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2400 - Doug Martin Contracting Company Inc - 2018-2019 Annual Slurry Seal Project a A This page is part of your document- DO NOT DISCARD A ,,,„Og '“R.� 20200246225 --�t� .14E1 �} II111 1111111111111111 II III .II P0�04 Recorded/Filed in Official Records_____I }�0=4 pii I if Recorder's Office, Los Angeles County, r• iTT California K c'4t!N�rx 03/02/20 AT 12:20PM RECEIVED CITY OF ROSEMEAD FEES: 0.00 MAR 0 2 REC'D TAXES: 0.00 OTHER: 0.00 CITY CLERK'S OFFICE BY: PAID: 0.00 A A 11111 I 111111 1111 I 111 I I 1111 111011 111111 1 1111 III 111 ill LEADSHEET 202003023260036 00017954990 III II II I IIII I II II I 1111 II I IIII 010563963 SEQ: 01 DAR - Counter (Upfront Scan) III II IIIIIIIIMI IIIIIIIIIHhII IIIIIIIIII II II II III III 1 IIIA IIII II I III I II 1 1 11 I I II I II III III 111111101 IIII A THIS FORM IS NOT TO BE DUPLICATED A EMM” RECORDING REQUESTED BY r� 03021204u CITY OF ROSEMEAD "Sig% AND WHEN RECORDED MAIL TO: \11.� Zp200246225" Name City of Rosemead -- Street Address 8838 E.Valley Blvd. City&State Rosemead, CA 91770 ATTN: CITY CLERK SPACE ABOVE THIS LINE FOR RECORDER'S USE Notice of Completion Notice is hereby given that: 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full name of the undersigned is: City of Rosemead 3. The full address of the undersigned is: 8838 E. Valley Blvd., Rosemead, CA 91770 4. The nature of the title of the undersigned is: In fee (If other than fee,strike"In fee"and insert,for example,"purchaser under contract of purchase",or"lessee") 5. The full names and full addresses of all persons, if any,who hold title with the undersigned are: Names Addresses N/A N/A 6. The names of the predecessors in interest of the undersigned, if the property was transferred subsequent to the commencement of the work of improvement herein referred to: Names Addresses N/A N/A (If no transfer made,insert,"none".) 7. A work of improvement on the property hereinafter described was completed on: January 21, 2019 8. The name of the contractor, if any for such work of improvement was: Doug Martin Contracting Company, Inc. 9. The property on which said work of improvement was completed is in the City of Rosemead County of Los Angeles ,State of California, and is described as follows: 2018-2019 Annual Slurry Seal Project 10. The street address of said property is: as listed in No. 9 (If no street address has been officially assigned,insert"none") Signature of !, owner named Dated: PZ I �'l//_t in paragraph 2: n Chris as e l� Director of Public Works By: City of Rosemead I certify (or declare) under penalty of perjury that the foregoing is true and correct. 61 2J azo Date Chris Daste Director of Public Works City of Rosemead, California Rosemead, CA Place of Execution l s a CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies onlythe identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of & AQ nq�,�,J' �6� On A(k 2i /4 - before me, � �s �� 4\-9 pko \c Date He>Insert Name and Title of the Officer personally appeared V `! UNJ Name( of Signer(( who proved to me on the basis of satisfactory evidence to be the personJ4'whose name($'isIefe subscribed to the within instrument and acknowledged to me that he,t& €,1 y executed the same in hisAier4414eir authorized capacity(;;and that by his� tiir signature(sron the instrument the person(ss, or the entity upon behalf of which the person$acted, executed the instrument. I certify under PENALTY OF PERJURY under the 4 E,;a.rF NATALIE HAWORTH laws of the State of California that the foregoing Notary Public-California Z ¢ : fa.' Los Angeles County paragraph is true and correct. Commission#2272060 ° �•"' My Comm.Expires Dec 20,2022 WITNESS my hand and official seal. Signature .)\3� Place Notary Seal and/or Stamp Above Signature Notary Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Docume t i/ ./� \ Title or Type of Document: �v"�l � p1Jr + Document Date: 3 2.120 l0 1 Number of Pages: 3 Signer(s) Other Than Named Above: \\I, ' Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— 0 Limited 0 General ❑ Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator 0 Trustee 0 Guardian of Conservator ❑ Other: 0 Other: Signer is Representing: Signer is Representing: :r:::: ::3:o-: ,..E•'• . ..•9•:. .. .. ,.,. .. .... .. .... .... .. .. .. .. .. .... .. .. .... .. .... .. .. . .. . ©2017 National Notary Association • O 9 Vii.;is p•F rwE (pm • McoRcoRareo vat CITY OF ROSEMEAD, CALIFORNIA Public Works/Engineering: 8838 East Valley Boulevard,Rosemead,California 91770 (626)569-2150 FAX:(626)307-9218 CONTRACT CHANGE ORDER Date: February 25, 2020 Contract Number: C 20101 Project: 2018-19 Annual Slurry Seal Project Change Order Number: 2 To: Doug Martin Contracting Company, Inc. 220 E. Foundation Avenue La Habra, CA 90631 Contractor Telephone: (714)441-0513 Attention: Mr. Doug Martin Contractor Fax: (714)441-0541 Description of Change (additional sheet attached) CO#2- Removal of Item No. 6 (Paint Home Addresses — Curb Numbers) from the base bid schedule. Please see attachment: -$16,496.00 Total Contract Change Order No. 2: -$16,496.00-CREDIT Reason for Change (additional sheets attached) The above-described changes are outside of the original scope of work. . Distribution Contractor E Consultant 0 Division ® Project Manager ® Project File ® Other: 0 Form PWE(Revised 5/09) Page 1 of 2 CITY OF ROSEMEAD CONTRACT CHANGE ORDER. . The change results in the following adjustment of Contract Price and/or Time: Description Amount %Change Original Contract Price $ 301,309.00 Net Change by Previously Authorized Change Orders/Contract Amendment $ 20,217.00 This Change Order $ -16,496.00 Credit Total Change Order Amount including this Change Order $ 3,721.00 Contract Price after Change Order(s) $ 305,030.00 Account/Program Numbers 201-6005-5395-21849-301->-$16,496.00 Contract Time prior to Change Order N/A • Net Increase In Days Authorized by this Change Order N/A Current Contract Time including this Change Order N/A Project Completion Date Including Net Increase in Days by Change Order , Contractor is hereby directed to make the herein-described changes and/or perform said herein-described work in connection with above reference project. All new work shall conform to the applicable provisions of the plans and specifications, except as specifically modified by the Contract Change Order. This Change Order No. 2 to Contract No. C20101 constitutes full and complete compensation for all costs associated with the above changes inclusive of insurance, contractors profit, direct and indirect overhead, extended office overhead, bonds,supervision, labor, materials and equipment. All other costs are non-compensable. All other provisions, requirements, terms and conditions contained in the above referenced Agreement remain in full force • and effect. This Change Order is not valid until signed by both City and Contractor. • Attachments: (List attached documents that support Change Order) Attached is Change Order#2 City of Rosemead Contractor/Consultant Prepared/Approved By: Accepted By; 37- ? "?e,7 Doug Martin Contracting Company, Inc. Chris Daste, rector of Public Works Date Name of Contractor )(JOIE hietA., ) 3/2/20 Contractor Representative Signature Date Additional City Approvals: Dixie Martin, Secretary Printed Name,Title Title Date • Tftle Date • Form PWE(Revised 5/09) Page 2 of 2 • w erg OS E A 10) Public Works Department-Engineering Division ANNUAL SLURRY SEAL PROJECT PROJECT No.21849 FISCAL YEAR 2018-2019 Preconstruction Meeting Agenda October 22ND, 2018—10:00 a.m. A. Opening Introductions • B. Project Description The project consists of crack sealing,slurry seal type II, striping and miscellaneous C. Construction Schedule Start Date: /U •, 1'41-4"/ .44/1.-e'-. //All&� Duration: 30 Calendar Days • Completion: A ax D. Project Contacts General Contractor Doug Martin Contracting Co _Fijitr/6_ 220 Foundation Avenue La Habra, CA 90631 A", tie 66 • (714)441-0513 • 3 l)el-1 S Attention:Doug Martin City of Rosemead Rafael M. Fajardo -City Engineer 8838 E. Valley Blvd. City of�oserrte Rosemead, CA 91770 Direct:.626/569-2151 PuflicWorks Department • Fax: 626/307-9218 Engine Division Email: rfajardo@cityofrosemead.org Recei /?f,! Dam; yro- Jason Best—Public Works Inspector Appronatj = _,_ �enieci (760) 885-4664 _,- ...�.` -• -�".- • E. Submittals • Emergency Contact List • Notice to Residents - • Construction Schedule • .17r Preconstruction Meeting Agenda Annual Slurry Seal Project Page 2 of 1 a Public Works Department-Engineering Division • F. Work o Hours 7:00 a.m.to 5:00 p.m. Monday to Friday. ® Traffic Control o AQMD o NPDES o Notice to Residents o Weight Master Certifications • ® Crack Sealing ® Striping-Thermoplastic . o Paint House Number-Delete G. Comments • a Notice to Proceed if Adjourn • • • Preconstruction Meeting Agenda Annual Slurry Seal Project Page 2 of 2 • • E M f O CAt�f F, ilb7tOf ���'OgATED 10h CITY OF ROSEMEAD, CALIFORNIA Public Works/Engineering: 8838 East Valley Boulevard,Rosemead,California 91770 (626)569-2150 FAX:(626)307-9218 CONTRACT CHANGE ORDER Date: March 2, 2020 Contract Number: C 20101 Project: 2018-19 Annual Slurry Seal Project Change Order Number: 3 To: Doug Martin Contracting Company, Inc. 220 E. Foundation Avenue La Habra, CA 90631 Contractor Telephone: (714)441-0513 Attention: Mr. Doug Martin Contractor Fax: (714)441-0541 Description of Change(additional sheet attached) CO#3- For an additional 8.34 tons of slurry seal. Please see attachment: $1,891.51 • Total Contract Change Order No. 3: $1,891.51 Reason for Change(additional sheets attached) El The above-described changes are outside of the original scope of work. Distribution Contractor ® Consultant 0 Division ® Project Manager ® Project File ® Other: 0 Form PWE(Revised 5/09) Page 1 of 2 • • CITY OF ROSEMEAD CONTRACT CHANGE ORDER • The change results in the following adjustment of Contract Price and/or Time: Description Amount %Chance Original Contract Price $ 301,309.00 Net Change by Previously Authorized Change Orders/Contract Amendment $ 5,612.51 This Change Order $ 1,891.51 Total Change Order Amount including this Change Order • $ 3,721.00 Contract Price after Change Order(s) $ 306,921.51 Account/Program Numbers 201-6005-5395-21849-301->$1,891.51 • Contract Time prior to Change Order N/A Net Increase in Days Authorized by this Change Order N/A Current Contract Time including this Change Order N/A Project Completion Date Including Net Increase in Days by Change Order__ Contractor is hereby directed to make the herein-described changes and/or perform said herein-described work in connection with above reference project. All new work shall conform to the applicable provisions of the plans and specifications, except as specifically modified by the Contract Change Order. This Change Order.No. 3 to Contract No. C20101 constitutes full and complete compensation for all costs associated with • the above changes inclusive of insurance, contractors profit, direct and indirect overhead, extended office overhead, bonds,supervision, labor, materials and equipment. All other costs are non-compensable. All other provisions, requirements, terms and conditions contained in the above referenced Agreement remain in full force and effect. This Change Order is not valid until signed by both City and Contractor. Attachments: (List attached documents that support Change Order) Attached is Change Order#3 City of Rosemead Contractor/Consultant Prepared/Approved By: Accepted By: -Jr 31(9ZV Z® Doug Martin Contracting Company, Inc. Chris Daste, r.ecto .f-ublic Works Date Name of Contractor (1)_ (AD 3/2/20 Contractor Representative Signature Date • Additional City Approvals: Dixie Martin, Secretary Printed Name, Title Title Date Title- Date Form PWE(Revised 5/09) Page 2 of 2 • • • • • • • • Page 1 JGAl 220 E FOUNDATION AVE. l.H HAORA,CA00931 O (114)441-0519 (714)441-0541 Fax L=/ Project Rosemead,2018-2019 Annual Application No: 2 s CONTRACTING Slurry Seal Project Invoice No: 2354.2 co.,INC. Invoice Date: 1/8/2019 Period To: 1/8/2019 • Project No: To:City ofRosemead ' Contract Date: 9/27/2018 8838 E.Valley Blvd. Rosemead,CA 91770 • Project Mgr. Rafael Fajardo For: DMC Yob No.1843 • . . _ COMPLETED CURRENT DUB Tons ITEM No. DESCRIPTION • TOTAL QuAxrnY UNrr COST TOTAL COST UMTS VALUE _ RIME Vi=va REQUEST 1 Clearing&Grubbing Demolition 1 LUMP • 6000.00 6,000.00 1 6,000.00 3,000.00 3,000.00 SUM 2 Disposal of Waste Materials • I LUMP 3000.00 3,000.00 1 ' 3,000.00 0.00 3,000.00 SUM 3 Crack Sealing 1 Lump 44000.00 • 44,000.00 . 1 ' 44,000.00 44,000.00 . 