, products and completed operations, vehicle coverage and employer's non-ownership liability '\" coverage, with limits of at least $2,000,000 per occurrence. Th e CGL policy must protect against any and all liability for personal injwy, death, property damage or destruction, and personal and advertising injury. If a general .t-.1\Jl.ggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG \Y 25 03 or 25 04) or the general aggregate limit sha11 be twice the required occurrence limit. a. It shall be a requirement under th is agreement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be made available to the Additional ]nsured and shall be (1) the minimum coverage/limits specified in this agreement; or (2) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Contractor's policy shall be "primary and non-contributory," will not seek contribution from City's insurance/self-insurance, and shall be at least as broad as ISO CG 20 01 04 13 c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess insurance, provided each policy complies with the requirements set forth in this Contract. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of City before the City's own insurance or self-insurance shall be called upon to protect City as a named insured . 2. Automobile Liability: ISO Form CA 00 01 covering any auto (Code 1), or if Contractor has no owned autos, then hired autos (Code 8) and non-owned autos (Code 9), with limit no less than $1,000,000 per accident for bodily injury and property damage. 3. Workers' Compensation: As required by the State of California, with Statutory Limits, and Employer's Liability Insurance of no less than $1,000,000 per accident for bodily injury or disease, or as otherwise required by statute. If Contractor is self-insured, Contractor must provide a Certificate of Permission to Self-Insure, duly authorized by the DIR. D N/A if box checked (Contractor provides written verification it has no employees). 4. Professional Liability with limits no less than $1 ,000,000 per occurrence or claim, and $2,000,000 aggregate. l2sL NIA if box checked (Contract is not design/build). 5. Builder's Risk. Course of Construction insurance utilizing an "A ll Risk" (Special Perils) coverage form, with limits equal to the completed value of the project and no coinsurance penalty provisions. . ~ NIA if box checked (Project does not involve construction or improvements/installations to property). Insu rance Requirements/or Construction Contracts -$45,000 Ve rsion: Nov 201 7 6. Contractors' Pollution Legal Liability and/or Asbestos Legal Liability and/or Errors and Omissions with limits no leRiss than $1,000,000 per occurrence or claim , and $2,000,000 policy aggregate. · NIA if box checked (Project does not involve environmental hazard:;). £ If Contractor maintains broader coverage and/or higher limits than the minimums shown above, City requires and shall be entitled to the broader coverage and/or higher limits maintained by the contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. Self-l11sured Retentions. Self-insured retentions must be declared to and approved by City. At City's option , either: (1) Contractor shall cause the insurer to reduce or eliminate self-insured retentions as respects City, its officers, officials, employees, and volunteers; or (2) Contractor shall provide a financial guarantee satisfactory to City guaranteeing payment of losses and re lated investigations, claim administration, and defense expenses. The policy language shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the named insured or the City . OTHER INSURANCE PROVISIONS The insurance policies are to contain, or be endorsed to contain , the following provisions: ~dditional Insured Status The City of Cupertino, its City Council, officers, officials, employees, agents , servants and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of the Services performed by or on behalf of Contractor including materials, parts , or equipment furnished. Endorsement of CGL coverage shall be at least as broad as ISO Form CG 20 IO 11 85 or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 if a later edition is used. Primary Coverage For any claims related to this Project, Contractor's insurance coverage shall be "primary and non-contributory" and at least as broad as ISO CG 20 01 04 13 with respect to City, its officers, officials, employees and volunteers, and shall not seek contribution from City's insurance. If the limits of insurance are satisfied in part by Umbrella/Excess Insurance, the Umbrella/Excess Insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a "primary and non-contributory" basis for the benefit of City. Notice of Cancellati011 Each insurance policy required shall provide that coverage shall not be canceled, except with notice to the City. Each certificate of insurance must state that the coverage afforded by the policy is in force and will not be reduced, cancelled or allowed to expire without at least 30 days advance written notice to City, unless due to non-payment of premiums, in which case ten days advance written notice must be provided to City. Such notice must be sent to City via certified mail and addressed to the attention of the City Manager. Builder's Risk Contractor may submit Builder's Risk insurance in the form of Course of Construction coverage, which shall name the City as a Joss payee, as its interest may appear. The Builder's Risk policy must be issued on an occurrence basis, for all-risk coverage on a l 