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2100 - Onyx Paving Company, Inc. - Various Residential Street Resurfacing, FY 2021-22 (C24001)RECORDING REQUESTED BY CITY OF ROSEMEAD AND WHEN RECORDED MAIL TO: Name City of Rosemead Street Address 8838 E. Valley Blvd. City & state Rosemead, CA 91770 ATTN: CITY CLERK Notice is hereby given that: 23029022 Batch Number: 13816360 I IIIIII IIIA VIII VIII VIII VIII VIII VIII IIII IIII SPACE ABOVE THIS LINE FOR RECORDER'S USE Notice of Completion 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 no transfer made, insert, "none".) 7. A work of improvement on the property hereinafter described was completed on: August 25, 2022 B. The name of the contractor, if any for such work of improvement was: Onyx Paving 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: Various Residential Street Resurfacing Project FY 2021-22 10. The street address of said property is: as listed in No.9 no street address has been officially assigne , insert 'none" Signature of owner named Dated: �Z2 y/Z Z in paragraph 2: Michael Chung Director of Public Works By: City of Rosemead I certify (or declare) under penalty of perjury that the foregoing is true and correct. I I /�y/ z z Date Michael Chung Director of Public Works City of Rosemead, California Rosemead, CA Place of Execution CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 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 ofV�e s r L A� On �/vYA►&i ? 29Ti before me, EI7GG kerAMIeZ i, Date Here Insert Name and Title of tbi6 Officer personally appeared SignerX who proved to me on the basis of satisfactory evidence to be the personspf whose namej4 s re subscribed to the within instrument and acknowled ed to me that®she/they executed the same in i her/their authorized capacity(!W,and that by rLs er/their signatureyon the instrument the person(W, or the entity upon behalf of which the person(�racted, executed the instrument. ERKKA NERNANDEZ Notary Public • California * 5 Los Anpies County Commission 1 z7e6 Al Comm. Expires Dec 14, 2025 Place Notary Seal and/or Stamp Above 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. Signature Signature of Motary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: /1%DiliGC ! Gm.,/��.•>r Document Date: /V"ej0"&- 2f���LZ Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer - Title(s): ❑ Partner- ❑ Limited ❑ General ❑ Individual D Attorney in Fact O Trustee ❑ Guardian or Conservator O Other: Signer is Representing: 02019 National Notary Association Signer's Name: ❑ Corporate Officer - Title(s): ❑ Partner - ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: A This page is part of your document - DO NOT DISCARD 20221156502 o9ta II I Ie11IIII,IIIeII, lI I,IIaI IeIIrds I I II flaB1 + Recorder's Office, Los Angeles County, t.__ f California 12/12/22 AT 08:31AM Pages:0004 RECEIVED FEES: 0.00 CITY OF ROSE MEAD TAXES: 0.00 OTHER: 0.00 DEC 2 0 2022 PAID: 0.00 CITY CL RIC FFICE BY: LEADSHEET 1111111111111111111111111111111111111111111111111 202212122840007 00023029022 I IIIIII VIII (IIII VIII (IIII (IIII VIII VIII VIII IIII IIII 013816360 SEQ: 01 DAR - Mail (Intake) IIIIII IIIIIIIIVIVIIIVIII VIII VIII II�IIIIIIIIIIIVIIIVIIIIIIII (VIIIVIIIII IIIIIII VIII IIIIII (IIII VIII IIIIII III 1111111 VIII IIII IIIIII IIII (IIII IIIIII IIII IIIIII IIII IIIIII IIII IIII IIII - THIS FORM IS NOT TO BE DUPLICATED - EIIIHf E M F O S `�I 9 2. i o o f t � AV IPPIP RPORATED X959 CONSTRUCTION CONTRACT VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22 (ONYX PAVING COMPANY, INC.) 1. PARTIES AND DATE This Contract is made and entered into this 22th day of March, 2022 (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 Onyx Paving Company, Inc. with its principal place of business at 2890 E. La Cresta Avenue, Anaheim, CA 92806 (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 Various Residential Street Resurfacing, FY 2021-22 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 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, rules and regulations. Onyx Paving Company, Inc. Page 2 of 11 3.1.2 Term. The term of this Contract shall be from Effective Date shown above to December 31, 2022 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 Manager, Gloria Molleda, or her 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 Corey R. Kirschner, 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 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. Onyx Paving Company, Inc. Page 3 of 11 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 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) Onyx Paving Company, Inc. Page 4 of 11 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 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 the bonds to be increased accordingly and shall promptly deliver satisfactory evidence of such increase to the City. To the extent available, Onyx Paving Company, Inc. Page 5 of 11 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:VII I 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 not exceed Nine Hundred Twenty Seven Thousand Dollars ($927,000.00) without advance written approval of City's project manager. Extra Work may be 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 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 