03-033A Republic Electric for De Anza Blvd. Adaptive Traffic signal Control System, Project No. 420-9535 }
�1 CONTRACT FOR PUBLIC WORKS '
This CONTRACT made on ., by the CITY OF CUPERTINO, a municipal
corporation of the State of California, hereinafter called CITY, and Republic Electric hereinafter called
CONTRACTOR.
IT IS HEREBY AGREED by CITY and CONTRACTOR as follows:
1. THE CONTRACT DOCUMENTS. The complete contract consists of the following contract
documents:
a. Notice to Contractors, Proposal, Time of Completion, Estimated Quantities, Noncollusion Affidavit,
Bidder Qualification Form, Subcontractors Form and Signature Form.
b. Standard Specifications, General Provisions and Special Provisions.
c. Plans and Specifications
d. Faithful Performance and Labor&Material Bonds
e. Insurance Agreement, Certificate of Insurance, Endorsement of Primary Insurance, Additional
Insured Endorsement, Endorsement of Aggregate Limits of Insurance per Project, Waiver of
Subrogation Endorsement Worker's Compensation Insurance and Notice of Policy Cancellation
Endorsement.
f. This Contract for Public Works.
All of the above documents are intended to cooperate so that any work called for in one and not
mentioned in the other, or vice versa, is to be executed the same as if mentioned in all of said documents.
The documents comprising the complete contract: are sometimes hereinafter referred to as the Contract
Documents. In case of conflict between the Plans and the Specifications on the one hand, and this
Contract on the other,the Plans and Specifications shall prevail.
2. THE WORK. CONTRACTOR agrees to furnish all of the tools, equipment, apparatus,
facilities, labor, transportation and materials necessary to perform and complete in a good and working
order, the work of furnishing and installing detector loops, detector lead in cable, detector
handholes, disconnecting existing detector loops, and furnishing detector sensor units,fiber
optic data transceivers, fiber optic data receivers,.and. a fiber optic data receiver chassis as
called for, and in the manner designated in, and in strict conformity with, the Plans and Specifications
prepared by the Engineer and adopted by CITY, which Plans and Specifications are entitled,
respectively,DeAnza Boulevard Adaptive Trafjfic.Signal Control System, Project No. 420-9535,
and which Plans and Specifications are identified by the signatures of the parties to this Contract. It is
understood and agreed that said tools, equipment, apparatus, facilities, labor, transportation and materials
shall be furnished, and that said work shall be performed and completed as required in said Plans and
Specifications under the sole direction of CONTRACTOR, but subject to the inspection and approval of
CITY, or its representative. CITY hereby designates as its representative for the purpose of this Contract
the City Engineer,Ralph A. Qualls, Jr.
3. CONTRACT PRICE. CITY agrees to pay, and CONTRACTOR agrees to accept, in full payment
for the work above agreed to be done, the sum of $176,550 (one hundred seventy-six thousand five
hundred fifty dollars) subject to additions and/or deductions as provided in the Contract Documents, per
Exhibit A attached hereto.
4. DISPUTES PERTAINING TO PAYMENT FOR WORK. Should any dispute arise respecting
the true value of the work done, or any work omitted, or any extra work which CONTRACTOR may be
�- required to do, or respecting the size of any payment to.CONTRACTO during the performance of this
Contract, said dispute shall be determined either by reference to the Unit Prices bid, if applicable, or in
accordance with agreement of prices, if applicable, or in accordance with the agreement of the parties, or
in accordance with Section 6,paragraph"f"of of the General Provisions.
5. PERMITS, COMPLIANCE WITH LAW. CONTRACTOR shall obtain and bear all expense for
all necessary permits, licenses and easements for- the construction of the project, give all necessary
notices,pay all fees required by law, and comply with the laws, ordinances and regulations relating to the
work and to the preservation of the public health and safety.
