Loading...
11-083 American Guard Services, Project Number 2011-03, 2011 Contractual Crossing Guard Services Project No. 2011 -03 DOCUMENT 00520 prs S 74)-- CONTRACT Z THIS CONTRACT, dated this 7 m day of Su N , 2011 , by and between American Guard Services, Inc.[Name of Contractor] whose place of business is located at 1299 E. Artesia Boulevard. Suite 200, Carson, CA 90746 [Address of Contractor] ( "Contractor "), and the CITY OF CUPERTINO, a Municipal Corporation of the State of California ( "City") acting under and by virtue of the authority vested in the City by the laws of the State of California. WHEREAS, City, on the t T" day of 5 V N>✓ , 2011 awarded to Contractor the following Project: PROJECT NUMBER 2011 -03 2011 CONTRACTUAL CROSSING GUARD SERVICES NOW, THEREFORE, in consideration of the mutual covenants hereinafter set forth, Contractor and City agree as follows: ARTICLE 1. WORK 1.1 Contractor shall complete all Work specified in the Contract Documents, in accordance with the Specifications and all other terms and conditions of the Contract Documents. ARTICLE 2. AGENCY AND NOTICES TO CITY 2.1 City has designated Roger Lee, Assistant Director of Public Works to act as City's Authorized Representative(s), who will represent City in performing City's duties and responsibilities and exercising City's rights and authorities in Contract Documents. City may change the individual(s) acting as City's Authorized Representative(s), or delegate one or more specific functions to one or more specific City's Representatives, including without limitation engineering, architectural, inspection and general administrative functions, at any time with notice and without l:.ability to Contractor. Each City's Representative is the beneficiary of all Contractor obligations to City, including without limitation, all releases and indemnities. 2.2 All notices or demands to City under the Contract Documents shall be to City's Authorized Representative at: 10555 Mary Avenue, Cupertino, California 95014 or to such other person(s) and address(es) as City shall provide to Contractor. ARTICLE 3. CONTRACT TIME AND LIQUIDATED DAMAGES 3.1 Contract Time. The Contract Time will commence to run on the c.ate indicated in the Notice to Proceed. City may give a Notice to Proceed at any time within 30 Days after the Notice of Award. Contractor shall not do any Work at the Site prior to the date on which the Contract Time commences to run. With satisfactory performance by the contractor, the term of this agreement shall be two (2) years from the start date of the agreement. The City shall retain :he option to extend the term of the agreement for an additional two (2) years, for a possible total of ter, years. Contractor performance will be documented weekly by the Street / Fleet Supervisor, with deficiencies communicated to the contractor. An annual City of Cupertino 2011 Contractual Crossing guard Services Project 110. 2011 -03 review of contractor performance will be completed by March 31 of each year. Satisfactory performance will be achieved if annual liquidated damages are less than $1,500 for missed crossing guard events and $200 for improper staging of pedestrian flow. Any such renewal after the first two years shall be accomplished by the City providing a written notice of renewal to the Contractor at least 30 days prior to expiration of the term. Any such renewal shall contain the same provisions as the original agreement, including an increase or decrease in compensation paid to the Contractor. Any increase or decrease in the previous contract price shall be based on the annual percentage change in the Consumer Price Index (CPI) as of June of the year the adjustment is being made. The CPI shall be the San Francisco /Oakland/San Jose Consumer Price Index for all urban wage earners. There will be no CPI adjustment during the first one -year term of the agreement. At the end of the initial twelve months of the contract period, and each anniversary thereafter for the duration of the contract, the unit prices on the Schedule of Bid Prices will be increased or decreased in direct proportion to the increase or decrease in the Consumer Price Index (CPI). The most recent CPI for June San Francisco /Oakland/San Jose area for all urban wage earners shall be used. The City shall have the authority to suspend this agreement, wholly or in part, for such period as deems necessary due to unfavorable conditions or to the failure on the part of the Contractor to perform any provisions of this agreement. 3.2 Liquidated Damages. City and Contractor recognize that time is of the essence of this Contract and that City will suffer financial loss in the form of contract administration expenses (such as project management and consultant expenses), if all or any part of the Work is not completed within the times specified above, plus any extensions thereof allowed in accordance with the Contract Documents. Consistent with Document 00700 (General Conditions), Contractor and City agree that because of the nature of the Project, it would be impractical or extremely difficult to fix the amount of actual damages incurred by City because of a delay in completion of all or any part of the Work. Accordingly, City and Contractor agree that as liquidated damages for delay Contractor shall pay City: 3.2.1 $500 for each and every day that services are not completed on time and/or designated crosswalk areas are omitted. 3.2.2 $50 for each event where it is observed over a 30 minute time period that the crossing guard is not properly staging pedestrians in a manner consistent with these contract documents. Liquidated damages shall apply cumulatively and, except as provided below, shall be presumed to be the damages suffered by City resulting from delay in completion of the Work. 3.3 Liquidated damages for delay shall only cover administrative, overhead, interest on bonds, and general loss of public use damages suffered by City as a result of delay. Liquidated damages shall not cover the cost of completion of the Work, damages resulting from defective Work, Lost revenues or costs of substitute facilities, or damages suffered by others who then seek to recover their damages from City (for example, delay claims of other contractors, subcontractors, tenants, or other third- parties), and defense costs thereof. ARTICLE 4. CONTRACT SUM 4.1 City shall pay Contractor the Contract Sum for completion of Work in accordance with Contract Documents as set forth in Contractor's Bid, attached hereto: See Exhibit "A" attached City of Cupertino 2011 Contractual Crossing guard Services Project loo. 2011 -03 ARTICLE 5. CONTRACTOR'S REPRESENTATIONS In order to induce City to enter into this Contract, Contractor makes the following representations and warranties: 5.1 Contractor has toured the City streets and has examined thoroughly and understood the nature and extent of the Contract Documents, Work, Site, locality, actual conditions, as -built conditions, and all local conditions, and federal, state and local laws and regulations that in any manner may affect cost, progress, performance or furnishing of Work or which relate to any aspect of the means, methods, techniques, sequences or procedures of crossing guards to be employed by Contractor and safety precautions and programs incident thereto. 