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20-003 Silicon Valley Paving, Inc., Cupertino Senior Center ADA Sidewalk Contract This public works contract("Contract")is entered into by and between the City of Cupertino ("City"), a municipal corporation, and SILICON VALLEY PAVING,INC.("Contractor"),for work on the Cupertino Senior Center ADA Sidewalk("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 December 11,2019, City authorized award of this Contract to Contractor for the amount set forth in Section 4 below. 2. Contract Documents. The Contract Documents incorporated into this Contract include and are comprised of all the documents listed below. The definitions provided in Article 1 of the General Conditions apply to all the Contract Documents, including this Contract: 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, and Performance Bond; 2.7 General Conditions; 2.8 Special Conditions; 2.9 Project Plans and Specifications; 2.10 Change Orders, if any; 2.11 Notice of Award; 2.12 Notice to Proceed; 2.13 City of Cupertino Standard Details 2.14 The following: no other documents. 3. Contractor's Obligations. Contractor will perform all 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, onsite facilities and utilities, unless otherwise specified in the Contract Documents. Contractor must use its best efforts to diligently prosecute and complete the Work in a professional and expeditious manner and to meet or exceed the performance standards required by the Contract Documents. 4. Payment. As full and complete compensation for Contractor's timely performance and completion of the Work in strict accordance with the terms and conditions of the Contract Documents, City will pay Contractor$70,670. ("Contract Price")for all of Contractor's direct and indirect costs to perform the Work, including all labor, materials, supplies, equipment, taxes,insurance, bonds and all overhead costs,in accordance with the payment provisions in the General Conditions. 5. Time for Completion. Contractor will fully complete the Work for the Project within forty (40)working days from the commencement date given in the Notice to Proceed ("Contract Time"), By signing below, Contractor expressly waives any claim for delayed early completion. Cupertino Senior Center ADA Sidewalk CONTRACT Project 2020-09 Page 25 6. Liquidated Damages. If Contractor fails to complete the Work within the Contract Time, City will assess liquidated damages in the amount of$2,000 per day for each day of unexcused delay in completion, and such liquidated damages may be deducted from City's payments due or to become due to Contractor under this Contract.An important Senior Center event is scheduled for March 28, 2019 and the project must be complete by that date and the parking lot available for use. 7. Labor Code Compliance. 7.1 General. This Contract is subject to all applicable requirements of Chapter 1 of Part 7 of Division 2 of the Labor Code, including requirements pertaining to wages, working hours and workers'compensation insurance, as further specified in Article 9 of the General Conditions. 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 may not enter into the Contract with a bidder without proof that the bidder and its Subcontractors are registered with the California Department of Industrial Relations to perform public work pursuant to Labor Code section 1725.5, subject to limited legal exceptions. 8. Workers'Compensation Certification. Pursuant to 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 relation to this Contract in violation of any City ordinance or requirement or in violation of any California law, including Government Code section 1090 et seq., or 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 requirement 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. Cupertino Senior Center ADA Sidewalk CONTRACT Project 2020-09 Page 26 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 file. Notice is deemed effective upon delivery, except that service by U.S. Mail is deemed effective on the second working day after deposit for delivery. 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: 1-(408)777-3248 Attn: Director of Public Works Email: mzimmermann@cupertino.org Copy to: Michael Zimmermann Contractor: Name: Silicon Valley Paving, Inc. Address: 1050 Commercial Street, Suite 101 City/State/Zip: San Jose, CA 95112 Phone: (408)286-9101 Attn: Mr.Todd Slyngstad Email:todd@svpinc.com 12. General Provisions. 12.1 Assignment and Successors. Contractor may not assign its rights or obligations under this Contract,in part or in whole,without City's written consent. This Contract is binding on Contractor's and City's lawful heirs, successors and permitted assigns. 12.2 Third Party Beneficiaries. There are no intended third party beneficiaries to this Contract. 12.3 Governing Law and Venue. This Contract will be governed by California law and venue will be in the Santa Clara County Superior Court, and no other place. Contractor waives any right it may have pursuant to Code of Civil Procedures Section 394,to file a motion to transfer any action arising from or relating to this Contract to a venue outside Santa Clara County, California. 