6. INSPECTION BY THE CITY. CONTRACTOR shall at all times maintain proper facilities and
provide safe access for inspection by CITY to all parts of the work, and to the shops wherein the work is
in preparation. Where the Specifications require work to be specially tested or approved, it shall not be
tested or covered up without timely notice to CITY of its readiness for inspection and without the
approval thereof or consent thereto by CITY. Should any such work be covered up without such notice,
approval, or consent, it must, if required by CITY, be uncovered for examination at CONTRACTOR'S
expense.
7. EXTRA OR ADDITIONAL WORK AND CHANGES. Should CITY at any time during the
progress of the work require any alterations, deviations, additions or omissions from the Plans and
Specifications or the Contract Documents, CITY shall have the right to do so, and the same shall in no
way affect or make void the Contract, but the cost or value thereof will be added to, or deducted from,
the amount of the Contract price, as the case may be, by a fair and reasonable valuation, which shall be
determined either by reference to the Unit Prices bid, if applicable, the Standard Specifications, or in
accordance with the agreement of the parties. No extra work shall be performed or change be made
except by a written order from CITY, duly authorized by resolution of the City Council, and by all
agencies whose approval is required by law, stating that the extra work or change is authorized, and no
claim for an addition to the Contract sum shall be valid unless so ordered.
8. CHANGES TO MEET ENVIRONMENTAL ]REQUIREMENTS. CITY shall have the right to
make changes in this Contract during the course of construction to bring the completed improvements
into compliance with environmental requirements o;r standards established by State and Federal statutes
and regulations after the Contract has been awarded or entered into.
CONTRACTOR shall be paid for such changes either by reference to the Unit Prices bid, if applicable,
or in accordance with the agreement of the parties.
9. TERMINATION, AMENDMENT OR MODIFICATION. This Contract may be terminated,
amended or modified, with the mutual consent of the parties. The compensation payable, if any, for such
termination, amendment or modification, shall be determined either by reference to the Unit Price bid, if
applicable,the Standard Specifications, or in accordance with the agreement of the parties.
10. TIME FOR COMPLETION. All work under this Contract shall be completed in accordance with
the Time for Completion section in the Proposal and the Specifications of this project. If
CONTRACTOR shall be delayed in the work by the acts or neglect of CITY, or its employees, or those
under it by contract or otherwise, or by changes ordered in the work, or by strikes, lockouts by others,
fire, unusual delay in transportation, unavoidable casualties or any causes beyond CONTRACTOR'S
control, or by delay authorized by CITY, or by any cause which CITY shall determine justifies the
delay, then the time of completion shall be extended! accordingly. This paragraph does not exclude the
recovery of damages for delay by either party under other provisions in the Contract Documents.
11. INSPECTION AND TESTING OF MATERIALS. CONTRACTOR shall notify CITY a
sufficient time in advance of the manufacture, production or testing of materials to be supplied under this
Contract, in order that CITY may arrange for mill, factory or laboratory inspection and testing of same.
12. TERMINATION FOR BREACH OR INSOLVENCY. If CONTRACTOR should be adjudged a
bankrupt, or should make a general assignment for the benefit of creditors, or if a receiver should be
appointed on account of insolvency, or if CONTRACTOR or any subconfra
provisions of the Contract, CITY may serve written notice upon CONTRACTOR and CONTRACTOR'S
surety of its intention to terminate the Contract. Such notice shall contain the reasons for CITY'S
intention to terminate the Contract, and unless within ten (10) days after serving of such notice, such
violation shall cease and satisfactory arrangements for corrections thereof be made, the Contract shall,
upon the expiration of said ten (10) days, cease and terminate. In the event of any such termination,
CITY shall immediately serve notice thereof upon CONTRACTOR'S surety and CONTRACTOR, and
the surety shall have the right to take over and perform the Contract; provided, however, that, if the
surety within fifteen (15) days after the serving upon it of notice of termination does not give CITY
written notice of its intention to take over and perform the Contract, or does not commence performance
thereof within thirty (30) days from the date of the serving of such notice, CITY may take over the work
and prosecute the same to completion by contract, or by any other method it may deem advisable, for the
account and at the expense of CONTRACTOR, and CONTRACTOR AND CONTRACTOR'S surety
shall be liable to CITY for any excess cost occasioned by CITY thereby, and in such event CITY may,
without liability for so doing, take possession of, and utilize in completing the work, such materials,
appliances, plant and other property belonging to CONTRACTOR as may be on the site of the work and
necessary therefor.