0.00 Sum 4 Slurry 8cal Type IfStreet Location 820 ELT 226.80 185,976,001 828.34 187;867.51 0.00 187,867,51 &Area 5 Traffic Striping&Pavement 1 Lump 45837.00 45,837.00 1 45,837.00 16,501.32 29,335.68 Markers Sum 6 Paint Home Addresses Curb 800 Each 20.62 16,496.00 0 0.00 0.00 0.00 Numbers 301,309.00 286,704.51 63,501.32 223,203.19 Original Contract 301,309.00 Change Order 0.00 • Contract Sum 301,309.00 Completed to Date 286,704.51 Retention • 14,335.23 Total Earned less Retention 272,369.28 Previous Billings 60,326.25 Current Payment Due 212,043.03 Total Due 212,043.03 • City offs .d Pub&Work Department . Engineering Di isian Si))'Receiv'! ) Date:3(21ZUZ Approv'1' . r 1t1 _ponied: ieed.. - 7 (is M 6 * 9O GiVIG,„„ 7 rf t�'' CITY OF ROSEMEAD, CALIFORNIA Public Works/Engineering: 8838 East Valley Boulevard, Rosemead,California 91770 (626)569-2150 FAX:(626)307-9218 CONTRACT CHANGE ORDER Date: January 7, 2019 Contract Number: C 20101 Project: 2018-19 Annual Slurry Seal Project Change Order Number: 1 To: Doug Martin Contracting Company, Inc. ' 220 E. Foundation Avenue La Habra, CA 90631 Contractor Telephone: (714)441-0513 Attention: Mr. Doug Martin Contractor Fax: (714)441-0541 Description of Change (additional sheet attached) O. CO#1 - Restripe City Hall and Library parking lot with one coat of traffic paint and add a second coat of paint. Please see attachment: $ 20,217.00 Total Contract Change Order No. 1: $20,217.00 Reason for Change(additional sheets attached) r The above-described changes are outside of the original scope of work. Distribution Contractor ® Consultant ❑ Division ® Project Manager ® Project File ►/ Other: 0 Form PWE(Revised 5/09) Page 1 of 2 - . v CITY OF ROSEMEAD CONTRACT CHANGE ORDER The change results in the following adjustment of Contract Price and/or Time: Description Amount %Change Original Contract Price $ 301,309.00 Net Change by Previously Authorized Change Orders/Contract Amendment $ 0.00 This Change Order $ 20,217.00 Total Change Order Amount including this Change Order $ 20,217.00 Contract Price after Change Order(s) $ 321,526.00 Account/Program Numbers 201-6005-5395-21849-301- $ 20,217.00 Contract Time prior to Change Order N/A • Net Increase in Days Authorized by this Change Order N/A Current Contract Time including this Change Order N/A Project Completion Date Including Net Increase in Days by Change Order._ Contractor is hereby directed to make the herein-described changes and/or perform said herein-described work in connection with above reference project. All new work shall conform to the applicable provisions of the plans and specifications, except as specifically modified by the Contract Change Order. This Change Order No. 1 to Contract No. C 20101 constitutes full and complete compensation for all costs associated with the above changes inclusive of insurance, contractors profit, direct and indirect overhead, extended office overhead, bonds, supervision, labor, materials and equipment. All other costs are non-compensable. All other provisions, requirements, terms and conditions contained in the above referenced Agreement remain in full force and effect. This Change Order is not valid until signed by both City and Contractor. Attachments: (List attached documents that support Change Order) Attached is Change Order#1 City of Rosemead Contractor!Consultant Prepared/Approved By: Accepted By: Doug Martin Contracting Company, Inc. Rafael M.Fajardo,P.E.,City Engineer Date Name : . ontractor fir Rey Alfonso,P.E.,Director of Public Works Date Contra. or Representative Signature Date Additional City Approvals: Tj(✓f�f A;na, 4) j9ilt Printed Name, Title I Title Date Title Date Form PWE(Revised 5/09) Page 2 of 2 466. . d ffmovige WW e# ® 1W1 44 c®cavwmcvisv� 0 d J 4 I lIT F4-4, ca,i m® Complete Road Slurry Services L ----D Doug Martin Contracting Co., Inc. LICENSE NO.: 470131 220 Foundation Ave. DIR NO.: 1000006526 La Habra, CA 90631 QUOTE NO.: 12/10/2018 REVISED 714-441-0513 FAX: 714-441-0541 DATE December 10, 2018 CUSTOMER ID EXPIRATION DATE TO Rafael M. Fajardo, P.E. PROJECT: Annual Slurry Seal City of Rosemead Project No. 21849 8838 E.Valley Blvd. Rosemead Rosemead, CA 91770 rfaiardo(c citvofrosemead.orq JOB SALESPERSON PAYMENT TERMS DUE DATE ' • iDue upon receipt Private Public Works x QUANTITY. ITEM NO. UNITS DESCRIPTION UNIT PRICE LINE TOTAL ' 1. !1 iLS ;RESTRIPE CITY HALL/LIBRARY PARKING i 10398.000! 10,398.00 ' `LOT WITH ONE COAT OF TRAFFIC PAINT ' ' 1 '2 :LS Add 2nd Coat of Paint 9819.000; 9,819.00 . Price includes traffic control Price includes sweeping '. Posting "No Parking" signs SUBTOTAL $ 20,217.00 Quotation prepared by: Doug Martin This is a quotation on the goods named,subject to the conditions noted below: (Describe any conditions pertaining to these prices and any additional terms of the agreement. TOTAL; $ 20,217,00 You may want to include contingencies that will affect the quotation.) T1-accept=this-quotation;sigith'ere and FettiaT —gyp Cit of Rps ,nee 'Put11c'i4/ rhs'Departmeni qual Opportunity Employer :nrtTe::ro��ct Division TH KYOU FOR YOUR BUSINESS! 2` c ,• Ol �C1'z (� `Deceived: -_____.._ ._._-• dle._ I Approved: 47 i en&Iar__._ E M F CIVIC PRIDE 9,' 9 ^� i� 'NCORPORATED 19y9 CONSTRUCTION CONTRACT 2018-2019 ANNUAL SLURRY �4SEAL PROJECT !' 1. PARTIES AND DATE This Contract is made and entered into this 27 day of SeplemAe c, 20 /3 (Effective Date) by and between the City of Rosemead, a municipal corporation of the State of California, located at 8838 E. Valley Blvd., Rosemead, California 91770, ("City") and Doug Martin Contracting Company, Inc. with its principal place of business at 220 E. Foundation Avenue, La Habre, CA 90631 (hereinafter referred to as"Contractor"). City and Contractor are sometimes individually referred to as "Party" and collectively as "Parties" in this Contract. 2. RECITALS 2.1 Contractor Contractor desires to perform and assume responsibility for the 2018-2019 Annual Slurry Seal Project by the City on the terms and conditions set forth in this Contract. Contractor represents that it is experienced in providing such work services to public clients, that it and its employees or subcontractors have all necessary licenses and permits to perform the Services in the State of California, and that is familiar with the plans of City. 2.2 Project City desires to engage Contractor to render such services described herein as Project ("Project") as set forth in this Contract. 3. TERMS 3.1 Scope of Services and Term 3.1.1 General Scope of Services. Contractor promises and agrees to furnish to the City all labor, materials, tools, equipment, services, and incidental and customary work necessary to fully and adequately supply the professional construction services necessary DOUG MARTIN CONTRACTING COMPANY, INC. Page 2 of 10 for the Project ("Services"). The Services are more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. All Services shall be subject to, and performed in accordance with, this Contract, the exhibits attached hereto and incorporated herein by reference, and all applicable local, state and federal laws, rulesand regulations. 3.1.2 Term. The term of this Contract shall be from Effective Date shown above to June 30, 2019 unless earlier terminated as provided herein. Contractor shall complete the Services within the term of this Contract, and shall meet any other established schedules and deadlines. The Parties may, by mutual, written consent, extend the term of this Contract if necessary to complete the Services. 3.2 Responsibilities of Contractor. 3.2.1 Control and Payment of Subordinates; Independent Contractor. The Services shall be performed by Contractor or under its supervision. Contractor will determine the means, methods and details of performing the Services subject to the requirements of this Contract. City retains Contractor on an independent contractor basis and not as an employee. Contractor retains the right to perform similar or different services for others during the term of this Contract. Any additional personnel performing the Services under this Contract on behalf of Contractor shall also not be employees of City and shall at all times be under Contractor's exclusive direction and control. Contractor shall pay all wages, salaries, and other amounts due such personnel in connection with their performance of Services under this Contract and as required by law. Contractor shall be responsible for all reports and obligations respecting such additional personnel, including, but not limited to: social security taxes, income tax withholding, unemployment insurance, disability insurance, and workers' compensation insurance. 3.2.2 Schedule of Services: Contractor shall perform the Services expeditiously,within the term of this Contract, and within the schedules timeline. Contractor represents that it has the professional and technical personnel required to perform the Services in conformance with such conditions. In order to facilitate Contractor's conformance with the Schedule, City shall respond to Contractor's submittals in a timely manner. Upon request of City, Contractor shall provide a more detailed schedule of anticipated performance to meet the Schedule of Services. 3.2.3 Conformance to `Applicable Requirements. All work prepared by Contractor shall be subject to the approval of City. 3.2.4 City's Representative. The City hereby designates the City Engineer, or his designee, to act as its representative for the performance of this Contract ("City's Representative"). City's Representative shall have the power to act on behalf of the City for all purposes under this Contract. Contractor shall not accept direction or orders from any person other than the City's Representative or his or her designee. 3.2.5 Contractor's Representative. Contractor hereby designates Mr. Doug Martin, or his designee, to act as its representative for the performance of this Contract ("Contractor's Representative"). Contractor's Representative shall have full authority to represent and act on behalf of the Contractor for all purposes under this Contract. 'The DOUG MARTIN CONTRACTING COMPANY, INC. Page 3 of 10 Contractor's Representative shall supervise and direct the Services, using his/her best skill and attention, and shall be responsible for all means, methods, techniques, sequences and procedures and for the satisfactory coordination of all portions of the Services under this Contract. 3.2.6 Coordination of Services. Contractor agrees to work closely with City staff in the performance of Services and shall be available to City's staff, consultants and other staff at all reasonable times. 3.2.7 Standard of Care; Performance of Employees. Contractor shall perform all Services under this Contract in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Contractor represents and maintains that it is skilled in the professional calling necessary to perform the Services. Contractor warrants that all employees and subcontractors shall have sufficient skill and experience to perform the Services assigned to them. Finally, Contractor represents that it, its employees and subcontractors have all licenses, permits, qualifications and.approvals of whatever nature that are legally required to perform the Services, including a City Business License if applicable, and that such licenses and approvals shall be maintained throughout the term of this Contract. As provided for in the indemnification provisions of this Contract, Contractor shall perform, at its own cost and expense and without reimbursement from the City, any services necessary to correct errors or omissions which are caused by the Contractor's failure to comply with the standard of care provided for herein. Any employee of the Contractor or its sub-contractors who is determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project, a threat to the safety of persons or property, or any employee who fails or refuses to perform the Services in a manner acceptable to the City, shall be promptly removed from the Project by the Contractor and shall not be re-employed to perform any of the Services or to work on the Project. 3.2.8 Laws and Regulations. Contractor shall keep itself fully informed of and in compliance with all local, state aind federal laws, rules and regulations in any manner affecting the performance of the Project or the Services, including all Cal/OSHA, AQMD requirements, and shall give all notices required by law. Contractor shall be liable for all violations of such laws and regulations in connection with Services. If the Contractor performs any work knowing it to be contrary to such laws, rules and regulations and without giving written notice to the City, Contractor shall be solely responsible for all costs arising therefrom. Contractor shall defend, indemnify and hold City, its officials, directors, officers, employees and agents free and harmless, pursuant to the indemnification provisions of this Contract, from any claim or liability arising out of any failure or alleged failure to comply with such laws, rules or regulations. 3.2.9 Insurance: Contractor shall maintain, prior to the beginning of and for the duration of this Contract, insurance coverage as specified in Exhibit B attached to and part of this Contract. 3.2.10 Safety. Contractor shall execute and maintain its work so as to avoid injury or damage to any person or property. In carrying out its Services,the Contractor shall DOUG MARTIN CONTRACTING COMPANY, INC. Page 4of10 at all times be in compliance with all applicable local, state and federal laws, rules and regulations, and shall exercise all necessary precautions for the safety of employees appropriate to the nature of the work and the conditions under which the work is to be performed. Safety precautions as applicable shall include, but shall not be limited to: (A) adequate life protection and life saving equipment and procedures; (B) instructions in accident prevention for all employees and subcontractors, such as safe walkways, scaffolds, fall protection ladders, bridges, gang planks, confined space procedures, trenching and shoring, equipment and other safety devices, equipment and wearing apparel as are necessary or lawfully required to prevent accidents or injuries; and (C) adequate facilities for the proper inspection and maintenance of all safety measures. 3.2.11 Prevailing Wages. Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 1600, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the Services are being performed as part of an applicable"public works"or"maintenance"project, as defined by the Prevailing Wage Laws, and if the total compensation is$1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Contract. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the Services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 3.2.12 Bonds. 3.2.12.1 Performance Bond: If specifically requested by City, Contractor shall execute and provide to City concurrently with this Contract a Performance Bond in the amount of the total, not-to-exceed compensation indicated in this Contract, and in a form provided or approved by the City. If such bond is required, .no payment will be made to Contractor until it has been received and approved by the City. 3.2.12.2 Payment Bond. If required by law or otherwise specifically requested by City, Contractor shall execute and provide to City concurrently with this Contract a Payment Bond in the amount of the total, not-to-exceed compensation indicated in this Contract, and in a form provided or approved by the City. If such bond is required, no payment will be made to Contractor until it has been received and approved by the City. 3.2.12.3 Bond Provisions. Should, in City's sole opinion, any bond become insufficient or any surety be found to be unsatisfactory, Contractor shall renew or -replace the affected bond within 10 days of receiving notice from City. In the event the surety or Contractor intends to reduce or cancel any required bond, at least thirty (30) days prior written notice shall be given to the City, and Contractor shall post acceptable replacement bonds at least ten (10) days prior to expiration of the original bonds. No further payments shall be deemed due or will be made under this Contract until any replacement DOUG MARTIN CONTRACTING COMPANY, INC. Page 5 of 10 bonds required by this Section are accepted by the City. To the extent, if any, that the total compensation is increased in accordance with the Contract, the Contractor shall, upon request of the City, cause the amount of thebonds to be increased accordingly and shall promptly deliver satisfactory evidence of such increase to the City. To the extent available, the bonds shall further provide that no change or alteration of the Contract (including, without limitation, an increase in the total compensation, as referred to above), extensions of time, or modifications of the time, terms, or conditions of payment to the Contractor, will release the surety. If the Contractor fails to furnish any required bond, the City may terminate this Contract for cause. 