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14-133 Breneman Inc Project No 2014-02 2014 Reconstruction of Curbs, Gutters and Sidewalks DOCUMENT: 22978772 Pages 3 RECORDING REQUESTED BY: Fees. . . . No Fees Taxes. . . I Copies. City of Cupertino AMT PAID WHEN RECORDED,MAIL TO: RDE # ee 1 REGINA ALCOMENDRAS 6/e8/2e15 SANTA CLARA COUNTY RECORDER 11 38 AM City Clerk's Office Recorded at the request of City of Cupertino City ----- -------------- --- --- --- 10300 Torre Avenue Cupertino, CA 95014-3255 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NO FEE IN ACCORDANCE WITH GOV. CODE 27383 Certificate of Completion and Notice of Acceptance of Completion RECONSTRUCTION OF CURBS, GUTTERS, AND SIDEWALKS CITY PROJECT NUMBER 2014-02 Original 13 For Fast Endorsement City Hall 10300 Torre Avenue Cupertino, CA 95014-3255 (408).777-3354 C U P E RT I N O PUBLIC WORKS DEPARTMENT CERTIFICATE OF COMPLETION AND NOTICE OF ACCEPTANCE OF COMPLETION RECONSTRUCTION OF CURBS, GUTTERS,AND SIDEWALKS CITY PROJECT NUMBER 2014-02 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 curb, gutter and sidewalk reconstruction, performed at various locations in Cupertino, California, in hereinafter described in the contract which was entered into, by, and between the City of Cupertino and Breneman, Inc., July 30, 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 June 8, 2015. 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. erector of�Pubh�cW�orks and City Engineer of the City of Cupertino Date: June 8, 2015 "NO FEE" City of Cupertino CERTIFICATE OF ACCEPTANCE is hereby given in order to comply with the provisions of Section 27383 of the Government Code. This is to certify that the development agreement DECONSTRUCTION OF CURBS, GUTTERS, AND SIDEWALKS CITY PROJECT NUMBER 2014-02 and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on June 8, 2015 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: June 8, 2015 i By: Andrea S''Ahd�. s Senior Offic�'Assistant,City Clerk "t OFFICE OF THE CITY CLERK CITY HALL 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 MME TELEPHONE: (408)777-3223- FAX: (408)777-3366 C U P E RT'N® WEBSITE:www.cuperi:ino.org Breneman Inc., 2000 Norris Road Walnut Creek, CA 94596 Re: Bid Award, Project Number 2014-02 2014 Reconstruction of curbs, gutters and sidewalks. 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 OFFICE OF THE CITY CLERK CITY HALL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 TELEPHONE: (408)777-3223- FAX: (408)777-3366 C U P E RT I N O W EBSITE:www.cupertiiio.org August 13, 2014 J.J.R. Construction 1120 Ninth Avenue San Mateo, CA 94402 Re: Bid Award, Project Number 2014-02 ::014 Reconstruction of curbs, gutters and sidewalks. Thank you for your participation in the City of Cupertino's bid process for the above-stated project. The contract was awarded to Breneman Inc. Your bid bond and statement of qualifications envelope are 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 OFFICE OF THE CITY CLERK CITY HALL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 TELEPHONE:(408)777-3223• FAX: (408)777-3366 R�, ® WEBSITE:ww. wcuper ino.org August 13, 2014 SpenCon Construction, Inc. P.O. Box 1220 Danville, CA 94526 Re: Bid Award, Project Number 2014-02 :1,014 Reconstruction of curbs, gutters and sidewalks. Thank you for your participation in the City of C-upertino's bid process for the above-stated project. The contract was awarded to Breneman In"c. Your bid bond and statement of qualifications envelope are 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 i Project No. 2014-02 DOCUMENT 00520 _ CON.CRACT � I �—Jr THIS CONTRACT, dated this day oJ4 -- 2014, by and between Breneman Inc., whose place of i located at 2000 Norris Road Walnut Creek ' 94596 ("Contractor"), and the CITY OF CUPERTINO,a business s ( ) Municipal Corporation of the State of California("City")a.cting under and by virtue of the authority vested in the City by the laws of the State of California. 4 WHEREAS,City,on tl� day ofJ411A ,2014 awarded to Contractor the following Project: PROJECT NUMBER 2014-02 2014 RECONSTRUCTION OF CURBS, GUTTERS, AND SIDEWALKS NOW,THEREFORE, in consideration of the mutual covenants hereinafter set forth, Contractor and City agree as follows: Article 1. Work 1.1 Contractor shall complete all Work specified in the Contract Documents, in accordance with the Specifications, Drawings,and all other terms and conditions of the Contract Documents. Article 2. Agency and Notices to City 2.1 City has designated Roger Lee,Assistant Director of Public Works, to act as City's Authorized Representative(s), who will represent City in performing City's dutie,e 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 nnnore specific City's Representatives,including without limitation engineering, architectural, inspection and general administrative functions, at any time with notice and without liability to Contractor. Each City's Representative is the beneficiary of all Contractor obligations to City, including without limitation,all releases and indemnities. 