Onyx Paving Company, Inc. Page 6 of 11 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: CITY: Onyx Paving Company, Inc. 2890 E. La Cresta Avenue, Anaheim, CA 92806 Attn: Corey R. Kirschner Tel: (714) 632-6699 City of Rosemead 8838 E. Valley Boulevard Rosemead, CA 91770 Attn: Ben Kim, Acting City Manager 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 party at its applicable address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. Onyx Paving Company, Inc. Page 7 of 11 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 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 Onyx Paving Company, Inc. Page 8 of 11 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 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 Onyx Paving Company, Inc. Page 9 of 11 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] Onyx Paving Company, Inc. Page 10 of 11 CITY OF ROSEMEAD Ben Kim, AoKdg City Manager Date Attest: 3 23�ti2 Ericka Hernandez, i y Clerk Date Approved as to Form: ONYX PAVING COMPANY, INC. 312212 2 *aclelRichman, City Attorney Date By: & ql*/?C, M Signature Date Name: Carey ) f sckyker Print Title: rmided [If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary, AND CORPORATE SEAL OF CONTRACTOR REQUIRED] By: Afi- Name: ('ofp� �irsc6er Title: Onyx Paving Company, Inc. EXHIBIT A SCOPE OF CONTRACT SERVICES SEE ATTACHED BID SCHEDULE/PROPOSAL City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 CITY OF ROSEMEAD CALIFORNIA Document Control Page 1 of 124 CONTRACT DOCUMENTS SPECIFICATIONS AND STANDARD DRAWINGS FOR VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22 PROJECT No. 21032 FISCAL YEAR 2021-2022 IN THE CITY OF ROSEMEAD PUBLIC WORKS DEPARTMENT, ENGINEERING DIVISION 8838 E. VALLEY BOULEVARD ROSEMEAD, CA 91770 TELEPHONE: (626) 569-2150 FAX: (626) 307-9218 BIDS DUE: WE, MARCH 9, 2022 AT 10:30 AM City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 15 of 124 BIDDER:yr CITY OF ROSEMEAD VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22 PROJECT No. 21032 SECTION 1- BID SCHEDULE CONTRACT BID FORMS CBF -1 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 16 of 124 BIDDER: ONYX PAVING COMPANY, INC. BID SCHEDULE SCHEDULE OF PRICES FOR VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22 PROJECT No. 21032 NO. ITEM DESCRIPTION UNIT EST. UNIT ITEM QTY. PRICE COST Cold -mill 2" existing asphalt concrete and construct 2" AC Type 1 C2 -PG 64-10, adjust MH frame and SF 473,000 $ 05 $133,150 cover, water valve cover and gas valve cover to grade. Work includes crack sealing. Full Depth Localized Asphalt Concrete Patch. Work includes remove existing AC pavement 2 section to 10" depth. Construct 4" SF 10 000 $13.70 $ 1- 7 000 AC Type C2 -PG 64-10 over 6" ' Crushed Aggregate Base (CAB) over 8" scarified and compacted subgrade. Remove existing pavement markings and striping including 3 raised pavements markers and LS 1 $�1 f��JO $ ��j grj0 install pavement markings & striping including raised pavement markers. Remove and reinstall traffic signal 4 loops to match existing. EA 2 $ 1 f 560 $ 3, COO Furnish and Install Construction 5 Project Information and Funding EA 1 $0(000 $ Z/000 Identification Sign SB 1 TOTAL BID AMOUNT IN NUMBERS $ q,27, OGo. co TOTAL BID AMOUNT IN WORDS: AlIA/E X104 O (ZE p TW GAIT t' 5rV6,-V T8a)51No Dou')US Avo nits) 661,)t5 CBF -2 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 17 of 124 BIDDER: ONYX PAVING COMPANY, INC. The award of Contract shall be based on the TOTAL BID AMOUNT. In the case of discrepancies in the amount of bid, unit prices shall govern over extended amounts, and words shall govern over figures. A. Mobilization / Demobilization Full compensation for the items listed to the B. Traffic Control right as Items A, B, C, D and E are considered C. NPDES, WWECP, and Best Management as inclusive in each Bid Item listed above in the Practices (BMPs), Public Convenience and Base Bid Schedule as applicable, and no Safe ty additional and/or separate compensation will be D. Construction Staking by Land Surveyor allowed. E. Clearing and Grubbing The bid prices shall include any and all costs, including labor, materials, appurtenant expenses, taxes, royalties and any and all other incidental costs to complete the project, in compliance with the Bid and Contract Documents and all applicable codes and standards. The City reserves the right to add, delete, increase or decrease the amount of any quantity shown and to delete any item from the contract and pay the contractor at the bid unit prices so long as the total amount of change does not exceed 25% (plus or minus) of the total bid amount for the entire project. If the change exceeds 25%, a change order may be negotiated to adjust unit bid prices. All other work items not specifically listed in the bid schedule, but necessary to complete the work per bid and contract documents and all applicable codes and standards are assumed to be included in the bid prices. A bid is required for the entire work, that the quantities set forth in the Bid Schedule are to calculate total bid amount, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. 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. 