13. THE CITY'S RIGHT TO WITHHOLD CERTAIN AMOUNTS AND MAKE APPLICATION
THEREOF. In addition to amounts which CITY may retain under other provisions of the Specifications
until final completion and acceptance of all work covered by the Contract, CITY may withhold from
payment to CONTRACTOR such an amount or amounts as in its judgment may be necessary to pay just
claims against CONTRACTOR or subcontractors for labor and services rendered and materials furnished
in and about the work.
City may apply such withheld amount or amounts to the payment of such claims in its discretion. In
doing so, CITY shall be deemed the agent of CONTRACTOR, and any payment so made by CITY shall
be considered as a payment made under the Contract by CITY to CONTRACTOR, and CITY shall not
be liable to CONTRACTOR for any payment made in good faith. Such payment may be made without
prior judicial determination of the claim or claims. With respect to any retention of payment by CITY to
ensure performance of the Contract, CONTRACTOR will be entitled to substitute securities as provided
in Section 4590 of the California Government Code as more fully described in CITY'S Notice to
Contractors.
14. NOTICE AND SERVICE THEREOF. Any notice from one party to the other under this Contract
shall be in writing, and shall be dated and signed either by the party giving such notice, or by a duly
authorized representative of such party. Any such notice shall not be effective for any purpose
whatsoever unless served in the following manner: (a) if the notice is given to CITY, either by personal
delivery thereof to the Engineer of CITY, or by depositing same in the United States mails, enclosed in a
sealed envelope, addressed to CITY OF CUPERTINO; 10300 TORRE AVENUE; CUPERTINO, CA
95014; postage prepaid and certified; (b) if the notice is given to CONTRACTOR, either by personal
delivery thereof to CONTRACTOR, or to CONTRACTOR'S:duly authorized representative at the site of
the project, or by depositing same in the United States mails enclosed in a sealed envelope, addressed to ,
Republic Electric, 7120 Redwood Boulevard, Novato, CA 94945-4114 postage prepaid and certified;
and (c) if notice is given to CONTRACTOR'S surety or any other person, either by personal delivery
thereof to CONTRACTOR'S surety or other person, or by depositing same in the United States mails,
enclosed in a sealed envelope, addressed to CONTRACTOR'S surety or person, as the case may-be, at
the address of CONTRACTOR'S surety or the address of the person last communicated by such person
to the party giving the notice,postage prepaid and certified.
15. ASSIGNMENT OF CONTRACT. Neither the Contract, nor any part thereof, nor moneys
due or to become due thereunder, shall be assigned. by CONTRACTOR without the prior written
approval of CITY.
16. COMPLIANCE WITH SPECIFICATIONS OF MATERIALS. Whenever in the Specifications,
any material or process is indicated or specified by patent or proprietary name, or by name of
manufacturer, such Specifications must be met by CONTRACTOR, unless CITY agrees in writing to
some other material, process or article offered by CONTRACTOR whi A)is e ual in all 11 respects to the
one specified. It shall be CONTRACTOR'S responsibility to prove equality of any such material,
process or article offered as a substitution to the one(s) specified.
17. WORKER'S COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY
INSURANCE. CONTRACTOR shall take out and maintain during the life of this Contract Worker's
Compensation Insurance and Employer's Liability Insurance for all of CONTRACTOR'S employees
employed at the site of the project. In case any work:is sublet, CONTRACTOR shall require any and all
subcontractors similarly to provide Worker's Compensation and Employer's Liability Insurance for all
of the latter's employees unless such employees are covered by the protection afforded to the
CONTRACTOR.
