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14-087 Project # 2013-05 Pavement Maintenance Project -Phase 2 with VSS InternationalRECORDING REQUESTED BY City of Cupertino WHEN RECORDED MAIL TO City Clerk's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 NO FEE IN ACCORDANCE WITH GOV. CODE 27283 DOCUMENT: 22820434 1111I11'�I1111�9I111W'I1111Ilil1i11 REGINA ALCOMENDRAS SANTA CLARA COUNTY RECORDER Recorded at the request of City Pages: 3 Fees.... No Fees Taxes... Copies.. AMT PAID RDE # 024 1/05/2015 4:04 PM (SPACE ABOVE THIS LINE FOR RECORDER'S USE) CERTIFICATE OF COMPLETION AND NOTICE OF ACCEPTANCE OF COMPLETION 2013 PAVEMENT MAINTENANCE PROJECT - PHASE 2 CITY PROJECT NUMBER 2013-05 O Original • For Fast Endorsement "NO FEE" City of Cupertino CERTIFICATE OF COMPLETION AND NOTICE OF ACCEPTANCE OF COMPLETION is hereby given in order to comply with the provisions of Section 27283 of the Government Code. This is to certify that the Certificate of Completion and Notice of Acceptance of Completion dated January 5, 2015, for 2013 PAVEMENT MAINTENANCE PROJECT - PHASE 2 CITY PROJECT NUMBER 2013-05 and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on October 21, 2014, and the grantee consents to recordation thereof by its duly authorized officer. I certify under Penalty of Perjury under the laws of the State of California that the foregoing paragraph is true and correct. Dated: January 5, 2015 By: Kirsten Squarcia Deputy City Clerk City Hall 10300 Torre Avenue Cupertino, CA 95014-3255 12 (408) 777-3354 C U P E RT I N O PUBLIC WORKS DEPARTMENT CERTIFICATE OF COMPLETION :gyp. NOTICE OF ACCEPTANCE OF COMPLETION 2013 PAVEMENT MAINTENANCE PROJECT — PHASE 2 CITY PROJECT NUMBER 2013-05 NOTICE IS HEREBY GIVEN THAT I, Timm Borden, Director of Public Works and City Engineer of the City of Cupertino, California, do hereby certify that the work and improvements for rubberized asphalt chip seal, conventional chip seal, and slurry seal performed at various locations in Cupertino, and a portion of Homestead Road in the City of Los Altos, California, in hereinafter described in the contract which was entered into, by, and between the City of Cupertino and VSS International, Inc., June 6th, 2014, in accordance with the plans and specifications for said work, have been completed to the City's satisfaction and acceptance of completion was ordered on October 21, 2014. That said work and improvements consisted of furnishing all labor, materials, tools, and equipment required to complete said project, all as more particularly described in the plans and specifications for said project. w oft al,11.1161 �WQ I Director of Public Works and City Engineer of the City of Cupertino Date: January 5, 2015 V S S International, Inc . 3785 Channel Dr. West Sacramento, CA 95691 OFFICE OF THE CIIY CLERK CITY HALL 10300JORRE AVENUE - CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3223 - FAX: (408) 777-3366 WEBSITE: www.cupi3rtino.org Bid Award, Project Number 2013-05.2013 Pavement Maintenance Project -Phase 2 Your bid bond and contract for the above stated. project is enclosed If you have any questions or need additional information, please contact the Public Works Department at (408) 777-3354. Sincerely, Andrea Sanders City Clerk's Office cc: Public Works Enclosure Project No. 2013-05 DOCUMENT 00520 CONTRACT THIS CONTRACT, dated this ® day of ���� , 2014, by and between VSS INTERNATIONAL whose place of business is located at P.O Box 981330, West Sacramento, CA 95798 ("Contractor"), and the CITY OF CUPERTINO, a Municipal Corporation of the State of Califorma ("City") acting under and by virtue of the authority vested in the City by the laws of the State of California. WHEREAS, City, on the 6th day of May , 2014 awarded to Contractor the following Project: PROJECT NUMBER 2013-05 2013 PAVEMENT MAINTENANCE PROJECT - PHASE 2 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 t:he Contract Documents. Article 2. Agency and Notices to City 2.1 City has designated Roger Lee, Assistant Director, Public Works, to act as City's Authorized Representative(s), who will represent City in performing City's duties and responsibilities and exercising City's rights and authorities in Contract Documents. City may change the individual(s) acting as City's Authorized Representative(s), or delegate one or more specific functions to one or more specific City's Representatives, including without limitation engineering, architectural, inspection and general administrative functions, at any time with notice and without 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 nun 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 nun. 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 2 Project No. 2013-05 any part of the Work is not completed within th-, 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 0 10 10, Section 6. 3.2.4 $500.00 per day for failure to place temporary pavement markings as required by Document 01010, Section 6. 3.2.5 $5,000 for each occurrence of a violation of Document 00800, Section 1.7 WORK DAYS AND HOURS. 3.2.6 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 froin 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 oth(:r 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 t)at 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 City of Cupertino 00520-2 Contract 2013 Pavement Maintenance Project — Phase 2 Project No. 2013-05 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. 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 seg. 