5.2 Contractor has conducted or obtained and his understood all such examinations, investigations, explorations, tests, reports and studies and all other physical conditions at or contiguous to the Site or otherwise that may affect the cost, progress, performance or furnishing of Work, as Contractor considers necessary for the performance or furnishing of Work at the Contract Sum, within the Contract Time and in accordance with the other terms and conditions of the Contract Documents, including specifically the provisions of Document 00700 (General Conditions); and no additional examinations, investigations, explorations, tests, reports, studies or similar info-mation or data are or will be required by Contractor for such purposes. 5.3 Contractor has correlated its knowledge and the results of all such observations, examinations, investigations, explorations, tests, reports and studies with the terms and conditions of the Contract Documents. 5.4 Contractor has given City prompt written notice of all conflicts, errors, ambiguities, or discrepancies that it has discovered in or among the Contract Documents and actual conditions and the written resolution thereof through Addenda issued by City is acceptable to C ontractor. 5.5 Contractor is duly organized, existing and in gooc standing under applicable state law, and is duly qualified to conduct business in the State of California. 5.6 Contractor has duly authorized the execution, delivery and performance of this Contract, the other Contract Documents and the Work to be performed herein. The Contract Documents do not violate or create a default under any instrument, contract, order or decree binding on Contractor. 5.7 Contractor has listed Subcontractors pursuant to the Subcontractor Listing Law, California Public Contracting Code §4100 et seq. in document 00340 (Subcontractors List) ARTICLE 6. CONTRACT DOCUMENTS 6.1 Contract Documents consist of the following documents, including all changes, addenda, and modifications thereto: Document 00400 Bid Form Document 00430 Subcontractors List Document 00450 Statement of Qualifications Document 00455 Insurance Document 00460 Schedule of Crossing Guard Services Equipment Document 00481 Non - Collusion Affidavit Document 00482 Bidder Certifications Document 00510 Notice of Award Document 00520 Contract Document 00530 Insurance Forms City of Cupertino 2011 Contractual Crossing guard Services Project No. 2011 -03 Document 00550 Notice to Proceed Document 00610 Performance Bond Document 00650 Agreement and Release of Any and All Claims Document 00700 General Conditions Document 00800 Special Conditions Addenda(s) 6.2 There are no Contract Documents other than those listed in this Document 00520, Article 6. Document 00320 (Geotechnical Data, Hazardous Material Surveys and Existing Conditions), and the information supplied therein, are not Contract Documents. The Contract Documents may only be amended, modified or supplemented as provided in Document 00700 (General Conditions). ARTICLE 7. MISCELLANEOUS 7.1 Terms used in this Contract are defined in Document 00700 (General Conditions) and will have the meaning indicated therein. 7.2 It is understood and agreed that in no instance are the persons signing this Contract for or on behalf of City or acting as an employee, agent, or representative of City, liable on this Contract or any of the Contract Documents, or upon any warranty of authority, or otherwise, and it is further understood and agreed that liability of the City is limited and confined to such liability as authorized or imposed by the Contract Documents or applicable law. 7.3 Contractor shall not assign any portion of the Contract Documents, and may subcontract portions of the Contract Documents only in compliance with the Subcontractor Listing Law, California Public Contracting Code §4100 et seq. 7.4 The Contract Sum includes all allowances (if any). 7.5 In entering into a contract or a subcontract to supply goods, services or materials, Contractor or Subcontractor offers and agrees to assign to the awarding body all rights, title and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. §15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, services or materials pursuant to the contract or the subcontract. This assignment shall be made and become effective at the time City tenders fmal payment to Contractor, without further acknowledgment by the parties. 7.6 Should any part, term or provision of this Contract or any of the Contract Documents, or any document required herein or therein to be executed or delivered, be declared invalid, void or unenforceable, all remaining parts, terms and provisions shall remain in full force and effect and shall in no way be invalidated, impaired or affected thereby. If the provisions of any law causing_ such invalidity, illegality or unenforceability may be waived, they are hereby waived to the end that this Contract and the Contract Documents may be deemed valid and binding contracts, enforceable in accordance with their terms to the greatest extent permitted by applicable law. In the event any provision not otherwise included in the Contract Documents is required to be included by any applicable law, that provision is deemed included herein by this reference(or, if such provision is required to be included in any particular portion of the Contract Documents, that provision is deemed included in that portion). 7.7 This Contract and the Contract Documents shall be deemed to have been entered into in the County of Santa Clara, State of California, and governed in all respects by California law (excluding choice of law rules). The exclusive venue for all disputes or litigation hereunder shall be in Santa Clara County. Both parties hereby waive their rights under California Code of Civil Procedure Section 394 to file a motion to transfer any action or proceeding arising out of the Contract Documents to another venue. Contractor accepts the Claims Procedure in Document 00700, Article 12, established under the California Government Code, Title 1, Division 3.6, Part 3, Chapter 5. City of Cupertino . 