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13-111 O'Grady Paving Inc., 2013 Pavement Maintenance Project Phase I, Project No. 2013-01 OFFICE OF THE CITY CLERK CITY HALL 10300 TORRE AVENUE: •CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3223• FAX: (408) 777-3366 WEBSITE:www.cupertitio.org CUPERTINO August 8, 2013 O'Grady Paving, Inc. 2513 Wyandotte Street Mountain View, CA 94043 Re: Project Number 2013-01, 2013 Pavement Maintenance Project Phase I Your bid bond and a fully executed contract for the above stated project are enclosed. If you have any questions or need additional information, please contact the Public Works Department at (408) 777-3354. Sincerely, Dorothy+Steenfott Senior Office Assistant Enclosure cc: Public Works Project No.2013-01 DOCUMENT 00520 CONTRACT THIS CONTRACT, dated this a3 day of ZS"-1 , 2013 ,by and between O'GRADY PAVING, INC. whose place of business is located at 2513 Wyandotte Street,Mountain View, CA ("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. REAS,City,on the._,2z?—day of 2013 awarded to Contractor the following Project: V `t l PROJECT NUMBER 2013-01 � 2013 PAVEMENT MAINTE1ANCE PROJECT - PHASE 1 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, Drawings,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, Public Works — Maintenance, 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. C:'Lty 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 liability 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: 10300 Torre 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 date 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. Contractor shall achieve Final Completion of the entire Work and be ready for Final Payment in accordance with Section 00700(General Provisions)within 60 working days as provided in Document 00700(General Provisions) 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 City of Cupertino 00520- 1 Contract 2013 Pavement Maintenance Project—Phase 1 Project No.2013-01 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 Provisions), 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 $1,500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Substantial Completion as specified above. 3.2.2 $1,500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Final Completion of the entire Work as specified above. 3.2.3 $150.00 per day for failure to replace traffic striping as required by Document 01010, Section 109-3D. 3.2.4 $5,000 for each occurrence of a violation of Document 00800, Section 1.7 WORK DAYS AND HOURS. 3.2.5 Three Months Salary for each Key Personnel named in Contractor's SOQ pursuant to Article 2.G of Document 00450 (Statement of Qualifications for Construction Work) who leaves the Project and/or Contractor replaces at any point before Final Completion, for any reason whatsoever, that Contractor can demonstrate to City's satisfaction is beyond Contractor's control. 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 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 visited the Site 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 construction to be employed by Contractor and safety precautions and programs incident thereto. 5.2 Contractor has examined thoroughly and understood all reports of exploration and tests of subsurface conditions, as-built drawings, drawings, products specifications or reports, available for Bidding purposes, of physical conditions, including Underground Facilities, or which may appear in the Drawings. Contractor accepts the determination set forth in these Documents and Document 00700(General Provisions)of the limited extent of the information contained in such materials upon which Contractor may be entitled to rely. Contractor agrees that except for the information so identified, Contractor does not and shall not rely on any other information contained in such reports and drawings. City of Cupertino 00520-2 Contract 2013 Pavement Maintenance Project—Phase 1 Project No.2013-01 5.3 Contractor has conducted or obtained and has understood all such examinations, investigations, explorations, tests, reports and studies (in addition to or to supplement those referred to in Section 5.2 of this Document 00520) that pertain to the subsurface conditions, as-built conditions, underground facilities, 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 Provisions); and no additional examinations, investigations, explorations, tests, reports, studies or similar information or data are or will be required by Contractor for such purposes. 5.4 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. 5.5 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 as-built drawings and actual conditions and the written resolution thereof through Addenda issued by City is acceptable to Contractor. 5.6 Contractor is duly organized, existing and in good standing under applicable state law, and is duly qualified to conduct business in the State of California. 5.7 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. 