00% completed value basis on the insurable portion of the Project, with no coinsurance penalties, and for the benefit of City. ff the Project does not involve new or major reconstruction, City may elect, acting in its sole discretion, to accept an Installation Floater policy instead of Builder's Risk. For such projects, the Property Installation Floater shall include improvement, remodel, modification, alteration, conversion or adjustment to existing buildings , structures, processes, machinery and equipment, and shall provide property damage coverage for any building, structure , machinery or equipment damaged, impaired , broken, or destroyed during the performance of the Work, including during transit, installation , and testing at the City 's site. Insurance Requirements for Construction Contracts -$45,000 Version: Nov 2 01 7 2 V Waiver of Subrogation v Each required policy must include an endorsement providing that the carrier agrees to waive any right of subrogation it may have against City. Contractor agrees to waive rights of subrogation which any insurer of Contractor may acquire from Contractor by virtue of the payment of any lo ss . Contractor agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation. The Workers ' Compensation policy shall be endorsed w ith a waiver of subrogation in favor of the City for all work performed by the Contractor, its employees, agents and subcontractors. Acceptability of Insurers Insurance must be issued by insurers acceptable to City and licens ed to do business in the State of California, and each insurer must have an A.M. Best's financial strength rating of"A" or better and a financial size rating of"VII " or better. Verification of Coverage Contractor shall frnnish the City with original certificates and amendatory endorsements, or copies of the applicable insurance language, effecting coverage required by this contract. All certificates and endorsements are to be received and approved by the City before work commences. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements, required by these specifications, at any time . Subcontractors Contractor shall require and verify that all subcontractors maintain insurance meeting all th e requirements stated here in , and Contractor shall ensure that City is an additional insured on insurance required from subcontractors. For CGL coverage subcontractors shall provide coverage with a form at least as broad as CG 20 38 04 13 . Surety Bonds As required by Contract and described in the Contract Documents. The Payment and Performance Bonds shall be in a sum equal to the Contract Price. If the Performance Bond provides for a one-year warranty a separate Maintenance Bond is not necessary. If the wananty period specified in the Contract is for longer than one year a Maintenance Bond equal to I 0% of the Contract Price is required. Bonds shall be duly executed by a responsible corporate surety, authorized to issue such bonds in the State of California and secured through an authorized agent with an office in California. Special Risks or Circumstances City reserves the right to modify these requirements, based on the nature of the risk, prior experience, insurer, coverage, or other circumstances. In surance Requirements.for Constru ction Contracts -$45,000 Version: Nov 2017 3 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 09/13/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poli cies may require an endorsement. A statement on th is certificate does not confer rights to the certificate holder in lieu of such endorsement(s ). PROD UCER CONTACT Marie Teixeira NAME: MOC Insurance Services r:ig ~o Extl: (415) 957-060 0 I FAX (A/C, No): (415) 957-0 577 License No. 0589960 E-MAIL mte ixeira@mocins.com ADDRESS: 101 Montgomery St., Suite 800 INSURER(S) AFFORDING COVERAGE NAIC# San Francisco CA 94104 INSURER A: Rockhill In surance Company INSURED INSURER B : Ohio Security In surance Co. 24082 American Custom Marble Inc. INSURER C: Granite State Insurance Compa ny 806 West Home INSURER D: National Un ion Fire In c Co. Pittsburgh PA INSURERE: San Jose CA 95126-3517 INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 Misc REVISION NUMBER: THI S IS TO CERT IFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDI CATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OT HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIF ICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOR DE D BY THE PO LI CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ,n ,~, 1~m-Ji~, (~grJi~, LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 V -D CLAIMS-MADE [8] OCCUR UAMI\C,tc I U "~' I I tcU PREM ISES (Ea occurrence\ $ 50,000 - MED EXP (Any one person) $ 5,000 -A y y RCGLPG0189803 v 03/01/2018 03/01/201 !¥ PERSONAL & A DV INJURY $ 1,000,00 0 - GEN'LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $ 2,000,000 v ~ ~ D PRO-DLOC PRODUCTS -COMP/OPAGG 2,000 ,000 \ POLICY JECT $ OTHER : $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 v-(Ea accident) -X ANY AUTO BODILY INJURY (Per person) $ -OWNED ~ SCHEDULEO BAS57760112 02/01/2018 02/01/2019 V B AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ I -HIRED I--NON-OWNED PROPERTY DAMAGE I AU TOS ONLY AUTOS ONLY (Per accident\ $ -I--I Bus Auto Enhncmt Endt $~ UMBRELLA LIAB H OCCUR EACH OCCURRENCE {2,000,000 / D x EXCESS LIAB CLAIMS-MADE EBUOB0678031 08/13/2 018 03/01/2019v AGGR EGATE ! 