In signing this Contract CONTRACTOR makes the following certification, required by Section 1861 of
the Labor Code: "I am aware of the provisions of Section 3700 of the Labor Code which requires every
employer to be insured against liability for worker's compensation or to undertake self insurance in
accordance with the provisions of the Labor Code, and I will comply with such provisions before
commencing the performance of the work of this Contract."
18. ACCIDENT PREVENTION. Precaution shall be exercised at all times for the protection of
persons (including employees) and property. The safety provisions of applicable laws, building codes
and construction codes shall be observed. Machinery, equipment and other hazards shall be guarded or
eliminated in accordance with the safety provisions of the Construction and Safety Orders issued by the
Industrial Accident Commission of the State of California.
19. CONTRACTOR'S RESPONSIBILITY FOR THE WORK. CONTRACTOR shall not be
responsible for the cost of repairing or restoring damage to the work caused by Acts of God.
NEVERTHELESS, CONTRACTOR shall, if the insurance premium is a separate bid item, obtain the
insurance to indemnify CITY for any damage to the work caused by Acts of God. "Acts of God" shall
include only the following occurrences or conditions and effects: earthquakes and tidal waves, when
such occurrences or conditions and effects have been proclaimed a disaster or state of emergency by the
President of the United States or by the Governor of the State of California, or were of a magnitude at the
site of the work sufficient to have caused a proclamation of disaster or state of emergency having
occurred in a populated area. Subject to the foregoing, CITY shall not, in any way or manner, be
,answerable or suffer loss, damage, expense or liability for any loss or damage that may happen to said
building, work, or equipment or any part thereof, or in, on, or about the same during its construction and
before acceptance.
20. CONTRACTOR'S GUARANTEE. CONTRACTOR unqualifiedly guarantees the first-class
quality of all work and of all materials, apparatus and equipment used or installed by CONTRACTOR or
by any subcontractor or supplier in the project which is the subject of this.Contract, unless a lesser
quality is expressly authorized in the Plans and Specifications, in which event CONTRACTOR
unqualifiedly guarantees such lesser quality; and that the work as performed by CONTRACTOR will
conform with the Plans and Specifications or any written authorized deviations therefrom. In case of any
defect in the work, materials, apparatus or equipment;, whether latent or patent, revealed to CITY within
one (1) year of the date of acceptance of completion of this Contract by CITY, CONTRACTOR will
forthwith remedy such defects without cost to CITY.
_ P.O. No.
U
21. DEFERRED ALTERNATE SELECTION. The City reserves the right for the term of the ,
Contract, the deferred selection of none, any or all alternate bid items at the bid price. The alternates 1-
chosen would be for any sites currently under construction or to be constructed in the future.
IN WITNESS WHEREOF, the parties have executed this Contract, in duplicate, the day and year
first hereinabove written.
CITY CUPERTINO: CONTRACTOR:
By: J�I.t-�(.6L G
MAYOR
B
Attest: Notary acknowledgment i0-equired. If a
City C rk core oration, corporate seal and corporate
notary acknowledgment and Federal Tax
I.D. are required. If not a corporation, a
Date: nS�C.fJ f J , 2003 Social Security No. is required.
t5o(-;�— oz-'t&grL-+
Social Security# Federal Tax I.D. #
APPROVED A TO FO
Contractor's License No. S�-
City Attorney
PROJECT NAME& NUMBER: DeAnza Boulevard[ Adaptive Traffic Signal Control System,
Project No. 420-9: 35
CONTRACTOR'S NAME& ADDRESS:Republic Electric, 7120 Redwood Boulevard,Novato, CA
94945-4114
CONTRACT AMOUNT: $1 76,550
ACCOUNT NUMBER: 420-9535
FILE NO: 74,001.29
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of
_M& ) o ss.
On _Q before meJ.r�1, 9)_,,T X`tat"�k
Date .� Name and Title of Officer e.