2.2 All notices or demands to City under the Contract Documents shall be to City's Authorized Representative at: 10300 Torre Avenue,Cupertino,California 95014 or to such other person(s)and address(es)as City shall provide to Contractor. Article 3. Contract Time and Liquidated Damages 3.1 Contract Time. The Contract Time will commence to run on the date indicated in the Notice to Proceed. City may give a Notice to Proceed at any time within 30 Days after the Notice of Award. Contractor shall not do any Work at the Site prior to the date on which the Contract Tinxe commences to run. Contractor shall achieve Final Completion of the entire Work and be ready for Final Payment in accordance with Section 00700 (General Provisions)within by June 30,2015 as provided in Document 00700 (General Provisions). All curb ramps on Stevens Creek Blvd and De Anza Blvd(approx. 37)shall be completed by August 30,2014. All curb ramps on Miller Ave shall be complete by September 30,2014. City of Cupertino 00520- 1 Contract 2014 Reconstruction of Curbs,Gutters and Sidewalks Addendum 1 I T J.5 Project No. 2014-02 3.2 Liquidated Damages. City and Contractor recognize that time is of the essence of this Contract and that City will suffer financial loss in the form of contract administration expenses (such as project management and consultant expenses), if all or any part of the Work is not completed within the times specified above, plus any extensions thereof allowed in accordance with the Contract Documents. Consistent with Document 00700 (General 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 $500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Completion of the Work as specified above. 3.2.2 $75 per Calendar Day for failure to remove concrete from a work area within the same calendar week. 3.2.3 $75 per Calendar Day for failure to replace asphalt to finish grade within 30 calendar days. Liquidated damages shall apply cumulatively and, except as provided below, shall be presumed to be the damages suffered by City resulting from delay in completion of the Work. 3.3 Liquidated damages for delay shall only cover administrative, overhead, interest on bonds, and general loss of public use damages suffered by City as a result of delay. Liquidated damages shall not cover the cost of completion of the Work, damages resulting from defective Work, lost revenues or costs of substitute facilities, or damages suffered by others who then seek to recover their damages from City (for example, delay claims of other contractors, subcontractors, tenants, or other third -parties), and defense costs thereof. Article 4. Contract Sum 4.1 City shall pay Contractor the Contract Sum for completion of Work in accordance with Contract Documents as set forth in Contractor's Bid, attached hereto: See Exhibit "A" attached Article 5. Contractor's Representations In order to induce City to enter into this Contract, Contractor makes the following representations and warranties: 5.1 Contractor has visited the Site and has examined thoroughly and understood the nature and extent of the Contract Documents, Work, Site, locality, actual conditions, as -built conditions, and all local conditions, and federal, state and local laws and regulations that in any manner may affect cost, progress, performance or furnishing of Work or which relate to any aspect of the means, methods, techniques, sequences or procedures of construction to be employed by Contractor and safety precautions and programs incident thereto. 5.2 Contractor has examined thoroughly and understood all reports of exploration and tests of subsurface conditions, as -built drawings, drawings, products specifications or reports, available for Bidding purposes, of physical conditions, including Underground Facilities, or which may appear in the Drawings. Contractor accepts the determination set forth in these Documents and Document 00700 (General Provisions) of the limited extent of the information contained in such materials upon which Contractor may be entitled to rely. Contractor agrees that except for the information so identified, Contractor does not and shall not rely on any other information contained in such reports and drawings. 