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 frilly 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 BIDDER'S BOND - 10% Dollars ($ ) said amount being not less than ten percent (10%) of the Total Bid Price. The undersigned agrees that said amount shall be retained by the CBF -3 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No, 21032 Document Control Page 18 of 124 BIDDER: ONYX PAVING COMPANY, INC. 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) per calendar day if project is not completed in FORTY (40) working 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 fill consideration of the following addenda to the Contract Documents, Addenda Nos, N/A 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. CBF -4 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 By: /Z S4fnature COREY R. KIRSCHNER Type or Print Name CEO, PRIES, VP, SEC, TREA Title Document Control Page 19 of 124 BIDDER: ONYX PAVING COMPANY, INC. 2890 E. LA CRESTA AVE. Business Street Address ANAHEIM, CA 92806 City, State and Zip Code 714-632-6699 Telephone Number .Bidder's/Contractor's State of Incorporation: CALIFORNIA Partners or Joint Venturers: N/A Bidder's License Number(s): 630360; A, C-12 Department Industrial Relations Registered No. 1000004798 NOTES: 1) By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of the representations made on the Contract Bid Forms. 2) If Bidder is a corporation, enter State of Incorporation in addition to Business Address 3) If Bidder is a partnership or joint venture, give frill names of all partners or joint venturers. As further discussed in the Instructions to Bidders, Bidder will be -equired to provide evidence that the person signing on behalf of th -orporation, partnership or .joint venture has the authority to do so CBF -5 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 SECTION 2 BID DATA FORMS CBF -6 Document Control Page 20 of 124 BIDDER: ONYX PAVING COMPANY, INC. City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 21 of 124 BIDDER: Onyx Paving Company, Inc. Bond No. TS22-092 Bidder shall submit its Bid data in accordance with the format shown on each of the following Bid Data Forms. Bidders shall prepare and use as many sheets as are necessary to adequately provide the information required. Bidder shall ensure that every page of its Bid Data Forms are properly identified. with the Bidder's natne and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT Onyx Paving Company. Inc. , as Principal, and Harco National Insurance Company , as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of Amount Bid DOLLARS ($ 10% of Amount Bid ), being not less than ten percent (10%) of the Total Bid Price; for the payment of which sum will and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS, said Principal has submitted a bid to the OWNER to perform all Work required for the VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22—as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated March 9th, 2022 NOW, THEREFORE, if said Principal is awarded a Contract for the Work by the OWNER and, within the time and in the manner required by the above- referenced Bid Documents, enters into the written form of Contract bound with said Bid Documents, furnishes the required bonds (one to guarantee faithful performance and the other to guarantee payment for labor and materials) furnishes the required insurance certificates and endorsements, and furnishes any other certifications as may be required by the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. In the event suit is brought upon this bond by the OWNER and judgment is recovered, said Surety shall pay all costs incurred by the OWNER in such suit, including reasonable attomeys' fees to be fixed by the court. SIGNED AND SEALED, this 4th day of March 2022 . Onyx Paving Company, Inc. (SEAL) Harco National Insurance Co EAL) Principal Sur t By: By: 9iinature Signature Kerissa Ricciardi, Attorney -in -Fact rCeL CBF -7 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 March 4, 2022 before me, Deanne K. Dodge-Krows, Notary Public (insert name and title of the officer) personally appeared Kerissa Ricciardi who proved to me on the basis of satisfactory evidence to be the person("hose nam s r4�- subscribed to the within instrument and acknowledged to me that,ht�q executed the same in hispe - heirauthorized capacity(ies-�, and that by -tri � l heir signatup*) on the instrument the pertrnrf)<or the entity upon behalf of which the persor-v(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.DEANNE K. DODGE-KROWS � � � � COMM, 82318011 x � NOTARY PUBLIC•CALIMORNIA ORANGE COUNTY x —�My Camm. Explraa Jen. 0, 2024 Signature (Seal) POWER OF ATTORNEY Bond # TS22-092 HARCO NATIONAL INSURANCE COMPANY INTERNATIONAL FIDELITY INSURANCE COMPANY Member companies of IAT Insurance Group, Headquartered: 4200 Six Forks Rd, Suite 1400, Raleigh, NC 27609 KNOW ALL MEN BY THESE PRESENTS: That HARCO NATIONAL INSURANCE COMPANY, a corporation organized and existing under the laws of the State of Illinois, and INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing under the laws of the State of New Jersey, and having their principal offices located respectively In the cities of Rolling Meadows, Illinois and Newark, New Jersey, do hereby constitute and appoint KERISSA RICCIARDI, JAMES BALDASSARE, JR., JEREMY PENDERGAST