( g.."Jane Doe,Notary Public")
personally appeared vo��(`� �._�
Names)of Signer(s/yy '
-p rsona known tome
❑ proved to me on the basis of satisfactory
evidence
to be the person whose name(#) is/4e
LAURA J.KIRWAN-BENSOIN� subscribed to the within instrument and
Commission#1331537 acknowledged to me that he/s e,/Yey executed
Notary Public-California > the same in his/fR�r/t r authorized
Marin County capacity( ), and that by his/yr/tlkr
MY Comm.Expires Nov 22,2005 signature on the instrument the person(' or
the entity upon behalf of which the persbno)
acted, executed the instrument.
WI ESS my hand nd official sea
Signa r of Notary Public
OP7/ONAL
Though the information below is not required bylaw,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(ies) Claimed by Signer
Signer's Name:
❑ Individual Top of thumb here
❑ Corporate Officer—Title(s):
❑ Partner—❑ Limited ❑General
❑ Attorney-in-Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
O 1999 National Notary Association•9350 De Soto Ave..P.O.Box 2402•Chatsworth,CA 91313-2402•www.nationalnotary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827
INSURANCE FORMS INSTRUCTIONS
FOR ITEMS 3, 4 AND 5, THE FORMS PA:OVIDED BY THE CITY OF CUPERTINO
MUST BE USED. FORMS OTHER THAN THESE WILL NOT BE ACCEPTED.
ALL DOCUMENTS MUST BE ORIGINALS -• SUBMIT IN TRIPLICATE
1. Insurance Agreement - Must be signed by Contractor.
2. Certificate of Insurance to the City of Cupertino - must be completed by the insurance
agent or must provide a certificate on the company's form. They must contain the same
information.
3. Endorsement of Additional Insured and Primary Insurance and Notice of Cancellation - must
be signed by the insurance agent for general liability and automobile liability only.
4. Comprehensive general liability/commercial ;general liability endorsement of aggregate limits
of insurance per project - must be signed by the insurance agent for general liability only.
5. Waiver of subrogation endorsement worker's compensation insurance - must be signed by the
insurance agent for worker's compensation only.
It
CITY OF
CUPERTINO INSURANCE AGREEMENT
A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires
every employer to be insured against liability for worker's compensation or undertake self-insurance
in accordance with the provisions of that Code, and will comply with such provisions before
commencing the performance of the work of this Contract.
B. Contractor and all subcontractors will carry worker's compensation insurance for the
protection of its employees during the progress of the work. The insurer shall waive its rights of
subrogation against the City, the City's officers, agents and employees and shall issue an
endorsement to the policy evidencing same.
C. Contractor shall carry at all times, on all operations hereunder, commercial general liability
insurance, automobile liability insurance and builder's all risk insurance. All insurance coverage
shall be in amounts required by the City and shall be evidenced by the issuance of a certificate in a
form prescribed by the City and shall be under",ritten by insurance companies satisfactory to the
City for all operations, sub-contract work, contractual obligations, product or completed operations,
all.owned vehicles and non-owned vehicles. Said insurance coverage obtained by the Contractor,
excepting worker's compensation coverage, shall name the City, its engineer, and each of its
directors, officers, agents and employees, as determined by the City, as additional insureds on said
policies. Insurers must be licensed to do business in the State of California. The Insurers must also
have an "A" policyholder's rating and a financial rating of at least Class VII in accordance with the
current Best's Guide Rating.
D. Before Contractor performs any work at, or prepares or delivers materials to, the site of
construction, Contractor shall furnish certificates of insurance evidencing the foregoing insurance
coverages and such certificates shall provide the name and policy number of each carrier and policy
-and that the insurance is in force and will not be canceled or modified without thirty (30) days
written notice to the City. Contractor shall maintain all of the foregoing insurance coverages in
force until the work under this Contract is fully completed. The requirement for carrying the
foregoing insurance shall not derogate from the provisions for indemnification of the City by
Contractor under this Contract and for the duration of the warranty period. Notwithstanding nor
diminishing the obligations of Contractor with respect to the foregoing, Contractor shall maintain in
full force and effect during the life of this Contract, the following insurance in amounts not less than
the amounts specified and issued by a company admitted in California and having a Best's Guide
Rating of A, Class VII or better.