3.2.12.4 Surety Qualifications. Only bonds executed by an admitted surety insurer, as defined in Code of Civil Procedure Section 995.120, shall be accepted. The surety must be a California-admitted surety with a current A.M. Best's rating no less than A:VIII and satisfactory to the City. If a California-admitted surety insurer issuing bonds does not meet these requirements, the insurer will be considered qualified if it is in conformance with Section 995.660 of the California Code of Civil Procedure, and proof of such is provided to the City. 3.3 Fees and Payments. 3.3.1 Compensation. The total compensation shall"'°'a exceed Three,s' '!,ul d zero T Dasa hreWRROTredWi i fl rsTM($ M,0VO ithoutFad. .an" i.ge appsiva ofCitjrs projectaar�ag,er. Extra Work maybe authorized, as described below, and if authorized, will be compensated at the rates and manner set forth in this Contract. 3.3.2 Payment of Compensation. Contractor shall submit to City a monthly itemized statement that indicates work completed and hours of Services rendered by Contractor. The statement shall describe the amount of Services and supplies provided since the initial commencement date, or since the start of the subsequent billing periods, as appropriate, through the date of the statement. City shall, within 45 days after receiving such statement, review the statement and pay all approved charges. The payments will be subject to a 5% retention amount, which would be released and paid after all work under the Contract has been satisfactorily completed, and 35 days after a Notice of Completion is filed with the County of Los Angeles. 3.3.3 Reimbursement for Expenses. Contractor shall not be reimbursed for any expenses unless authorized in writing by City. 3.3.4 Extra Work. At any time during the term of this Contract, City may request that Contractor perform Extra Work. As used herein, "Extra Work"means any work that is determined by City to be necessary for the proper completion of the Project, but which the parties did not reasonably anticipate would be necessary at the execution of this Contract. Contractor shall not perform, nor be compensated for, Extra Work without written authorization from City's Representative. 3.4 Accounting Records. 3.4.1 Maintenance and Inspection. Contractor shall maintain complete and DOUG MARTIN CONTRACTING COMPANY, INC. Page 6 of.10 accurate records with respect to all costs and expenses incurred under this Contract. All such records shall be clearly identifiable. Contractor shall allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Contract. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to the Contract for a period of three (3) years from the date of final payment under this Contract. 3.5 General Provisions. 3.5.1 Termination of Contract. 3.5.1.1 Grounds for Termination. City may, by written notice to Contractor, terminate the whole or any part of this Contract at any time and without cause by giving written notice to Contractor of such termination, and specifying the effective date thereof, at least seven (7) days before the effective date of such termination. Upon termination, Contractor shall be compensated only for those services that have been adequately rendered to City, and Contractor shall be entitled to no further compensation. Contractor may not terminate this Contract except for cause. 3.5.1.2 Effect of Termination. If this Contract is terminated as provided herein, City may require Contractor to provide all finished or unfinished Documents and Data and other information of any kind prepared by Contractor in connection with the performance of Services under this Contract. Contractor shall be required to provide such document and other information within fifteen (15) days of the request. 3.5.1.3 Additional Services. In the event this Contract is terminated in whole or in part as provided herein, City may procure, upon such terms and in such manner as it may determine appropriate, services similar to those terminated. 3.5.2 Delivery of Notices. All notices permitted or required under this Contract shall be given to the respective parties at the following address, or at such other address as the respective parties may provide in writing for this purpose: CONTRACTOR: Doug Martin Contracting Company, Inc. • 220 E. Foundation Avenue La Habra, CA 90631 Attn: Mr. Doug Martin CITY: City of Rosemead 8838 E. Valley Boulevard Rosemead, CA 91770 Attn: Rafael M. Fajardo P.E., City Engineer Such notice shall be deemed made when personally delivered or when mailed, forty-eight (48) hours after deposit in the U.S. Mail, first class postage prepaid and addressed to the DOUG MARTIN CONTRACTING COMPANY, INC. Page 7 of 10 party at its applicable address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. 3.5.3 Cooperation; Further Acts. The Parties shall fully cooperate with one another, and shall take any additional acts or sign any additional documents as may be necessary, appropriate or convenient to attain the purposes of this Contract. 3.5.4 Attorney's Fees. If either party commences an action against the other party, either legal, administrative or otherwise, arising out of or in connection with this Contract, the prevailing party in such litigation shall be entitled to have and recover from the losing party reasonable attorney's fees and all other costs of such action. 3.5.5 Indemnification. Contractor shall defend, indemnify and hold the City, its officials, officers, employees, volunteers and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful death, in any manner arising out of or incident to any alleged acts, omissions or willful misconduct of Contractor, its officials, officers, employees, agents, consultants and contractors arising out of or in connection with the performance of the Services, the Project or this Contract, including without limitation the payment of all consequential damages and attorneys fees and other related costs and expenses. Contractor shall defend, at Contractor's own cost, expense and risk, any and all such aforesaid suits, actions or other legal proceedings of every kind that may be brought or instituted against City, its directors, officials, officers, employees, agents or volunteers. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against City or its directors,officials, officers, employees, agents or volunteers, in any such suit, action or other legal proceeding. Contractor shall reimburse City and its directors, officials, officers, employees, agents and/or volunteers, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by the City, its directors, officials, officers, employees, agents or volunteers. 3.5.6 Entire Contract. This Contract contains the entire Contract of the • parties with respect to the subject matter hereof, and supersedes all prior negotiations and understandings. This Contract may only be modified by a writing signed by both parties. 3.5.7 Governing Law. This Contract shall be governed by the laws of the State of California. Venue shall be in Los Angeles County. 3.5.8 Time of Essence. Time is of the essence for each and every provision of this Contract. 3.5.9 City's Right to Employ Other Contractors. City reserves right to employ other contractors in connection with this Project. 3.5.10 Successors and Assigns. This Contract shall be binding on the successors and assigns of the parties. 3.5.11 Assignment or Transfer. Contractor shall not assign, hypothecate, or transfer, either directly or by operation of law,this Contract or any interest herein without the DOUG MARTIN CONTRACTING COMPANY, INC. Page 8 of 10 prior written consent of the City. Any attempt to do so shall be null and void, and any assignees, hypothecates or transferees shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. 3.5.12 Construction; References; Captions. Since the Parties or their agents have participated fully in the preparation of this Contract, the language of this Contract shall be construed simply, according to its fair meaning, and not strictly for or against any Party. Any term referencing time, days or period for performance shall be deemed calendar days and not workdays. All references to Contractor include all personnel, employees, agents, and subcontractors of Contractor, except as otherwise specified in this Contract. All references to City include its elected officials, officers, employees, agents, and volunteers except as otherwise specified in this Contract. The captions of the various articles and paragraphs are for convenience and ease of reference only, and do not define, limit, augment, or describe the scope, content, or intent of this Contract. 3.5.13 Amendment; Modification. No supplement, modification, or amendment of this Contract shall be binding unless executed in writing and signed by both Parties. 3.5.14 Waiver. No waiver of any default shall constitute a waiver of any other default or breach, whether of the same or other covenant or condition. No waiver, benefit, privilege, or service voluntarily given or performed by a Party shall give the other Party any contractual rights by custom, estoppels, or otherwise. 3.5.15 No Third Party Beneficiaries. There are no intended third party beneficiaries of any right or obligation assumed by the Parties. 3.5.16 Invalidity; Severability. If any portion of this Contract is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction,the remaining provisions shall continue in full force and effect. 3.5.17 Prohibited Interests. Contractor maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Contractor, to solicit or secure this Contract. Further, Contractor warrants that it has not paid nor has it agreed to pay any company or person, other than a bona fide employee working solely for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Contract. For breach or violation of this warranty,.City shall have the right to rescind this Contract without liability. For the term of this Contract, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Contract, or obtain any present or anticipated material benefit arising therefrom. 3.5.18 Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor,employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. Contractor shall also comply with all relevant DOUG MARTIN CONTRACTING COMPANY, INC. Page 9 of 10 provisions of City's Minority Business Enterprise program, Affirmative Action Plan or other related programs or guidelines currently in effect or hereinafter enacted. 3.5.19 Labor Certification. By its signature hereunder, Contractor certifies that it is aware of the provisions of Section 3700 of the California Labor Code that require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions of that Code, and agrees to comply with such provisions before commencing the performance of the Services. 3.5.20 Authority to Enter Contract. Contractor has all requisite power and authority to conduct its business and to execute, deliver, and perform the Contract. Each Party warrants that the individuals who have signed this Contract have the legal power, right, and authority to make this Contract and bind each respective Party: 3.5.21 Counterparts. This Contract may be signed in counterparts, each of which shall constitute an original. 3.6 Subcontracting. 3.6.1 Prior Approval Required. Contractor shall not subcontract any portion of the work required by this Contract, except as expressly stated herein,without prior written approval of City. Subcontracts, if any, shall contain a provision making them subject to all provisions stipulated in this Contract. [SIGNATURES ON NEXT PAGE] DOUG MARTIN CONTRACTING COMPANY, INC. Page 10 of 10 • CITY OF ROSEMEAD DOUG MART ►. ,ONTRACTING COMPANY,INC. % � 24 �� By: r 141 September 7, 2018 Gloria Molleda, City Manager Date Date Name: Doug Martin Attest: `1/A i7 Title:Title: President EriCka Hernndez, City Clerk Da e ©de.'g er tion, *An Eti,A - o itti6W" de17 e_aary, 'D • C iis''6'0 %Az.. bir • Approved as to Form: By: ((.. bJL ri)Offthi / ' 7/.rb Name: Dixie Martin Rachel Richman, City Attorney Date Title: Secretary DOUG MARTIN CONTRACTING COMPANY, INC EXHIBIT A SCOPE OF CONTRACT SERVICES SEE ATTACHED BID SCHEDULE/PROPOSAL Issued in Triplicate Project No.21849 Performance Bond Annual Slurry Seal Project Page 1 Bond Number: 024065891 SECTION 00510 Premium: $1,736.00 PERFORMANCE BOND WHEREAS the CITY OF ROSEMEAD (also herein "Obligee") has awarded to Doug Martin Contracting Company, Inc. (hereinafter"Contractor"), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment,services, and incidentals for the ANNUAL SLURRY SEAL PROJECT PROJECT No.21849 and all other required structures and facilities within the rights-of-way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth in that certain contract for the said Public Work dated (hereinafter the "Public Work Contract"); and WHEREAS, the Contractor is required by said Public Work Contract to perform the terms thereof and to provide a bond both for the performance and guaranty thereof, NOW,THEREFORE, we Doug Martin Contracting Company, Inc. , the undersigned Contractor, as Principal, and Liberty Mutual Insurance Company , a corporation organized and existing under the laws of the State of Massachusetts , and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the CITY OF ROSEMEAD in the sum of Three Hundred One Thousand Three Hundred Nine and No/100 - - - dollars, ($ 301,309.00 --- ), said sum being not less than 100% of the total amount payable by the said Obligee under the terms of the said Public Work Contract, for which payment well and truly to be made,we bind ourselves, our heirs, executors and administrators, successors and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the said Public Work Contract and any alteration thereof made as therein provided, on his or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their intent and meaning; and shall faithfully fulfill the one-year guarantee of all materials and workmanship; and indemnify and save harmless the Obligee, its officers and agents, as stipulated in the said Public Work Contract, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. In the event legal action is required to enforce the provisions of this agreement, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements, and other damages. In case legal action is required to enforce the provisions of thil bond, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements and other consequential damages. The said Surety, for value received, hereby stipulates and agrees that no change, extensions of time, alteration or addition to the terms of the Public Work Contract or to the Work to be performed thereunder, or the specifications accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work or to Specifications. PB-1 Project No.21849 Performance Bond Annual Slurry Seal Project Page 2 IN WITNESS WHEREOF,we have hereto set our hands and seals this 10th day on September ,20 18 , Doug Martin Contracting Company, Inc. Princ. 