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 -Reference Table Document 00100 Advertisement For Bids Document 00200 Instructions to Bidders Document 00210 Indemnity and Release Agreement Document 00400 Bid Form Document 00411 Bond Accompanying Fid 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 City of Cupertino 00520 - 3 Contract 2013 Pavement Maintenance Project — Phase 2 Project No. 2013-05 Document 00821 Insurance Document 00822 Apprenticeship Program Document 00850 Technical Specifications Document 00860 General Requirements Attachment A 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 floe 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 shal!1 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/DLSIUPWD/Northem.html and shall be made available to any interested party on request. Pursuant to Section 1.861 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 2 Project No. 2013-05 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, establiished 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 2 Project No. 2013-05 pc 1 4- .7 IN WITNESS WHEREOF the parties have executed this Contract in quadruplicate the day and year first above written. 2013 PAVEMENT MAINTENANCE PROJECT— Phase 2 CITY: CONTRACTOR: CITY OF CUPERTINO, a Municipal Corporation of the State of California Attest: �j L60414 - r City Clerk: Grace SchmidtU Approved as to form by City Attorney: jVD A A City A torney: Carol Korade I hereby certify, under penalty of perjury, that Timm Borden, Director of Public Works of the City of Cupertino was duly authorized to execute this document. Dated: Timm Borden, Director of Public Works of the City of Cupertino, a Municipal Corporation of the State of California Designated Representative: Name: Roger Lee Title: Assistant Director of Public Works - Address: 10555 Mary Ave, Cupertino, CA 95014 Phone: 408-777-3269 Facsimile: 408-777-3399 AMOUNT: $548,341.00 ACCOUNT NUMBER: 270-8404-9<O`23Z FILE NO.: 98,493.101 City of Cupertino 114 2013 Pavement Maintenance Project — Phase 2 6 [Signature] Jeff Roberts [Please print name here] Title: Chief Operations. Officer [If Corporation: By: [Signature , President, or Vice President] Jordan Meed [Please print name here] Title: Treasurer [If Corporation: Secretary, Assistant Secretary, Chief Financial Officer, or Assistant Treasurer] 293727 A,B,C12 State Contractor's License No. Classification 03/31/2015 Expiration Date Taxpayer ID No. 94-2270766 Name: Jeff Roberts Title: Chief Operations Officer Address: 3785 Channel Dr., West Sacramento, CA 95691 Phone: 916.373.1500 Facsimile: 916.373.0183 NOTARY ACKNOLEDGEMENT IS REQUIRED. IF A CORPORATION, CORPORATE SEAL AND CORPORATE NOTARY ACKNOWLEDEMENT AND FEDERAL TAX ID ARE REQUIRED. IF NOT A CORPORATION SOCIAL SECURITY NO. IS REQUIRED END OF DOCUMENT 00`)2.0 - 6 Contract ACKNOWLEDGMENT State of California County of Y010 On May 16, 2014 before me, - Elizabeth R. Lowrie, Notary Public (insert name and title of the officer) personally appeared Jeff Roberts who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS %y hand and official seal. _ ELIZABETH R. LowRtE Commission # 1957638 sem.._. Notary Public - California D Yolo County Signature eal) My Comm. Expires Oct 22, 2015 State of California County of Yolo On May 16, 2014 ADKNOWL.EDGMENT before me, __Elizabeth R. Lowrie, Notary Public (insert name and title of the officer) personally appeared Jordan Reed who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ELIZABETH R. LOWRIE WITNESS my,hand and official seal. _ %= q_ � _ Commission # 1957638 `"' y of Notary Public -California z Z' Yolo County D My Comm. Expires Oct 22, 2015 Signature (Seal) 4 A EXHIBIT A Project No. 2013-05 SCHEDULE OF BID PRICES BASE B11D ITEMS All Bid items, including lump sums and unit prices, must b€, filled in completely. Quote in figures only, unless words are specifically requested. ITEM DESCR'iPTION U1VIT EST. QNTY UNIT COST TOTAL 1 Traffic Control ILS 2 Rubberized Chip Seal .3 44600 3 Conventional Type 3 Chi Seal :3Y 24295 C771 , 4 Micro Surfacing:3Y 44600 R 500.00 5 Conventional Type 2 Slur . ".30 Y 14966: 2.?2o ;�4 $0 6 Install Blue RPM's @ Fire Hydrant EA 16 ' 2.00 1124. 2 •vo 7 4" White Thermo LF 550 O. Z75O0 12" White Crosswalk/Limit Line 8 Thermo LF 1056 3 7� 3, gbo.00 9 12" Yellow Crosswalk(Thermo) LF 260 440 0,00 10 24" White Thermo LF 285 77-4t 2 14q.00 11 Strl in Detail # 21 Thermo LF 1325 Q d0 12 Striping Detail .# 22(Thermo & .Markers LF 5050 1.5;8 -1 q7g.O0 13 Stripinq Detail # 23 :Markers LF 100 r . -OV 14 Striping Detail # 8 LF 475: 0.40 �, Ofl 15 Striping Detail # 27B Thermo LF 500 0. 240.00 16 Striping Detail #31 LF 1650 2 + K9. 17 Striping Detail # 38 Thermo & Markers L,F 246 1,00 pw 18 Striping Detail #38A LF 1000 O$ 49 Striping Detail # 39(Therm o LF 3285 0, &0 -Co 20 Strij2ing Detail # 39A Thermo LF 4520 0 • 2 q3g .� 21 Striping Detail #2,5 Therm LF 350 11q. 22 Arrow T. e I hermo . EA8 40 2.Oo 23 Arrow Type 11 Thermo EA 3 VO CO 24 Arrow Type IV(Thermo) E;A 20 �� a.00 25 Arrow Type V Thermo E,4 2 33-pfl Arrow Type A (Thermo) Right Lane 26 Drop EA 4 170.00 27 "25" Legend (Thermo)F-A2 q5, 00 O Op 28"30" Legend -Thermo Ej N 3 29 113511.Le end(Thermo),Eli 1 30 "AHEAD" Legend Thermo EA 5 ; 1 (0Z. CO 31 "Bike Lane" Le end Thermo Elk 29 fig. CC) 32 Bike Lane Arrow(Therm, o EA 29. • p0 1,073-00 33 "CLEAR" Legend (Thermo)EA fi '. 142.00 Q IZ,O0 34 "KEEP" Legend(Thermo) EA 5 . 126. 00 0. 