LIMITS
Worker's Compensation In accordance with the Worker's Compensation
& Employers' Liability Act of the State of California—Worker's comp—
"statutory"per CA Law; Employers' Liability—
$1,000,000 per occurrence.
Insurance Agreement Page I of 2
1
General Liability - commercial general liability; Combined single limit of$1.0 million per
including provisions for contractual liability, occurrence; $2.0 million in the aggregate.
personal injury, independent contractors and
products completed operations hazard.
Automobile Liability - comprehensive covering Combined single limit of$1.0 million per
owned, non-owned and hired automobiles. occurrence.
Consultants only: Errors and Omissions liability. $1.0 million per occurrence.
(Contractor's Name)
Datec : 12 20 CD3
Insurance Agreement Page 2 of 2
k
V
CITY Of
CUPERTINO CERTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO
This certifies to the City of Cupertino that the following described policies have been issued to the
insured named below and are in-force at this time.
Insured:
Address:
Description of operations/locations/products insured (show contract name and/or number, if any):
WORKER'S COMPENSATION * Statutory Min.
* Employer's
Liability
(name of insurer)
Insurance Company's State License No.
Check Policy Type: Each Occurrence $
COMPREHENSIVE GENERAL
LIABILITY
[ ] Premises/Operations General Aggregate $
(if applicable)
[ ] Owners & Contractors
Protective Aggregate $
[ ] Contractual for Specific
Contract Personal Injury
[ ] Products Liability
[ ] XCU Hazards
[ ] Broad Form P.D. Fire Damage(any one fire) $
[ ] Severability of Interest
Clause
[ ] Personal Injury with Medical Expense $
Employee Exclusion Removed (any one person)
or Self-Insured
COMMERCIAL GENERAL LIABILITY Retention $
(name of insurer)
Policy No. Expiration Date
Certificate of Insurance Agreement Page I of 2
AUTOMOTIVENEHICLE LIABILITY BODILY INJURY PROPERTY DAMAGE
Commercial Form Each Person Each Accident
Liability Coverage
Each Accident
(name of insurer)
$ or
Combined Single Limit $
Policy No. Expiration Date
A copy of all Endorsements to the policy(ies) which in any way
(agent's initial) limit the above-listed types of coverage are attached to this
Certificate of Insurance.
This Certificate of Insurance is not an insurance policy and does not amend, extend or alter the
coverage afforded by the policies listed herein.. Notwithstanding any requirement, term, or
condition of any contract or any other document with respect to which this Certificate of Insurance
may be issued or may pertain, the insurance afforded by the policies described herein is subject to
all the terms, exclusions and conditions of such policies.
IT IS HEREBY CERTIFIED that the above policy(ies)provide liability insurance as required by the
Agreement between the City and the insured.
By: Dated: 20
Attach Certificate of Insurance and Additional Insured Endorsement on company forms.
Certificate of Insurance Agreement Page 2 of 2
CITY OF
CUPEkTINO
ADDITIONAL INSIURED ENDORSEMENT
and
ENDORSEMENT OF PRIMARY INSURANCE
and
NOTICE OF POLICY
CANCELLATION ENDORSEMENT
Project Title and Number:
In consideration of the policy premium and notwithstanding any inconsistent statement in the policy
to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as
follows:
The City of Cupertino ("City") and its directors, officers, engineers, agents and employees,
and all public agencies from whom permits will be obtained and their directors, officers, engineers,
agents and employees are hereby declared to be additional insureds under the terms of this policy,
but only with respect to the operations of the Contractor at or upon any of the premises of the City
in connection with the Contract with the City, or acts or omissions of the additional insureds in
connection with, but limited to its general supervision or inspection of said operations.