5.8 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 00002 Signature Page Document 00003 Project Directory Document 00012 Caltrans/City Cross-Re;:erence Table Document 00100 Advertisement For Bide Document 00200 Instructions to Bidders Document 00210 Indemnity and Release Agreement Document 00400 Bid Form Document 00411 Bond Accompanying Bid Document 00430 Subcontractors List Document 00450 Statement of Qualifications Document 00481 Non-Collusion Affidavit Document 00482 Bidder Certifications Document 00520 Contract Document 00530 Insurance Forms Document 00610 Construction Performance Bond Document 00620 Construction Labor and Material Payment Bond Document 00630 Guaranty Document 00650 Agreement and Release of Any and All Claims Document 00660 Substitution Request Form Document 00700 General Conditions Document 00800 Special Conditions Document 00820 Traffic Control Requirements Document 00821 Insurance Document 00822 Apprenticeship Program City of Cupertino 00520-3 Contract 2013 Pavement Maintenance Project—Phase 1 Project No.2013-01 Document 00850 Technical Specifications Document 00860 General Requirements Attachment A Residential Crack Seal Street List Attachment B Work Hour Restrictions Addenda(s) Drawings/Plans 6.2 There are no Contract Documents other than those listed in this Document 00520, Article 6. The Contract Documents may only be amended, modified or supplemented as provided in Document 00700 (General Provisions). Article 7. Miscellaneous 7.1 Terms used in this Contract are defined in Document 00700 (General Provisions) 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 public works contract or a subcontract to supply goods, services or materials pursuant to a public works contract, 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 public works contract or the subcontract. This assignment shall be made and become effective at the time City tenders final payment to Contractor,without further acknowledgment by the parties. 7.6 Copies of the general prevailing rates of per diem wages for each craft, classification, or type of worker needed to execute the Contract,as determined by Director of the State of California Department of Industrial Relations, are deemed included in the Contract Documents and on file at City's office, or may be obtained of the State of California web site http://www.dir.ca.gov/DLSR/PVrD/Northem.html and shall be made available to any interested party on request. Pursuant to Section 1861 of the Labor Code, Contractor represents that it is aware of the provisions of Section 3700 of the Labor Code 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 Contractor shall comply with such provisions before commencing the performance of the Work of the Contract Documents. 7.7 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 City of Cupertino 00520-4 Contract 2013 Pavement Maintenance Project—Phase 1 Project No.2013-01 to be included in any particular portion of the Contract Documents, that provision is deemed included in that portion). 7.8 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 00520-5 Contract 2013 Pavement Maintenance Project—Phase 1 Project No.2013-01 `" IN WITNESS WHEREOF the parties have executed this Contract in quadruplicate the day and year first above written. 2013 PAVEMENT MAINTENANCE PROJECT—Phase 1 CITY: CONTRACTOR: CITY OF CUPERTINO,a Municipal Corporation of the State of California By: c— . [Signatur Attest: Craig E. Young [Please print name here] OPA- iry Clerk: Grace Schmi t Approved as to form by City Attorney: Title: Vice President [If Corporation: Chairman,President,or Vice President] Attorney: Carol Korade y: [Signature] Celine O. Duran I hereby certify,under penalty of perjury,that Timm Borden, [Please print name here] Director of Public Works of the City of Cupertino was duly authorized to execute this document. Title: Sect./Trea. [If Corporation: Secretary,Assistant Secretary, Chief Financial Officer,or Assistant Treasurer] Dated: �� �1 201696 A, C12 State Contractor's License No. Classification 12/31/13 Da Brandt,City Manager of the City of Cupertino,a Expiration Date Municipal Corporation of the State of California Designated Representative: Taxpayer ID No. 94-1493692 Name:Roger Lee Name: Craig E. Young Title:Assistant Director of Public Works- Title: Vice President • Address: 10555 Mary Ave, Cupertino, CA 95014 Address: 2513 Wyandotte St. Mtn. View, CA 94043 Phone:408-777-3269 Phone: (650) 966-1926 Facsimile:408-777-3399 Facsimile: (650)966-1946 NOTARY ACKNOLEDGEMENT IS REQUIRED. IF A AMOUNT: $1,974,836.00 CORPORATION, CORPORATE SEAL AND CORPORATE ACCOUNT NUMBER: 170-6`101-9 3�� NOTARY D. IF NO L A CORPORATION AND FEDERAL SE ID ARE REQUIRED. IF NOT A CORPORATION SOCIAL SECURITY FILE NO.: NO.IS REQUIRED END OF DOCUMENT 5/of Cupertino 00520-6 Contract 2013 Pavement Maintenance Project—Phase 1 California All-Purpose Acknowledgm,ent .q 4Z; State of California S S. CO unt y Of IN On before me, personally appeared ku 'Jj 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 j of which the person(s) acted, executed the instrument. A I certify under PENALTY OF PERJURY unc'er the laws of the State of California N - - - --- - - - -- -—-- -- - the foregoing paragraph is true and correcl. ww' EFAA COMN"I"•Ill" NoWy PWk•Cdft*s WITNESS my hand and official sea[. Soft CW8 CWAq 1A WConan.E*W158921.20161 _Flus POW offici-al no'kariad -y Signature of Notary Public My commission expires AN 6.0 Phone No.: Taiv rn�r%,- cer 40. a:i 4 r C4 x n ,D,2008 No -.3a. Al Rights Re.S4:'r'v'(:d M ­­11 �_ . :1 Project No. 2013-01 DOCUMENT 00400 BID FORM To be submitted as part of Envelope "A" by the time and date specified in Document 00200 (Instructions to Bidders). TO THE HONORABLE CITY COUNCIL OF THE CITY OF CUPERTINO THIS BID IS SUBMITTED BY: Name) Re: PROJECT NUMBER 2013-01 2013 PAVEMENT MAINTENANCE PROJECT PHASE 1 1. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into a contract with the City of Cupertino ("City") in the form included in the Contract Documents, Document 00520 (Contract), to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Sum and within the Contract Time indicated in this Bid and in accordance with all other terms and conditions of the Contract Documents. All portions of this Bid Form must be completed and signed before the bid is submitted. Failure to do so will result in the bid being rejected as non-responsive. 