2,000,000 ' ) DED I I RETENTION $ $ \__ / WORKERS COMPENSATION X I PER I I OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y/N WC005643465 ./ /E.L. EACH ACCIDENT s 1,000,000 V C ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A 12/31/2017 12/31/2018 ' OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under $ 1,000,000 DESCR IPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if m ore space Is required) The City of Cupertino, its City Council, officers, officials, employees, agents, servants a nd vol unteers are named as additiona l insured's in respects to liability as required per written contract or agreement policy will primary and non-contributory as per endorsement attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. Service Center AUTHORIZED REPRESENTATIVE 10555 Mary Avenue QYJ~~~~~~ Cupertino CA 95014 I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016 /03) The ACORD name and logo are registered marks of ACORD POLICY NU COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -(FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Any person or organization to which you are obligated by virtue of a written contract to provide insurance such as is afforded by this policy, but only with respect to ( 1) occur- rences taking place after such written contract has been executed and (2) occurrences re- sulting from work performed by you during the policy period, or occurrences resulting from the conduct of your business during the policy period. A person or organization that qualifies as an "insured" under the above paragraph of this Endorsement shall be an additional insured solely with respect to such additional insured's liability for "bodily injury," property damage" or "personal and advertising injury" caused in whole or in part by your acts or omissions in the performance of "your work" for the addi- tional insured on or at "commercial construction projects." For the purposes of this Endorsement, "commercial construction projects" are defined as buildings or structures constructed for commercial use and also include apartments, hotels, homes for the aged, dormitories or barracks. However, "commercial construction projects" shall not include any building or structure which, in whole or in part, contains individual owner occupied units or dwellings . (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you . Coverage provided by this policy to the Additional lnsured(s) shown in the Schedule shall be primary insurance and any other insurance maintained by the Additional lnsured(s) shall be excess and non-contributory, but only if required of the Named Insured and by written contract. CG 201011 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 D 0 COMMERCIAL AUTO CA 88 10 01 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFUL LY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGE INDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT , AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 19 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 22 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 23 EXTRA EXPENSE -BROADENED COVERAGE 10 GLASS REPAIR-WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN/ LEASE GAP 14 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 R!;:NTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 TWO OR MORE DEDUCTIBLES 17 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 18 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 20 SECTION II -LIABILITY COVERAGE is amended as follows : 1. BROAD FORM INSURED SECTION II -LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured : d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period . However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy . Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply : (1) If there is similar insurance or a self-insured retention plan available to that organization; © 2013 liberty Mutual Insurance CA8810 0113 Includes copyrighted material of Insurance Services Office , Inc., with its permission. Page 1 of 7 0 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization . 2. EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own , hire or borrow, but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name , with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION 11 -LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation , maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement , or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract , agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds . (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule , or similar protection, the following provision is added: SECTION II -LIABILITY, exclusion 8.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended as follows : 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4 . Coverage Extensions of SECTION Ill -PHYSICAL DAMAGE COVERAGE , is amended by adding the following : If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow ; or © 2013 Liberty Mutual Insurance CA8810 0113 Includes copyrighted material of Insurance Services Office , Inc., with its permission . Page 2 of 7 0 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss . E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V -DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value . 