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. w 12.5 Integration. This Contract and the Contract Documents incorporated herein, including authorized amendments or Change Orders thereto, constitute the final, complete, and exclusive terms of the agreement between City and Contractor. 12.6 Severability. If any provision of the Contract Documents, or portion of a provision, is determined to be illegal, invalid, or unenforceable,the remaining provisions of the Contract Documents will remain in full force and effect. Cupertino Senior Center ADA Sidewalk CONTRACT Project 2020-09 Page 27 12.7 Iran Contracting Act. If the Contract Price exceeds$1,000,000,Contractor certifies,by signing below,that it is not identified on a list created under the Iran Contracting Act, Public Contract Code§2200 et seq. (the"Act"),as a person engaging in investment activities in Iran, as defined in the Act,or is otherwise expressly exempt under the Act. 12.8 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. The parties agree to this Contract as witnessed by the signatures below: CONTRACTOR SILICON VALLLY P ING, INC. CITY OF CUPERTINO A Municipal Corpora i 6 By. By Name TODD SLYNGSTAD <ti Roger Lee Title PRESIDENT-OWNER Director of Public Works Date �_12.E Ip`I I Date I / Z° By G Name JOSE VIA INP Title SECRETARY Date 1 a-\l o�1 APPROVED AS TO FORM: By Name e..1�.-r nn• w., ,��.cf City Attorney Date 1,- ATTEST: LL Grace Schmidt City Clerk Date 1 b/L Contract Amount:$70,670 P.O.No. Account No. 64 0-0 ©6 91 cV �3S f V N-4-m END OF CONTRACT Cupertino Senior Center ADA Sidewalk CONTRACT Project 2020-09 Page 28 AcoRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/9/2019 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT InterWest Insurance Services NAME: Joanne Cadarette License#0B01094 PHCNN Ext: 916-609-8362 FAX No):916-979-7562 P.O. Box 255188 AbDRless: icadarette@iwins.com Sacramento CA 95865-5188 INSURERS AFFORDING COVERAGE NAIC# License*OB01094 INSURERA:Financial Pacific Ins Company 31453 INSURED SILICA INSURERS:Westchester Surplus Lines Ins 10172 Silicon Valley Paving Inc P O Box 26558 INSURER c: Everest Premier Insurance Company 16045 San Jose CA 95159 INSURER D:Travelers Property&Casualty Co of America 25674 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:870162400 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR D D POLICY NUMBER MMIDD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y 60459179 3/20/2019 3/20/2020 V EACH OCCURRENCE $1,000,000 (/ �OCCUR DAMAGE TO S(RENTED CLAIMS-MADE PREMISES Ea occurrence) $100,000 X Contracual Liab. MED EXP(Any one person) $5,000 X $3.000 BI/PD Ded PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JE� LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y 60459179 V 3/20/2019 3/20/2020 COMBINED SINGLE LIMIT $1,000,000 Ea accident IX ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS DAMAGE X HIRED X NON-OWNED PROPERTY D $ AUTOS ONLY AUTOS ONLY Per accident D X UMBRELLA LIAB X OCCUR ZUP41M9278319 8/22/2019 3/20/2020 V EACH OCCURRENCE 8,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE ,000,000 DED I X I RETENTION$, $ C WORKERS COMPENSATION Y 7600017420191 3I20/2019 3/20I2020 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ./ ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $1,000,000 V OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B POLLUTION LIABILITY G70916691002 9/28/2019 9/28/2020 V LIMIT EA OCC $1,000,000 LIMIT EA AGG $1,000,000 DEDUCTIBLE $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Re:Job#19131,Project#2020-09,Cupertino Senior Center ADA Sidewalk,21251 Stevens Creek Blvd.,Cupertino,CA. City of Cupertino,its City Council,officers,officials,employees,agents,servants and volunteers Additional Insured status applies to requested entities if required by written contract per the attached endorsements.Primary wording per attached endorsement.Per Project Aggregate applies to General Liability per attached endorsement.Waiver of Subrogation applies to General Liability,Automobile Liability and Workers Compensation per the attached endorsements. Excess is follow form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Cupertino 10300 Torre Avenue AUTHORIZED REPRESENTATIVE Cupertino CA 95014 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBEf2: 60� COMMERCIAL GENERAL LIABILITY 7 CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following.- COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Blanket as required by written contract. Blanket when required by written contract. Effective during the policy period as stated in the When this insurance applies, and required by policy declarations. contract, such insurance is afforded by the General Liability policy is primary and any other insurance shall be excess and shall not contribute to the insurance afforded by this endorsement. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" pp y y caused, in whole or in part, by: property damage occurring after: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed;or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: 6459179 i COMMERCIAL GENERAL LIABILITY { CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Blanket as required by written contract. Blanket when required by written contract. Effective during the policy period as stated in the When this insurance applies, and required by policy declarations. contract, such insurance is afforded by the General Liability policy is primary and any other insurance shall be excess and shall not contribute to the insurance afforded by this endorsement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III — Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on be half of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and 1. Required by the contract or agreement; or included in the "products -completed operations 2. Available under the applicable Limits of hazard". Insurance shown in the Declarations; However: 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 21 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - VOLUNTEER WORKERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART WHO IS AN INSURED (Section II) is amended to c. For which there is any obligation to share include as an insured any person(s) who are volun- damages with or repay someone else who teer worker(s) for you, but only while acting at the must pay damages because of the injury direction of, and within the scope of their duties for described in paragraphs 1.a. or b. above; you. However, none of these volunteer worker(s) are or insureds for: d. Arising out of his or her providing or failing 1. "Bodily injury" or"personal injury": to provide professional health care serv- a. To you, to your partners or members (if you ices. are a partnership or joint venture), to your 2. "Property damage"to property: members (if you are a limited liability com- a. Owned, occupied, or used by, pany), to your other volunteer worker(s) or to your "employees" arising out of and in b. Rented to, in the care, custody or control the course of their duties for you; of, or over which physical control is being b. To the spouse, child, parent, brother or exercised for any purpose by sister of your volunteer worker(s) or your you, any of your other volunteer workers, your "employees" as a consequence of para- "employees", any partner or member (if you graph 1.a. above; are a partnership or joint venture), or any member(if you are a limited liability company). CG 20 21 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 ❑ POLICY NUMBER: 60459179 COMMERCIAL GENERAL LIABILITY CG 25 03 03 97 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL_LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: Designated Construction Projects: Where As Required By Written Contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally 4. The limits shown in the Declarations for Each obligated to pay as damages caused by Occurrence, Fire Damage and Medical Ex- "occurrences"under COVERAGE A(SECTION pense continue to apply. However, instead of 1), and for all medical expenses caused by acci- being subject to the General Aggregate Limit dents under COVERAGE C(SECTION 1), which shown in the Declarations, such limits will be can be attributed only to ongoing operations at a subject to the applicable Designated Con- single designated construction project shown in struction Project General Aggregate Limit. the Schedule above: B. For all sums which the insured becomes legally 1. A separate Designated Construction Project obligated to pay as damages caused by General Aggregate Limit applies to each "occurrences" under COVERAGE A(SECTION designated construction project, and that limit 1),and for all medical expenses caused by acci- is equal to the amount of the General Aggre- dents under COVERAGE C (SECTION 1),which gate Limit shown In the Declarations cannot be attributed only to ongoing operations 2. The Designated Construction Project General at a single designated construction project shown Aggregate Limit is the most we will pay for in the Schedule above: the sum of all damages under COVERAGE 1. Any payments made under COVERAGE A A, except damages because of"bodily injury" for damages or under COVERAGE C for or"property damage"Included in the medical expenses shall reduce the amount "products-completed operations hazard", and available under the General Aggregate Limit for medical expenses under COVERAGE C or the Products-Completed Operations Ag- regardless of the number of: gregate Limit, whichever is applicable;and a. Insureds; 2. Such payments shall not reduce any Desig- b. Claims made or"suits"brought;or nated Construction Project General Aggre- c. Persons or organizations making claims gate Limit. or bringing"suits". C. When coverage for liability arising out of the 3. Any payments made under COVERAGE A "products-completed operations hazard"is pro- for damages or under COVERAGE C for vided,any payments for damages because of medical expenses shall reduce the Desig- "bodily injury"or"property damage" included in nated Construction Project General Aggre- the"products-completed operations hazard"will gate Limit for that designated construction reduce the Products-Completed Operations Ag- project. Such payments shall not reduce the gregate Limit, and not reduce the General Ag- General Aggregate Limit shown in the Decla- gregate Limit nor the Designated Construction rations nor shall they reduce any other Des- Project General Aggregate Limit. ignated Construction Project General Aggre- gate Limit for any other designated construc- tion project shown in the Schedule above. D, If the applicable designated construction project E. The provisions of Limits Of Insurance(SECTION has been abandoned, delayed, or abandoned III) not otherwise modified by this endorsement and then restated, or if the authorized contract- shall continue to apply as stipulated, ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction project. Pnrnn 7 of 7 ('nnvr'nht InciiranrP JqPnwir.a¢nffir.P Inn. 1Q()R C(; 95 nn m 97 - _._.._..................W.......... .........................