2. Bidder accepts all of the terms and conditions of the Contract Documents, Document 00100 (Advertisement for Bids), and Document 00200 (Instructions to Bidders), including, without limitation, those dealing with the disposition of Bid Security. This Bid will remain subject to acceptance for 90 Days after the day of Bid opening. 3. Bidder has visited the Site and performed all tasks, research, investigation, reviews, examinations, and analysis and given notices, regarding the Project and the Site, as set forth in Document 00520 (Contract), Article 5. 4. Bidder has given City prompt written notice of all conflicts, errors, ambiguities, or discrepancies that it has discovered in or among the Contract 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 00430 (Subcontractors List). 6. The undersigned Bidder understands that City reserves the right to reject this Bid. 7. If written notice of the acceptance of this Bid, hereinafter referred to as Notice of Award, is mailed or delivered to the undersigned Bidder within the time described in paragraph 2 of this Document 00400 or at any other time thereafter before it is withdrawn, the undersigned Bidder will execute and deliver the documents required by Document 00200 (Instructions to Bidders) within the times specified therein. These documents include, but are not limited to, Document 00520 (Contract), Document 00610 (Construction Performance Bond), and Document 00620 (Construction Labor and Material Payment Bond). 8. Notice of Award or request for additional information may be addressed to the undersigned Bidder at the address set forth below on the signature page. 10. The undersigned Bidder herewith encloses cash, a cashier's check, or certified check of or on a responsible bank in the United States, or a corporate surety bond furnished by a surety authorized to do a surety business in the State of California, in form specified in Document 00200 (Instructions to Bidders), in the amount of ten percent (10%) of the total of Bid and made payable to the "City of Cupertino". City of Cupertino Bid Form 2013 Pavement Maintenance Project — Phase 1 00400-1 Project No. 2013-01 11. The undersigned Bidder agrees to 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 City has reserved the right to delay or modify the commencement date. The undersigned Bidder further acknowledges City has reserved the right to perform independent work at the Site, the extent of such work may not be determined until after the opening of the Bids, and that the undersigned Bidder will be required to cooperate with such other work in accordance with the requirements of the Contract Documents. 12. The undersigned Bidder agrees that, in accordance with 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 set forth in Document 00520 (Contract). City of Cupertino Bid Form 2013 Pavement Maintenance Project —Phase 1 00400-2 Project No. 2013-01 SCHEDULE OF BID PRICES BASE BID ITEMS All Bid items, including lump sums and unit prices, must be filled in completely. Quote in figures only, unless words are specifically requested. ITEM DESCRIPTION UNIT EST. QNTY UNIT COST TOTAL 1 Traffic Control LS 0 ` 5 1' w 5 00c) 2 Hot Mix As halt, 3/8" Maximum Type A TN 2,458 / �J� 02 S-A 70 3 Hot Mix Asphalt, 1/2" Maximum Type A TN 7,405 lv51(Q 4D 4 Hot Mix Asphalt, 3/4" Maximum, Type A TN 4,034 —1 -j �� tpl 5 Pavement Fabric SY 64,534 (., Sir-) / 6 Asphalt Removal - 4" Di out SY 370 ods ® % of So 7 Asphalt Removal - 6" Di out SY 2,191 of U S74 9G G 8 Asphalt Removal - 9" Di out SY 3,211 lio 9 Cold Plane and Remove 4" AC SY 8,193 p' 10 Ke cut A LF 29,761 1-1 f -Ib q S!? 11 ke cut B LF 4,147 41 /(o,s91- ' 12 Crack Sealing LF 130,000 35 Jr oo 13 Adjust Survey Monument Cover to Finish Grade EA 81 jU0 d 930v 14 Lower Manhole Covers Prior to Cold Planing EA 47 $v 11 750 15 Lower Cleanout / Water / Gas Valve Cover Prior to Cold Planing EA 13 goo oZ LL�j 16 Adjust Manhole Covers to Finish Grade EA 122 SCJ() Col 0#0 17 Adjust Cleanout / Water / Gas Valve Cover to Finish Grade EA 77 300 p23 106 18 Install Blue RPM's @ Fire Hydrant EA 29 Z 715 19 12" White Crosswalk/Limit Line (Thermo) LF 881 Ll 3 sa y 20 12" Yellow Crosswalk (Thermo) LF 100 9 21 24" White (Thermo) LF 110 22 24" Yellow Thermo LF 1,160 % X 120 23 4" White (Thermo) LF 0 24 Striping Detail # 8 LF 75 01 So 25 Stiping Detail #10 Markers LF 1,800 26 Striping Detail # 21 (Thermo) LF 945 a. V 27 Striping Detail # 22 (Thermo & Markers) LF 1,190 28 Striping Detail # 23 Markers LF 1,380 Z- 50 -3 L/$v 29 Striping Detail # 38 (Thermo & Markers) LF 115 01- SCS '- tel, $c) 30 Striping Detail # 39 (Thermo) LF 1,750 600 , 31 Striping Detail # 39A (Thermo) LF 200 Z 1400 32 "XING" Legend (Thermo) EA 2 bo 3311 STOP" Legend (Thermo) EA 12 cdo LO 34 "SLOW" Legend (Thermo) EA 2 J City of Cupertino Bid Form 2013 Pavement Maintenance Project — Phase 1 00400-3 Project No. 2013-01 ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUMS Bidder herby acknowledges receipt and examination of all Contract Documents and the following Addenda: Addendum No. Addendum Date Bidder proposes and agrees to fully perform the Work within the time stated and in strict accordance with the Contract Documents for the sums of money listed in this Bid Form. NAME OF BIDDER: re C. . licensed in accordance with an act for the registration of Contractors, and with license number: 20l (pgdp Expiration Date: 17-1 3 1113 Wi6nni0. Where incorporated, if applicable bm i N G . 