1Contrar for By: c Pres'.ent Doug Martin Liberty Mutual Insurance Company Surety By: Attorney-in-Fact Denise Bennett The rate of premium on this bond is $5.76 per thousand. The total amount of premium charged, $ 1,736.00 1 (The above must be filled in by corporate surety.) . PB-2 Project No.21849 Performance Bond Annual Slurry Seal Project Page 3 STATE OF CALIFORNIA ) See Attached Acknowledgment with Correct California Wording ) ss. CON' Y OF On this day of , in the year , before me, , a Notary Public in and for said state, personally appeared , known to me (or proved to be on the basis of satisfactory evidence) to be the person whose name is s :-cribed to the within instrument as the Attorney-in-Fact of the (suret : d acknowledged to me that he subscribed the name of the (su thereto and his own name as Attorney-in-Fact. Notary Public in and for sal. ate (SEAL) My Commission expires • � 1 PB-3 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On September 10, 2018 before me, Candy A. Dakin, Notary Public (insert name and title of the officer) personally appeared Denise Bennett 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 bis/her/their signature(e) 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. , ���:�, CANDY A. DAKIN COMM. #2204226 z cc t; �;_," Notary Public.California o zaVittM;; San Bernardino County C/ � �� 1 'tafax_• NI Comm.ExpireAu$.3,20211 Signature (Seal) _i-, THIS-POWER OF ATTORNEY.IS NOT VAL=ID GNLESS IT IS`PRINTED-0N RED BACKGROUND Thts;Powef ofAttorney`_Iimitsthe;acts of those:named hereto andafiey,'have;noautliority to bind the Company exc"apt in the manner and;to the extent:hereih stated ` ----,-`,:-_-.-:--.:.-,-_,„;,---4.-_5•--------=---.----,-7=- ti"^✓\;� = is ;_ r _ �� ='ice CertificateNo8136003 Vii; `�'� r\'-� ti^�� '�� i"-` _ _^ ;%'�!�./ - _ --moi _��:J�`-^�✓C: ���.'-"_,,._.__-7._,:,..:2-.-,-,-„:„%--,,,,_-_-.„-_-,,y.„2„:' - " _ =v^ _.-_,,,,,-------- ---------;*---`7.---:5,--"s:----:,-- ��_� �-^ _ -3 Liberty-Mutuafl----ranee Com an- "- - ..r_ -`i" ,�^ —�.- �> _ J' `%,- ' ='= The•Ohio Casualt-Gi"surance--,.;,->-•:',"7-m p = = ;West Americana lnsurance,Com an :,-..„---;-_- --,7,,--,;-_-..,--, = _ _. - ---','"-.=-1,-.-->----%7:-',..7,-;"-----------,;-‘ — may' --,----.'-z- -P.Y ,<•� P Y`' _ �-- ' :- 5 �`lty-I -_ ��; _y� ti mow' _ - �- - iii ^ _.^ /. ^- � - \/ 'z=� .i=•'�T"%- .;'; �^\'\ _� POWER '.JI? I TORNEY - 1� -� ..----f,--.'''.; _ �'-KNOWN:ALL_PERSONS'BY THESE,PRESENTS That Thhe-0z9 -is=a=corporation;tlulyjorganiiedundi 'iheaaws:of-the State_of New;Hampstiiie,•thaf , Liberty Mutual lesuranceCompany,ls.a co�poratiohduly oigamzed'u ider the,laws;of;the State;oJMessac___,ts and=West Amencan Insurance Company is;a corporation duly or anlzea=under the"laws•of the State.of Indiana Herein collectively=called the'Companies%) pursuant to?..1)0.-12Y::authority,hereir set forth does,hereby name constitute and appoint; - Denise Bennetf:t aul:A.Bland JohiiM=Ga��ettCharise`M Steven C Mosier,- nfhla'S:Woznee_.,..7....*_---„,,-,-_-_--...‘.--_---- �=;-,- -;,-,-.:7,--:::?:-_--,.._-----.-_,,,-._-__ Y, Y Y:... � �. ^--_-::*...:.=.:::'---',-:--'-'2'----.,-,- -'-'-,-;---,;-_,::. ! , : • -If of the city of-Irvine—,..-, estate,_-..--:.,•,,A-,,:-_-,,,,.,„,..o _ each individually if there be Thore"than.flne named;itsarue arid.lawful:'attorney to-fact to m`ake;ezeoute;sel;acknowledg`e��, "and.'deliver;for a`nd omits;tielialfiassu�ety and as its acEand:deed,_ai)y:and;7.all undertaking`s;bonds,:recoghizances and othe[urety obligations iii pursuz cn a of thesepres'erits-and=shall -'= ice- �, t-:an �_; ' be as binding upondhe Companies as-if,they_have:been duly-"signed by tttepresldent and=attested by the secretary of the Companies in their'own proper persons — -.:-_-_-::-.3,-,-,-,,-...---,-:3--:. iN WlTNESScWHERE_OF;1fiis Power=of•Attorney has been subscnbed byan authorized:off cei_of`offcial of the Companies-and the corporate seals of the:Companies have been affixed �_,; therV"-IfN s,22ndB=,day of�iJune'- 2018 ===>_ - L; =�^ _ _>+ 1lv-_ ,, �.�NSGq�„,17-1,--`,-,..<4,--,-,,,--, .f N•iNSUr�`i \' �,,.:..:-,-,-..:;-_-.•,z- •„,-- __,...----`-.-;-:----:,-7,-- ✓'� „�; f-%; ,-�_. _C; �o. 9 ��Q +r .•,,,. ^, y„�F�, • _\,., :: The-'1. C e-II-ntyaeribe 9In aft pant' '� �T .'"-*E-:----- =:".,-,-.?�J i =� �' �� ”' Liberty Mutual Insurance Commpany ._'d' _^ 0 7• ? ; > ,1.912, :9 1-. ;1991_ 1 =� - = - 'i ""_ o •y: _� b _" �`: _ 1Nest me�ican"lris`_urance-Company_ -� Wr `ai-1 �-wi - - -=i�_ - - - - :1'''!"..'"-:A.\-:-n .:\ids= - .r,!ac - - - ��_.`. `i�•. ma . "_ _ 9 - ter`' - - - _ - -(:2"-*----.' ( - - "l-_;*'�� - -i _!_��'�.�:'-moi :i-u.Y��- ::-...-::::-.;:7_,.:7:� -- _ - _- 'i�-o): f -,ct^'s:- -�- a -,:=•----..::::',-.2. - �F. ;_.� �=,`���B -�.�� � '_ - _ -. " : - �'=�s � :-.--:3;':::.--7:::"--- �;��.�„ David M_Care ,_Assistant Secretary;-= _ _; '^O "ST4TEF.OF PENNSYLVANIA ss..� �_ "_ �,\ -- - _. _ter_ COUNTY OF,MONTGOMERY _,_ - __ _ _...;:_:„..._,...i.. _ _ d= On:Us- 2nd..da.6,June _._,.2018:before me ersonall;a eared-David:M..Care~-who acknowletl ed-himself=to.de the Asistant:Secretary of;Libert Mulualansurance s�`F c� Cf �.Y. P Y-_PP Davi. _ y'- =.9.: Y c). :v^ui.:Company„The Ohio CasualtyCompany,'and West`AmericanjnsuTance`Company;•:and that he; as=such;beirig'.auttiorizedso=.to do,execute,the_foregoing instrument for:the;purposes_ :j;uj- lL �'3' therein;coniained bysighing on'hetialf of the corporations by;himself a---;---,-1,-,i y authonzed.of_ficer:-, = - __.,--:--,----:.:-. -.:--"--- --f-..-5-:1-,:---,-..-:--,-_-_-_, i = ":1',--== _ "0= -� 7-1:_ _�i --- _ - - 31:7' _ - C =d=?; IN WITNESS:WHEREOF,-I:have'hereunto;subscribed my r•ame:and affixed-my,ootanalseal:at King'of Prussia,JPenn"sylvariia;on the---day and year first abo_ve_writteri, = "4)-7,0-. d,�' C' l r ,-7--"---:-.-.:-------.` 6P,?aSr �_ COMMONWEALTH OF PENNSYLVANIA ` \ � ; �� `E �--_ Q�Foe{w - '-. ^ -_--_ '7-7:: \ �/ 7������ Q-M =� 7x,_�Ev _ �Notan�l Seal ��' "-"- - _ _ V -_/- / Citi '4i e73:--...--:::::::1`..:7 ,.%Sis -� ��L - _._ -C,N_-:----'1-_:,-'-f:-.--1----':';:-`---- `���-` ��- ✓•��; - 1� o__- -,r_, �.--j1.----',7_:: :.; �ti;� _._:TereaP�stellallotaryPublic By .. _% _ J- w o t Dine _Count' Teresa Pastella-,Notary'Public_ ;•: =-�_ _ y-5_ Q'� •:-_ _ �. '��:_ ;oF �`^ `.%;��;UppeCMerion.T p. M n 9 ry� .;-� — `."--- -' '': --- ----- -;:. ".'' .---'7'‘-..---''7.::'' '- '-'2"7-'1'°7' i� `i a�P • MyComnnssion Explres.March'28t2021 ;r `Y �J _ ��, fo -o)�tJ' ;=% =, -,1---,-------=-,:--=----7--_---T- -� 20p �\ Mumtmr•:Perinsvlvania_,... ahon-ol Notanos ,:.---..7",-",,,:7-72.„."7;„•":„:,-,,,:::-.....7:--,- -f / s � F-2;=-_-_-.22.--; >r ;'o -This_ower=ofAttofpe is=made--and--executed%ursuant-to=and-b -autfiorit;of the-fojlowin B-Paws=and Authorizations-of_TheOhio=Casualty,Insurance'Company,'-Liberty=M_utuat.=y1_p C,` .Y .,.viii, :P_ Y_ _..Y _ g Y,. Insurance:CoTh an ;"and WestAmer'rcanansurance;Compaanywhich resolutionsare now iri_full force and effect reading-as.follows:i- :%, ;= _N_a+ ��_ _P Yom____---2:.-_--.,:_- .---- �, - "_-� ; - _ ^. = -':::>.---:' : _.: __ ,^ _ '++_a ea LART ICLE IV,OFFICERS;Section 12':Rowe of Attorney:Any officer or other official of the Corporation-authorized for.that-purpose inwriting by the Ghairma_n'or-the President and subject: OC: : .;; to such limdation_as the.Chairman o the President may pre`scnbe,snail appoint such attorneys m fact„asinaybe necessary to act ui_behalf ofzthe Corpo�ahon to make,:execute seal r :y C-,c.=ackriowle`dge:arid,de”"liver=asstirety any and-all_uridertaktngs,:6onds recognizances and othersuretyobligations-Suchattorneys;in fact,subject to the limitations set forth in their�espective= - - power of-attorney,shallhave-full power to bind=the Corporation by_their_sigriature,antl_ezecuhon of any such instruments and to:attach therein theseal=of the Corporation'When=so" -�-d= L'_t: a cute9 such;insfrumentsshall be as bindiri as_ifsi ned b the Rre`sident and attested to:6 the Sec�etar rAn• ower or authority rented to an`.re resentativ or aftome in-fact under".> - O;ca. _. 9 . . 9 Yc_, y Y- YP,_ Y9_ y,P Y _, o the;provisions:oftliis"articN.-P ay be revoked-:at any-time:by if.e Board;t-:z--firman the:P,res{dent'or.by tfie.officer or off cars granting sticti power_or,authority` _ - et_ v”=ARTICL=E:XIII-Ezecutio_n of Contracts SECTION 5--Sure Bonds and Undertakin s`An,officer.of,the Com ars authorised for that a os`e in:w�itiri:b -the;cfiairman or-the. resident; 00_ ns_c ry 9� Y P_ _Y,_-._ _ - P �P 9 Y_, ,__ri -_ P . ;? �, 2fld subjecttosUchaimitations=aas=the.ehairrtiafiorrthe pfesltlent mayprescribe,st"all appoint3uch:attomeys in=factras;may_be necessary to:act;in'behalf ofthe;Compariy to make,"execute; _�Ny- p,0 seal„acknowledge and deliver s;suretyany and alt undeltakings aiontls;,recogn zances and othersurety`obligations $uch attorneys to fact subject tJthe,limitations sal forth-in'their=:C ?_�- respective,Powers'of.atto`rriey;shall have full power to bind the Company by thirsignafu�e and execution of any such instruments and io attach thereto the seal of the Company When so-:O o_ ^`-_z v =executed sucfiirist�uments shall:6e.as=bind{ng as if signed tit'the:president=and attested by thesecretary - - -_ .0,.._ p_� _ Wit. = = _ -_ - _ _ - - I-'e- '.".Certificate of-Desi"nation:'The President•of the Com an�actiri ursuant-lathe 6,laws:of the Com en ,authonzes David.M.Carey,?Assistant Secreta-ry to'appoint suc_h'aftomeys in facf•as may;6eoecessary Coact on`behalf-of thiCd`inpany;to make,execute;seal,:acknowledge and:delrverassu�ef`y any and'all=undertakings bonds,,"recogn¢ances arid;other surety: obligatiins =I:b _ - - _; Authorization_By unanin diTh wnsentat the Company s Board of Directors;•the Company consentsthat facsimde:or mechanically'reproduced signature of any assistant sec�etary,ofthe,_ Go`mpanY,.whe�ever appearing upon a certified copy of any."power of attorney issued by.the:Company in connection with suety bonds;shall be_valid andib--nding;upon the Co ripany with tlie'same force and effect as though manually aff xed -\ ; l;;Re`nee C_Llewellyn,;ttie:_un`dersigned,:Assistant Secretary' Ttie Ohio:.Casualty,,Insivance;.Company-Liberty Mutual In'surance:Company, and_Wes"t=Amencan=Insurance;-Company do= =hereby ertify\that,the-original power of attorney of which atte;foregoing,is a full true and correct copy,of the Power of Atiomey executed by said.Companies;is"in full force and_effecCand l_ v has not been revoked` e: - _� - J -------:=_-_-:_ - '.IN TESTIMONY_WHEREOF,l have hereunto set;my_hand-a-----`xed-the seals of said Compan\es this` =day of -2018 20-- i, h,3-_-.�( & i91 ( l9 - ,C_� fj --„,_:_-,---e, ..(7,..: , r, - - - - - - = - Wil=-4_:.,:,---:.3.-,::::,--.5-_--:,-„.--,=:-:•-• - - - - - _ '- - u. -01-_:.--.-:.-19 :^ 1: o i '--..'1.::::.:`,„---', :gy„ _ _ _ _ r= _° f b y j �; Renee._C.Llewe ssistant Secretary O D "p 47-,-f,„.---,v<' - 7 ' ✓- /-_-_'>-:_'rte - c - _ " e".......2 b -- �- ),• `- Yi_ :,47 - - - - - . Wit. _ - _ J --.-.---R,=',;--;- %------ --''':=::::Jl -� \. i ` --.:::=4---7.-..--_-:,;--s,-----4:-- , \ ' icy �=i _ �✓ ✓ 16 of 500 �: - - ,..;-_-_-:::•.? ' =tSMS=12873-02201.T i i= Project No.21849 Performance Bond Annual Slurry Seal Project Page 4 CERTIFICATE AS TO CORPORATE PRINCIPAL I, Dixie Martin , certify that I am the Secretary of the corporation named as principal to the within bond; that Doug Martin who signed the said bond on behalf of the principal was then President of said corporation; that I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed and attested for and in behalf of said corporation by authority of its governing Board. (Corporate Seal) Q i bur___ I Vk cudi Signature September 12, 2018 Date NOTE: A copy of the power of attorney to local representatives of the bonding company may be attached hereto. • END OF SECTION PB-4 r - - Issued in Triplicate Project No.21849 Labor and Material Bond Annual Slurry Seal Project Page 1 SECTION 00520 Bond Number: 024065891 Premium included in the PAYMENT(LABOR AND MATERIALS)BOND Performance Bond WHEREAS the CITY OF ROSEMEAD(hereinafter"Obligee")has awarded to Doug Martin Contracting Company, Inc. (hereinafter"Contractor"), a contract for work consisting of but not limited to,furnishing all labor, materials,tools,equipment,services, and incidentals for the ANNUAL SLURRY SEAL PROJECT PROJECT No.21849 and all other required structures and facilities within the rights of way,easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth in that certain contract for the said Public Work dated , (hereinafter the "Public Work Contract");and WHEREAS, said Contractor is required to furnish a bond in connection with said Public Work Contract providing that if said Contractor or any of his or its subcontractors shall fail to pay for any materials, provisions, or other supplies, or terms used in, upon, for or about the performance of the Work contracted to be done;or for any work or labor done thereon of any kind, or for amounts due under the provisions of 3248 of the California Civil Code, with respect to such work or labor, that the Surety on this bond will pay the same together with.a reasonable attorney's fee in case suit is brought on the bond. NOW, THEREFORE, we Doug Martin Contracting Company, Inc. , the undersigned Contractor, as Principal and Liberty Mutual Insurance Company , a corporation organized and existing under the laws of the State of Massachusetts and duly authorized to transact business under thelaws of the State of California,as Surety, are held and firmly bound unto the CITY OF ROSEMEAD and to any and all material men, persons, companies or corporations furnishing materials, provisions, and other supplies used in, upon, for or about the performance of the said Public Work, and all persons, companies or corporations renting or hiring teams, or implements or machinery, for or contributing to said Public Work to be done, and all persons performing work or labor upon the same and all persons supplying both work and materials as aforesaid excepting the said Contractor, the sum of Three Hundred One Thousand Three Hundred Nine and No/100#ellars, ($ 301,309.00--- ), said sum being not less than 100% of the total amount payable by said Obligee under the terms of the said Public Work Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Principal, his or its subcontractors, heirs, executors, administrators, successors, or assigns, shall fail to pay for any materials, provisions, or other supplies or machinery used in, upon,for or about the performance of the Work contracted to be done, or for work or labor thereon of any kind,or fail to pay any of the persons named in California Civil Code Section 3181,or amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such claimant, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from — the wages of employees of the contractor and his subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor, and all other applicable laws of the State,of California and rules and regulations of its agencies,then said Surety will pay the same in or to an amount not exceeding the sum specified herein. LMB-1 ; f Project No.21849 Labor and Material Bond Annual Slurry Seal Project Page 2 In case legal action is required to enforce the provisions of this bond, the prevailing party shall be entitled to recover reasonable attorneys'fees in addition to court costs, necessary disbursements and other consequential — damages. In addition to the provisions hereinabove, it is agreed that this bond will inure to the benefit of any and all persons, companies and corporations entitled to make claims under Sections 3110, 3111, 3112 and 3181 of the California Civil Code,so as to give a right of action to them or their assigns in any suit brought upon this bond, The said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or additions to the terms of the said Public Work Contract or to the Work to be performed thereunder or —E the specification accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. IN WITNESS WHEREOF, we have hereto set our hands and seals this 10th day on September 1 2018 . Doug Martin Contracting Company, Inc. , PrincipalCordactor . By: , _ , /Uri-4 — President ! Doug Martin Liberty Mutual Insurance Company — Surety - By .. _.