00 35 "PED" Legend Thermo Efk a 36 "STOP" Legend Thermo: _ k 20 l�l. = � z 320. co ciry opt eupertino 2013 Pavement Maintenance Project — Phase 2 00410 - 3 Addendum 3 Bid Form �V�,- 41AIJPWI Unit Le end �Q A,Q) 7* -O 6Af FS LS = Lump Sum AL = Allowance EA -_ Each SF = Square Feet LF = Linear Feet TON = Ton or 2,000 Pounds CY = Cubic Yards LB = "Pounds r i City of Cupertino 2013 Pavement Maintenance Project — Phase 2 00400.4 Bid Form Addendum 3 Project No. 2013-05 2 1 600 z .00 2 1fb-0o �.po � 1Z6.Op f2� 1200 37 R R SLOW Le end Thermo, I.A .00 38 39 "XING" Legend Thermo to E:A 341.00 ."YIELD" end Thermo EA 40Color Bike 1 ane Treatment OF41 AC Dike Caltrans T e IDL_ L.F 42 "ONLY EXPIfifY SB" EA Total Base Bid Price: r i �V�,- 41AIJPWI Unit Le end �Q A,Q) 7* -O 6Af FS LS = Lump Sum AL = Allowance EA -_ Each SF = Square Feet LF = Linear Feet TON = Ton or 2,000 Pounds CY = Cubic Yards LB = "Pounds r i City of Cupertino 2013 Pavement Maintenance Project — Phase 2 00400.4 Bid Form Addendum 3 Project No. 2013-05 2 1 600 z .00 2 1fb-0o �.po � 1Z6.Op f2� 1200 130 .00 j Z0_ Iv0 1 341.00 �V�,- 41AIJPWI Unit Le end �Q A,Q) 7* -O 6Af FS LS = Lump Sum AL = Allowance EA -_ Each SF = Square Feet LF = Linear Feet TON = Ton or 2,000 Pounds CY = Cubic Yards LB = "Pounds r i City of Cupertino 2013 Pavement Maintenance Project — Phase 2 00400.4 Bid Form Addendum 3 Project No. 2013-05 'cru P E RT ;w o 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 underwritten 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 or that is otherwise acceptable to the City. 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 frilly 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 resf►ect 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 ;he amounts specified and having a Best's Guide Rating of A, Class VII or better or that is )therwise acceptable to the City. City of Cupertino 2013 Pavement Maintenance Project —Phase 2 Insurance Forms 00530-2 LIMITS Project No. 2013-05 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. General Liability - commercial general liability; Combined single limit of $2.0 million per including provisions for contractual liability, occurrence; $4.0 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. VSS International, Inc (Contractor's Name) Dated City of Cupertino 2013 Pavement Maintenance Project —Phase 2 Insurance Forms 00530-3 Project No. 2013-05 Bond No: 929588004 DOCUMENT 00620 Premium: Included in Performance Bond CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND THIS CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND (`Bond") is dated May 8, 2014 , is in the penal sum Five Hundred Forty Eight Thousand Three Hundred Fifty One Dollars and 00/100 [one hundred percent of the Contract Price], and is entered into by and between the parties listed below to ensure the payment of claimants under the Construction Contract listed below. This Bond consists of this page and the Bond Terms and Conditions, paragraphs 1 through 14, attached to this page. Any singular reference to VSS International, Inc. ("Contractor"), Western Surety Company ("Surety"), the City of Cupertino, a Municipal Corporation of the State of California ("City") or other party shall be considered plural where applicable. CONTRACTOR: SURETY: VSS International, Inc. Western Surety Company Name Name 3785 Channel Drive 333 Wabash Avenue Address Principal Place of Business West Sacramento, CA 95691 Chicago, IL 60604 City/State/Zip City/State/Zip CONSTRUCTION CONTRACT: 2013 PAVEMENT MAINTENANCE PROJECT - PHASE 2 PROJECT NUMBER 2013-05 at Cupertino, California. DATED May 6 � 20 14 in the Amount of $ 548,351.00 CONTRACTOR AS PRINCIPAL Company: (Cog ,,xeal)VSS International, Inc. Signature: Name and Title: the_ "Penal Sum") SURETY Company: (Corp. Se nWes rn Surety Company Signature: Namand Title: Tho. Hucik, Attorney -in -Fact BOND TERMS AND CONDITIONS Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to City and to Claimants, to pay for labor, materials and equipment furnished for use in the performance of the Construction Contract, which is incorporated herein by reference. 2. With respect to City, this obligation shall be null and void if Contractor: 2.1 Promptly makes payment, directly or indirectly, for all sums due Claimants; and 2.2 Defends, indemnifies and holds harmless City from all claims, demands, liens or suits by any person or entity who furnished labor, materials or equipment for use in the performance of the Construction Contact, provided City has promptly notified Contractor and Surety (at the address set forth on the signature page of this Bond) of any claims, demands, liens or suits and tendered defense of such claims, demands, liens or suits to Contractor and Surety, and provided there is no City Default. 3. With respect to Claimants, this obligation shall be null and void if Contractor promptly makes payment, directly or indirectly through its Subcontractors, for all sums due Claimants. If Contractor or its Subcontractors, however, fail to pay any of the persons named in Section 3181 of the California Civil Code, or amounts due City of Cupertino Construction Labor and Material Payment Bond 2013 Pavement Maintenance Project — Phase 2 00620- 1 Project No. 2013-05 under the Unemployment Insurance Code with respect to Work or labor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of Contractor or Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to such Work and labor, then Surety shall pay for the same, and also, in case suit is brought upon this Bond, a reasonable attorney's fee, to be fixed by the court. 4. Consistent with the California Mechanic's Lien :Law, Civil Code §3082, et seg., Surety shall have no obligation to Claimants under this Bond unless the Claimant has satisfied all applicable notice requirements. Surety's total obligation shall not exceed the amount of this Bond, and the amount of this Bond shall be credited for any payments made in good faith by Surety under this Bond. 6. Amounts due Contractor under the Construction Contract shall be applied first to satisfy claims, if any, under any Construction Performance Bond and second, to satisfy obligations of Contractor and Surety under this Bond. City shall not be liable for payment of any costs, expenses, or attorney's fees of any Claimant under this Bond, and shall have under this Bond no obligations to make payments to, give notices on behalf of, or otherwise have obligations to Claimants under this Bond. 8. Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purchase orders and other obligations. Surety further hereby stipulates and agrees that no change, extension of time, alteration or addition to th(; terms of the Construction Contract, or to the Work to be performed thereunder, or materials or equipment to be furnished thereunder or the Specifications accompanying the same, shall in any way affect its obligations under this Bond, and it does hereby waive any requirement of notice or any such change, extension of time, alteration or addition to the terms of the Construction Contract or to the Work or to the Specifications or any other changes. Suit against Surety on this Bond may be brought: by any Claimant, or its assigns, at any time after the Claimant has furnished the last of the labor or materials, or both, but, per Civil Code §3249, must be commenced before the expiration of six months after the period in which stop notices may be filed as provided in Civil Code §3184. 10. All notices to Surety or Contractor shall be mailed or delivered (at the address set forth on the signature page of this Bond), and all notices to City shall be mailed or delivered as provided in Document 00520 (Contract). Actual receipt of notice by Surety, City or Contractor, however accomplished, shall be sufficient compliance as of the date received at the foregoing addresses. 11. This Bond has been furnished to comply with the California Mechanic's Lien Law including, but not limited to, Civil Code §§3247, 3248, et seq. Any provision in this Bond conflicting with said statutory requirements shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirements shall be deemed incorporated herein. The intent is that this Bond shall be construed as a statutory bond and not as a common law bond. 12. Upon request by any person or entity appearing to be a potential beneficiary of this Bond, Contractor shall promptly furnish a copy of this Bond or shall permit a copy to be made. 13. Contractor shall pay to persons performing labor in and about Work provided for in the Contract Documents an amount equal to or more than the general prevailing rate of per diem wages for (1) work of a similar character in the locality in which the Work is performed and (2) legal holiday and overtime work in said locality. The per diem wages shall be an amount equal to or more than the stipulated rates contained in a schedule that has been ascertained and determined by the Director of the State Department of Industrial Relations and City to be the general prevailing rate of per diem wages for each craft or type of workman or mechanic needed to execute this Contract. Contractor shall also cause a copy of this determination of the prevailing rate of per diem wages to be posted at each Site. City of Cupertino Construction Labor and Material Payment Bond 2013 Pavement Maintenance Project — Phase 2 00620-2 Project No. 2013-05 14. Definitions. 14.1 Claimant: An individual or entity having a direct contract with Contractor or with a Subcontractor of Contractor to furnish labor, materials or equipment for use in the performance of the Contract, as further defined in California Civil Code §3181. The intent of this Bond shall be to include without limitation in the terms "labor, materials or equipment" that part of water, gas, power, light, heat, oil, gasoline, telephone service or rental equipment used in the Construction Contract, architectural and engineering services required for polrformance of the Work of Contractor and Contractor's Subcontractors, and all other items for which a stop notice might be asserted. The term Claimant shall also include the Unemployment Development Department as referred to in Civil Code §3248(b). 14.2 Construction Contract: The contract between City and Contractor identified on the signature page of this Bond, including all Contract Documents and changes thereto. 14.3 City Default: Material failure of City, which has neither been remedied nor waived, to pay the Contractor as required by the Construction Contract, provided that failure is the cause of the failure of Contractor to pay the Claimants and is sufficient to justify termination of the Construction Contract. END OF DOCUMENT City of Cupertino Construction Labor and Material Payment Bond 2013 Pavement Maintenance Project — Phase 2 100620-3 State of California County of Yolo On May 16, 2014 ACKNOWLEDGMENT before me, Elizabeth R. Lowrie, Notary Public (insert name and title of the officer) personally appeared Jeff Roberts who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. May ELIZABETH R. LOWRIE� Commission # 1957638 Notary Public - California z z ` Yolo County r My Comm. Expires Oct 22, 2015 State of California County of Sacramento On May 8, 2014 ACKNOWLEDGMENT before me, Rosalie A. Miszkiel, Notary Public (insert name and title of the officer) personally appeared Thomas R. Hucik who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the; person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ROS1EA. MIS KIEL CL COMM. 02009058 m m . a►' Notary Public-Caiifomia -Ko SACRWENTO COUNTY '"► MY Comm. Exp. Feb. 28, 2017 Signature _ (Seal) Western Surety Company POAVER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakotacorporation, is a duly organized and.existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue .of the signature and seal herein affixed hereby make, constitute and appoint David Weise, Thomas R Hucik, Lynn Patton, Rosalie A Miszkiel, 'P A Gouker, Nicki Moon, Individually of Rancho Cordova,, CA, its true and lawful Attorneys) -in -Fact with frill poiNer and,authority Hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and ,other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby.as fully and to.the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pur3uant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant. to and by authority of ttre By -Law printed or the reverse hereof duly adopted -as indicated, by the shareholders of the corporation: In Witness Whereof, WESTERN SURETY COMPANY has caused tthese presents to be signed by its Vice President and its corporate seal .to be hereto affixed on this 9th day of.May, 2013. WESTERN SURETY COMPANY ��S�r,�rYco =y44aPOggr�'�D aul T. Bruflat, Vice President State of South Dakota .. _ County of Minnehalra ss On this:9th day of May, 2013, before me personally cairn Paul T. Brutlat, to me knoivri, who, beiiigby me duly scorn, did depose and say: that .he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTF..RN SURFTY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such. corporate seal; that :it was so affixed pursuant to authority given by the Board of Directors of said corporation and that tie signed his name thereto pursuant to like authority, and ackriowledges same to be the act and deed of said :corporation.. My commission expires s �• NOTARY PUBLIC s June.23, 2015 r SEAL, s sourH aatcota $ hM�.h�s�.e.MM.M.�.Gw•.h.i.yvyao4 J. Motu•, Notary Public CERTIV ICATE 1,.L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney,hereinabove set forth is still in force, and further certify that.the By -Law of the corporation printed on thercverse:trereof is still in force. in testimony «hereof I have her"eunto subscribcd my name and affixed the seal of the said corporation this 8th day of May 2014 �\11\MNNNNIr .. � — �v rY WF,STE:R.N SURETY C;C)MYAN�` • �;�Q44PORgj�3D _. ewt fA�:'•Ya �HIiW1nµ� L. Form F4280-7-2012 Nelson, Assistant Secretary GENERAL PURPOSE RIDER To be attached to and form part of Bond Number 929588004 effective May 8, 2014 issued by the Western Surety Company in the amount of Five Hundred Forty Eight Thousand Three Hundred Fifty One and 00/100 DOLLARS, on behalf of VSS International, Inc. as Principal and in favor of City of Cupertino as Obligee: Now, Therefore, it is agreed that.- Surety hat:Surety acknowledges corrected bond amount: FROM: $548,351.00 TO: $548,341.00 The bond premium remains the same. It is further understood and agreed that all other terms and conditions of this bond shall remain unchanged. This rider is to be effective the 8th day of May 2014 Signed, sealed and dated this 15th day of May 2014 VSS International, Inc. F � ,e,4.6le'CPt noy7sb:4::ic&4'Western Surety Company (Principal) (Surety) By: By: - omas R. Attorney -in -Fact Accepted By: Form F5340 ACKNOWLEDGMENT State of California County of Y010 ) On May 16, 2014 before me, _ Elizabeth R. Lowrie, Notary Public (insert name and title of the officer) personally appeared Jeff Roberts who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS m hand and official seal. ELIZABETH R. LOWRIE y e4:^ Commission # 1957638 Notary Public - California z z Yolo County D My Comm. Expires Oct 22, 2015 P Signature /f/Iji!seall) . ACKNOWLEDGMENT State of California County of Sacramento ) On May 15, 2014 before me,. Rosalie A. Miszkiel, Notary Public (insert name and title of the officer) personally appeared Thomas R. Hucik who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ,_.. • ROSALIE A. MISZKIEL CL COMM. #2009058 00 Notary Public-Califomia -o SACRAMENTO COUNTY ,.«► Signature (Seal) Comm Ex My p. Feb. 28, 2017 A Western Surety Company P0117ER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal oMge in the City of Sioux falls, and State of South Dakota, arid that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint David Weise, Thomas R Hucik, Lynn Patton, Rosalie A Miszkiel, P A G-ouker, Nicki Moon, Individually of Rancho Cordova, CA, its true and lawful Attorney(s)4n-Fact with full ptiw.,r and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings. and other obligatory instruments of similar nature - III Unflinited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly au[horized officer of the corporation and all the acts of said Attorney, pursuant to'the authority hereby givers, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by author Ay of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by itsVice President and its corporate seal to be hereto affixed on this 9th day of -May, 2413. WESTERN SURETY COMPANY �,•°"��c�rY c s 0 44ray: aul T. Bnrilat, Vice President State of South Dakota ss County of Miniiet'alia On this 9th. day of:May, 2013, before me personally cairn Paul T. Bruflat, to me known, wlio, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota, that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he 'knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affked pursuant to authority given by the Board of Directors of said corporation and mat tie signed his name thereto pursuantto lihe authority, and acknowledges same to be the act and deed of said corporation. My commission expires♦'+``+'+�+'+`'+hh�,.,..w...aw•.5� s NOTARY PUBLIC ft June 23, -01 S S SEAL, SF.A1 i f.,SOUTk 0AKOTAN�$ }hhJn�s�NtitiNWsh.+h.4�ris�oti} J. Motu, Ncitary Public CERTIFICATE 1, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY ado hereby certify that the Power of Altorney hereinabove set forth is still in force; and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have Hereunto subscribed my name and affixed the seal of the said coilioration this 15th day of May 2014 p„uw�ywa Sva>rY WESTERN SURETY COMPANY rWrV Flb!