'tau" Ce li" U. bureArl Principals I certify (or declare) under penalty of perjury under the laws of the Sta of California that a foregoing is true and correct. Signature ifBidder NOTE: If Bidder is a corporation, set forth the legal name of the corporation, state where incorporated, together with the signature of the officer or officers authorized to sign contracts on behalf of the corporation. If Bidder is a partnership, set forth the name of the firm together with the signature of the partner or partners authorized to sign contracts on behalf of the partnership. Business Address: 2.613 [j,y J44k_ S1% a0k1y A.. v1 V1i--JL-3�CA g40+A Officers authorized to sign contracts: GinCi 1` yOv VXA Typed Full Name: Telephone Number(s): ( casa :) ct Lo (p — LC( 'Lb Fax Number(s): L650� 9 lP (o — l9 4 (... E -Mail Address: cr Irck'a ti O QV 1 v� Yy) J END OF DOCUMENT City of Cupertino Bid Form 2013 Pavement Maintenance Project — Phase 1 00400-5 Project No. 2013-01 DOCUMENT 00430 REQUIRED SUBCONTRACTORS LIST Bidder must provide the following Listed Subcontractor information in conformance with the California Public Contract Code where the value of the Subcontractor's work is or exceeds '/� of one percent (.05%) of the Bid on Document 00400. Failure to do so will render Bid Non Responsive. Bidder is reminded that Listed Subcontractors cannot be substituted by the Apparent Low Bidder after Bid has been submitted and opened, without City's formal approval. Subcontractor Name Address & Phone No. License No. Trade $ Value $ t—rcxr%Uw s t o (,5(,-2A'40 3"q "o f h _ 4 4 0, 000 qua -7111 �2 & 0_G0�94cal 13100 "CA -A -C. No�-4 o-�b3 4.7_2- 7052`1(0 c_ tq I00C) Lta 51_t Io �-Ah 5 -151& 3 l5 7g (fv c do Sea B 43 000 Attach additional sheets if necessary VOLUNTARY SUBCONTRACTOR LIST Bidder is requested to voluntarily provide Subcontractor information listed below for subcontract work whose value is less than '/2 of one percent of the Bid on Document 00400. Failure to do so will have no impact on Bid. Bidder is requested not to substitute Subcontractors after Bid has been submitted and opened, without City's informal approval. Subcontractor Name I Address & Phone No. License No. Trade $ Value $ Attach additional sheets if necessary END OF DOCUMENT City of Cupertino 00430-1 Subcontractors List 2013 Pavement Maintenance Project —Phase 1 Project No. 2013-01 DOCUMENT 00481 NON -COLLUSION AFFIDAVIT PUBLIC CONTRACT CODE §7106 NON -COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID STATE OF CALIFORNIA ) ) ss. COUNTY OF Saytbp�: ej&rc1 l.r tJ�l G E •'VouyyLI being first duly sworn, deposes ano, says that he or she is y [Office of Affiant] of ()' (ar .CW Vct %AA4 r �ln.c_ , [Name of Bidder], the party making the foregoing Bid, that the Bid is not made in the intere of, or on b alf of, any undisclosed person, partnership, company, association, organization, or corporation; that the Bid is genuine and not collusive or sham; that Bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham Bid, and has not directly or indirectly colluded, conspired, connived or agreed with any bidder or anyone else to put in a sham Bid, or that anyone shall refrain from bidding, and that the Bidder has not in any manner, directly or indirectly, sought by contract, communication or conference with anyone to fix the Bid price of Bidder or any other bidder, or to fix any overhead, profit or cost element of the Bid price, or of that of any other bidder, or to secure any advantage against the City of Cupertino, or anyone interested in the proposed contract; that all statements contained in the Bid are true; and further, that Bidder has not, directly or indirectly, submitted its Bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, Bid depository, or to any member or agent thereof to effectuate a collusive or sham Bid. Executed under penalty of perjury under the laws of the State of California: 0 r Com► ra�cv(,N 7 wtt ►^q . . (Name of B' er) -,(, 47 <Z, �,_— (Signature of P ncipal) G/ C_-�) Subscribed and sworn before me This ) VI' -day of r , 2013 A WKZ COHM Commission # 1989050 Notary Public of the State of L' C.Ju Svc in i o` a : =w Notary Public • CAW111e D In and for the County of Ste•—- Glc. rc�. a Santa Clara County My Commission expires $� . Z 1 ZO 1 b (Seal) My Comm. E ares Se 21, 2016 (If Bidder is a partnership or a joint venture, this affidavit must be signed and sworn to by every member of the partnership or venture.) (If Bidder [including any partner or venturer of a partnership or joint venture] is a corporation, this affidavit must be signed by the Chairman, President, or Vice President and by the Secretary, Assistant Secretary, Chief Financial Officer, or Assistant Treasurer.) (If Bidder's affidavit on this form is made outside the State of California, the official position of the person taking such affidavit shall be certified according to law.) END OF DOCUMENT City of Cupertino 00481-1 Non -Collusion Affidavit 2013 Pavement Maintenance Project - Phase 1 1 ® 282688 DATE(MM/DD/YYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 6/26/2013 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 pollcy(les) 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 IIAME: Construction 8 Real Estate Practice ('HONE 358-1487 fAIC.No.E:tl;- _ A/C,NoC (866) Wells Fargo Insurance Services USA,Inc.