--..... Named Insured Endorsement Number Silicon Valley P ing, I c. .............._......._,.__ __., __ ._.,_...._._..................._._..,,..... Policy Symbol rolicy Number Policy Period Effective Date of Endorsement CPW jG70916691002) 1 09/28/1.9 To 09/28/20 109/28/19 Issued By(Name of Insuran Company) Westchester Surplus tines Insu nce Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT OWNERS, LESSEES OR CONTRACTORS—SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE j CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: ___........_.._.. _._._._..........�..,...,,,,,,,,,. —......._...... _._...,,...._,_, Name of Pet son or ql can moon: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you,wherein such request is made prior to cornmencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II -WHO IS AN INSURED 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 ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ENV-3100(08-04) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1 it _,......._...--._....._._,.........-.....-......................._._..........._._..................._.._......................._..._.............__._,_--__._............................_.................._..................-..........,...............................................................__................._.............................__..-_...._.._...._____._..._.............................................._...... Named Insured Endorsement Number Silicon Valley Paving, Inc. Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G70916691002 09/28/19 To 09/28/20 09/28/19 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT-OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NON-CONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION 11 -WHO IS AN INSURED is amended to include: A. SECTION II -WHO IS AN INSURED 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 ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of your work aut of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. The coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. ENV-3101 (08-04) Includes copyrighted material of Insurance Services Office, Inc.with its permission Page 1 of 1 i ADDITIONAL INSURED ENDORSEMENT— PRODUCTS-COMPLETED OPERATIONS HAZARD Named Insured�� Endorsement Number Silicon Valley Paving, Inc. Policy Symbol Policy Number Policv Period Effective Date of Endorsement CPW G70916691002 09/28/19 To 09/28/20 09/28/19 _.. s__._.. ___.__._... ____._........................................................................................................................................................................................................................................................................................................... Issued By(Name. of Insura_. nce Company)- Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organization that is an owner of real property or personal property on which you are Performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and included in the products-completed operations hazard. All other terms and conditions remain the same. ENV-3225 (10-08) @Chubb Copyright 0 2016 Page 1 of 1 WAIVER DF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TUU8 Rd Insured Endorsement Number Silicon Valley Paving, Inc. Policy Symbol Effective Date of Endorsement Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [TCAREFULLY. This endorsement modifies insurance provided under the following: � COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ! SCHEDULE Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to You, wherein such request is made prior to commencement of (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS DF RECOVERY AGAINST OTHERS TO US Condition is amended bvthe addition of the following: VVe waive any right of recovery vve may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the prod ucts-completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same, ' / ' ENV-31*3(03*5) Includes copyrighted material of Insurance services office,Inc.with its permission Page-1 of 1 WORKERS COMPENSA'r[ON AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT'TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule.(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be,2%of the California workers'compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCIUPTION ANY PERSON OR ORGANIZATION FOR WITOM THE BLANKET WAIVER OF SUBROGATION NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER This endorsement changes the policy to which it is attached and'is-effbctive on the date issued unless otherwise stated. (The information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective: 03/20/19 Policy No, 7600017420191 Endorsement No.001 Insured:Silicon Valley Paving,Inc. Premium$INC L. Insurance Company:Everest National Insurance Comp,llqz.