7. TOWING AND LABOR SECTION Ill -PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following : We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVWJ of 10 ,000 pounds or less. c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 -20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION Ill -PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of $50 per day and a maximum limit of $1,500 © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission . Page 3 of 7 0 9. RENT AL REIMBURSEMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following : a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto ." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality , up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail - able for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the pr ivate passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension . f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10 . EXTRA EXPENSE -BROADENED COVERAGE Under SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you . The maximum amount we will pay is $1 ,000 . 11. PERSONAL EFFECTS COVERAGE A. SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. COVERAGE , is amended by adding the following : If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance . B. SECTION V -DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools , equipment, jewelry, money or securities . 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE , B. EXCLUSIONS is amended by adding the follow- ing : If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag . Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty . However, we agree to pay any deductible applicable to the other cov- erage or warranty . 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION Ill -PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following : © 2013 Liberty Mutual Insurance CA 88 10 0113 Includes copyrighted material of Insurance Services Office, Inc., with its permission . Page 4 of 7 0 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound , if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system , in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio , visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible . 14. LOAN / LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the : 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance , Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", i. Any amount representing taxes, j. Loan or lease termination fees ; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS T his coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral , or lease written on the covered "auto" that incurred the loss . C. SECTION V -DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply : 'Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value . A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. © 2013 Liberty Mutual Insurance CA 88 10 0113 Includes copyrighted material of Insurance Services Office , Inc., with its permission . Page 5 of 7 Q 15. GLASS REPAIR-WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following : No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is : a. In the charge of an "insured"; b. Legally parked; and c. Unoccupied . The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations . This provision does not apply to any "loss " if the covered "auto" is in the charge of any person or organization engaged in the automobile business. 17. TWO OR MORE DEDUCTIBLES Under SECTION Ill PHYSICAL DAMAGE COVERAGE , if two or more company policies or coverage forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group . SECTION IV -BUSINESS AUTO CONDITIONS is amended as follows: 18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph 8.2. is amended by adding the following: If you un intentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 19 . AMENDED DUTIES IN THE EVENT OF ACCID ENT, CLAIM, SUIT, OR LOSS SECTION IV -BUSINESS AUTO CONDITIONS , paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership ; 3. Member, if you are a limited liability company; 4 . An executive officer or the "employee" designated by the Named Insured to give such notice , if you are a corporation . © 2013 Liberty Mutual .Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc ., with its permiss ion . Page 6 of 7 0 To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following : If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 21 .. HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is amended by the addition of the following : f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to . This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V -DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V -DEFINTIONS, definition C. is replaced by the following : "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time . COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS , paragraph A. -CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion . © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 WAIVER OF SUBROGATION INFORMATION REQUEST PRODUCER NAME_MOC Insurance Services INSURED NAME:_American CustoJJl Marbl e Inc . _ Effective Date of Waiver: _/_ -'- NAME AND ADDRESS REQUESTING THE WAIVER: City of Cupertino 10300 Torre Ave . CONTRACT OR PROJECT NUMBER: _ CONTRACT OR PROJECT LOCATION: ( Please include street address and state) _ City of Cupertino _ _ Cupertino 95014 Ca_ JOB DESCRIPTION: _Cornman hall Counters_ START/COMPLETION DATES :_/_/_ _/_2018_ 7_ _/_ _/_2 018 _ PROJECTED LENGTH OF JOB : _ 16 hrs .. _ Codes Payrolls # Employees (FT/PT) Location 5146 $800.00 Sivestre Recendez Install er 5146 $200.00 David Mayen insta ll er $ $ $ $ *PL EAS E NOTE: ALL PAYROLL R ECORDS FOR TH E JOB CARRYING THE WAIVE R MUST BE KEPT SEPARATELY FOR PREMIUM AUDIT PURPOSES. EDITION 04/2005