__,. % l: — Attorney-in-Fact Denise Bennett _ STATE OF CALIFORNIA ) See Attached Acknowledgment with Correct California Wording , C••k TY OF ) ss, On this day of , in the year , before me, ,a Notary Public in and for s '4 state, personally appeared , known to me(or proved to be on . oasis of satisfactory evidence)to be the person whose name is subscribed to the within instrument as the , orney-in-Fact of the -. surety) and acknowledged to me that he subscribed the name of the (surety •- eto and his own name as Attorney-in-Fact. Notary Public in ani or said State (SEAL) My Commission Expires LMB-2 i ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On September 10, 2018 before me, Candy A. Dakin, Notary Public (insert name and title of the officer) personally appeared Denise Bennett who proved to me on the basis of satisfactory evidence to be the person(.0whose name(() is/are subscribed to the within instrument and acknowledged to me that#m=/she/they executed the same in his/her/tbeir authorized capacity(.ies), and that by We/her/their signature.(s}on the instrument the person(s), or the entity upon behalf of which the person(ay 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. ,�.-�1+,. CANDY A. DAKIN r . r c COMM. #2204226 z z" r�^' Notary Public California o '; San Bernardino County Signature (Seal) Comm.Exaires A 3,2021 ' a- THIS POWER OF ATTORNEY IS NOT VALID UNLESS.IT"IS PRINTED ON RED BACKGROUND.- - " This Power of Attorney limits the acts of those-named herein,and they have no authority to bind the Company except M the manner and to the extent herein stated: "- - - Certificate No.-8136004 . : _ _• " -- Liberty Mutual Insurance Company- _, - _ -- • --• - - _ _. " - _ _ __ ". _ - The Ohio Casualty Insurance Company-.- ", West American_Insurance Company - -- "- ,- POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The-Ohio Casualty Insurance.Company is a corporation duly organized under the laws of the State of New Hampshire,that " `_=liberty Mutual Insurance Company is a-corporation duly organized under"the laws of the State of Massachusetts; and West American Insurance Company is a corporation duly ' • -organized under the laws of the State-of.Indiana(herein collectively called the"Companies');pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Denise Bennett;Paul A.Bland;John M.Garrett;Charise May;Steven C.Mosier;Cynthia S.Wozridy -. - - - - • all of the city of Irvine - ,state of CA" each individually if there be morelhan one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge "and deliver,for and on its,behalf as surety"and as its act and.deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall -=be as binding upon the Companies as-if they have-been duly signed by the president and attested by the secretary of the Companies in their own proper persons. - IN WITNESS WHEREOF:this, of Attorney-has been subscribed by an-authorized officer or official of the Companies and the-corporate seals of the.Companies have been affixed - -1 - thereto this 22nd -day of June -- , 2018 - - - - " - _ �' -, l.vs(,T - r,Nsuy^ :rain �F - The Ohio Casualty-Insurance Company ` tn } z - _ :- _ _Liberty Mutual Insurance'Company " 0 1919 1912. ° , 1991 - West AmerlCan Insurance Company _ •N a yN, p� ail- - David M.Carey'Assistant Secretary - = C " c STATE OF PENNSYLVANIA ss - - CO +_L- COUNTY OF-MONTGOMERY- -- - - - - .= - - O, — O 2� On this-22nd "day of June - " •_ -, 2018,before me personally appeared David M.Carey,who acknowledged himself to-be the Assistant Secretary of Liberty Mutual Insurance v F-I U m Company,-The Ohio Casualty-Company,and West American Insurance Company, and that he, as such, being authorized so•to do, execute the foregoing instrument for the purposes >W *6 therein contained by signing on behalf of the corporations by himself as a duly-authorized officer. " O.i c Ei N >" • IN-WITNESS WHEREOF,I have hereunto-subscribed name • and affixed my notarial seal at King of Prussia,Pennsylvania,on the day • and year7irst above written. O Q Co Z 7,6 _ ec, PASr� COMMONWEALTH OF PENNSYLVANIA _- Q ce) .0 a t 4.Qo r��oro ,Eq`^�? j Notarial Seal (//�� LJ2Z0By: f�'( -- co ` •- - _ - ..OF i Upper Marion Twp..Montgomery County - Teresa Pastella,Notary Public -� _ — L. - _ 'O -��'r - 1 My.Cornmission Expires March 28.2021 _ - 3 tC l y lysytvr ,s, _... - - - E 6 O .- - - - - -r4Fiy P�� . Member,Pennsyrvenm Association ol,Notaries - - - a as 1 e as This Power of Attorney is made and-executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual ut o j 1- Insurance Company,and West,Ainerican Insurance Company which resolutions are now in full force and effect reading as follows:. • - " - c as m •ARTICLE IV-OFFICERS-Section 12.Power of Attorney.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject 0 e r to such limitation as the Chairman or the President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the-Corporation to make,execute,seal,' .�y -O.E -acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surely obligations- Such attorneys-in-fact,subject to the limitations set forth in their respective a, E powers of attorney,"shall have full power to bind the Corporation-by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so 76 d O executed,"such instruments shall betas binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under >_C2 cls the provisions of this article may be revoked at any lime"by the Board,the Chairman,the President or by the officer or officers granting such power or authority. " - - - - a)Tt �.,N a/ c ARTICLE XIII-Execution of Contracts-SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, E 00 -� and subject to such limitations-as the chairman orthe president may prescribe,shall appoint such attorneys-in-fact;as may be necessary to act in behalf of the Company to make,execute, ,-M O 3 seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their Eo? ? 0respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and-to-attach thereto the seal of the Company. When so O o - executed such instruments shall be as binding as:if signed by the president and attested by the secretary.- _ - " " " " - " O t0 Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- - :"_fact as may be necessary to act on.behalf of the Company to make,execute.seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety - obligations. • Authorization-By unanimous consent of the Company's Board Of Directors,the Company consents that facsimile or mechanically reproduced signature of any.assistant secretary of the Company,wherever appearing upon_a certified copy of any power.of attorney issued by the Company in connection with surety bonds,shall be valid-and binding upon the Company with the same force and effect as though manually affixed. ;, - - - - " . _ .I, Renee C. Llewellyn, the"_undersigned,,Assistant Secretary, The Ohio.Casualty Insurance Company, Liberty_Mutual Insurance Company, and West American Insurance Company do hereby certify that the"originalpower of attorney of which the foregoing is,a full,true and correct copy of the Power of Attorney executed-by said.Companies, is in full force and effect and ,has not been revoked. - _- - -- _ - ,-IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of - - - "'SEP 1 n 201R ,20 • yJ�\,ov-AI �-9.,,, e •2 ° 1991 - o • -- - By: - - - ce _. �5 _ y - - _- - - - - _ - - • o Renee C.Llewe Assistant Secretary �y�lsrn:•.as``� 7l'srt;N4c - ,>rna;:H" _ - " - k t it .. - " : 17 of 500 _ LMS"12873 022017 - - - _ - - - - - . -_ - - - — - r • Project No.21849 Labor and Material Bond Annual Slurry Seal Project Page 3 CERTIFICATE AS TO CORPORATE PRINCIPAL is Dixie Martin , certify that I am the Secretary of the corporation named as principal in the attached bond, that Doug Martin who signed the said bond on behalf of the principal was then President of said corporation; that I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed and attested for and in behalf of said corporation by authority of its governing Board. (Corporate Seal) (1 CU.� Signature September 12, 2018 Date NOTE: A copy of the power of attorney to local representatives of the bonding company may be attached hereto. END OF SECTION LMB-3 SECTION 00300 BID FORMS FOR ANNUAL SLURRY SEAL PROJECT PROJECT No,21849 .C-1 V(C "Pa6it1'f£0 ig Bid Submittal Form Project No.2'f 8+E9 Annual Slurry Seal Project Page 1 1 SECTION 00300 BID FORMS BID PROPOSAL ANNUAL SLURRY SEAL PROJECT PROJECT No.21849 BID SCHEDULE Name of Bidder DOUG MARTIN CONTRACTING COMPANY, INC. The undersigned, having examined the proposed Contract Documents and having visited the site and examined the conditions affecting the work, hereby proposes and agrees to furnish all labor, materials, equipment, and appliances, and to perform operations necessary to complete the work as required by said proposed Contract Documents,excluding work of alternates for. a CL1R13QII11RGt I1IIC1IIRGGRRGLTB QIIR Q EIMIIIIII IfIIIIRIIRIIRIIt1IIII Lt U131113IIGG13IIIIRII IIR RLlAIIIIIIRRRIIIItiOLiHR9 GRQ01 11 BASE BID SCHEDULE • NO, ITEM DESCRIPTION UNIT QTY. UNIT PRICE TOTAL Clearing &Grubbing per Demolition Plans and LS Specifications. 2 Disposal of Waste Materials LS 1 l- ezr0. 3 Crack Sealing LS 1 Jill 61o ¢ Slurry Seal Type II–See exhibit"AR&"B"per ELT 820 �z street locations&areas. Traffic Striping and Pavement Markers–See LS 1 b exhibit"C"per details. 451?1 4/5- 1 o 6 Paint Home Addresses (Curb Numbering) EA 800 ,'A(;2., J TOTAL BASE BID PRICE–items 1 to 6(in Figures) $ 30/ 5®r /1-,-',11-2116116\ til . Y�lii J, 7.4"ele Dollar Amount in Written Form • Note:The City of Rosemead reserves the right to reduce or increase the quantities of any items in the schedule of bid items above, within the limits define in Section 3-2.2.1 of the Standard Specifications, to stay within the budgeted amount of this project. Project No.21849 Bid Submittal Form Annual Slurry Seal Project Page 2 If the Bid Documents specify alternate bid items,the following Alternate Bid amounts shall be added to or deducted from the Total Bid Price entered above. The owner can choose to include one or more of the alternates in the Total Bid Price of the Project.If any of the Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total Bid Price for the Project, The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party,whichever is earlier. The undersigned also agrees that if there is a discrepancy between the written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall govern. Attached hereto is a certified check, a cashier's check or a bid bond in the amount of Dollars ($ 10%an) aid amount being not less than ten percent(10%)of the Total Bid Price. The undersigned agrees that said amount shall be retained by the Owner if,upon award,we fail or refuse to execute the Contract and furnish the required bonds, certificates and endorsements of insurance and other certifications within the time provided. If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be prepared by the Owner for execution,within five(5) Calendar Days following the Letter of Award for the Contract,and will deliver to the Owner within that same period the necessary original Certificates of insurance, Endorsements of insurance, Performance Bond, Payment Bond and all other documentation and certification required by the Contract. The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing 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. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the Business and Professional Code), arising from purchases of goods, materials or services by the Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to he Contractor. Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom;and(3)any other information and documentation,financial or otherwise,needed by Owner to award a Contract to the lowest responsible and responsive bidder. Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts of five hundred dollars($500.00)if project is not completed in THIRTY(30)calendar days.The Contract Time will begin to run ten (10) Working Days from the date of the Notice of Proceed and subject to the terms and conditions described in the Contract Form and the Contract Documents. Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be incorporated into a Contract arising out of this Submittal has been so identified by Bidder. Bidder further acknowledges that the Owner may, at its discretion, incorporate any of the remaining data submitted herewith into a contract arising out of this Bid. - The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. • , Project No.21849 Bid Submittal Form Annual Slurry Seal Project Page 3 Addenda Nos. The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials,and equipment or supplies necessary to complete the Work as described in the Bid Documents, If this bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the necessary bonds and accept the Total Bid Price as compensation in full for all Work under the contract. Respectfully submitted: �� ,A4 z, 220 Foundation Ave., La Habra, CA 90631 ignatu yr Address Doug Martin, President _ July 31, 2018 Title Date 470131 March 31, 2019 1000006526 Contractor's License Number Date of Expiration Department of Industrial Relations Registered No. (Seal—if Bid is by a Corporation) • Attest Dixie Martin, Secretary 10% of Total Amount Bid Amount of Certified Check or Bid Bond Liberty Mutual Insurance Company Name of Bonding Company Project No.21549 Bid Submittal Form , Annual Slurry Seal Project Page 4 Bond No. N/A BID BOND KNOW ALL PERSONS BY THESE PRESENTS that WHEREAS the City of ROSEMAD, California ("City") has issued a notice inviting bids for the work described as follows:ANNUAL SLURRY SEAL PROJECT—PROJECT No. 21849 WHEREAS Doug Martin Contracting Company, Inc. 220 E. Foundation Avenue, La Habra, CA 90631 (Name and address of bidder) ("Principar),desires to submit a bid to City for the work. WHEREAS,bidders are required to furnish a form of bidder's security with their bid. NOW,THEREFORE,we,the undersigned Principal, and that the said Surety's Office is located at: • Name Liberty Mutual Insurance Company Address 790 The City Drive South, Suite 200 Orange, CA 92868 Telephone 714-634-3311 and the California Licensed Resident Agent for said Surety is: Name Garrett/Mosier Insurance Services, Inc. insurance Agent's Licens&,No. CA License No. 0684519 Address 12 Truman Irvine, CA 92620 Telephone 949-559-6700 ("Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the City in the penal sum of Ten Percent of the Total Amount Bid--- Dollars ($ 10%-- ), being not less than ten percent(10%0).of the total bid price,including alternates,in lawful money of the United States of America,for the payment of which sum well and truly to be made., we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal is awarded a Contract for the work by the City and,within the time and in the manner required by the bidding specifications,enters into the written form of Contract included with bidding specifications,furnishes the required bonds,one to guarantee faithful performance and the other to guarantee payment for labor and materials, and furnishes the required insurance coverage,then this obligation shall become null and void;otherwise,it shall be and remain in full force and effect. In case suit is brought upon this bond, Surety further agrees to pay all court costs incurred by the City in the suit Project No.21849 Bid Summit€el Forst , Annual Slurry Seal Project Page 5 and reasonable attorneys'fees in an amount fixed by the court. IN WITNESS WHEREOF, this instrument has been duly executed by Principal and Surety, on the date set forth below,the name of each corporate party being hereto.affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Date: July 31, 2018 "Principal" "Surety" Doug Martin Contracting Company, Inc. Liberty Mutual Insurance Company BY: Au VA B 4 , /6 aZarinia11146(0- Doug Ma tin, is President Cy j - . Wozey, Its A-orn�.l -Fact By: By: Its Its (Seal) (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney-in-fact must be attached. Corporate seal must be impressed hereon in case of corporation. II 11 - C LiiFORM ALL PURPOSE T P Li ill __A.notary public or-other officer completing.this.certificate.verifies only,the identity =_ of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. N X51 -State of Ca•lifornia County of Orange. } On July 31, 2018 before me, Heather M° Martin, Notary Public _i (Here insert name and tale of the officer) J 'l pi�t rally.a Doug Martin: who-proved to me on the basis of satisfactory evidence to be the.person- whose �` name$ are subscribed to the wit `n instrument and acknowledged to me that �' /she/they executed the same i his her/their authorized capacity(i s), and that by is her/their signature on the instrument the person(, or the entity upon behalf of , VII I L��__,�_ r l whlic t the verso*acted,executed the instrument €t l I certify under PENALTY OF PERJURY under the laws of the State of California that . 1 the foregoing paragraph is true and correct- ._._ -- -,.. HEATHER M. MARTIN ` ,6I lel- • ,,,,,•- . P. z'1 NESS my hand and off€ciai seal. r`" -v Commission No.2116253 g i U i:,w"'•- ole: 2 -" NOTARY PUBLIC-CALIFORNIA • `".�`'�r, l l{ ORANGE COUNTY i J " My Comm_Expires JUNE 19,2019 - W ,,, , y - / Al" (NotaryPublic Seal) I Notary Public Signature 7 1�ISTRt TIONS": OR.CO11IIt f*Krbiti': EES FORB/1 3 AD .IiT; AL OPTIONAL h FJ it AT kki €Thfe farm complies-with current California sfatttfes regarding notary wording and, D.€SC-RII'.TI.ON-oF THEATTIACFIED 1)OGUME-IT (needed,should be completed and attached to the doczmzenL Aclnouledagrnents from other states may be completed for documents being sent to that state so Iong as the wording does not require the California notary to violate California notary law. - (rale or description of attached document) • o State and County information'must he the State and County where the document I. signers)personally appeared before the notary public for aeliaowledginent FM • -a =vdce-tif-au .amost-be,trctetelha.he-s-igrer�Esj.persuntiil-appm-1-.tauiu •fiitiaorerescripfton-of aria rid dormtfe„ILoli:rotted) must also be the sante-date the aclatowledgment is completed.- o The notary public must print his or her name as it appears within his or her 8 - Nurnb€r-=of=P-ageS 'DocumenrDate -comniission-fdllOwelrbyacomma-emit'llieuyour-title(notarypublic). o Print the names) of document signer(s) who personally appear at the time of notari?ation_ CAPACITY CLAIMED BY THE SIGNER ° Indicate the correct singular or plural forms by crossing off incorrect forms(ie. 1 Individual t he/she/ -is/are)or circling the correct forms.Failure to correctly indicate this LI ndiv€dual(S) ?_Thent-vr..!S?iroa-nfa int --to-rektoborn.flf.3�,rc,ttn„er.d.Tacr.,rr7s La... a row seat impression.mast be clear and photographically tepmd1tribfe. - Impression must not cover te��t or lines.Ifseal impression smudges,n;-seal if a Titl -suficientareapemiits;otherwise-complete,a=differentaelm ttled„amentform: e Signature of the notary public must match the signature on file with the office of 1 Ci f ai-tne'(s) the county clerk. I ❑ Attorney-in-Fact Additional information is not required but could help to ensure this i D Trustee(s) . aelmowledgment is not misused or attached to a different documem( i Indicate title orttypeofattacheddocument,number ofgagesand date. _ . i u I e^; 1 z In icste the capacity claimed by the aper.7f the nlairreed r�p2�tx is-a T 1 corporate officer,indicate the title(i.e.CEO,CFO,Secretary). . Gic Jc800-873-9365 Securely aftach this document to the signed document-witha staple.e- ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On July 31, 2018 before me, Candy Dakin, Notary Public (insert name and title of the officer) personally appeared Cynthia S. Wozney who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/afe subscribed to the within instrument and acknowledged to me that-he/she/thy executed the same in his/her/treir 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 persons) 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. i'� '4'. CANDY A. DAKIN 6 COMM. #2204226 z c. " NotaryPublic.California o:d; �;s.� / / z it^-.0 San Bernardino County //�� Q G /--` 111.,„ Comm.Ex tires Aug.3,2021 ' Signature <.�— (Seal) • :-THIS POWER:OFATTORNEYIS NOT.VALID UNLESS IT-IS(PRINTED ON RED BACKGROUND -..I Thi • s Power of Attorney limitsthe acts of.those:named Herein and they have no authority to bind the Company except in the manner and to_the extent herein stated.: . Certificate No:.-7935893. - Liberty Mutual Insurance Company-- . -• The Ohio Casualty Insurance Company West American Insurance:Company . " 1 " . - . P.OWE(-''OP ATTORNEY • ' - ;KNOWN:ALL PERSONS..BY THESE,PRESENTS:That The:Ohio'Casualty:Insurance.Company is a corporation duly organised under the laws-of the State of New Hampshire;.that - : Liberty Mutual Insurance.Company is a corporation duly organized under the laws of the State of Massachusetts,.and West American Insurance Company IS'a corporation'duly :organized.under the laws-of the State of Indiana-(herein collectively called the"Companies');pursuant to and by_authority herein set forth,does hereby-name,-constitute ands appoint, . • •-.Denise Bennettt Paul A.Bland,_fill t1%.".Garrett Ctiarise May Steven C Mosier;-Cynthia S Wozney = • : - _; •- • 'allofthe-City of:lrvine - -. ,state-ofC : .:"::.7-7,.:.-':':eachigdividuallyifthe ebe orethan:onetianled its" true:and awful attorne -in,i,.,c to make,execute seal;acknowledge -and deliver for :on its behalf as surety and as:its act and deed anrand all undertakings;bonds recognizances•and other-suretyobligations in:pursuance of these presents and shall •` be as binding upon the Companies as_if theyhave.beera;duly signed by tfiepresident and attested'by the secretary of the Companies in their own pfoper persons- have been affixed-Co antes v e`-s of the m : ::IN WITNESS WHEREOF;this Power of AttorneyJi:as beensubscribedljy•an authorized o€fce[:.aeofficial afithe::Companres and.ahecotpo.:rates 2i p .: :: thereto this Rilldayof November •.1 2017 = ". - _ ••''��Y INist, • As..1 SUq,I : `P�tt4S//.44 : . - • The Ohio-Casualt Irisurance:Com an. - - N• J'`p43C.fl.��'/C' J�JCLJPY.)n.,'T<`S'F `r�`L�PPO,'rn)��,.' y. P Y tR:, ,; - ...• z . •6 .n . 'o • Liberty Mutual Insurance Company. �-, o- 1919 a . 1912 ° 199?. Z • • WestAmerican Insurance Company c o ' z �> • fz , Y • • N _ .-.-..s. rtimaw: yA >'`-rnctnn= .ntawJ • • . • ,As STATE OFPENNSYLVANIA ss • • David M.Care sistant Secretary d. : COUNTY'OF MONTGOMERY- p -P 0) On-this 10th -.day of Noverriber 2017,before.me personally appeared David M:.Catey,who acknowledged.himself to-be the Assistant:Secretary of Liberty Mutual.Insurance: -v H-; J. Gi: Company,,The Ohio 0 44 Casualty Company,and West American Insurance.Company,_and that'he, as such; being authorized so,to do,execute the foregoing instrument for purposes ?y,(n. therein contained b sr nin on behalfof the co orations byhimself as a dui authorized officer. 5 Y 9 g' rP Y • ° • L Ey:>'`_IN WITNESS WHEREOF,I have hereunto subscribed.my name and-affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above:written. •. `:o.0_ • +'Its • p, PAS)- COMMONWEALTH OF PENNSYLVANIA M - ._. • .Izt So- .1(( . .. Notarial Seal - - ��" ""`" -. • tri: r- o =.p Teresa Pastella;Notary Public • .By: -0 B y • -. , OF. - • Upper uerienTwpx Montgomery County . - - Teresa.Pastella;Notary Public • - --y-S_ �. 6-••= - ��s My Commission Expires March 28,2021 CC� i 0'; .. • Q: dig? -•410.. _ Member:Pennsyivania Association of Notaries - ' • G- ' Y p y. Y 9 Y P y. y ci _.� -This Power of-Attorney is roads and executed Pursuant to,and•b Authority of the followin B -laws:and Authorizations of The Ohio.Casualty Insurance Company::;:Elbert-Mutual . rn �: 'Insurance Company,end.West American Insurance Company which resolutions are now in full force and effect reading.as follows:• :;.co • Is 2.: ARTICLEIV-OFFICERS-Section 92-Power ofAttorney:Any Officer or other official of the Corporation authorized.for that purpose in writing by the Chairman or the President,and subject:.0.e ??,01:•to such limitation as:the Chairman or thePresident may prescribe,shall appoint such:attorneys-in fact,.as may be necessary to act in behalf of the Corporation to:make:execute;:seal;. g 7,C -acknowledge and deliver as surety anyandell undertakings,bonds,recognizances endother suretyobligations: Such attorneys-in-fact,subjectto the limitations set forth in their respective 'a 2 Gi_"powers of attorney,'shall-have fill]power to bind:the Corporation:by their signature and execution.of any such instruments and to"attach thereto the sea}of.the Corporation:..When'so- �.00. . - g.. 9. Y _ y ry .yp Y9 y. p Y .. 5 �,iexecuted;such.instruments shallbe as.bindjn as if sf ried-6 the-Presidenfand attested to b the Secreta An ower of authorit ranted to an re resentative orattome-in=fact under >,it-.: .the:provisions of this article may be revoked:at.any time by-.the Board;the Chairman,tho.Prepident or by the.ofceror officers granting such power or authority: E. :ARTICLE XIII. Execution of Contracts-SECTION 5;Surety Bonds and Undertakings.Any officer of the Company authorized,for that purpose in writing by the the president; -EoT. a?.::and:subject to-such limitations as the orthe president may prescribe,shall appoint such attorneys-in-fact;as maybe necessary'to actin behalf of.the C_ompany to make,-.execute,.., - j' L._•seal_acknowled a and deliver.-as suretyan and all . undertakiR s,bonds,-recti nizanceS and other sure obligations: :Such attorneys-in-fact subject to,the limitations:set forth in tfieir. _:0' respective.powers of attorney,shall have full power to bind.the Company by their signature and execution of any such instruments and to:attacb thereto the:seal of the Company::When so :V o • executed:such instruments=shall be as-binding as if signed by-the president and attested bythe,secretary, -r.p f°. -.7-certificate.of Designation.-The Presideot:of the Compan re~ brig p Fstianf tathe B lawso#the Com 'an authorizes peuld. l Care ,is•MSI tant;Secretarry tAapppint such attorneys-in r. ' `=fact es may beinecessary-lo act on behalf f the to i iake execute,seal,acknowledgs-and deliver as.suretyanyand all undertakings,bonds,•recognizances and other surety =obligations. - — s creta o th -�fa � assistate f - facsimile or mectiariicall ie roduced si nature o n .• ;'Autlioriiation=By-unanirnousc0nsent offi;e,Gompariy'sl3gard of Dili�etors,thy=Companycortsenlstfiat f rn.... y p g .. _.. �' ry ::Company;whereverappeanng.upon a certified.copy of-any power of`attorney issued by the Company in connection-witti surety bonds,shall be.vali -and binding upon the.Company with..- -the sameforce and effect as.though•fttantfalfy.affaed:= = • - _ ' ::.do : ance Co an ercan Insur m - :�'a ua d su`ance Com an `•rand=:V11"est Am i • elC Llewel(�- the-undersi ried, AssistahY=.Se'cretary•The Ohio='.Casualty Insurance�;Gompany;:Ciberfy.M t I n• r p .y,. - ... P Y • =':I Rene . . Yn, 9 . . . - - - : hereby certify that the original power.of-attorney:of-ttihith the:foregoing is:a:fu11;'{fue-and-correct•copy of"the.-Power of Attorneyexeeuted]iy'-sa¢LConipanies,is.in full force:and"effect.and has not beers revoked:::' = - -IN TESTJMOh1YWHEREOF,I.have hereunto setmy.hand and affixed:the seals of"saidCompanies this'`. -day of ' .i-b• �L'tNSU ,- Pi tt--s'bgl hJ .coy, �'%2 A:3 NOnq-Gt, 4.,,,,4P0R9T�( ' '•. ' --;-a-.:-.. 1919 : ? ? 1912 • " :.-1991 o, By; -•t'.-' - -.