� Countersigned By: -.1999 by the Workers'CompenNution Insurance Rating Bureau of California.All rights ircqerve-d. From the WCHIH's California Workers'Compensation Insurance Forms Manual-1999. POLICY NUMBER:60459179 COMMERCIAL GENERAL LIABILITY CG24041093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Re: Job#19131, Project#2020-09, Cupertino Senior Center ADA Sidewalk, 21251 Stevens Creek Blvd., Cupertino, CA. City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers Additional (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMER- CIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 I POLICY NUMBER: 60459179 ASDA AU 07 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE NAMED INSURED: Silicon Valley Paving Inc P O Box 26558 San Jose CA 95159 ADDITIONAL INSURED:Re:Job*19131,Project*2020-09,Cupertino Senior Center ADA Sidewalk,21251 Stevens Creek Blvd., Cupertino,CA. City of Cupertino,its City Council,officers,officials,employees,agents,servants and volunteers Additional Insured status applies to requested entities if required by written contract per the attached endorsements. Primary wording per attached endorsement.Per Project Aggregate applies to General Liability per attached WHO IS AN INSURED (SECTION II) is amended to include as an insured the organization shown in the Schedule above, but only with respect to the operation of vehicles owned by the named insured and operated on behalf of the named insured. This endorsement does not apply to any operations for other than the named insured. Each person or organization named above is an insured for liability coverage, but only to the extent that person or organization qualifies as an insured under the Who Is An Insured provision of Section II Liability Coverage. The additional insured is not required to pay for any premiums stated in the policy or earned from the policy. Any return premium, if applicable, declared by us shall be paid to you. You are authorized to act for the additional insured in all mailers pertaining to this insurance. We will mail the additional insured notice of any cancellation of this policy. If the cancellation is by us, we will give thirty days notice to the additional insured. The additional insured will retain any right of recovery as a claimant under this policy. ASDA AU 07 01 Page 1 of 1 POLICY NUMBER:60459179 ASDA AU 07 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE Name of Person or Organization: Re: Job#19131, Project#2020-09, Cupertino Senior Center ADA Sidewalk, 21251 Stevens Creek Blvd., Cupertino, CA. City of Cupertino, its City Council, officers, officials, employees, agents, The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV BUSINESS AUTO CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above be- cause of payments we make for bodily injury or property damage arising out of losses or accidents which occur during the policy period. This waiver applies only to liability you assume pursuant to a contract with the person or organization shown in the schedule. ASDA AU 07 02 Page 1 of 1 Bond #38K007887 Premium: $1,060. subject to adjustment of final contract price Performance Bond The City of Cupertino("City")and SILICON VALLEY PAVING,ING ("Contractor")have entered into a contract,dated Desepber. l-N. 3 ,20 20("Contract°)for work on the Cupertino Senior Center ADA Sidewalk("Project"). The Contract is incorporated by reference into this Performance Bond("Bond"). 1. General. Under this Bond,Contractor as Principal and The Ohio Casualty Insurance Company, its surety("Surety"),are bound to City as obligee for an amount not less than $70,670.00--- to ensure Contractor's faithful performance of its obligations under the Contract,This Bond is binding on the respective successors,assigns,owners,heirs,or executors of Surety and Contractor. 2. Surety's Obligations. Surety's obligations are co-extensive with Contractor's obligations under the Contract. If Contractor fully performs its obligations under the Contract,including Its warranty obligations under the Contract,and Contractor has timely provided a warranty bond as required under the Contract. Surety's obligations under this Bond will become null and void upon City's acceptance of the Project, excluding any exceptions to acceptance,if any.Otherwise Surety's obligation will remain in full force and effect until expiration of the one year warranty period under the Contract. 3. Waiver. 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, 4. 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 back charges to which City is entitled under the terms of the Contract. 5. Contractor Default. Upon written notification from City of Contractor's termination for 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: 5.1 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; 5,2 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 5.3 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. 6. 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. Cupertino Senior Center ADA Sidewalk PERFORMANCE BOND Project 2020-09 Page 30 7. Notice. Any notice to Surety may be given in the manner specified in the Contract and sent to Surety as follows; Attn: Phyllis Jarvis Address: 17771 Cowan,#too City/State/Zip: Irvine,CA 92614 Phone: (916)924-8656 Fax: (916)924-6749 Email: Phyllis.Jarvis@LlbertyMutual.com 8. Law and Venue. This Bond wilt be governed by California law,and venue for any dispute pursuant to this Bond will be in the Santa Clara County Superior Court,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. 