The insurance afforded by this policy is primary insurance, and no additional insurance held
or owned by the designated additional insured(s) shall be called upon to cover a loss under said
additional policy.
Cancellation Notice. The insurance afforded by this policy shall not be suspended, voided,
canceled, reduced in coverage or in limits, or materially altered, except after thirty (30) days' prior
written notice by certified mail, return receipt requested, has been given to the City of Cupertino
("City"). Such notice shall be addressed to the City as indicated below.
POLICY INFORMATION
1. Insurance Company:
2. Insurance Policy Number:
3. Effective Date of this Endorsement: 20
4. Insured:
Additional Insured and Primary Insurance and Notice of Cancellation Endorsement Page 1 of 2
All notices herein provided to be given by the Insurance Company to the City in connection
with this policy and these Endorsements, shall be mailed to or delivered to the City at 10300 Torre
Avenue; Cupertino, California 95014.
I, (print/type name)
warrant that I have authority to bind the below listed Insurance Company and by my signature
hereon do so bind this Company.
Signature of Authorized Representative:
(Original signature required on all Endorsements furnished to the District)
Names of
Agent/Agency: Title:
Address: _ Telephone:
Facsimile:
Additional Insured and Primary Insurance and Notice of Cancellation.Endorsement Page 2 of 2
CITY Of
CUPEt,T1NO
COMPREHENSIVE GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
ENDORSEMENT OF AGGREGATE LIMITS OF
INSURANCE PER PROJECT
Project Title and Number:
In consideration of the policy premium and notwithstanding any inconsistent statement in the
policy to which this Endorsement is attached or any other Endorsement attached thereto, it is as
follows:
This Endorsement modifies the insurance provided under the General Liability Coverage part of
the below-referenced policy of insurance.
The general aggregate limit under LIMITS OF INSURANCE applies separately to the project
described as
POLICY INFORMATION
1. Insurance Company:
2. Insurance Policy Number:
3. Effective Date of this Endorsement: 20
4. Insured:
5. Additional Insured: City of Cupertino, its directors, officers, agents and employees.
All notices herein provided to be given by the Insurance Company to the City in connection
with this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre
Avenue; Cupertino, California 95014.
I, (print/type name)
warrant that I have authority to bind the below listed Insurance Company and by my signature
hereon do so bind this Company.
Signature of Authorized Representative:
(Original signature required on all Endorsements furnished to the District)
Names of
Agent/Agency: _ Title:
Address: Telephone:
Facsimile:
Aggregate Limits 13ndorsement Page 1 of 1
CITY OF
CUPERTINO
WAIVER OF SU$ROGATION ENDORSEMENT
WORKER'S COMPENSATION INSURANCE
Project Title and Number: _
In consideration of the policy premium and notwithstanding any inconsistent statement in the
policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed
as follows:
It is agreed that with respect to such insurance as is afforded by the policy, the Insurance
Company waives any right of subrogation against: the City of Cupertino, and each of its directors,
officers, agents, consultants and employees by reason of any payment made on account of injury,
including death resulting therefrom, sustained by any employee of the insured, arising out of the
performance of the above-referenced Contract.
POLICY INFORMATION
1. Insurance Company: _
2. Insurance Policy Number:
3. Effective Date of this Endorsement: 20
4. Insured:
All notices herein provided to be given by the Insurance Company to the City in connection
with this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre
Avenue; Cupertino, California 95014.
I, _ (print/type name)
warrant that I have authority to bind the below listed Insurance Company and by my signature
hereon do so bind this Company.
Signature of Authorized Representative:
(Original signature required on all Endorsements furnished to the District)
Names of
Agent/Agency: _ Title:
Address: _ Telephone:
Facsimile:
Subrogation Endorsement Page 1 of 1
LFAITHFUL PERFORMANCE BOl\-.,
KNOW ALL MEN BY THESE PRESENT:
THAT WE, as
Principal, (contractor's name)
and as
Surety, (bonding company's name)
are held and firmly bound unto the City of Cupertino, State of California, in the sum of
lawful
money of the United States, for the payment of which will and truly to be made, we bind ourselves,
our heirs, executors, successors and assigns,jointly and severally, firmly by these presents.