2011 Contractual Crossing guard Services Project No. 2011 -03 . pa 4i .3 7.8 Contractor and all subcontractors shall comply with the Uniform Administrative Requirements for State and Local Governments set forth in the Code of Federal Regulations (CFR), Title 49, Part 18. In addition, the Contractor agrees to comply with the cost principles and procedures set forth in Office of Management and Budget Circular A -87. The Contractor agrees that a reference to either Office of Management and Budget (OMB) Circular A -87of the Code of Federal Regulations, Title 49, Chapter 1, Part 31, whichever is applicable, and the Code of Federal Regulations, Title 49, Part 18, will be included in any subcontracts entered into as a result of this contract. IN WITNESS WHEREOF the parties have executed this Contract in quadruplicate the day and year first above written. 2011 CONTRACTUAL CROSSING GUARD SERVICES ,,,--"'"- -- - --- V_ 4/7 CITY: CONTRACTOR: —•- CITY OF CUPERTINO, a Municipal Corporation of [_American Guard Services, Inc.] the State of California g �' B, __ [Signature] Attest: Sheri ` fIg SCu I 1 ' < '=- ''Y!'e r k [Please print name here] City Clerk: Kimberly Smi . ,t Approved as to form by City Attorney: Title: V r C' e P i s i d en 'y /ecy [If Corporation: Chairman , President, or Vice President] A. 74--....-,_ / f ) City Atto y: By: [Signature] I hereby certify, under penalty of perjury, that David W. [Please print name here] Knapp, City Manager of the City of Cupertino was duly authorized to execute this document on behalf of the City Title: of Cupertino by a majority vote of the City Council on: [If Corporation: Secretary, Assistant Secretary, Chief Financial Officer, or Assistant Treasurer] Dated: B • 2-2 . t 1 10 9 (,, c P to CJ State Contractor's License No. Classification GC J c_ c) ,�, � ` r Ari to et- H2O 11 David W. Knapp, City Manageeof the City of Cupertino, a Expiration Date Municipal Corporation of the State of California Designated Representative: Taxpayer ID No. 9 6 L (0 5 Y 5 City of Cupertino • 2011 Contractual Crossing guard Services Project No, 2011 -03 Name: Roger S. Lee Name: Sher-; -1' I s _s Title: Assistant Director of Public Works Title: $ r V) C E Pf re .s e.il l a99 E. A4-1 -c.S e Address: 10555 Mary Ave., Cupertino, CA 95014 Address: C.or Sc 907 Phone: 408-777-3269 Phone: ?) t ('j - CD (.5 • Cn 2-0 C Facsimile: 408-777-3399 Facsimile: 310 • (.o `I" • L .2_ 53 AMOUNT: $ � -C, ,, NOTARY ACKNOWLEDGEMENT IS REQUIRED. IF A CORPORATION, ACCOUNT NUMBERS: / re %¢ CORPORATE SEAL AND CORPORATE FILE NO • NOTARY ACKNOWLEDGEMENT AND FEDERAL TAX ID ARE REQUIRED. IF NOT A 4aib r W, f i 1 CORPORATION SOCIAL SECURITY NO. IS J REQUIRED END OF DOCUMENT City of Cupertino 2011 Contractual Crossing guard Services CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Leis 1 eS ^_ t C3L rL Onv�e 7 20 � I beforeme, t� /v im Data ) � - _ Here insert N and Title of ins Officer personally appeared C) h al If A s cJ Name(s) of Signers) who proved to me on the basis of satisfactory evidence to be the personA whose name($) is/am-subscribed to the within instrument and acknowledged to me that hest oIthoy- executed the same in his/taer/thoir authorized capacity f ), and that by his/her/theirsignature(4 on the instrument the person), or the entity upon behalf of .! '. ' H AN NON which the person)) acted, executed the instrument. :,t f ri`,'s. h 17 717`6 - '1 .OTAfz•r PUUULUC - CALIFORNIA I certify under PENALTY OF PERJURY under the laws !_.:5 AN1 cLES COUNTY of the State of California that the foregoing paragraph is nrn [-',),res Oct. 5, 9(J11 true and correct. WITNESS my hand and official seal. Signature �--�-� A Q 0 Kj ca__ tom Baca Notary Seat Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: _ Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: Signer's Name: O individual (3 Individual O Corporate Officer — Title(s): _ ❑ Corporate Officer — Title(s): O Partner — 0 Limited ❑ General RIGHTTHU'u18PR NJT 13 Partner — 0 Limited ❑ General RIGHT7HUASBPRINT ❑ Attorney in Fact OF SIGNER 0 Attorney in Fact OF SIGNER ❑ Trustee Top of thumb here 0 Trustee Top of thumb here ❑ Guardian or Conservator 0 Guardian or Conservator O Other: ._..__ - - -- 0 Other: Signer Is Representing:__ Signer Is Representing: 02007 National Notary Associelion • 9350 De Soto Ave., P.O.Bra 2402 • Chatsworth. CA 91313 -2402• www.NationalNOtaryorg Item 15907 Reotder:Cat Toil -Free 1- 800 - 878.6827 ExhibitA Project No, 21)1 1 -1)3 DOCUMENT 00400 BID FORM To be submitted as part of Ern elope "A " by the lime and dale specified in Document 00200 (Instructions to Bidders). TO THE HONORABLE CITY COUNCIL OF THE CITY OF CUPERTINO THIS BID IS SLB\I11 TED BY: American Guard Services. Inc. (FirmJCompany Name) Re: PROJECT NUMBER 2011 -03 2911 CONTRACTUAL CROSSING GUARD SERVICES 1. The undersigned Bidder proposes and agrees. if this Bid is accepted. to ewer into a contract Nyilh Ole City of Cupertino ( "City ") in the forte included in the Contact Documents_ Docuriicnt 00520 (Contract)_ to perform and furnish all Work as specified or indicated in the Contmc Documents for the Contract Sum and y, ithin the Coronet Time indicated in this Bid and in accordance with all other roans and conditions of the Contract Documents. All portions of this Bicl Form must be completed and signed before the bid is submitted. Failure to do so will result in the bid being rejected as non - response c. 2. Bidder accepts all of the teams and conditions of the Coiitr'act Documents. Document 00100 (Advertisement for Bids). and Document 00200 ( Instructions to Bidders). including. •ithout limitation, those dealing w ith the disposition of Bid Security. This Bid will remain subject to acceptance for 90 Days after the clay of Bid opening. 3. Bidder has visited the Site and performed all (asks. research. investigation. reviews, exaluinations_ and analysis and given notices. regarding the Project and the Site- as set forth in Document 011520 (Contract). Anicle 5. 4. Bidder has given City prompt written notice of all conflicts. errors. anabiguirics. or discrepancies that it has disco\ cued in or among the Contiact Documents and as-built drawings and actual conditions and the written resolution thereof through Addenda issued by City is acceptable to Contractor. 