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 City of Cupertino 00520-2 Contract 2014 Reconstruction of Curbs, Gutters and Sidewalks Addendum 1 b c Project No.2014-02 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 esults 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 54100 et seq. in document 00340 (Subcontractors List) Article 6. Contract Documents 6.1 Contract Documents consist of the following documents,including all changes,addenda,and modifications thereto: Document 00002 Signature Page Document 00003 Project Directory Document 00012 Caltrans/City Cross-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 B id Document 00430 Subcontractors List Document 00450 Statement of Qualifications Document 00481 Non-Collusion Affidavit Document 00482 Bidder Certifications Document 00520 Contract Document 00530 Insurance Forms Document 00610 Construction Performance Bond Document 00620 Construction Labor and:Material Payment Bond Document 00630 Guaranty Document 00650 Agreement and Release of Any and All Claims Document 00660 Substitution Request Form Document 00700 General Conditions Document 00800 Special Conditions Document 00820 Traffic Control Requirements Document 00821 Insurance Document 00822 Apprenticeship Program Technical Specifications Addenda(s) Drawings/Plans City of Cupertino 00520-3 Contract 2014 Reconstruction of Curbs,Gutters and Sidewalks Addendum 1 Project No. 2014-02 6.2 There are no Contract Documents other than those listed in this Document 00520, Article 6. The Contract Documents may only be amended, modified or supplemented as provided in Document 00700 (General Provisions). Article 7. Miscellaneous 7.1 Terms used in this Contract are defined in Document 00700 (General Provisions) and will have the meaning indicated therein. 7.2 It is understood and agreed that in no instance are the persons signing this Contract for or on behalf of City or acting as an employee, agent, or representative of City, liable on this Contract or any of the Contract Documents, or upon any warranty of authority, or otherwise, and it is further understood and agreed that liability of the City is limited and confined to such liability as authorized or imposed by the Contract Documents or applicable law. 7.3 Contractor shall not assign any portion of the Contract Documents, and may subcontract portions of the Contract Documents only in compliance with the Subcontractor Listing Law, California Public Contracting Code §4100 et seq. 7.4 The Contract Sum includes all allowances (if any). 7.5 In entering into a public works contract or a subcontract to supply goods, services or materials pursuant to a public works contract, Contractor or Subcontractor offers and agrees to assign to the awarding body all rights, title and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. §15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, services or materials pursuant to the public works contract or the subcontract. This assignment shall be made and become effective at the time City tenders final payment to Contractor, without further acknowledgment by the parties. 7.6 Copies of the general prevailing rates of per diem wages for each craft, classification, or type of worker needed to execute the Contract, as determined by Director of the State of California Department of Industrial Relations, are deemed included in the Contract Documents and on file at City's office, or may be obtained of the State of California web site http://www.dir.ca.gov/DLSRJPWD/Northem.html and shall be made available to any interested party on request. Pursuant to Section 1861 of the Labor Code, Contractor represents that it is aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that Code, and Contractor shall comply with such provisions before commencing the performance of the Work of the Contract Documents. 7.7 Should any part, term or provision of this Contract or any of the Contract Documents, or any document required herein or therein to be executed or delivered, be declared invalid, void or unenforceable, all remaining parts, terms and provisions shall remain in full force and effect and shall in no way be invalidated, impaired or affected thereby. If the provisions of any law causing such invalidity, illegality or unenforceability may be waived, they are hereby waived to the end that this Contract and the Contract Documents may be deemed valid and binding contracts, enforceable in accordance with their terms to the greatest extent permitted by applicable law. In the event any provision not otherwise included in the Contract Documents is required to be included by any applicable law, that provision is deemed included herein by this reference(or, if such provision is required 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 City of Cupertino 00520-4 Contract 2014 Reconstruction of Curbs, Gutters and Sidewalks Addendum 1 1 P , Project No.2014-02 Procedure in Document 00700,Article 12, established under the California Government Code,Title 1,Division 3.6,Part 3,Chapter 5. City of Cupertino 00520-5 Contract 2014 Reconstruction of Curbs, Gutters and Sidewalks Addendum 1 Project No. 2014-02 IN WITNESS WHEREOF the parties have executed this Contract in triplicate the day and year first above written. 2014 RECONSTRUCTION OF CURBS, GUTTERS AND SIDEWALKS CITY: CONTRACTOR: CITY OF CUPERTINO, a Municipal Corporation of the State of California Attest: (CqA(,,e- 1A,"', (�� City Clerk: Grace Schmidt r /.-7 .- Approved as to form by City Attorney: City Attorney: 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: -(2 r Davia Brandt, City Manager of the City of Cupertino, a Municipal Corporation of the State of California Designated Representative: Name: Roger Lee Title: Assistant Director of Public Works By: [Si ature] [Please print name here] Title..