-. y - . Renee C.Llew •, ssistent Secretary `['fiats A�S�'. - �7?`sAcrNs`,yp? • *4 - • • _ _ . . 225 of 2S0 - -•• - LMs_i2873_022017-. - Project No.21849 Bid Submittal Form Annual Slurry Seal Project Page 6 DESIGNATION OF SUBCONTRACTORS Doug Martin Contracting Company, Inc. Name of Bidder Each bidder shall set forth below: 1. The name and location of the place of business of each subcontractor who will perform work or labor _ or render service to the Contractor in or about the construction of the work or improvement, or a subcontractor Iicensed in the State of California who, under subcontract to the Contractor, specially fabricates and installs a portion of the work or improvement according to detailed drawings contained in the Plans and Specifications, in an amount in excess of one-half of one percent of the Contractor's total bid. 2. The portion and estimated dollar amount of the work which will be done by each subcontractor. The Contractor shall list only one subcontractor for each portion as is defined by the Contractor in his/her bid. 3. If the Contractor fails to specify a subcontractor or if the Contractor specifies more than one subcontractor for the same portion for work to be performed under the Contract in excess of one-half of one percent of the Contractor's total bid, he/she agrees that he/she is fully qualified to perform that portion himself/herself, and that he/she shall perform that portion himself/herself. If after award of Contract, the Contractor subcontracts any such portion of the work, the Contractor shall be subject to the statutory penalties. This list, and subsequent changes thereto, shall be subject to the approval of the City and additionally for cause cited in the public contract code. Submit an updated and approved DESIGNATION OF SUBCONTRACTORS form prior to execution of the City-Contractor Contract. Please type or legibly print each subcontractor's information(attach additional sheets as necessary). SUBCONTRACTORS Name; gc.6O 2 i iWiQ, 6atQa,�fork Description: t% K 5 � Address: e C '1/4()U ereYv ,City; t ' f ti State: elk Zip: ?/ n License No. 9-Yee', C6"7 Department of Industrial Relation Registration No,/OOOO /72,C ax'A:.FAAAAAAAAAA.CAA;.AAkF'kk:F**:FAA:.AAAAAAAA:.AAAl. , 45— Name: ./L 4_, �� //.i ark Description: 9 fi Address: 3/ City: l/ /' ' / State: )- Zip: License No. `7'7 I 3 0 4 Department of Industrial Relation Registration No. /oo6je/62 kk.tic:FSAAA:****Jc*************—** ********r,** Project No.21849 Bid Submittal Form , Annubl Slurry Seal Project - Page 7 Name: Work Description: Address: City: State: Zip: License No. Department of industrial Relation Registration No. **********AAAA**AAAAAkl:***AAAA**AAAAAAAA,LA** Name: Work Description: Address: City: State: Zip: License No. Department of Industrial Relation Registration No. AAAAAA*AAAAA AAA;.;.AAAk.,AAAAk*********AAAk**** , Name: Work Description: Address: City: State: Zip: License No. Department of Industrial Relation Registration No. ..._. **AAA*:.::..7.. .AAAAAAAAAAAAA.LA****;,IA***AAAAA The Contractor shall not: A. Substitute any person as subcontractor in place of the subcontractor listed in the original bid, except that the City may consent to the substitution of another person as subcontractor: 1. When the subcontractor listed in the bid,after having had a reasonable opportunity to do so,fails or refuses to execute a written Contract, based upon the general terms, conditions, Plans and Specifications for the project involved or the terms of such Contractor's written bid, is presented to him by the Contractor,or 2. When the listed subcontractor becomes bankrupt or insolvent,or 3. When the listed subcontractor fails or refuses to perform his/her subcontract,or 4. When the listed subcontractor fails or refuses to meet the bond requirements of the Contractor,or 5. When the Contractor demonstrates to the City that the name of the subcontractor was listed as the result of an inadvertent clerical error,or 6. When the listed subcontractor is not licensed pursuant to the Contractors License Law,or 7. When the City determines that the work performed by the listed subcontractor is substantially unsatisfactory and not in substantial accordance with the Plans and Specifications, or that the subcontractor is substantially delaying or disrupting the progress of the work. B. Permit any subcontract to be voluntarily assigned or transferred or allow it to be performed by anyone other than the original subcontractor fisted in the original bid, without the consent of the City. Project No.21849 Bid Submittal Form Annual Slurry Seal Project Page 8 C. Other than in the performance of"change orders" causing changes or deviations from the original Contract, sublet or subcontract any portion of the work in excess of one-half of one percent of the Contractor's total bid as to which his/her original bid did not designate a subcontractor. Prior to approval of a Contractor's request for a subcontractor substitution,the City will give notice in writing to the listed subcontractor of the Contractor's request to substitute and of the reason for the request. The notice will be served by certified or registered mail to the last known address of the subcontractor. The listed subcontractor who has been so notified shall,have five(5)working days within which to transmit to the City written objections to the - substitution. Failure to file these written objections shall constitute the listed subcontractor's consent to the substitution. If written objections are filed, the City will give notice in writing of at least five (5) working days to the listed subcontractor of a hearing by the City on the Contractor's request for substitution. The Contractor, as a condition to assertinga claim of inadvertent clerical error in the listing of a subcontractor,shall within two working days after the time of the bid opening by the City, give written notice to the City and copies of such notice to both the subcontractor he/she claims to have listed in error and the intended subcontractor who had bid to the Contractor prior to the bid opening. Subletting or subcontracting of any portion of the work in excess of one-half of one percent of the Contractor's total — bid as to which no subcontractor was designated in the original bid shall only be permitted in cases of public emergency or necessity, and then only after a finding reduced to writing as a public record of the City setting forth the facts constituting the emergency or necessity. If the Contractor violates any of the above provisions the Contractor may be in breach of this Contract and the City may exercise the option,in its own discretion,of(1)canceling this Contract,or(2)assessing the Contractor a penalty in an amount not more than ten percent of the amount of the subcontract involved, and this penalty shall be deposited in the fund out of which the prime Contract is awarded. • • 4 Project No.21849 • Bid Submittal Form Annual Slurry Seal Project Page 9 NONCOLLUSION AFFIDAVIT State of California ) ss. County of Los Angeles ) Doug Martin ,being first duly sworn, deposes and says:That he or she Name - President of Doug Martin Contracting Company, Inc. ,the party making the foregoing bid; Title Company Name that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive of sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and,further, that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to'any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid, BIDDER: Doug Martin Contracting Comp , Inc. By: .7 Ze . Title: Doug Martin, President State of County of On before me, I�N� DATE OW,1. -OF OFFICER-EG.,°JANE DOE,NOTARY PUBIJC° Personally appeared NAME(S)SIGNER(S) Personally known to m- d OR A 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. WITNESS my hand and official seal. • SIGNATURE OF NOTARY ...�..m_ -.,.-".----.--->;,.,,_>.- .,aa.a.urs ......:za2.�^,r.- ..�..�, _ - 'c-+�,. ,::cur ..�r...�sa;...,.o ,K.,..-.. �.�,,.. .y..-a.: m,,ca -.-�,r�':. rs'.,,,. l ` iii; g. 1i!' t uRAT i„ rill ii" ii1 il;.l iil1 0 • mi Ilii IjA notary public or other officer completing this certificate verifies only the identity of lid =1 . I.E¢ Twit:,.i 1 f a, e.ti= me-:: _ . .1 41 lii� ?�-..:�-� !����`�,�-�! #'hy c1n.!�-5�.;.w�##�r�.nchi[r�t�t thisr.�3.9�fi��tri f��t#�r1�r�rl_i �a-t��n� .- Il ?o, the truthfulness, accuracy, or validity of that document. ,. itlf r if-i State f r:lifnria 1'` it io rid Ki County of Oraiage • It M. 1.11 IN iii Subscribed and sworn to (or affirmed) before me on this 31 day of July , NI `111111! i1 i' "' 20 18 by Doug Martin i ' ih� � i`iI 411! IIT 1ji `i 1111 proved to me on the basis of satisfactory evidence to be the person who appeared iiiii i iiii i 1 before me. HEATHER Rile MARTIN~ E ii iim 'i - cti,,art Commission No.2116253 g io, 1i z :}, r.; ? NOTARY PUBLIC-CALIFORNIA 2 WI Ilii z :s ORANGE COUNTY IN I, // . C ata—4 My Comm.Expires JUNE 19.2019 ii i 114 �t 'ill II„ Signature (Seal) IN i671 la. iN o e. ki °';ii Marr T ON.a L INF= R A o eON INS R'U :TiONS t`l; int - i-:. I, i:i - ii j The wording of all Jurats completed in California after January 1,2015 must be in the form i i • as set.,. K • within this Jurat There am no exceptions.If a Jurat to be completed does not Ili' I it; rollowthisfpm,the nater/mustcorrectthe verbiage byusingajuretStav ntainingthe !til rill correct wording or attaching a separate jurat form such as this one with does contain the !NI I �? proper wording. In addition, the notary must require an oath or ahirmation hem the � I IA DESCRIPTION OF THE ATTACHED DOCUMENT document signer r gardng theilrss of he:enfants of the docuinent. The 19 111 docanant must be a:vied FLR the oath or ea-rill-Samif Ore dammedJaspr�scusy 111 Isigned,it must be resigned in front of the notary public during the Jurat process. ill Ili ' iitleordescriptionofat`tacheddocument) !pi IIi v-State: -and L'ouniy"ittbmnatio-n mustte'-th s alt:and' o ,i`dereretne- NI tridocument signer(s) ersonall appeared before the notaryl i' i personally pp public. lit, ;IA (Pile or descripfion of attached document continued) , o Date of notarization must be the date the signer(s) i personally 11 i:$ 10 til, appeared which must also be the same date the jurat process is NI completed. Fell I 1 Number of Pages Document Date Print the name(s)of the document signer(s)who personally appear at Irl ilNI • the time of notarization. iii rlii }}`_i _ s-<S.sgnat%.'r.:of:the motany:publc:must: at"- the —Ffiile:bi4§tri:the sill it;� Additional information ofce ofthe county clerk ->!l a The notary seal impression must be clear and photographically i' Il`~?t • reproducible.Impression must not cover text or lines.if seal impression r, I1ll i}f smudges, re-seal if a sufficient area permits, otherwise compiete a i°' ltd Iii Illi different jurat-form. , • ;;ill 11 . - Additional information Is not required but could help : 1= to ensure this jurat is not misused or attached to a i'� If different document. � `'� Indicate title or type of attached document,number of I' (tlt pages and date. 14�'!I , it'.il. Securelyatar ithis document tot the signed document will a staple. '�� kPa Isl Ili iii %1115 Version wwi.itotaiyClasses.com 800-873-9565 !Hi ,`�!F it I Project No.21849 Bid Submittal Form . Annual Stony Seal Project Page 12 5. REFERENCES The following are the names, addresses and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two(2)years: t City of Lake Forest, 15555 Commercentre,92630 Name and Address of Owner • Madjid Yazdi, 310-809-6820 Name and telephone number of person familiar with project 772,068.04 Slurry Seal, Crackfill, Sstriping, AC 02/28/18 Contract amount Type of Work Date Completed 2. City of Pasadena, 101 Garfield Ave., Pasadena Name and Address of Owner John Ramey, 626-744-7311 Name and telephone number of person familiar with project $441,359.35 Slurry Seal Striping,AC 04/25/18 Contract amount Type of Work Date Completed 3. City of Bellflower, 9944 Flora Vista Street, 90706 Name and Address of Owner Frank Preciado, 562-804-1424 Name and telephone number of person familiar with project 454,009.14 Slurry Seal, Striping 06/30/2017 Contract amount Type of Work • Date Completed 4. City of Arcadia, 240 Huntington Drive _ Name and Address of Owner • Jan Balancy, 626-256-6582 • Name and telephone number of person familiar with project 624,135.54 Slurry Seal, Striping, Crackfill,AC 04/07/90_17 Contract amount Type of Work Date Completed DOUG MARTIN CONTRACTING COMPANY, INC E 1111;IT INSURANCE REQUIREMENTS Prior to the beginning of and throughout the duration of the Work, Contractor will maintain insurance in conformance with the requirements set forth below. Contractor will use existing coverage to comply with these requirements. If that existing coverage does not meet the requirements set forth here, Contractor agrees to amend, supplement or endorse the existing coverage to do so. Contractor acknowledges that the insurance coverage and policy limits set forth in this section constitute the minimum amount of coverage required. Any insurance proceeds available to City in excess of the limits and coverage required in this Contract and which is applicable to a given loss, will be available to City. Contractor shall provide the following types and amounts of insurance: Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01 or the exact equivalent. Defense costs must be paid in addition to limits. There shall be no cross liability exclusion for claims or suits by one insured against another. Limits are subject to review but in no event less than $1,000,000 per occurrence. Business Auto Coverage on ISO Business Auto Coverage form CA 00 01 including symbol 1 (Any Auto) or the exact equivalent. Limits are subject to review, but in no event to be less that$1,000,000 per accident. If Contractor owns no vehicles,this requirement may be satisfied by a non-owned auto endorsement to the general liability policy described above. If Contractor or Contractor's employees will use personal autos in any way on this project, Contractor shall provide evidence of personal auto liability coverage for each such person. Workers Compensation on a state-approved policy form providing statutory benefits as required by law with employer's liability limits no less than $1,000,000 per accident or disease. Excess or Umbrella Liability Insurance (Over Primary) if used to meet limit requirements, shall provide coverage at least as broad as specified for the underlying coverage. Any such coverage provided under an umbrella liability policy shall include a drop down provision providing primary coverage above a maximum $25,000 self-insured retention for liability not covered by primary but covered by the umbrella. Coverage shall be provided on a "pay on behalf' basis, with defense costs payable in addition to policy limits. Policy shall contain a provision obligating insurer at the time insured's liability is determined, not requiring actual payment by the insured first. There shall be no cross liability exclusion precluding coverage for claims or suits by one insured against another. Coverage shall be applicable to City for injury to employees of Contractor, subcontractors or others involved in the Work. The scope of coverage provided is subject to approval of City following receipt of proof of insurance as required herein. Limits are subject to review. DOUG MARTIN CONTRACTING COMPANY, INC FOR NON-CONSTRUCTION CONTRACTS: Professional Liability or Errors and Omissions Insurance, as appropriate, shall be written on a policy form coverage specifically designed to protect against acts, errors or omissions of the Contractor and "Covered Professional Services" as designated in the policy must specifically include work performed under this Contract. The policy limit shall be no less than $1,000,000 per claim and in the aggregate. The policy must "pay on behalf of' the insured and must include a provision establishing the insurer's duty to defend. The policy retroactive date shall be on or before the effective date of this Contract. Insurance procured pursuant to these requirements shall be written by insurers that are admitted carriers in the state of California and with an A.M. Bests rating of A-or better and a minimum financial size VII. General conditions pertaining to provision of insurance coverage by Contractor. Contractor and City agree to the following with respect to insurance provided by Contractor: • 1. Contractor agrees to have its insurer endorse the third party general liability coverage required herein to include as additional insured City, its officials, employees and agents, using standard ISO endorsement No. CG 2010 with an edition prior to 1992. Contractor also agrees to require all contractors, and subcontractors to do likewise. 