5. Subcontractors for work included in all Bid items. in accordance with the criteria in the Public Contract Code. are listed on the attached Document 01)4 Vii) (Subcontractors List). G. The undersigned Bidder understands that City reser,cs the right to reject this Bid. II notice of the acceptance of this Bid. hereinafter referred to as Notice of Award_ is mauled or delivered to the undersigned Bidder within the time described in pameraph 2 of this Document 00400 or at any other time tlaereaaller before 0 is w itladrawn. the undeisigned Bictdc - will execute and deli\ cr ilic documents required b\ Document 00200 (instructions to Bidders) within the times specified therein. These documents include. but are not limited to. Document 00520 (Contract) and Document 00610 (Performance Bond). K. Notice of Award or request for additional information nay be addressed to the undersigned Bidder at the address set forth below on the signature page. 9. The undersigned Bidder herewith encloses cash. a cashier's check. or certified check of or on a responsible bank in the L iiitcd States. or a corporate surety bond furnished Ly a surety authorized to do a surely business in the Slate of City of Cupertino 2011 Contractual Crossing (;meet lien ices • Project No. 2011-03 California_ in form specified in Document 00200 (instructions to Bidders). in the amount of ten percent (10°: %) of the total of Bid and utadc payable to the `City of Cupertino 10. The undersigned Bidder agrees w commence Work under the Contract Documents on the date established in • Document 00700 (General Conditions) and to complete all work within the time specified in Document 00520 (Contract). The undersigned Bidder acknowledges that (Pity has reserved the right to delay or modify the commencement date. the undersigned Bidder further acknowlcdgcs City has reserved the right to perform independent work at the Sitc. the extent of such work nrw not be determined until after the opening of the Bids. and that the undersigned Bidder w ill be required to cooperate with such other work in accordance with the requirements of the Contract Documents. 11. The. undersigned Bidder agrees that, in accordance w nli Document 00700 (General Conditions), liquidated damages for failure to complete all Work in the Contract within the time specified in Document 00520 (Contract) shall be as sct forth in Document 00520 (Contract). • • City of Cupertino 2011 Contractual Cros ing Guard Services Project No. 2011 -03 SCHEDULE OF BID PRICES All Bid items, including lump sums and unit prices, must be filled in completely. Total hours for Bid Item No. 1 not to exceed 8,200. Quote in figures only, unless words arc specifically requested. - - - - AVERAGE . HOURLY RATE 1 ESTIMATED ESTIMATED • (Rate to be the ! HOURS (4 HOURS PER TOTAL EXTENDED PRICE PER SCHOOL same for all . hours SITE PER ITEM DESCRIPTION sites) minimum) SCHOOL MONTH PER SITE MONTH "A" x "B" " " ? PER DAY 1 Adult Crossing Guard (locations 1 -10) Collins Elementary - Blaney & Forest 13.72. 4 80 $1, 097.60 Eaton Elementary - Blaney & Suisun 13.72 4 80 1,097.60 Garden Gate Elementary - Greenleaf & Stelling $13.72 4 80 $1,097.60 Kennedy Middle - Bubb & Hyannisporl $13.72 4 80 $1,097.60 Lawson Middle - De Anza Blvd &Mariam $13.72 4 80 $1,097.60 Lawson Middle -Vista & Merritt $13.72 4 80 $1,097.60 Lawson Middle -Vista & Stevens Creek'Blvd $13.72 4 80 $1,097.60 Lincoln Elementary - McClellan (e, Lincoln Elementary $13.72 4 80 $1,097.60 Regnarl Elementary - Bubb & Regnart $13.72 4 80 $1,097.60 Scdgnick Elementary - Barnhart & Tantau $13.72 4 80 $1,097.60 2 Adult Crossing Guard (locations 11 & 12) Tri- school Area — Bubb & McClellan $13.72 4 80 $1097.60 1 Tri — School Area — Orange & McClellan $13.72 4 80 $1097.60 ALLOWANCES TOTAL MONTHLY BID PRICE: S13.171 20 TOTAL SCHOOL YEAR BID PRICE: S1 18.54:0.80 City of Cupertino 2011 Contractual Crossing Guard Sen ices Project No. 2011-03 Total School Year Bid Price: , d t t • ( Words) ACI(NOWLEDC EMENT OF RECEIPT OF ADDENDUMS Bidder herby Acknowlecilies receipt and c‘aiiiinat ion or all Contract DOCI1111CTIIS and the thilowitil! Addenda: Addendum No. Addendum Dat Bidder proposes and tierces 10 fully perli.mit the Work within the timc stated a id in strict accordance IN 1111 the Contract Doc U11112111'6 fOr z41111:3 Or 11.101 11:54:d in this Bid Form. - NAME OF BIDDER: American Guard Services, Inc. Iiceri3edin Leek...I ith an act fcr the reLtistration of Con:Factors. and with license number 644178 L:piration Date: _ 04/30/2010 California Sherine Assaf, President Where incorporated. if applicable Sherif Assaf, Vice President Principals . 1 certify (or deckwe) under penalty of perjury ander the laws of the State of Ca :Komi the_foregicina is true and correct. r)/ SiLmattlre ol Bidder NOTE: If Bidder is d curpontion, set !bill) the leuul name of the corporation, stale 1\ licrc incorporated, together with the sicnature of officer or officers authorized to sign contracts on behalf of the corporation. If 3idder is a partnership, set forth the name of the finn toeelher the signature of the partner or partners authorized to sign contracts no behalf of the partnership. Business Address: American Guard Services, Inc. 1299 E Artesia Blvd, Suite 200 ..__Carson.CA 90746 Officers authorized tJ sign contracts: Sherif Asset Tmxid Full Name: 310-645-6200 ext. 4080 • Telephone Nut nber(s): • • • Fax Nuinberfs): 310 E Aires: sherifcg,)americanguardser-vices.com • END OF DOCUMENT City of Cupertino 2011 Contniclual Crossing Gunrcl SCITICCS ACORD,. Client#: 30666 AMEGU2 TI IS CERTIFICATE CERTIFICATE A o P CERTIFICATE OFLIABILITY INSURANCE ) THIS 22 /2011 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an er dorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Szerlip & Company, Inc. PHONE FAx ac No, E 973 FAX (A/C. No): 973 -467 -0725 288 Main Street ADDRESS: Millburn, NJ 07041 PRODUCER 973 467 -0400 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: First Mercury Ins Co 10657 American Guard Services, Inc. INSURER B Everest National Ins Co 10120 1299 E. Artesia Blvd., Ste 200 INSURER C: Chubb /Federal Ins Co 20281 Carson, CA 90746 -1686 INSURER D : Travelers Cas & Sur Co Amer 31194 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 AWL $UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE NSR AND POLICY NUMBER lMM/DD/YYYY) (MM/DDJYYYY) LIMITS A GENERAL LIABILITY FMMIO208072 09/30/2010 09/30/2011 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $100,000 CLAIMS -MADE I X OCCUR MED EXP (Any one person) s5,000 X Errors & Omissions PERSONAL & ADV INJURY $1,000,000 • GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $3,000,000 — 1 POLICY 1 i1 JFC LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE $ (Per accident) NON -OWNED AUTOS $ - $ A X UMBRELLA LIAB X OCCUR CUMI001068 09/30/2010 09/30/2011 EACH OCCURRENCE $9,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $9,000,000 DEDUCTIBLE $ X RETENTION $ 10000 $ B WORKERS COMPENSATION 5300001531111 03/16/2011 03/16/2012 X Tf1RY WC STATU- ITS 1 I FR FR AND EMPLOYERS' LIABILITY Y / N 1 IM B ANY PROPRIETOR/PARTNER/EXECUTIVE HI E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? n DEN N/A B (Mandatory in NH) 5300001532111 03/16/2011 03/16/2012 E.L. DISEASE - EA EMPLOYEE $1,000,000 B DESCRIPTION OF OPERATIONS below FL, NV, AZ E.L. DISEASE - POLICY LIMIT $1,000,000 C Property /I.M. 6615676 12/22/2010 12/22/2011 Scheduled D Crime 105569336 02/18/2011 /2012 $100,000 3rd Party DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space Is required) Subject to a written contract agreement that includes an additional insured requirement, certificate holder is an additional insured. Coverage affored to an additional insured is primary and non - contributory if (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION i City of Cupertino SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 0300 Torre Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cupertino, CA 95014 AUTHORIZED REPRESENTATIVE Ia .[ t 0„ 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 2 The ACORD name and logo are registered marks of ACORD #S123588/M120005 WRR f DESCRIPTIONS (Continued from Page 1) required by written contract. 1 AMS 25.3 (2009/09) 2 of 2 #S123588/M120005 1 POLICY NUMBER:FMM1020807 - 2 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Any Person or Organization as Required By Written ANY Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 1I — Who Is An Insured is amended to 13. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts or equip- ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project (other than service, maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) desig- covered operations has been completed; or nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 © ISO Properties Inc., 2004 Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY / NON- CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE Schedule Name and Address of Person or Organization: Any Person or Organization as Required By Written Contract It is understood and agreed that coverage for the person or organization shown in the above schedule is primary and non- contributory as respects liability created by the errors, acts or omissions of the named insured herein and subject to the terms and conditions in the Additional Insured Endorsement attached hereto. All other terms, conditions, limitations and exclusions of this policy are unchanged and applicable. This endorsement forms a part of the Policy to which attached, effective on the inception date of the Policy unless otherwise stated herein. (The following information is required only when this endorsement is issued subsequent to preparation of the Policy.) Endorsement effective Policy No.FMMIO20807 - 2 Endorsement No. Named Insured Countersigned by (Authorized Representative) CVX -G L- 5077(02/2008) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE. READ IT CAREFULLY. CG 25 03 11 85 AMENDMENT-AGGREGATE LIMITS OF INSURANCE (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIMITS OF INSURANCE (SECTION III) applies separately to each of your projects away from premises owned by or rented to you. CL 344(11-85) CG 25 03 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 ACORD CERTIFICATE OF LIABILITY INSURANCE A 00002 0 102 D 57 6 6/22/2011 10:21:47AM PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Highpoint Risk Services LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 5510 LBJ FREEWAY, SUITE 1200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Dallas, TX 75240 , Al TFR THF COVFRA(;F AFFORfFO RY THF POI ICIFS RFI OW (800) 728 -0623 (972) 404 -0380 Fax: (972) 404 - 0380 INSURERS AFFORDING COVERAGE INSURED: INSURER A: Comnani on Property and Casualty Insurance C American Guard Services, Inc INSURER B: 1299 E. Artesia Blvd, Ste 200 .INSURER C: Carson, CA 90746 - (310) 645 -6200 Fax: (310) 608 -0405 INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR POLICY EFFECTIVE POLICY EXPIRATIOIs TR TYPE OF INSURANCE POLICY NUMBER nATF (MM /nn/VV) nATF (MM /nn/VV) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any One Fire) $ CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY n PRO- n LOC IFC T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ — ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) — HIRED AUTOS BODILY INURY $ NON -OWNED AUTOS (Per accident) — PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO - OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ — DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND CPCAl2480 03./16/2011 03/16/2012 X ITngvilAMiTCI X IVFR EMPLOYERS' LIABILITY 1000000 E.L. EACH ACCIDENT $ A E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 OTHER LIMITS $ LIMITS $ utJLHI 11UN Ur UrtNA 1 IUNJ/LUt.A 11UNJ/VEt11l.LCA/CAl.LUSlUr AUUCU DT CNUUHJCMC I /Jr'Ct IAL PIIUVIJIL rib 1. Waiver of Subrogation for Workers' Compensation is provided in favor of Certificate Holder as required by written contract. 2. Coverage is provided fog the State of California. CERTIFICATE HOLDER 1 1 ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL CITY OF CUPERTINO IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 10300 TORRE AVENUE CUPERTINO, CA 95014 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 -S (7/97) © ACORD CORPORATION 1988 ACCPR D CERTIFICATE OF LIAI3ILITY INSURANCE DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jeanie Druebert NAME: Elizabeth Souther Insurance Group - Ac N o. Exu: (866)544 - 8273 FAx No): (866)544 -3486 29395 Agoura Rd ADDRESS : ] druebert @elizabethsouther.com Suite #202 PRODUCER 00000188 CUSTOMER ID #. Agoura Hills CA 91301 _ INSURER(S) AFFORDING COVERAGE NAIC # INSURED _INsuRERA:Philadelphia Indemnity Ins Co 18058 American Guard Services, Inc. INSURERS: 1299 E. Artesia Boulevard _ INSURERC: Suite 200 INSURERD: _ INSURER E : Carson CA 90746 INSURERF: COVERAGES CERTIFICATE NUMBER:11 - 12 American Guard Only 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 INSR WVD POLICY NUMBER (MM /DD/YYYY) (MM /DD/YYY`n GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PR ( RENTED PREEMIMI E