� • Fo;ni F4280-7-2012 L. Nelson,�Acit��mt�ecret.asy Project No. 2013-05 DOCUMENT 00630 GUARANTY TO THE CITY OF CUPERTINO, a Municipal Corporation of the State of California ("City"), for construction of 2013 PAVEMENT MAINTIENANCE PROJECT — PHASE 2 CUPERTINO, CALIFORNIA The undersigned guarantees all construction performed on this Project and also guarantees all material and equipment incorporated therein. Contractor hereby grants to City for a period of one year following the date of Final Acceptance, or such longer period specified in the Contract Documents, its unconditional wa). anty of the quality and adequacy of all of the Work including, without limitation, all labor, materials and equipment provided by Contractor and its Subcontractors of all tiers in connection with the Work. Neither final payment nor use or occupancy of the Work performed by the Contractor shall constitute an acceptance of Work not done in accordance with this Guaranty or relieve Contractor of liability in respect to any express warranties or responsibilities for faulty materials or workmanship. Contractor shall remedy any defects in the Work and pay for any damage resulting therefrom, which shall appear within one year, or longer if specified, from the date of Final Acceptance. If within one year after the date of Final Acceptance, or such longer period of time as may be prescribed by laws or regulations, or by the terms of Contract Documents, any Work is found to be defective, Contractor shall promptly, without cost to City and in accordance with City's written instructions, correct such defective Work. Contractor shall remove any defective Work rejected by City and replace it with Work that is not defective, and satisfactorily correct or remove and replace any damage to other Work or the wort: of others resulting therefrom. If Contractor fails to promptly comply with the terms of such instructions, or in an emergency where delay would cause serious risk of loss or damage, City may have the defective Work corrected or the rejected Work removed and replaced. Contractor shall pay for all claims, costs, losses and damages caused by or resulting fi-om such removal and replacement. Where Contractor fails to correct defective Work, or defects are discovered outside the correction period, City shall have all rights and remedies granted by law. Inspection of the Work shall not relieve Contractor of any of its obligations under the Contract Documents. Even though equipment, materials, or Work required to be provided under the Contract Documents have been inspected, accepted, and estimated for payment, Contractor shall, at its own expense, replace or repair any such equipment, material, or Work found to be defective or otherwise not to comply with the requirements of the Contract Documents up to the end of the guaranty period. All abbreviations and definitions of terms used in this Agreement shall have the meanings set forth in the Contract Documents, including, without means of limitation, Section 00700 (General Conditions). The foregoing Guaranty is in addition to any other warranties of Contractor contained in the Contract Documents, and not in lieu of, any and all other liability imposed on Contractor under the Contract Documents and at law with respect to Contractor's duties, obligations, and performance under the Contract Documents. In the event of any conflict or inconsistency between the terms of this Guaranty and any warranty or obligation of the Contractor under the Contract Documents at v,suefir�nconsistency or conflict shall be resolved in favor of the higher level of obligation of the Contractor's Name VS.Alnte,(nlional, Inc. 3785 Channel Drive Address West Sacramento, CA 691 City/State/Zip 05/16/2014 Date END OF DOCUMENT City of Cupertino 00630-1 Guaranty 2013 Pavement Maintenance Project — Phase 2 BASIC -1 OP ID: JV ACOR[7' CERTIFICATE 4F LIABILITY INSURANCE DATE (MMlDDrfYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 05/08/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an einforsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 650-573-1111' r—ON Brian Connolly Andreini & Company -San Mateo I PHONE Fax: 650.378-43611 License 0208825 c o x .650-378-42510 No ; 650-378-4361 220 West 20th Avei-EMAIL San Mateo, CA 94403 f ADDRESS: bconnolly@andreini.com INSURERS AFFORDING COVERAGE NAIC k INSURER A: National Union Fire Ins Co PA 19445 INSURED VSS'International, Inc. INSURERS: Starr Indemnity 81 Liability Co 38318 3785 Channel Drive West Sacramento, CA 95691 INSURER C. Travelers Property Casualty 36161 INSURER D X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE k .• I OCCUR INSURER E: INSURER F.: 03/01/2014 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 LTR TYPE OF INSURANCE INSR MOa POLICY NUMBER OL CY EFF IMKMD POLICY EXP MM)DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE k .• I OCCUR X GL 5388220 03/01/2014 03/01/2015 . DAMAGETOPREMISES RERToccurrence)S 100,00 MED EXP (Any one person) 5 10,00 X Ded $1,000,000 PERSONAL & ADV INJURY $ 2,000,000 X I OCIP Excluded GENERAL AGGREGATE $ 4,000,00 GEWL AGGREGATE LIMIT APPU ES PER: PRODUCTS -COMPIOPAGG $ 4,000,00 PRO LOc POLICY X JECT $ AUTOMOBILE LIABILITY COMBINED SINGLE'LIMfT 2,000,00 Ea acddent BODILY INJURY (Per person) $ A X ANYALITO X CA5101610 03/01/2014 03/01/2015 ALL OWNED SCHEDULED NON-OWAUTOS AUTOS X HIRE )AUTOS X AUTOS NED BODILY INJURY (Per accident) $ (Per acPROEddent GE $ MCS 90 $ Include X Ded $1M X OCIP Excl UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 B X EXCESS LIAS CLAIMS -MADE 1000020753 03/01/2014 03/01/2015 AGGREGATE $ 5,000,00 DEORETENTIONS $ — A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER AND ANY PROPRIETORIPARTNEMXECUTIVEYiN OFFICERIMEMBEREXCLUDED? � (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA CALIFORNIA SELF INSURED I ID,NV,NM,TX,UT/1049342394 STATU- PTH -'. X WTOCRY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE S 1,000,000 