Santa Ana, CA their true and lawful aftorney(s)-In-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such Instrument(s) In pursuance of these presents, shall be as binding upon the said HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY, as fully and amply, to all Intents and purposes, as If the same had been duly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed, and may be revoked, pursuant to and by authority of the By -Laws of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY and Is granted under and by authority of the following resolution adopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duly held on the 13th day of December, 2018 and by the Board of Directors of HARCO NATIONAL INSURANCE COMPANY at a meeting held on the 13th day of December, 2018, "RESOLVED, that (1) the Chief Executive Officer, President, Executive Vice President, Senior Vice President, Vice President, or Secretary of the Corporation shall have the power to appoint, and to revoke the appointments of, Attorneys -In -Fact or agents with power and authority as defined or limited In their respective powers of attorney, and to execute on behalf of the Corporation and affix the Corporation's seal thereto, bonds, undertakings, recognizances, contracts of indemnity and other written obligations in the nature thereof or related thereto; and (2) any such Officers of the Corporation may appoint and revoke the appointments of Joint -control custodians, agents for acceptance of process, and Attorneys -In -fact with authority to execute waivers and consents on behalf of the Corporation; and (3) the signature of any such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of Indemnity or other written obligation in the nature thereof or related thereto, such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation, to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY have each executed and attested these presents on this 31st day of December, 2021 , U 141,, �1M1TY \0(/ STATE OF NEW JERSEY STATE OF ILLINOIS tY p�OR4f y County of Essex�; Go �r C2 v SEAL County of Cook ONO a SEAL !on'. 1904 n // +uea ;; %'149,N O�.ba ? 1E D� Kenneth Chapman , y V0" !M/ + � Executive Vice President, Harco National Insurance Company "••+'`` and International Fidelity Insurance Company On this 31st day of December, 2021 , before me came the individual who executed the preceding Instrument, to me personally known, and, being by me duly sworn, said he Is the therein described and authorized officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies; that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. A. 06 �''. IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, at the City of Newark, "I ��� •�Q':F,aerp•oy• ,�1 New Jersey the day and year first above written. + :60079?{�'/,l,`,`• Shirelle A. Outley a Notary Public of New Jersey 'h+JEF 1111'S,; My Commission Expires April 4, 2023 CERTIFICATION I, the undersigned officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the Power of Ai.torney and affidavit, and the copy of the Sections of the By -Laws of said Companies as set forth in said Power of Attorney, with the odglnais on file in the home office of said companies, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the sold Powzr of Attorney has not been revoked and Is now In full force and effect. IN TESTIMONY WHEREOF, I have hereunto set my hand on this day, March 4th, 2022 A02699 Irene Martins, Assistant Secretary CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 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 March 4, 2022 before me, Ashlie Blanchard, Notary Public , Date Here Insert Name and Tltle of the Officer personally appeared of who proved to me on the basis of satisfactory evidence to be the person(x) whose name(g) is/a*e subscribed to the within instrument and acknowledged to me that he/sNe/they executed the same in his/hoer/their authorized capacity(Me), and that by his/hor/their signature(g) on the instrument the person(g), 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. Signature w"- Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 ASHLIE BLANCHARD 1( V CONIIN. #k2279550 ro Notary Public -California -2s" jl My ORANGE COUNTY LL CunnYi. rxpirns Mardi 3, 2023 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. Signature w"- Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 22 of 124 BIDDER: ONYX PAVING COMPANY, INC. 2.B LIST OF PROPOSED SUBCONTRACTORS In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one-half of one percent (greater than 0.5 %) of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders twenty-four (24) additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be permitted to subcontract that portion of the Work except under the conditions hereinafter set forth below. Subletting or subcontracting of any portion of the Work in excess of one half of one percent (greater than 0.5%) of the Total Bid Price or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no subcontractor was designated in the original bid shall only be permitted in cases of public emergency or necessity, and then only after Owner approval. CBF -8 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 23 of 124 BIDDER: ONYX PAVING COMPANY, INC. 