SES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ ■ POLICY ■ P CT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED AUTOS X PHPK689980 3/1/2011 3/1/2012 BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) X NON -OWNED AUTOS Underinsured motorist BI single $ 1, 000,000 X $1,000 Ded Comp & Coll Uninsured /Underinsured $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TORY I IMITS FR ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is named as Additional Insured, but only as respects Auto Liability arising out of the operations of the Named Insured per form attached 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 Toree Ave. - Cupertino, CA 95014 AUTHORIZED REPRESENTATIVE Bruce Monteith /JD ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD PI- MANU -1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Blanket Additional Insured BLANKET ADDITIONAL INSURED Section II - Liability Coverage - A.1. WHO IS AN INSURED provision is amended by the addition of the following: e. Any person or organization for whom /au are required by an "insured contract" to provide insurance is an "insured," subject to the following additional provisions: (1) The "insured contract" must be in effect during the policy period shown in the Declarations and must have been executed prior to the "bodily injury" or "property damage." (2) This person or organization is an "insured" only to the extent you are liable due to your ongoing operations for that insured, whether the work is performed by you or for you, and only to the extent you are held liable for an "accident" occurring while a covered "auto" is being driven by you or one of your employees. (3) There is no coverage provided to this person or organization for "bodily injury" to its employees or for "property damages" to its property. (4) Coverage for this person or organization shall be limited to the extent of your negligence or fault according to the applicable principles of comparative negligence or fault. (5) The defense of any claim or "suit" must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or "suit.' (6) The coverage provided will not exceed the lesser of: (a) The coverage and /or limits of this policy; or (b) The coverage and /or limits required by the "insured contract." (7) A person's or organization's status as an "insured" under this subparagraph d ends when your operations for that "insured" are completed. All other terms and conditions of this Policy remain unchanged. Page 1 of 1 EXECUTED IN TRIPLICATE PLATTE RIVER INSURANCE COMPANY Annually Renewable Performance Bond BOND #41232497 Premium: $1,054.00 KNOW ALL MEN BY THESE PRESENTS: That American Guard Services, Inc. (hereinafter called the Principal), and Platte River Insurance Company (hereinafter called the Surety), are held and firmly bound unto City of Cupertino (hereinafter called the Obligee), in the full and just sum of Fifty -Two Thousand Six Hundred Eighty -Four and 80/100 Dollars ($52, 684.80), the payment of which sum, well and truly to be made, the said Principal and Surety bind themselves, and each of their heirs, administrators, executors, and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has by written agreement dated the 8th * day of June, 2011 entered into a Contract with the Obligee for Contract No. 2011 -03 for Contract: 2011 Contractual Crossing Guard Services for a period of One year which contract is hereby referred to and made a part hereof. * Per Notice of Award Date June 8, 2011 WHEREAS, the Obligee has agreed to accept a bond guaranteeing the performance of said contract for a period of one year. NOW, THEREFORE, THE CONDITIONS OF THE ABOVE OBLIGATION IS SUCH, that if the Principal shall well and truly perform each and every obligation in said Contract at the time and in the manner specified during the term of this bond, and shall reimburse said Obligee for any loss which said Obligee may sustain by reason of failure or default on the part of said Principal, than this obligation shall be void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, That this bond is subject to the following conditions: 1. This bond is for the term beginning August 1, 2011 and ending July 31, 2012. The bond may be extended for additional terms at the option of the surety, by continuation certificate executed by the Surety. Neither non - renewal by the surety, nor failure, nor inability of the Principal to file a replacement bond shall constitute a loss to the Obligee recoverable under this bond. 2. In the event of default by the Principal, Obligee shall deliver to Surety by certified mail, a written statement of the facts of such default, within thirty (30) days of the occurrence. In the event of default, the Surety will have the right and opportunity, at its sole discretion, to: a) cure the default; b) assume the remainder of the Contract and to perform or sublet same; c) or to tender to the Obligee funds sufficient to pay the cost of completion Less the balance of the Contract price up to an amount not to exceed the penal sum of the bond. In no event :hall the Surety be liable for fines, penalties, liquidated damages, or forfeitures assessed against the Principal. 3. No claim, action, suit or proceeding, except as hereinafter set forth, shall be had or maintained against the Surety on this instrument unless same be brought or instituted upon the Surety within one year from termination or expiration of the bond term. 4. No right of action shall accrue on this bond to or for the use of any person or corporation other than the Obligee named herein or the heirs, executors, administrator or successors of Obligee. 5. The aggregate liability of the surety is limited to the penal sum stated herein regardless of the number or amount of claims brought against this bond and regardless of the number of years this bond remains in force. 6. If any conflict or inconsistency exists between the Surety's obligations or undertakings as described in this bond and as described in the underlying document, then the terms of this bond shall prevail. 