2. No liability insurance coverage provided to comply with this Contract shall prohibit Contractor, or Contractor's employees, or agents, from waiving the right of subrogation prior to a loss. Contractor agrees to waive subrogation rights against City regardless of the applicability of any insurance proceeds, and to require all contractors and subcontractors to do likewise. 3. All insurance coverage and limits provided by Contractor and available or applicable to this Contract are intended to apply to the full extent of the policies. Nothing contained in this Contract or any other Contract relating to the City or its operations limits the application of such insurance coverage. 4. None of the coverage required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved of in writing. 5. No liability policy shall contain any provision or definition that would serve to eliminate so-called "third party action over"claims, including any exclusion for bodily injury to an employee of the insured or of any contractor or subcontractor. 6. All coverage types and limits required are subject to approval, modification and additional requirements by the City, as the need arises. Contractor shall not make any reductions in scope of coverage (e.g.- elimination of contractual liability or reduction of discovery period) that may affect City's protection without City's prior written consent. DOUG MARTIN CONTRACTING COMPANY, INC 7. Proof of compliance with these insurance requirements, consisting of certificates of insurance evidencing all of the coverage required and an additional insured endorsement to Contractor's general liability policy, shall be delivered to City at or prior to the execution of this Contract. In the event such proof of any insurance is not delivered as required, or in the event such insurance is canceled at any time and no replacement coverage is provided, City has the right, but not the duty, to obtain any insurance it deems necessary to protect its interests under this or any other Contract and to pay the premium. Any premium so paid by City shall be charged to and promptly paid by Contractor or deducted from sums due Contractor, at City option. 8. Certificate(s) are to reflect that the insurer will provide 30 days notice to City of any cancellation of coverage. Contractor agrees to require its insurer to modify such certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of cancellation imposes no obligation, or that any party will "endeavor" (as opposed to being required) to comply with the requirements of the certificate. 9. It is acknowledged by the parties of this Contract that all insurance coverage required to be provided by Contractor or any subcontractor, is intended to apply first and on a primary, noncontributing basis in relation to any other insurance or self insurance available to City. 10.Contractor agrees to ensure that subcontractors, and any other party involved with the project who is brought onto or involved in the project by Contractor, provide the same minimum insurance coverage required of Contractor. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Contractor agrees that upon request, all Contracts with subcontractors and others engaged in the project will be submitted to City for review. 11.Contractor agrees not to self-insure or to use any self-insured retentions or deductibles on any portion of the insurance required herein and further agrees that it will not allow any contractor, subcontractor, Architect, Engineer or other entity or person in any way involved in the performance of work on the project contemplated, by this Contract to self-insure its obligations to City. If Contractor's existing coverage includes a deductible or self-insured retention, the deductible or self- insured retention must be declared to the City. At that time the City shall review options with the Contractor, which may include reduction or elimination of the deductible or self-insured retention, substitution of other coverage, or other solutions. 12.The City reserves the right at any time during the term of the contract to change the amounts and types of insurance required by giving the Contractor ninety (90) days advance written notice of such change. If such change results in substantial additional cost to the Contractor, the City will negotiate additional compensation proportional to the increased benefit to City. DOUG MARTIN CONTRACTING COMPANY, INC 13.For purposes of applying insurance coverage only, this Contract will be deemed to have been executed immediately upon any party hereto taking any steps that can be deemed to be in furtherance of or towards performance of this Contract. 14.Contractor acknowledges and agrees that any actual or alleged failure on the part of City to inform Contractor of non-compliance with any insurance requirement in no way imposes any additional obligations on City nor does it waive any rights hereunder in this or any other regard. 15.Contractor will renew the required coverage annually as long as City, or its employees or agents face an exposure from operations of any type pursuant to this Contract. This obligation applies whether or not the Contract is canceled or terminated for any reason. Termination of this obligation is not effective until City executes a written statement to that effect. 16.Contractor shall provide proof that policies of insurance required herein expiring during the term of this Contract have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. A coverage binder or letter from Contractor's insurance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City within five days of the expiration of the coverage. 17.The provisions of any workers' compensation or similar act will not limit the obligations of Contractor under this Contract. Contractor expressly agrees not to use any statutory immunity defenses under such laws with respect to City, its employees, officials and agents. 18.Requirements of specific coverage features or limits contained in this section are not intended as limitations on coverage, limits or other requirements nor as a waiver of any coverage normally provided by any given policy. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue, and is not intended by any party or insured to be limiting or all-inclusive. 19.These insurance requirements are intended to be separate and distinct from any other provision in this Contract and are intended by the parties here to be interpreted as such. 20.The requirements in this Section supersede all other sections and provisions of this Contract to the extent that any other section or provision conflicts with or impairs the provisions of this Section. 21.Contractor agrees to be responsible for ensuring that no contract used by any party involved in any way with the project reserves the right to charge City or Contractor for the cost of additional insurance coverage required by this Contract. Any such provisions are to be deleted with reference to City. It is not the intent of.City to reimburse any third party for the cost of complying with these requirements. There DOUG MARTIN CONTRACTING COMPANY, INC shall be no recourse against City for payment of premiums or other amounts with respect thereto. Contractor agrees to provide immediate notice to City of any claim or loss against Contractor arising out of the work performed under this Contract. City assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve City. ACO/?O® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/Y/VY) 46.------ 9/13/2018 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 have ADDITIONAL INSURED provisions or 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). CNACT PRODUCER Adamson & McGoldrick Insurance Solutions NAME:: Account Managers 1150 E. Orangethorpe Ave., Suite 100 HONE.Ext): 714-257-9644 FAX No ): 714-257-9833 Placentia, CA 92870 E-MAIL ADDRESS: certificates@adamsonmcgoldrick.com __ INSURER(S)AFFORDING COVERAGE _ NAIC# www.snains.com INSURER A: The Travelers Indemnity Companyf Connecticut 25682 INSURED INSURER B: Travelers Property Casualty Co of America 25674 Doug Martin Contracting Co., Inc. 220 E. Foundation Avenue INSURERC: La Habra CA 90631 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 44185788 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 SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) A / COMMERCIAL GENERAL LIABILITY / 4T22-CO-0L239505-TCT-18 4/1/2018 4/1/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE ,/ OCCUR PREMISES(Ea occurrence) $30_0,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ✓ JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BA-OL196955-18-CNS 4/1/2018 4/1/2019 (E°ao YrieDtSINGLE LIMIT $1,000,000 ✓ 1 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ✓ AUTOS ONLY HIRED ✓ AUTOS ONLYY (Peer ac(Pe )ac $ B / UMBRELLALIAB ,/ OCCUR CUP-0L243008-18-2S 4/1/2018 4/1/2019 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED RETENTION$None $ A WORKERS COMPENSATION 4TJ-UB-8119P586-18 4/1/2018 4/1/2019 / STATUTE 0TH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N N/A E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1.000.000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) 2018-2019 ANNUAL SLURRY SEAL PROJECT City of Rosemead is named as additional insured as required by written contract per endorsement attached. *30 days Notice of Cancellation for non-payment. CERTIFICATE HOLDER CANCELLATION 2018-2019 ANNUAL SLURRY SEAL PROJECT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Rosemead THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 8838 E. Valley Blvd. ACCORDANCE WITH THE POLICY PROVISIONS. Rosemead CA 91770 AUTHORIZED REPRESENTATIVE �12 1 I Dick Wells ©1988-2015 ACORD CORPORATION. All rights reserved. • ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 44185788 I DOUGM-1 118/19 GL/AUTO/UMB/WC I Sandy Staley 19/13/2018 12:24:33 PM (PDT) I Page 1 of 3 Doug Martin Contracting Co., Inc. 4T22-CO-0L239505-TCT-18 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you "property damage" or"personal injury"; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III —Limits Of Insurance. for such loss, and we will not share with that "other insurance". But the insurance provided to b) The insurance provided to the additional in- the additional insured by this endorsement still is sured does not apply to "bodily injury", "prop- excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- i. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- rence"ii. Supervisory, inspection, architectural or or an offense which may result in a engineering activities. claim. To the extent possible, such notice g g should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 44185788 I DOUGM-1 118/19 GL/AUTO/UMB/WC 1 Sandy Staley 19/13/2018 12:24:33 PM (PDT) 1 Page 2 of 3 a COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the"occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or"suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. i. Immediately record the specifics of the —DEFINITIONS: claim or"suit" and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement under which you are required to include a The additional insured must see to it that we in- receive written notice of the claim or"suit" as person or organization as an additional soon as practicable. sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- • c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or "suit", cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender the de- agreement is in effect; and fense and indemnity of any claim or "suit" to c. Before the end of the policy period. • • Page 2 of 2 ©2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 44185788 I DOUGM-1 118/19 GL/AUTO/UMB/WC I Sandy Staley 19/13/2018 12:24:33 PM (PDT) 1 Page 3 of 3 Adamson&McGoldrick Insurance Solutions 1150 E.Orangethorpe Ave.,Suite 100 Placentia,CA 92870 MAIL DOCUMENT Certificate of Insurance Delivery by eccrtsontincTM City of Rosemead ,Sender: Sandy Staley 8838 E. Valley Blvd. Phone: 714-257-9644 Rosemead CA 91770 Subject: SLURRY SEAL PROJECT2019 ANNUAL Date: 9/13/2018 No:of Pages: 4 • URL: www.snains.com Certificate of insurance attached, per your request. THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED,CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT.OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT,YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION,DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED.IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR.PLEASE NOTIFY US IMEDIATELY BYTELEPHONE,AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by ecertsonlineTM Insurance Visions, Inc.All rights reserved.