-CA Lic#:OD08408 I'MAIL /1DDRESS: g CertR nests wellsfar o.com _ _ 959 Skyway Rd.,2nd FI INSURER(S)AFFORDING COVERAGE NAIC# San Carlos,CA 94070 _ INSURERA: Wausau Underwriters Insurance Company 26042 INSURED _INSURER B: O'Grady Paving,Inc. INSURER C: 2513 Wyandotte Street INSURER O: IN_SURERE: Mountain View,CA 94043 INSURER F: COVERAGES CERTIFICATE NUMBER: 6261614 REVISION NUMBER: See below 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A GENERAL LIABILITY X YVJZ91459513023 7/1/2013 7/1/2014 EACHOCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 51000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- POLICY _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS _(Per accident) UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- TH- LIM EMPLOYERS'LIABILITY Y/N 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 I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) LC04430512 Re: Rosebowl Project in Cupertino. City of Cupertino is named as additional insured as respects general liability per :rldorsement attached. CERTIFICATE HOLDER CANCELLATION City of Cupertino SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10300 Torre Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cupertino,CA 95014-3255 A JTHORIZED REPRESENTATIVE DD 691 The ACORD name and logo are registered marks of AC DRD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) 1111111111111111111111 IN 1111111111111111111111111111111111111111111111111111 -cveose26/OD014,102,,,ro,o,oro' I Policy Number YVJZ91459513023 Issued by Wausau Underwriters Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY ENHANCEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following,- COMMERCIAL GENERAL LIABILITY COVERAGE PART Index of modified items: Item 1. Reasonable Force Item 2. Non-Owned Watercraft Extension Item 3. Damage To Premises Rented To You -Expanded Coverage Item 4. Bodily Injury To Co-Employees Item 5. Health Care Professionals As Insureds Item 6. Knowledge Of Occurrence Item 7. Notice Of Occurrence Item 8_ Unintentional Errors And Omissions Item 9. Bodily Injury Redefinition Item 10. Supplementary Payments-Increased Limits Item 11. Property In Your Care,Custody Or Control Item 12. Mobile Equipment Redefinition Item 13. Newly Formed Or Acquired Entities Item 14. Blanket Additional Insured Where Required By Written Contract Lessors of Leased Equipment Managers or Lessors of Premises Mortgagees, Assignees or Receivers Owners, Lessees or Contractors Architects, Engineers or Surveyors Any Person or Organization Item 15. Blanket Additional Insured-Grantors Of Permits Item 16. Waiver Of Right Of Recovery By Written Contract Or Agreement Item 17. Other Insurance Amendment Item 18. Contractual Liability-Railroads Item 1. Reasonable Force Exclusion a. of Section I -Coverage A- Bodily Injury And Property Damage Liability is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Item 2. Non-Owned Watercraft Extension Paragraph (2) of Exclusion g. of Section l - Coverage A - Booily Injury And Property Damage Liability is replaced by the following: (2) A watercraft you do not own that is: LC 04 43 0512 ®2012 Liberty Mutual Insurance. All rights reserved. Page 1 of 9 Includes copyrighted material of Insurance Services Office, Inc,, with its permission. 001668 IIIIIIIII IN 11111111111 IN 111111 11111111111111111111111111111111111111111111111 creosezer000,a,ro3ri,rorororo i (a) Less than 55 feet long; and (b) Not being used to carry persons or property for a charge; Item 3. Damage To Premises Rented To You -Expanded Coverage A. The final paragraph of 2. Exclusions of Section I -Cove+rage A- Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion or subsequent damages resulting from such fire, Ilghtning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III -Limits Of Insurance. B. Paragraph B. of Section IIi—Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of"property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner. The Damage To Premises Rented To You Limit is the greater of: a. $300,000; or b. The Damage To Premises Rented To You Limit shown on the Declarations. C. Paragraph 9.a. of the definition of"insured contract" in Section V—Definitions is replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnities any person or organization for damage by fire, lightning, explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract". D. The paragraph immediately following Paragraph (6) of exclusion j. of Section i — Coverage A — Bodily Injury And Property Damage Liability is replaced by the followirgi: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning or explosion or subsequent damages resulting from such fire, lightning or explosion including water damage) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies :a Damage To Premises Rented To You as described in Section III—Limits of Insurance. Item 4. Bodlly Injury To Co-Employees A. Paragraph 2. of Section 11 -Who Is An Insured is amended to include: Each of the following is also an insured: Your supervisory or management "employees" (other than either your "executive officers" (if you are an organization other than a partnership,joint venture or limited liability company) or your managers (if you are a limited liability company)) are insureds while in the course of their employment or while performing duties related to the conduct of your business with respect to"bodily injury": (1) To you; (2) To your partners or members(if you are a partnership or joint venture); LC 04 43 08 12 m 2012 Liberty Mutual insurance. All rights reserved. Page 2 of 9 Includes copyrighted material of Insurance Services Office, inc., with its permission, 001699 11111111111 IN 11111111111111111111111111111111111111111111111111111 CYBDfiB28/D00141/04/11 0/D/DD I (3) To your members(if you are a limited liability company); or (4) To a co-"employee" or "volunteer worker" while that co-"employee" or"volunteer worker" is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities:sponsored by you)_ Your "employees" (other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company)) or"volunteer workers" are insureds while in the course of their employment or while performing duties related to the conduct of your business for a Good Samaritan A.