THE CONDITION of the foregoing obligation is such that,
WHEREAS, the Principal has - entered into a contract with the City dated
20 with the obligee to do and perform the following work to-wit:..
NOW, THEREFORE, if the said principal shall well and truly perform the work contracted
to be performed under said contract, then this obligation shall be void; otherwise to remain in full
force and effect.
IN WITNESS WHEREOF, this instrument has been duly executed by Principal and Surety
this day of ,20
(To be signed by Principal and Surety,Notary acknowledgment required)
CONTRACTOR
Principal
Surety
Street Address: _
City, State, Zip
By: _
Attorney-In-Fact
The above bond is accepted and approved this__day of , 20
Faithful Performance Bond Page 1 of 1
i
PAYMENT BOND
KNOW ALL MEN BY THESE PRESENT:
WHEREAS, the City of Cupertino, State of California, and
I
hereinafter designated as "Principal" have entered into or are about to enter into a contract
providing;for the installation, construction, and erection by Principal of
more particularly described in said contract; and:incorporated herein by reference.
WHEREAS, said principal is required to furnish a bond in connection with said contract,
providingithat if said Principal, or any of his or its subcontractors, shall fail to pay for materials,
provisions, provender or other supplies or tearns used in, upon, for or about the performance of
work contracted to be done, or for any work or labor done thereon of any kind, the Surety on said
bond shall pay the same to the extent hereinafter set forth;
NOW, THEREFORE, WE, _ as Principal,
(contractor's name)
and as Surety,
(bonding company's name)
firmly bind ourselves, our executors, administrators, successors and assigns, jointly and
severally, unto the City of Cupertino, and any and all materialmen, persons, companies, or
corporations furnishing materials, provisions, provender or other supplies used in, upon, for or
about the performance of the aforesaid work contracted to be executed or performed under the
contract liereinabove mentioned, and incorporated herein by reference, and all persons,
companies or corporations lending or hiring teams, implements or machinery, for or contributing
to said work to be done, and all persons who perform work or labor upon the same, and all
persons who supply both work and materials, whose claim has not been paid by Principal or by
any other person, in the just and full sum of
THE CONDITION OF THIS OBLIGATION IS SUCH THAT if said principal, his or its
subcontractors, heirs, executors, administrators, successors or assigns, shall fail to pay for any
materials, !provisions, provender or other supplies or teams used in, upon, for or about the
performance of the work contracted to be done, or for any work or labor thereon of any kind, or
for amounts due under the Unemployment Insurance Act with respect to such work or labor, or
any and all damages arising under the original contract, then said Surety will pay the same and
also will pay in case suit is brought upon this bond, such reasonable attorney's fee as shall be
fixed by the court.
This bond shall insure to the benefit of any and all persons, companies, and corporations
entitled to ;file claims under Section 1184.1 of the Code of Civil Procedure, so as to give a right
of action to them or their assigns in any suit brought upon this bond.
Subrogation Endorsement Page 1 of 1
Arid the said Surety, for value received, hereby stipulates, and agrees that no change,
extension, of time, alteration or addition. to the terms of the contract or to the work to be
performed thereunder or the specifications acac)mpanying the same shall in any wise affect its
obligations on this bond, and it does hereby waive notice of any such change, extension of time,
alteration'or addition io the terms of the contract or to the work or to the specifications.
IN; WITNESS WHEREOF, this instrument has been duly executed by Principal and
Surety this day of
(To be signed by Principal and Surety. Notary acknowledgments required.)
CONTRACTOR
Principal
i
Surety
Street Address:
City, State, Zip _
By: -
Attorney-In-Fact
The above bond is accepted and approved this___day of , 20
I
Subrogation Endorsement Page 2 of 1