9, Effective Date; Execution.This Bond is entered into and effective on December10 ,2019 , SURETY: THE OHIO CASUALTY INSURANCE COMPANY Business Name sl Jo A.Johnso ,Attorney-in ct Name/Tltle[print] (Acknowledgment Will Notary Seal for Surety and Surety's Power of Attorney must be attached.) CONTRACTOR: SILICON A Y P ViNG,INC. Busin N e ; s/ IF — Todd Slyngstad,President iMmefTitle Date: December W 2019 S! NamelTitle Date: END OF PERFORMANCE BOND Cupertino Senior Center ADA Sidewalk PERFORMANCE BOND Project 2020-09 Page 31 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Santa Clara ) On t r) ; O � I before me, Therese Diaz, Notary Public (insert name and title of the officer) personally appeared Todd Slyngstad who proved to me on the basis of satisfactory evidence to be the person() whose name(s) is/ar-e subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(+es), and that by his/her/their signature(s) on the instrument the person{s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. THERESE DIAZ WITNESS my hand and official seal. a .� Commission #2143943 Z Z . Notary Public - California z Z '' Santa Clara County D My Comm. Expires Mar 21,2020 Signature d ( « �.-- -(Seal) J This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company mu 1.uc,1® The Ohio Casualty Insurance Company Certificate No:8201741-977114 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Joseph Gibson,Jody A.Johnson all of the city of Redding state of California each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 2nd day of August 2019 . Liberty Mutual Insurance Company 1NSUR (! INS& XX 1NSUo The Ohio Casualty Insurance Company O'�rgyo g`�PRPORar�y �VP:�Pa 0 y� West American Insurance Company > J 3 Fo R+ Ve 3 Fo m 2 Fo a+ co Y � 1912 0 oy1919� a a 1991 0 .� //r//�JJ y N YdV19�SACHUS�-aa y0 NAMPS L� Y �N010f' �� ej� * �� �yl * *�d s�M * *ad By: y c David M.Carey,Assistant Secretary -C State of PENNSYLVANIA >, Co County of MONTGOMERY ss m L a) On this 2nd day of August 2019 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o 0 Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes— 0 > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 0 W IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia;Pennsylvania,on the day and year first above written. a)0. ((U rn 5p PASr 0 M 0 0) Q� °NW F� COMMONWEALTH OF PENNSYLVANIA i 4 Q. �< < Notarial Seal Ql0 � � aZ� Teresa Paslella,Notary Public 0 ` C p OF Upper Medon T wp.,Montgomery County By: � C �4 My Commission Expires March 28,2021 >> E yo Nsyt l �� Teresa Pastella,Notary Public 0 m �� TgRY6v Member,Pennsylvania Association orNaiades dO CU W N 0)a) This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual-m o.S Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: 0 � a) ARTICLE IV—OFFICERS:Section 12.Power of Attorney. 3 o CU Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the�� _0 >, President may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety >o C any and all undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall N _ " have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed,such "y c Zn instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the �M provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. c°D ARTICLE XIII—Execution of Contracts:Section 5.Surety Bonds and Undertakings. 0— Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, I° shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the.Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 10 t h day of D e C e mb e r 2 0 19 P�1NStho PVZY INS& \NSU� J `°pPO'?, VC. a 00--14;, y0 4P`asPO/tgTo C� 1912 0 1919 z 1991 Z O G O dJl9s'T4CHUS��.da y0�N4MP`�a�a `( �NOIANP' a By: _ Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 062018 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A Notary Public or other officer completing this certificate verities only the identity of the individual who signed the document to which this certificate is attached.and not the truthfulness,accuracy,or validity of that document. I i j State of California i County of Shasta i i On December 10, 2019 before me, Kara Alon Yowell, Notary Public, personally appeared j Jody A. Johnson, who proved to me on the basis of satisfactory evidence to be the persons) I whose name(s) is/are subscribed to the within instrument and acknowledged to me that i I he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their j I j signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) I acted, executed the instrument. I I j I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. I j f� KARA ALON YOWELL I j M1f. Notary Public-California A. i WITNESS my hand and official seal. """ Shasta County n I Commission H 2264023 My Comm.Expires Nov 21,2022 I Signature: j j (Notary Seal) i ------------------------------------- ----OPTIONAL----------------------------------------- i Description of Attached Document i Title or Type of Document: Performance Bond j Document Date: December 10, 2019 I i Number of Pages: 3 I i Capacity(ies) Claimed by Signer(s) I Signer's Name: Jody A. Johnson Signer's N e: I ❑ Corporate Office—Title(s) ❑ Corp rate Office —Title(s) j Attorney in Fact ❑ Att rney in Fact I j ❑ Individual ❑ I dividual I ❑ Partner— Limited/General ❑ Partner— Limited /General j ❑ Trustee Trustee I ❑ Guardian or Conservator Guardian or Conservator ❑ Other: ❑ Other. I I ..... :.,eSdY-.aii�':1�.