-t that results in "bodily injury": (1) To you; (2) To your partners or members(if you are a partnership or joint venture); (3) To your members (if you are a limited liability company); or (4) To a co-"employee" or "volunteer worker" while that co-"employee" or "volunteer worker' is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities sponsored by you). A Good Samaritan Act means an attempt to rescue or eiid a person in imminent or serious peril, provided the attempt is not recklessly made. However, none of these "employees" (including super✓isory or management "employees") or "volunteer workers" are insureds for the providing or failure to provide professional health care services. B. The insurance provided by this Item 4. will not apply If the injured person's sole remedy for such injury is provided under a workers'compensation law or any similar law. C. Other Insurance The insurance provided by this Item 4. is excess over any other valid and collectible insurance available to the insured,whether primary, excess, contingent or on any other basis. Item 5. Health Care Professionals As Insureds A. Paragraphs 2.a.(1)(a) and (d) of Section 11 -Who Is An Insured do not apply to "bodily injury"or"personal and advertising Injury" arising out of the providing of or failure to provide professional health care services by any "employee"or"volunteer" of the Named Insured who is a "designated health care provider" If the"bodily injury" or"personal and advertising injury" occurs in the course and scope of the"designated health care provider's" employment by the Named Insured. B. With respect to"employees" and "volunteer workers" providing professional health care services, the following exclusions are added to Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: This insurance does not apply to: (1) Liability assumed under an"insured contract"or any other contractor agreement; (2) Liability arising out of the providing of professional health care services in violation of law; (3) Liability arising out of the providing of any professional health care services while in any degree under the influence of intoxicants or narcotics; (4) Liability arising out of any dishonest, fraudulent, malicious or knowingly wrongful act or failure to act; or LC 04 43 05 12 ®2012 Liberty Mutual insurance. All rights reserved. Page 3 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. o01690 IIIIIII III IIIIIII IIII 11111111111 IIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII 'C1BOBB28000141/OS/11/B/0/0/0' i (5) Punitive or exemplary damages, fines or penalties. C. The following definition is added to Section V-Definitions: "Designated health care provider" means any"employee" or"volunteer worker" of the Named Insured whose duties include providing professional health care sorvices, including but not limited to doctors, nurses, emergency medical technicians or designated first aid personnel. D. Other insurance The insurance provided by this Item 5. is excess aver any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis. Item S. Knowledge Of Occurrence Knowledge of an 'occurrence" by your agent, servant or"amployee" will not in itself constitute knowledge by you unless your "executive officer" or "employee" or other third party designated by you to notify us of"occurrences" has knowledge of the'occurrence". Item 7. Notice Of Occurrence For purposes of Paragraph 2.a. of Section IV - Conditions, you refers to an "executive officer" of the Named Insured or to the"employee"designated by the insured to give us notice. Item 8. Unintentional Errors And Omissions Unintentional failure of the Named Insured to disclose all hazards existing at the inception of this policy shall not be a basis for denial of any coverage afforded by this policy However, you must report such an error or omission to us as soon as practicable after Its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non- renewal. Item 9. Bodily Injury Redefinition The definition of"bodily injury"in Section V- Definitions is replaced by the following: "Bodily injury"means: a. Bodily injury, sickness or disease sustained by a person, Including death resulting from any of these at any time; and b. Mental anguish, shock or humiliation arising out of injury as defined in Paragraph a. above. Mental anguish means any type of mental or emotional illness or distress. Item 10. Supplementary Payments -Increased Limits Paragraphs 1.b. and 1.d. of Section I - Supplementary Payments - Coverages A And B, are replaced by the following: b. Up to$3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit' including substantiated loss of earning;; up to$500 a day because of time off from work. LC 04 43 05 12 02012 Liberty Mutual Insurance. All rights reserved. Page 4 of 9 Includes copyrighted material of Ins;urance Services Office, Inc., with its permission. 