7. This bond shall not bind the Surety unless the bond is accepted by the Obligee. The acknowledgement and acceptance of this bond is demonstrated by signing where indicated below. If this obligation is not accepted by way of signature of the Obligee below, this bond shall be deemed null and void. Signed and sealed this 23rd day of June 2011. Tr PRINCIPAL: 4110/1 SURETY: American Guard Servit Inc. (seal) Pla 4 . - e • mpany (seal) Stier Asscz.i Sr. V, (name & title) St en A Swartz Attorney -in -Fact THE ABOVE TERMS AND CONDITIONS OF THIS BOND HAVE BEEN REVIEWED AND ACCEPTED BY THE (OBLIGEE). ACKNOWLEDGED AND AC PTED : ' O :LI EE: BY: r i d /% 1► PRINTED NAME /TITLE: DATE: PLEASE RETURN A COPY OF ACCEPTED BOND TO: CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT esr- . ^t:i`i`c>.e7 STATE OF OF CALIFORNIA County of Orange On June 23, 2011 before me, Lorie Mandel. Notary Public Date Here Insert Name and Title of the Officer personally appeared Steven A Swartz Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) LORIE MANDEL acted, executed the instrument. COMM # 1914573 n' NOTARY PUBLIC-CALIFORNIA vt VT*, ORANGE COUNTY 7 I certify under PENALTY OF PERJURY under the laws of MY COMM. EXP. Dec, 24, 2014 � the State of California that the foregoing paragraph is true and correct. Witness my hand nd official seal. Signature s " Gig' ,, `� / Place Notary Seal Above Signat re of N Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Annually Renewable Performance Bond #41232497 Document Date: June 23, 2011 Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact RIGHTTHUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: Platte River Insurance Company �Cf:: Gi: rI.GCLt:t'uro`krfi.2:^?..:�i`` ._ ...., *2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313 -2402 • www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1- 800 -876 -6827 9 l9L §fas Qk .V.F P {i, i t "t axf§� " kk # § # ® 9k ;' ;` ;'4 i2`x 4s 4, l6 t. lbw` , a> d$ n. b.. ;' , ,o- ,,. R1 ; 9$ n 8 ,, f.." ,s, $ ,t /: # ,4 ;-Pe ca }t. lAkkaait gl{k §a% k�Pea V ° aldlk d:F:7Ak « d ,X ;ti ed§ $) e t`a! rl .e; : ° $ a lat.a e . ,+xto-a + 4:s } #:P. 4.04 SW t' a4aa4 § a:. # ;i i 4 §z # #§ aat°e£ , R r. ; §.,.. :', :,: , § *o s #4 §sa F #fog' ,¢9-0x4$ Eae9§ ¢g8t§s , §tpe46 #<g # 6 # i f¢ g a4 #a " .,. „€ #t#�tt + #$ + # §+ !i +ii: +t4£ti+ ;r:,+ # {fi t•. +tt +i tt,£ #4i tt $:. £f, i . f, + � ,. §;, §d<d. . g + a 4 � ,, # a 4 � „§ : # §§ v > # S #, k$ €£ # {§ kg ?Fh #4 3o.¢4ff+§ , t #$g +;a $$3 #h {+ :9 ?.t.t #t tfi?tf $ $#fii #§ ptf £ +f$ .a, §.p } °..., , .. .d9 +§ ';p §! #i + } + #9 : ;' +#$ + #+ :;:; t4$fi §t a rt +t #} +{i$t£ �:. ?. +££a + q +a.$ +¢ # €!,, #+ , a $iy a .e,d£x a + § §a > „.a,tg# i #: i9$ � # #;i {t ' >: a ; #ita : gqg { + s c } #t ## :;. +iit'.+ e$ + +t : fitt$ ++ +lti{+ ::. fiii ._ + {a;� »„ ,.: `t; -ppggzpl .�} 5,r $ { 1 { {5 jp} 9t „i2 4 gg i $ , 1, € g . $., a; k -.,:,, i t .,, 5g �$p., ,d g g. ,, 4 (.$ §.tgl , } (ti, : } j y t 8 i fi „ 4. _°..; ' « ».:�ln[l.tln ll:$'k+ k:. F& I+ H.! �%. t £I�RAAX4 % #t0.l.Q.ttYB.Tii1:�:Rk1 4E #��S #i$E�I: ,�.�� t �Q..�€d $ { k3 P. £E 3i.... X.: Z €i } f �. {°f 1..;9*EdS�e. -E i;�� tirz�€.$ k4T_ FV 34, �!: MSR+ F3: t& t, �4' a' 3�S+ �g�{ 4Yd# ��# MY.' sSti�i: tiS# o A.& i9�ll[Y %RIY:�ft&A_t:tAk.l.t! # °T �.... n':« ae .. .... 1 PLATTE RIVER INSLRANCE COMPANY 412 3 2 4 9 7 + = :, # ''t6:',:.:',", r POWER OF ATTORNEY S!$i ®`*d tom --- , KNOW ALL MEN BY THESE PRESENTS, That the PLATTE RIVER INSURANCE COMPANY, a corporation of the State of Nebraska, having its ... .", (lP °'c+ principal offices in the City of Middleton, Wisconsin, does make, constitute and appoint 7t `�� Q /, ` " , k \t +^!" " "e STEVEN A SWARTZ; NJCKI SWARTZ; LORIE MANDEL; MICHAEL WASKO 111; PATRICIA MINDER , t .. a� rata 5 �- { its true and lawful Attorney(s) -in -fact, to make, execute, seal and deliver foi and on its behalf as surety, and as its act and deed, any and all bonds t " !. ` undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in `= #{{ !f ' +s a. r.+�i p.!7 ?,,., amount the sum of 9, ,� T i t ;*- "+t t+Y``4 i §t} ALL WRITTEN INSTRUMENTS IN AN AMOUNT: $2,500,000.00 {!t; ° -4; ;i1) ..„ -1 This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board (1 # > il , * y? of D of PLATTE RIVER INSURANCE COMPANY at a meeting duly called and held on the 8th day of January, 2002. • '+ �; ; ) S +; c .*�i ' " RESOLVED, that the President and Vice- President, the Secretary or Treasurer, acting individually or otherwise, be and they hereby are granted the ..., �' : j z x ower and authorization to a oint b a Power of Attorne f'or the ur oses onl of executin and atte tin b nd rt kin n r itin � : p pp y y p p y g s g o s and un de a gs a d othe wr t gs ti r +� . ° { obligatory in the nature thereof, one or more vice - presidents, assistant secretc[ries and attorney(s) -in -fact, each appointee to have the powers and duties a ,..1 y '; = .- usual to such offices to the business of the Corporation; the signature of suet officers and the seal of the Corporation may be affixed to such power of . attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile , P,. =,i seal shall be valid and binding upon the Corporation in the future with resrect to any bond or undertaking or other writing obligatory in the nature {P, g P P F Y g g g Y / , 4` , p thereof to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any of said officers, at any tim = �. } (! . IN WITNESS WHEREOF, the PLATTE RIVER INSURANCE COMPANY has caused these presents to be signed by its officer undersigned and its -w°^• ° ;, corporate seal to be hereto affixed duly attested, this 1st day of January, 200' '' Attest: PLATTE RIVER INSURANCE COMPANY 4 MVP!' s \,JEP\t1NISUIR,iNC / p s sr `„ :.� , al SEAL {_ Y t t. -,. ` # + David E Pauly Chairman & CEO Y James J. McInt re w ! + °* w + , %\ �\ President +'�� t STATE OF WISCONSIN ) S.S. // J iig iq��q�lllllltl�n 'dAAtp� 4 J6 ; "' ' COUNTY OF DANE "��, f` i ,, On the 1st day of January, 2007 before me personally came James J. McIntyre, to me known, who being by me duly sworn, did depose and say: that he . °"o r< resides in the County of Dane, State of Wisconsin; that he is President of PLATTE RIVER INSURANCE COMPANY, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal that it was so affixed by order of the Board of Directors of said corporation find that he signed his name thereto by like order. _ I £ ° �° " / DANIEL = , Ci✓�" ✓ " " I a l m KRUEG R r = r 9 ! > t Daniel W. Krueger +; o, ` 1. s STATE OF WISCONSIN ,• Notary Public, Dane Co., WI 104:44, S.S.: * COUNTY OF DANE CERTIFICATE ,.ATE My Commission Is Permanent +r+ °°%. o.', =' I the undersigned, duly elected to the office stated below, now the incumbent n PLATTE RIVER INSURANCE COMPANY, a Nebraska Corporation, ilti ,e®`"rb ! authorized to make this certificate, DO HEREBY CERTIFY that the foregoing attached Power of Attorney remains in full force and has not been 1!":""'. #f}} revoked; and furthermore, that the Resolution of the Board of Directors, set 'orth in the Power of Attorney is now in force. lift 0 c +4{: •. ppl} 23rd ° "' Signed and sealed at the City of Middleton, State of Wisconsin thi da of June , 2 01 R M 1 > l w .'