���1�..a:ieuJ�'2Ma�7'-:...l.Kla�.i�-+�M4��. •_, iv..�...��..�yw�f..,yftti+'N'W�'Y�104'^k!M"'V�'sv+:J^"SIYa. �e.a!-, Bond # 38KO07887 Premium: Included in FP Bond Payment Bond The City of Cupertino ("City") andSILICON VALLEY PAVING, INC. ("Contractor") have entered into a contract, dated December Twn: ; , 201,�z,�("Contract")for work on the Cupertino Senior Center ADA Sidewalk("Project"). The Contract is incorporated by reference into this Payment Bond ("Bond"). 1. General. Under this Bond, Contractor as principal and The Ohio Casualty Insurance Company its surety ("Surety"), are bound to City as obligee in an amount not less than $70,670.00--- , under California Civil Code sections 9550, et seq., to ensure payment to authorized claimants.This Bond is binding on the respective successors, assigns, owners, heirs, or executors of Surety and Contractor. 2. Surety's Obligation. If Contractor or any of its Subcontractors fails to pay a person authorized in California Civil Code section 9100 to assert a claim against a payment bond, any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or 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 the obligation. 3. Beneficiaries. This Bond inures to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon this Bond. Contractor must promptly provide a copy of this Bond upon request by any person with legal rights under this Bond. 4. Duration. If Contractor promptly makes payment of all sums for all labor, materials,and equipment furnished for use in the performance of the Work required by the Contract, in conformance with the time requirements set forth in the Contract and as required by California law, Surety's obligations under this Bond will be null and void. Otherwise, Surety's obligations will remain in full force and effect. 5. Waivers. Surety waives any requirement to be notified of alterations to the Contract or extensions of time for performance of the Work under the Contract. Surety waives the provisions of Civil Code sections 2819 and 2845. City waives the requirement of a new bond for any supplemental contract under Civil Code section 9550. Any notice to Surety may be given in the manner specified in the Contract and delivered or transmitted to Surety as follows: Attn: Phyllis Jarvis Address: 17771 Cowan,#100 City/State/Zip: Irvine,CA 92614 Phone: (916)924-8656 Fax: (916)924-6749 Email: Phyllis.JarvisCcDLibertyMutual.com 6. Law and Venue. This Bond will be governed by California law, and venue for any dispute pursuant to this Bond will be in the Santa Clara County Superior Court, 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. Cupertino Senior Center ADA Sidewalk PAYMENT BOND Project 2020-09 Page 28 7. Effective Date; Execution. This Bond is entered into and is effective on December 10 2019 . SURETY: THE OHIO CASUALTY INSURANCE COMPANY Business Name r/ sl Jody A.Johnson,Attorney-in-Fact Name/Title Date: December 10,2019 (Attach Acknowledgment with Surety's Notary Seal and Power of Attorney.) CONTRACTOR: SILICON V LEY PAVING, INC. Busines e s/ / Todd Slyngstad, President Name/Title Date: December 10,2019 s/ Name/Title END OF PAYMENT BOND Cupertino Senior Center ADA Sidewalk PAYMENT BOND Project 2020-09 Page 29 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Santa Clara ) On i C'\ before me, Therese Diaz, Notary Public (insert name and title of the officer) personally appeared Todd Slyngstad who proved to me on the basis of satisfactory evidence to be the persons-) whose name(-&) is/a-re subscribed to the within instrument and acknowledged to me that he/srhe/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s). or the entity upon behalf of which the person(-s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. THERESE DIAZ WITNESS my hand an� official seal. a Commission #2143943 Z ,® Notary Public -California z ` � Santa Clara County .1 My Comm Expires Mar 21,2020 t Signature (Seal) This Power of Attorney limits the acts of those named herein,and they have no authority to y bind the Company except in the manner and to the extent herein stated. L1L�e Liberty Mutual Insurance Company Mutual® The Ohio Casualty Insurance Company Certificate No:8201741-977114 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Joseph Gibson,Jody A.Johnson all of the city of Redding state of California each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 2nd day of August 2019 . Liberty Mutual Insurance Company P�1NSUR� P-,IY INS& INSUkl The Ohio Casualty Insurance Company O'�T yC 5J o°RPORST�y uP°oaPORa1 y West American Insurance Company >; 3 b m vQ 3 Fo m W 3 Fo c'cn co 1912 0 0 1919 1991 y r s q y m o Q o o rd9SS �0 y0 Pa\ � DIA10 a C By: coc David M.Carey,Assistant Secretary -N State of PENNSYLVANIA 6 � County of MONTGOMERY ss m cc a) On this 2nd day of August 2019 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o o c:a Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes— (V > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. u LU IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. Q)Q- v cu Cl) Sp PAS1, om o o�goNWF�< COMMONWEALTH OF PENNSYLVANIA Q,� F u� as y Notarial Seal Teresa nTwp.la,Notary Public O C O� Upper MarionTwp.,Montgomery County By: LV OF (1) � C f>3 ��v My Commission Expires March 28.2021 3 E y NSYvl Teresa Pastella,Notary Public 0 to Member,Pennsylvania Association of Notaries m qRy PU 110 co a) o rn(D This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual:F o Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: o aa) ARTICLE IV-OFFICERS:Section 12.Power of Attorney. �'� o coo "-' Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the= CD to >1 President may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety >o any and all undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall N .,_, " have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed,such 'o0 z � instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the E� provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. c O° ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. 