E.L. DISEASE - POLICY LIMIT $ 11000,000 C Leased/Rent Equip QT6307444L337TIL14 03/01/2014 03101/2015 Blkt L(ml 750,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Addltional'Rernarks Schedule, It more space is requlred) VSSI Job #14-027. City of Cupertino, its engineer, and each of its directors, officers, agents and employees, as determined by the City, are included. as additional insureds for General Liability per Endt #001 a #062 attached and Auto Liability per Form CA20480299 attached. CERTIFICATE HOLDER CANCELLATION City of Cupertino 10555 Mary Ave. Cupertino, £A 95014 A ^^On plc VM4 nrnc% CUPCUP3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIONDATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED R Cl— ©1988-2010 ACORD CORPORATION. All rights reserved. TI-.. A t%^C2r1 ».. ..».1 1...... .........I..s.. -..J ..... -1... -f A ^f%nr% This endorsement, effective Policy No. G L5388220 ENDORSEMENT #001 12:01 A.M. 3!1!2014 issued to: VSS International, Inc. forms a part of By NATIONAL UNION FIRE INSURANCE COHPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL, INSURED -- OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the -following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: WHERE REQUIRED BY AN "INSURED CONTRACT" (If no entry appears above, Information required to complete this endorsement will be shown. In the Declarations as applicable to this endorsement.) A. Section II -- Who Is An Insured Is amended to Include as an Insured the person or organization shown In the Schedule, but only with respect to liability arising out of your ongoing operations per- formed for that Insured. B. With respect to the insurance afforded to these additional Insureds, the following exclusion Is added: 2. Exclusions This -insurance -does.. not_apply-to"bodily_in-_. jury" or "property damage" occurring after. (1) All work, including materials, parts or equipment fumished In connection with such work, on the project (other then service, maintenance or repairs) to be performed by or on behalf of the addl- tionai Insured(s) at the site of the cov- ered overed operations has been completed; or (2) That portion of "your work" out of which the Injury or damage arises has been put -to -(#s -Intended -use -by -any -person -or- organization other than another con- tractor or subcontractor engaged In performing operations for a principal as a part of the same project. ENDORSEMENT +002 This endorsement, effective 12:01 A.M. 3/112014 forms a part of Policy No. GL5388220 Issued to VSS International, Inc. By NATIONAL UNION FIRE INSURANCE CO11PANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE I Name of Person or Organlzation: WHERE REQUIRED BY AN "INSURED CONTRACT" Location And Description of Completed Operations: WHERE REQUIRED BY AN "INSURED Additional Premium: INCLUDED (if no entry appears above, information required to complate this endorsement will be shown In the Declarations as applicable to this endorsement.) Section ii -- Who Is An Insured Is amended to Include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule of this endorsement performed for that insured and Included In the "products - completed operations hazard". POLICY NUMBER: CA5101610 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLIICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effectiveon the Inception date of the policy unless another date is indicated below. Endorsement Effective: 311/2014 1 Countersigned By: (Autnorized Representative)' Named Insured: VSS International, Inc. SCHEDULE; (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to the endorsement.) Each person or organization shown In the Schedule is an "Insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section p of the Coverage form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc„ 1998 Page 1 of 1 insured: VSS INTERNATIONAL, INC Policy# : CA5101610 Term: 31111014.3/il2015 if we .pay for the loss", our payment will In- clude the applicable sales tax for the dam- aged or stolen proPerW. 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage form has rights to recover damages from another, those rights are transferred to us. That per- son or organization • rnust do everything necessary to secure our rights and must do nothing after "accident" or `loss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the 'Insured' or the "insured's' estate will not relieve us of any obligations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Goverags Form. It is also veld if you or any other "Insured", at any time, intentionally conceaf or misrepresent a material fact con- ceming: a. This Coverage Foran; b. The covered "auto°; c. Your interest in the covered "auto"; or d. A claim under this Coverage Form. 3. Liberalization 4, 5. If we revise this Coverage Form to provide more coverage without addltionei premium charge, your policy will automatically pro- vide the additional coverage as of the day the revision is effective In your stzte. No Benefit To Baliee - physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provision of this Coverage Form. Other Insurance a. For any covered "auto" you own,, this Coverage Form provides primary Insur- ance. For any covered "auto" you don't own, the insurance provided by this Cov- erage Form is excess over any other coft-ctible insurance. However, while a covered 'auto' which Is a"trailer" Is connected to another vehicle, the Liability Coverage -this Coverage Form provides for the "trailer' is: (1) Excess while it is connected to a motor vehicie you do not own. (2) Primary while it Is connected to a covered "auto' you own. b. For Hired Auto Physical Damage Cover- age, any covered "auto' you lease, hire, rem or borrovy is deemed to be a coveted "auto" you own. However, any "auto" V that is leased, hired, rented or borrowed t �Lso" with a driver is not a covered "auto". FCcRegardless of the provisions of Paragraph above, this Coverage Farm's liability overage is primary for arty liability asnaed under ars "itlsur4a! contract". d. When this Coverage Farm and any other Coveraoe Forfn of policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the lim)ts of 411 the Cdverage Forms and policies covering on the same basis. 