. 4, k q v. E O� j 110::<, M d , > ' , SEAL) � a��� tE ii a� ,¢ / Alan S. Ogilvie f v ; ' it Secretary : ``' THIS DOCUMENT IS NOT VALID UNLESS PRINTED ON GREEN SHADED BACKGROUND WITH A RED SERIAL NUMBER IN THE UPPER °` 4 ;0: 4 7. 147 - 1 ; RIGHT HAND CORNER. IF YOU HAVE ANY QUESTIONS CONCERNING THE AUTHENTICITY OF THIS DOCUMENT CALL 800-475-4450. ° ' � a+ 1 ,t PR -POA (8 -07) a ' __ ' K »Z T ifi it ° f re . : l • I!1! #$! $il Mi . $$I 1$ $ T l $ t$T: I ! t$ :4 IIt b$Tl $ T t r» $ � �' +� t g a;, # 't, + + . 1TI � , # T l$ i $ -t. T$ . li i , ; I F.I$ . � i! $ .;, $ P ..F q( : —� 1 #+# :.. # d$+ 1 . $ # # # ## :� 1} +6 # # + + }4 :�, di#4 #i #d # .,.. ## 4. Tat #.. 4# }! }# if d # t !_ 8 S4 # . si d # .. #41414 ! # #f4 4t 6f # ## $ # #I #1 {i Itt::.16 # iO4d {� #. 41 ## # , # + f4 fr . , ,,,, t ,,; {, 8 #f. #i {Y .;441 $ .:#..&. V a + -#4 : +tit$':.. { t . - t +i + .. ++4et. tilt {t # +ti t4 #,:. i i . +.{ { $ i $ +.. ...{ M + , ;y f . ...: r" . 4, .d «.s . 1 t+. ,. WO, # # # 4. + +i _ # + &$+ i # 4 . 1. #. ii 4 4 # AM # i A. + d t #i 1 j i i.4,. I i 4t , , .tY # d + +i # + E,. A # #i .i , + i # +t§$. : +i.l.i.j $. }i tt#$+ 1 { #il.r < .t, §- r . as +a +sae - t+tt - . ... j t+a +$t. #tI#aA :jj,+ >++et, jj tHt+ + . - {_#it{r: s +a + #a a #t +ae tt +.ta $p .t +o +t tjj a +at{t at+t #e jd .t{ < +at i + +t{r ter +tt. >x#tt +a, 4 + + se t+t +$ xt }.++ ltmst # :t "ti + t +s6+ + d ++t.1 : #t4+Wf. +... t `;{,V de e . { .461 st �:Pitib T: t44gP' �.' e4' F# t .4'Ofte4' ♦'etP#F�'4 #fad.7eF{a4 �P {6 #a.T aa{. §Te14P.P'♦ a @44i.T af}PP '91 :att #F 'T if + € #�P Ig4' {! .'a {44P`� Yblt++�df e 96P i PP{e # ' �dit /f ♦Yf f4 i' {gt`.8tea�". +fatd " P ° • °r�df ®# ®Z'fi iA + +�fg f{P y m fy a {@+ ®�fy 4NP gL,sj a4.t# g�f( 4te+ +4dfb +"4P ® ®ft k §.0# p�k; §i64 >Pt'e1` d4.ia }�,fg f V ®`ifd §d #t hkf € 1 ® "j 4 #8} akFfy iRit pa f Ot §.t `,,f4 {f ik ,�/ f14P gaf as <i+ `'f { # k +t ai' +itt 9'0+ t•� +4 k ®I # i �I d 4!® 0 ,1t ''' :''' ka a+ . m »>.f a Py4 ».^e Fed y »• ® » ®r.e a at,P ® »e. ® pfa® e»a a �p t ;5°„ y »e«a € a4,V .a a. + qv, , aa Ptb P B ,sP be { @ » "ar 9 ^ P O.as Fp» t bP "# ♦ 4,4t , f " a �.I ° •. ^. , ..w�.•. ° °l.-. ,'.- ve °.� °a` .s "�e . °:�.6, � ^ ° a: °d.p. ..e 't4 ✓S S d t4 a° CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT State of California County of AC° S On Co — 2 3 - i 1 before me, La ! t. a 'i 111 J■_1 Dale Here Insert erne and TRW of the Officer personally appeared �._ i� "b f if s sco J Neme(a) of Signer(s) who p•oved to me on the basis of satisfactory evidence to be the person(sj whose name(g) is/aro- subscribed to the within instrument and acknowledged to me that heJshe4hep executed the same in his/her/their authorized capacity i($), and that by his/her their signatureW on the r "':.°r,mA Rte? rAds �n4.Ms'i1eY Hart, instrurnent the person(a), or the entity upon behalf of C� t 0 SAN � , t a which the person) acted, executed the instrument. ,Or\1/; ..r 1 171726 ; i t ; I certify under PENALTY OF PERJURY under the laws OTAR Pi.J ;t 1t !; • Irk> t i, _ ;. , ES cr1u, Y of the State of California that the foregoing paragraph is r , ; ,. , ; 'et. b.% , true and correct. 4 a . , JAW s w'MdY rrF ° Y•YM 1 L WITNESS my hand and official seal. Signature Piece Notary Seal Above Signature ot Notary Public OPTIONAL. Though the information below is not required by Jaw, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description ot Attached Document Title or Type of Document: Document Date: _ —_ Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: _ Signer's Name: D individual C Individual D Corporate Officer — Title(s): _ 0 Corporate Officer — Title(s): O Partner — D Limited L General FIGHTTWU'u1QPR1NT LI Partner — 0 Limited 0 General RIGHT THUMBPRINT ❑ Attorney in Fact OF SIGNER El Attorney in Fact OF SIGNER Top of thumb hero Top of thumb here ❑ Trustee El Trustee D Guardian or Conservator D Guardian or Conservator D Other: 0 Other: Signer Is Representing: _ Signer Is Representing: • 02007 Nations! Notary Association • 9350 De Sab Ave., P.O.Box 2402 • Chatsworth. CA 91 :313 -2402• www.NationalNotery.org Item 15907 Reonter:Cal Toll -Free 1- 800-878.63827 � 7 ® A� DATE(MMIDD/YYYY) ° CERTIFICATE OF LIABILITY INSURANCE 10/1/2013 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 pelicy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Michele Thibodeaux NAME: _ E1 Dorado Insurance Agency, Inc. P+oNE (713)521-9251 A N : (713)521-0125 El Dorado Sec Srvs Ins Agy ADDRESS;mthibodeaux @eldoradoinsurance.com PO BOX 66571 INSURERS AFFORDING COVERAGE NAIC# Houston TX 77266 INSURERA:First Mercury Insurance Co. 10657 INSURED INSURERB:Philadel hia Insurance Company American Guard Services, Inc INSURERC:The Ins. Company of the State 19429 1299 E. Artesia Blvd. INSURER D:Travelers CasualtV Insurance Co #200 INSURER E: Carson CA 90746 INSURER F: COVERAGES CERTIFICATE NUMBER:AMERICAN GUARD (10/13) 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 01= ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEE 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 INSR SUER POLICY NUMBER MMIDONYYY MMIDD/Y LTR YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ r A CLAIMS-MADE 1X OCCUR SE-CGL-0000018236-02 9/30/2013 9/30/2014 MED EXP(Any one person) $ 10,000 X ERRORS 6 OMISSIONS PERSONAL&ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 B X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED PHPK999604 3/31/2013 3/31/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I X I RETENTION$ 10,000 SE-UMB-0000018238-02 9/30/2013 9/30/2014 $ C WORKERS COMPENSATION WC25052389 ALL OTHER ST X WC STATU- OTH- AND EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNER;EXECUTIVE -/N WC25052390 CA E.L.EACH ACCIDENT $ 1 000,000. OFFICERlMEMBER EXCLUDED? NIA 1/1/2013 1/1/2014 (Mand�te:y in NH) C25052391 FL E.L.DISEASE-EA EMPLOYE_ _$ _1100 1000 If yes,describe under C25052392 ND,OH,WA,W::,WY DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT Is 1,000,000 D 1ST AND 3RD PARTY CRIME 105844112 9/30/2013 9/30/2014 LIMIT $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) The General Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. The General Liability policy contains a special endorsement with "Primary and Nonccntributory" wording. 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 Cupertino, CA 95014-0000 AUTHORIZED REPRESENTATIVE F .L. Ring, Jr./MICHEL - ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025,zolcos;of The ACORD name and logo are registered marks of ACORD