�iiZ3 [If Corporation: Chairman, President, or Vice President] [Signature] [Please print name here] Title: [If Corporation: Secretary, Assistant Secretary, Chief Financial Officer, or Assistant Treasurer] State Contractor's License No. Classification Expiration Date Taxpayer ID No. Name: Title: Address: 10300 Torre Ave., Cupertino, CA 95014 Address: Phone: 408-777-3269 Phone: Facsimile: 408-777-3354 Facsimile: NOTARY ACKNOLEDGEMENT IS REQUIRED. IF A AMOUNT: $518,530.00 ,�a� !� CORPORATION, CORPORATE SEAL AND CORPORATE ACCOUNT NUMBER: �TO� �jv S� / 3'� f j REQUIREDNOTARY . IF A CORPORATIONOWLEDEMENT AND S SOCIAERAL L SECUAX ID RITY ACCOUNT NUMBER: NO. IS REQUIRED FILE NO.: (:y qJ 3/14-END OF DOCUMENT City of Cupertino 00520-6 Contract 2014 Reconstruction of Curbs, Gutters and Sidewalks Addendum 1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 State of California County of sa m-fz� On yr before me, !`�<'r'S��� �G�c e �cZ, c� Date Name and Title o the Officer personally appeared To-ki-t lfs _ 9R-r__t-?<"ck- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the personK whose name(W is re subscribed to th e within instrument and acknowledged t me that she/they executed the same in i Mier/their uthorized capacity), and that by /her/their signatureK on the instrument the person(',' or the entity upon behalf of which the KIRSTEN RENEE SCUARCIA person((s�acted, executed the instrument. Commission # 1906898 z ��_� Notary Public -California z I certify under PENALTY OF PERJURY under the laws z ' Santa Clara County D of lihe State of California that the foregoing paragraph My Comm. Expires Oct 4, 2014 is true and correct. WITNESS4 hanAad off icial seal. Place Notary Seal Above Sio�nature Signature of Notary Pu is OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this faun to an unintended document. Description of Attached Document Title or Type of Document: Gd 1-7 7�4 c _ Document Date: Number of Pages: -S Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑ General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑ Guardian or Conservator ❑Trustee ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 0 2013 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 Client#: 823451 BRENEMAN ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)7/18/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO.N'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 polic.y(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER CONTACT Tim Tarwater NAME: Tim Tarwater PHONE 916-945-5068 916-290-0187 (A/C No E)01): A/C,No HUB Int'I Insurance Serv. Inc. 1---MAIL ,ADDRESS: tim.tarwater@hubinternational.com P.O. BOX 4047 _ INSURER(S)AFFORDING COVERAGE NAIC## Concord, CA 94524-4047 INSURERA: Ironshore Specialty Insurance C INSURED IINSURER B Breneman, Inc. — 2143 Arnold Industrial Way Suite 20 IINSURER C Concord,CA 94520 IINSURER D IINSURER E: IINSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. IN SR TYPE OF INSURANCE NSRL WVD POLICY NUMBER _ MMfDDY�. MM/DI LIMITS A GENERAL LIABILITY AGS07290 6/24/2014 0612412015 EEAACCH�OECTCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea olccu ence $50,000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $5,000 X BI1P D Ded:5,000 PERSONAL&ADV INJURY $11,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 X POLICY PRO- LOC $ JECT _ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ _ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks:ichedule,It more space Is required) RE: 2014 Reconstruction of Curbs, Gutters and Sidewalks. City of Cupertino,the City's officers, agents and employees are listed as Additional Insured and this insurance is primary and non-contributory as respects to General Liability per attached endorsement#CG2010 0704 and CG2037 0704. Per Project Aggregate applies per attached endorsement#CG2503 0397. Waiver of Subroilation applies per endorsement#CG2404 0509. CERTIFICATE HOLDER CANCELLATION City of Cupertino SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE p THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10300 Torre Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Cupertino, CA 95014 _ AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S29847821M2929211 MH45 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Additional Insureds shown in a written contract, or The insurance afforded by this policy for the benefit of written agreement that includes primary and the additional insured does not apply to non-contributory wording where required. 'property damage' to any building, structure or appurtenant structure intended to be occupied as ii 'private residence'. The term"private residence" The inclusion of one or more Insured under the terms of includes single family homes or residences, this endorsement does not increase our Limits of multi-family homes or residences, condominiums, liability. townhomes, and apartments. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard'' CG 20 37 07 04 0 ISO PropertiE!s, Inc., 2004 Page 1 of 1 ❑ t POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHIE;DULED PERSON OR ORGANUKATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ lzation s : Locations Of Covered Operations Additional Insureds shown in a written contract, or written Any location. agreement that includes primary and non-contributory wording. The inclusion of one or more Insured under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. SECTION II — WHO IS AN INSURED is amended B. With respect to the insurance afforded to these to include as an additional insured the person(s) or additional insureds; the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily n ur " or damage" or "personal and advertising injury" "property damage"occurring after: y 1 y caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions, or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the locations) location of the covered operations has been designated above. completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 2010 07 04 © ISO Properties, Inc.,2004 Page 1 of 1 ❑ POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 25 03 03 97 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGIREGATE LIMIT This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: Where as; Required by Written Contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally 3. Any payments made under COVERAGE A for obligated to pay as damages caused by damages or under COVERAGE C for medical "occurrences" under COVERAGE A (SECTION expenses shall reduce the Designated 1), and for all medical expenses caused by Construction Project General Aggregate Limit accidents under COVERAGE C (SECTION 1), for that designated construction project. Such which can be attributed only to ongoing payments shall not reduce the General operations at a single designated construction Aggregate Limit shown in the Declarations project shown in the Schedule above: nor shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Fire Damage and Medical 2. The Designated Construction Project General Expense continue to apply. However, instead Aggregate Limit is the most we will pay for the of being subject to the General Aggregate sum of all damages under COVERAGE A, Limit shown in the Declarations, such limits 9 if except damages because of "bodily injury" or will be subject to the applicable Designated property damage included in the Construction Project General Aggregate Limit. "products-completed operations hazard", and B. For all sums which the insured becomes legally for medical expenses under COVERAGE C obligated to pay as damages caused by regardless of the number of: "occurrences under COVERAGE A (SECTION a. Insureds; 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), b. Claims made or"suits" brought; or which cannot be attributed only to ongoing c. Persons or organizations making claims or operations at a single designated construction bringing"suits". project shown in the Schedule above.- 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. CG 25 03 03 97 Copyright, Insurance Services Office, Inc., 1996 Page 1 of 2 ❑ POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete the Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or"your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 13 ® DATE(MM/DD/YYYY) A�.oRO CERTIFICATE OF LIABILITY INSURANCE 7/18/2014 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(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 14AME: FAX Brown &Brown Insurance Brokers of Sacramento, Inc I c"I CI L.E.11:916-630-8643 (A/C No: -7 P. O. Box 619043 Lic#01­138004 &MAIL Roseville CA 95661-9043 /ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A INSURED JAMES88 IINSURER B:Financial Pacific 31453 Breneman Inc INSURER C: 2000 Norris Road INSURER D: Walnut Creek CA 94596 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1547027711 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL 0WR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR I WVD POLICY NUMBER _ MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE F�OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $ PRO- LOC _ $COMBIN POLICY E T A AUTOMOBILE LIABILITY Y BAP0180416 /30!2014 /30/2015 Ea accident $1;000,000 BODILY INJURY(Per person) $ ANY AUTO ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED Per accident $ ` X HIRED AUTOS X AUTOS $ B UMBRELLA LIAR X OCCUR Y 27303145 /30/2014 /30/201.5 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 I T DIED RETENTION$ — WC STATU I OTH- WORKERS COMPENSATION ER AND EMPLOYERS'LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below — DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder is included as an Additional Insured under Commercial Commercial Auto per endorsement CN 615(07/11), subject to a written contract between the Named Insured and the Additional Insured. Sample endorsement attached. "Subject to company approval. City of Cupertino, its City Council, boards and commissions, officers, employees and volunteers. RE: 2014 Reconstruction of Curbs, Gutters and Sidewalks. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue Cupertino CA 95014 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD A CENTURY NATIONAL INSURANCE COMPANY P.O. Box 3999 •North Hollywood, CA 91609-0599 For Service Call Your Broker. For Claims Call:800-733-1980 Name of Insured: Fadorscment Effbctiuc Date and Time: 13RFNFMAN INC 04/08/2014 at 10:37 AM Policy Number: Policy Term Covers ftom: Endorsement Number: 13A PO 1 80416 12:01 AM on 03/30/2014 to 03/30/2015 at 12:01 AM 003 Name of Agency: BROWN & BROWN OF CALIF INC 153700 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC ADDITIIONAL INSUREDS The following provision is added to Section F, pc-gje 1, Words and Phrases: By this endorsement, your broker may complete an Acord additional Insured form with the policy liability Limit shown on the declarations page, then the entity you are required in a written contract ("the contract") to name as an Insured, ("the Additional Insured") is an insured but only with respect to vehicle liability arising out of"your work", for the Additional Insured. The Limits of insurance provided for the Additional Insured shall not be greater than those required by the contract and, in no event, shall the Limits of this policy be increased by this endorsement. All insuring agreements, exclusions, terms and conditions of the Policy shall apply to the coverage(s) provided to the Additional insured and such coverage shall not be enlarged or expanded by reason of the contract. This insurance does not apply to Bodily Injury or Property Damage occurring after all work on the project to be performed by the Named Insured at the site of the covered operations has been completed by them. An additional insured is only insured for liability which is the result of an act or omission of the "NAMED INSURED" on the policy and shall have no coverage under this endorsement or the policy for its own acts or omissions, or th03e of its agents or employees, or those of any other person or entity for which it is vicariot.asly liable. Attached list shows the Additional Insureds currently on this policy with an additional insured endorsement. CLAIMS: In the case of any claim on this policy, Broker shall notify the underwriting department, if the claim is reported to the broker, that there maybe a particular certificate holder or additional insured involved in the claim. CANCELLATION: Should this policy cancel for non pay there will be a $10. per certificate and $10. per Additional Insured Endorsement charge because of the inordinately huge number of Certificates and Additional Insured Endorsements and the large amount of work involved in the cancellation. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Date Printed: 04/08/2014 Sample ANDREW PAULUS CN 615(07/11) Page 1 r ACC? CERTIFICATE OF LIABILITY INSURANCE DATE`18/2014 Y' ��, 07118/2014 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: PHONE FAX Automatic Data Processing Insurance Agency,Inc. A/C No Ext: A/C,No): E-MAIL 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: NorGUARD Insurance Company 31470 INSURED INSURER B: BRENEMAN INC IN13URER C: 2000 Norris Rd Walnut Creek,CA 94596 INSURER D INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 250238 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF PM/DD/Y XP LIMITS LTR INSD WVD POLICY NUMBER _ MMIDD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE-1 CLAIMS-MADE 7 OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- F LOC PRODUCTS-COMP/OP AGG $ $ OTHER: I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY(Per person) $ ANY AUTO - ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS AUTO NON-OWNED Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $—d EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ _ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N 1,000,000. A ANY PROPRIETOR/PARTNER/EXECUTIVE N bA Y BRWC452334 12/29/2013 12/29/2014 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1 000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedulo,may be attached if more space Is required) This certificate has a blanket Waiver of Subrogation. CERTIFICATE HOLDER (:ANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Ave Cupertino,CA 95014 AUTHORIZED REPRESENTATIVE A©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating thE! remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be l.o?____% of the California workers' compensation premium otherwise due on such remuneration. Schedule,, Person or Organization Job Description Blanket Waiver-Any person or organization for whom the All CA Operations Named Insured has agreed by written contract to furnish this waiver. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsernont is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. BRWC452334 Endorsement No. Insured Insurance Company Countersigned By _ ©1998 by the Workers'compensation Insurance Rating Bureau of California.All rights reserved.