001691 III 1111111 IN 11111 111111 IN 11111111111111111111111111111111111111111111111111111 CYBO6B26/0001 4 1 106,11/0/B/0/0 1 Item 11. Property In Your Care,Custody Or Control A. Paragraphs (3) and (4) of exclusion j. of Section I —Coverage A—Bodily Injury and Property Damage Liability only apply to; 1. "Property damage"to borrowed equipment, or 2. "Property damage"to property in your care, custody and control while in transit_ B. This insurance does not apply to any portion of a loss for which the Insured has available any other valid and collectible insurance, whether primary, excess, contingent, or on any other basis, unless such other insurance was specifically purchased by the insured to apply in excess of this policy. C. Limits of Insurance Subject to Paragraphs 2., 3., and 5. of Section ill -'- Limits Of Insurance, the most we will pay for insurance provided by Paragraph A., above is: $10,000 Each Occurrence Limit $25,000 Aggregate Limit The Each Occurrence Limit for this coverage applies to all damages as a result of any one 'occurrence" regardless of the number of persons or organizations who sustain damage because of that"occurrence". The Aggregate Limit is the most we will pay for the sum of all damages under this Item 11. Item 12. Mobile Equipment Redefinition The definition of"Mobile Equipment' in Section V—Definitiona is amended to include self-propelled vehicles with permanently attached equipment less than 1000 pounds gross vehicle weight that are primarily designed for: (1) Snow removal; (2) Road Maintenance, but not construction or resurfacing; or (3) Street cleaning. Item 13. Newly Formed Or Acquired Entities Paragraph 3. of Section II —Who Is An Insured is replaced by the following: 3. Any organization, other than a partnership or joint venture, you newly acquire or form and over which you maintain majority ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. a. Coverage under this provision is afforded only until: (1) The 180th day after you acquire or form the organization; (2) Separate coverage is purchased for the organization; or (3) The end of the policy period, whichever is earlier. b. Coverage A does not apply to "bodily injury" or "property damage"that occurred before you acquired or formed the organization; and LC 04 43 05 12 ®2012 Liberty Mutual Insuran,cle. All rights reserved. Page 5 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 001692 11111111111 IN 11111111111111111111111111111111111 111111111111111111 CYBB6B26/0001 4 1/0 711 110/010!0' c. Coverage B does not apply to"personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. Item 14. Blanket Additional Insured Where Required SIP Written Contract Paragraph 2. of Section II -Who Is An Insured is amended to add the following: e. Additional Insured by Written Contract or Written Agreement The following are insureds under the policy when you have agreed in a written contract or written agreement to provide them coverage as additional insureds under your policy: (1) Lessors of Leased Equipment: The person(s) or organization(s)from whom you lease equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, In whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s)- (2) Managers or Lessors of Premises: Any manager or lessor of premises leased to you in which the written lease agreement obligates you to procure additional insured coverage. The coverage afforded to the additional insured is, limited to liability in connection with the ownership, maintenance or use of the premises leased to you and caused, in whole or in part, by some negligent acts or omissions of you, your"employees", your agents or your subcontractors. There is no coverage for the additional insured for liability arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured, except as provided below. If the written agreement obligates you to procure additional insured coverage for the additional insured's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if the applicable law would allow you to indemnify the additional insured for liability arising out the additional Insured's sole negligence. This insurance does not apply to: (a) Any "occurrence" which takes place after you cease to be a tenant in that premises or to lease that land; or (b) Any premises for which coverage is excluded by endorsement. (3) Mortgagees, Assignees or Receivers: Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of your premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. (4) Owners, Lessees or Contractors: any person(s) or organization(s) to whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injury", "property damage" or"personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of your "employees", your agents, or your subcontractors, in the performance of your ongoing operations. This insurance does not apply to"bodily injury", "property damage",or"personal and advertising injury" arising out of"your work" included in the"products-completed operations hazard"unless you are required to provide such coverage for the additional insured by the written agreement, and then only for the period of time required by the written agreement and only for liability caused, in whole or in part, by your acts or omissions or the acts or omissions of your"employeeS", your agents,oryour subcontractors. There is no coverage for the additional insured for liability arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured,except as provided below. LC 04 43 06 92 @ 2012 Liberty Mutual Insurance. All rights reserved. Page 6 of 9 Includes copyrighted material of Insurance Services Office, Inc_, with its perm i,sion. 00169] IIIIIIIII Jill 11111111111 Jill 11111 .CV 908926/000141106111 010/010' I If the written agreement obligates you to procure additional insured coverage for the additional insured's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if the applicable law would allow you to indemnify the additional insured for liability arising out the additional insured's sole negligence. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or Milling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. (5) Architects, Engineers or Surveyors: any architect:, engineer, or surveyor engaged by you but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; or (b) In the performance of your ongoing operations. This Insurance does not apply to"bodily injury", "property damage"or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings,and specifications; or (b) Supervisory, inspection, architectural or engineering activities. (6) Any Person or Organization Other Than a Joint Vonture: Any person or organization (other than a joint venture of which you are a member) for whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injury'', "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; or (b) In connection with premises owned by you. This insurance does not apply to: 1. Any construction, renovation, demolition or installation operations performed by or on behalf of you, or those operating on your behalf; 2. Any person or organization whose profession, business or occupation Is that of an architect, surveyor or engineer with respect to liability arising out of the preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs, specification or the performance of any other professional services by such person or organization; or 3_ Any person or organization more specifically covered in Paragraphs e.(1)through (5)above. The insurance afforded to any person or organization as an insured under this Paragraph 2.e.: (1) Applies only to coverage and minimum limits of insurance required by the written agreement or written contract, but in no event exceeds either the scope of --overage or the limits of insurance provided by this policy; LC 04 43 05 12 ®2012 Liberty Mutual insurance. All rights reserved. Page 7 of S Includes copyrighted material of Insurance Services Office, Inc., with its permission. 001694 1111111111 IN 11111 111111 IN 11111 11111 11111 11111 11111 11111 11111 11111 11111 IN 1111 .".06B26,D0014110911 I MOM' i (2) Does not apply to any person or organization for any "bodily injury", "property damage" or "personal and advertising injury" if any other additional insured endorsement attached to this policy applies to that person or organization with regard to the"bodily injury", "property damage"or"personal and advertising injury"; (3) Applies only if the "bodily injury" or "property damage" occurs, or offense giving rise to "personal and advertising injury" is committed, subsequent to the execution of the written agreement; and (4) Applies only if the written agreement is in effect at the time the"bodily injury"or"property damage"occurs, or at the time the offense giving rise to the"personal and advertising injury"is committed. Item 15. Blanket Additional Insured-Grantors Of Permits Paragraph 2. of Section II -Who Is An Insured Is amended to add the following: Any state, municipality or political subdivision with respect to any operations performed by you or on your behalf, or in connection with premises you own, rent or control and to which this insurance applies, for which the state, municipality or political subdivision has issued a permit. However, this insurance does not apply to: 1. "Bodily injury", "property damage" or"personal and advertising injury"arising out of operations performed for the state, municipality or political subdivision; 2. Any "bodily Injury" or "property damage" included within the "products-completed operations hazard", except when required by written contract or agreement initiated F►rior to loss; or 3. "Bodily injury", "property damage" or"personal and advertising injury",unless negligently caused, in whole or in part, by you or those acting on your behalf. Item 16. Waiver Of Right Of Recovery By Written Contract Or Agreement The following is added to Paragraph 8. Transfer Of Righter Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery because of payments we make under this policy for injury or damage arising out of your ongoing operations or"your work" included in the "products-completed operations hazard" that we may have against any person or organization with whom you have agreed in a written contract or agreement to waive your rights of recovery but only if the "bodily injury"or"property darnage" occurs,or offense giving rise to"personal and advertising injury" Is committed subsequent to the execution of the written contract or agreement. Item 17. Other insurance Amendment If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization that qualifies as an additional insured on this policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. Other insurance of Section IV- Conditions will not apply. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Othe Insurance of Section IV - Conditions will govern. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same"occurrence", claim or"suit". Item 18. Contractual Liability-Rallroads Paragraph 9. of Section V- Definitions is replaced by the following: 9. "Insured Contract" means: LC 04 43 03 12 0 2012 liberty Mutual Insurance. All rights reserved. Page 8 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 001695 III 1111111 IN 11111111111111111111111111111111111111111111111111111111111111111111 'Cl eos.2.10oo,a,,,0,,MUM' I a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business(including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by lave in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of_ (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications;or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failing to render professional services, including those listed in Paragraph (1)above and supervisory, inspection,architectural or engineering activities. LC 04 43 05 12 ®2012 Liberty Mutual Insurance. All rights reserved. Page 9 of 9 Includes copyrighted material of Inscirance Services Office, Inc., with its permin sion. 001696 111111111111111111 IN 111111111111111 IN 11111111111111111111111111111111111111111111111111111 'Cl....26/000141/11/11/U/U/U/U