0 Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, H r shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the.Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 10 t h day of D e c e m b e r 2 0.19 PV INSt/ PVSY INS& a 1NSU� A 4°µPortyTo�'t� d `&F ° .4 pgy� v 2°µPoor L m 3 ra1912y0 oy1919� 0 1991 0 `'-- rd�TiA*s a yo�y yq*Psa� rs� °*0.ada3 By Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 062018 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached.and not the truthfiihless.accuracy.or validity of that document. —.._..—.._.._.._.._..—.._.._.._.._.._.._.._.._.._.._.._.._.._.._..—.._.._.._..—..—.._..— I j i State of California I I County of Shasta i i On December 10, 2019 before me, Kara Alon Yowell, Notary Public, personally appeared j Jody A. Johnson, 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 I he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their j I signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) I acted, executed the instrument. j I j I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. I .� KARAALON YOWELL I Notary Public-California WIT Shasta County my hand and official seal. � � "" � Y I Commission N 2264023 My Comm.Expires Noy 21,2022 Signature. � uoL j (Notary Seal) I ------------------------------------- ----OPTIONAL----------------------------------------- i i Description of Attached Document i Title or Type of Document: Payment Bond j Document Date: December 10, 2019 I I i Number of Pages: 3 i Capacity(ies) Claimed by Signer(s) I Signer's Name: Jody A. Johnson Signer'rnFffa i Corporate Office—Titles i ❑ p ( ) ❑ Cor Title(s) Attorney in Fact ❑ Atto I i j ❑ Individual ❑ Indi i ❑ Partner— Limited / General ❑ ParGeneral j ❑ Trustee ❑ Tr stee j I ❑ Guardian or Conservator ❑ uardian or Conservator I I ❑ Other: ❑ Other: I I I I..—.._.._.._..—..—....._.._..—..—....._.....—.._.._..—.._.._.._..—..—.._.._.._.._.._.._.._.._.._..J i ;,,, �,n.i'r.a .'i, y; .�., nits - t, vewyj�'K,r�l^'.iF14^4W?W9fX'4'!Y'yCk.�..15;iT�.rp•�.�;,r:"'4f Request for Taxpayer Give Form to the Form (Rev.October2018) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service Go to www.irs.gov/ForrnW9 for instructions and the latest information. 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. Silicon Valley Paving,Inc. 2 Business name/disregarded entity name,if different from above Silicon Valley Paving,Inc. co m 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to m following seven boxes. certain entities,not individuals;see a instructions on page 3): o ❑ Individual/sole proprietor or ❑ C Corporation ❑� S Corporation ❑ Partnership ❑Trust/estate aiin single-member LLC Exempt payee code(if any) ao .�0 ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► p 2Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting *' in LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is ( y) � another LLC that is not disregarded from the owner for U.S,federal tax purposes.Otherwise,a single-member LLC that code if an a 9 is disregarded from the owner should check the appropriate box for the tax classification of its owner. Q m ❑ Other(see instructions)► (Applies to accounts maintained ouhida the U.S.) 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional) rn 1050 Commercial Street,Suite 101 6 City,state,and ZIP code San Jose,CA 95112 7 List account number(s)here(optional) Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number backup withholding.For individuals,this is generally your social security number(SSN).However,fora _m —m� resident alien,sale proprietor,or disregarded entity,see the instructions for Part I,later.For other entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN,later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number Number To Give the Requester for guidelines on whose number to enter. M77 — 0 5 0 3 6 M84 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 issued to me);and 2.1 am not subject to backup withholding because:(a)I am 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 3.1 am a U.S,citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(f any)indicating that I am exempt from FATCA reporting is correct. 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 a not rquirpd to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later. Sign Signature of Here U.S.person I- Date► , Cl General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise .Form 1099-MISO(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments .Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to wwwJrs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number(ITIN),adoption .Form 1099 A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018)