6.. Premium Audit a. The estimated premium for- this Coverage Farm is based an the exPD5ures you told us you would have when tMs pollcy be- gan. Wa wifi P WMI.0 the final pr@.rnium due when we determine your actual ex- poswes. The es iOfflafed to al KaWurn will be credited ags�st the final premium due and the first Named Insured will be Killed for the bdfa ra, if any. The due date for the final premium or retrospec- tive premium is the date shown as the due data on tate bill. If tha estimated, total premiurn exceeds the fibal premium due, the first Narnt3d Insured wifi get a refund. b. if this policy ]z IssLied far more than one year, the premium for this Coverage Form will be computed annually, basad an our rates or premiums in effect at the beginning of each y"r of the policy. 7. Policy Period, Coverage Territory Under this Coverage Form, we cover "ac- cidents"'and "losses' occurring: a. During the policy period shown in the Declarations; and b. Within the coverage territory. The coverage territory is: a. The United States of America; b. The territanas and possessions of the United States of America; c. Puerto Rico; d. Canada; end C. Anywhere in the world if: (1) A• covered "auto" of the private passenger type is leased, hired, rented or borrowed without a driver for a period of '30 days or.less; and ' 121 The "insured's' responsibility to pay Pnoe a of 1! Oc ISO Properties, Inc.,2005 CA 00 01 03 06 STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS OFFICE OF SELF-INSURANCE PLANS 2265 Watt Avenue, Suite 1 Sacramento CA. 95825 Phone No. (916) 574-0300 FAX (916) 483-1535 Edmund G. Brown Jr__ GnvPmnr CERTIFICATION OF SELF-INSURANCE OF WORKERS' COMPENSATION TO WHOM IT MAY CONCERN: This certifies that Certificate of Consent to Self -Insure No. 2106-C %Vas issued by the Director of'.Industrial Relations to: VSS Intern ado nal, Inc. under the }provisions of Section 3700, Labor Code of California with an effective date of August 1, 1988. The certificate is currently in full force and effective. Dated at Sacramento, California This day the loth of May 2013 Jun Wroten; Chief ORIG: Maty Beth Downs Andreini & Company 220 W. 20th Avenue San Mateo, Ca 94403 NUMBER: 2106 C STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS OFFICE OF THE DIRECTOR CERTIFICATE OF ' CONSE'IT TO SELF -INSURE THIS IS TO CERTIFY , That 'SSS International, Inc. (Name of Subsidiary ) STATE OF INCORPORATION CA B&SIC Resources, Inc. (Master CenilicatcHoldcr ) STATE OF INCORPORATION CA has complied with .the requirements of the Director of Industrial Relations under the provisions of Sections 3700 to 3705, inclusive, of the Labor Code of the State of Califoniin and is hereby ,mnrcd this Certificate of Consent to Self -Insure:, holder of Masicr Certificate No. 2106_ This certiFcatc tray be revoked at any time for good cause sholmn.- EFFECTIVE DATE: Jon Wroten, Chief Aa1�usY i. 1939 DI PARTNIE T OF 1N f)t'�'rR1.tt._ 1ZF1. ATMVVZ OF THE STATE OF CAL.iFOR\tA _.._ Christine Baker. Director `Rcvocmtion of Ccrtilicatc — to curnili;atc of coni-nt to xff-insurt may be revoked by the Dirt-cwr of indusuiat ttcLalion. of any time for goad cause art c- n hearing. Gadd rouse mcludos.:among other things, the itnpuirmcnt of soitency of such =plo)tr. the inability or the employer to r'utfill his obligations, or the pmcticc of such employer or his agent in churl c of the administrati��r. of obligations. tinder the this dna ion of any of the foilao'inG: (a) Itabiwally and as a matter of practice and custom inducing claimants for compcm;arion to accept 1cs than the compensation due or m iklrtL it ncccMry for thein to rrson to proceedings agatntit the employer to secure the eompemsutiun roue; (b) Discharging ht compcnsation obl'►eationc in a dishonest mariner: (c) Discharging his compcnbsuion obl(ptions in >uch a tnanrtcr as to cause injury to the public or tho%c dealing with htm.'(Scetion 3702 of lxbtrr Cg)tle.! 71ic Ccnilic itc may be revoked for non compliance witli Titic K. Caiifornta dministnttive Code. Group 2 -- A triinietration of Sclftnstwunce May 16, 2014 City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 RE: 2013 Pavement Maintenance - Phase 2 REF: Waiver of Subrogation VSS International, Inc. is licensed by the State of California to be self-insured for Workers Compensation (2106-C). VSS International, Inc. agrees to waive all rights of subrogation against the City of Cupertino, its officers, officials, employees and volunteers for losses paid under the terms of this policy/program which arise from the work performed by VSS International Inc., for the City of Cupertino. Yours Truly, VSS International, Inc. Jeff Roberts---- Chief oberts Chief Operation Officer VSSI Job No.: 14-027 vss inTERnarionRL, inc. P.O. BOX 981330 • WEST SACRAMENTO, CA, 95798, USA • PHONE (916) 373-1500 FAX NO. (916) 373-0183 • CONTRACTOR'S LICENSE NO. 293727A P VEMEnT MRinTEnt:; 10E SPECIALISTS ACKNOWLEDGMENT State of California County of YOIo ) On May 16, 2014 before me, Elizabeth R. Lowrie, Notary Public (insert name and title of the officer) personally appeared Jeff Roberts who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. U.. ELIZABETH R. LOWRIE Commission # 1957638 Q i -f, Z Z .�, Notary Public - California z Yolo County D f Gur Signature /G eat ; My Comm. Expires Oct 22, 2015