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [**Duplicate Next 2 Pages if needed for listing additional subcontractors."] Name and Location of Subcontractor Description of Work to be Subcontracted Name: PAVEMENT J26hJfi, Co, p,11v ( Address: C_�Tjq Ll"7 / L'/l License No.: I06/37y Department of Industrial elation Registration No. �OCYo�v�8Z3 Name and Location Description of Work of Subcontractor to be Subcontracted Name: ('456 G4411) 5()iy"'y � I'yc, License No.: L5yll ' Department of Industrial Relation Registration No. Name and Location of Subcontractor Description of Work to be Subcontracted Name: 1966 FF IC L ) 66 , C,kli - FILUAI61, I NC • Address: RNA P1,0/,,41 License No.: 65Zq 6 Department of Industrial Relation Registration No.-( 00000 37 y Name and Location of Subcontractor Name: UPJ 8102 rgVewfENT M gAKI NQS Description of Work to be Subcontracted Address: 6yX F,55 I C F1 License No.: 774,50& Department of Industrial Relation Registration No. ICZ06 I K76, Name and Location Description of Work of Subcontractor to be Subcontracted Name: MRAI NOGG da t1 ' J I Al C. Address: F160 6ZIU61ZA, e� License No.: 3g sgy3 Department of Industrial Relation Registration No. l0 oo 0 CBF -9 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 23 of 124 BIDDER: ONYX PAVING COMPANY, INC. 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [**Duplicate Next 2 Pages if needed for listing additional subcontractors.**] Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Name: Address:_ License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Name: Address:_ License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Name: Address:_ License No.: Department of Industrial Relation Registration No. Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 23 of 124 BIDDER: ONYX PAVING COMPANY, INC, 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) ["Duplicate Next 2 Pages if needed for listing additional subcontractors."] Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Description of Work to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. CBF -9 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 23 of 124 BIDDER: ONYX PAVING COMPANY, INC. 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) ["Duplicate Next 2 Pages if needed for listing additional subcontractors."] Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Name:_ Address: Description of Work to be Subcontracted License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Name: Address:_ License No.: Description of Work to be Subcontracted Department of Industrial Relation Registration No. Name and Location of Subcontractor Description of Work to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. CBF -9 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 24 of 124 BIDDER: ONYX PAVING COMPANY, INC. 2.0 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: 1. PLEASE SEE ATTACHED REFERENCES. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 2. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 3. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed CBF - 10 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 25 of 124 BIDDER: ONYX PAVING COMPANY, INC. 4. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed CBF- 11 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 26 of 124 BIDDER: ONYX PAVING COMPANY, INC. SECTION 3 NON-COLL USIONAFFIDA VIT CBF - 12 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 27 of 124 BIDDER: ONYX PAVING COMPANY, INC. NON -COLLUSION AFFIDAVIT In accordance with Public Contract Code Section 7106, the undersigned, being first duly sworn, deposes and says that he or she holds the position listed below with the bidder, the party malting the foregoing bid, that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or 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 body 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, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. /V1111", ugnature COREY R. KIRSCHNER Typed or Printed Name CEO, PRES, VP, SEC, TREA Title ONYX PAVING COMPANY, INC. Bidder Subscribed and sworn before me This day of , 20. Notaiy Public in and for the State of California My Commission Expires: RW, -]=K (Seal) CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 * See Attached Document (Notary to cross out lines 1-6 below) ❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) 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 Subscribed and sworn to (or affirmed) before me County of ORANGE on this 8 day of MARCH , 20 22 , by Date Month Year (1) rs D' (and (2) ), . Asi iuc r�t.nrarwai�o Name O of Signer( ) L'OMIVL 4P2179550 M Notary public California a roved to me on the basis of satisfactory evidence P ry "R". G COUNTY to be the person(x) who appeared before me. My Comm. L%Pir., Mmv,h 3, 2023 Signature S�Jnature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: 02014 National Notary Association • www.Nationa[Notary.org - 1 -800 -US NOTARY (1-800-876-6827) Item #5910 REFERENCES PROJECT NAME: PAVING THE WAY -PHASE 3 PROJECT DESCRIPTION: CITYWIDE STREET IMPROVEMENTS APPROXIMATE CONSTRUCTION DATES: 2020 - 2021 CONSULTING COMPANY: CITY OF MONTEBELLO -1600 W. BEVERLY BLVD, MONTEBELLO, CA 90640 CONTACT PERSON: JAMES ENRIQUEZ 323-887.1462 ORIGINAL CONTRACT AMOUNT: $1,929,000 FINAL CONTRACT AMOUNT: $3,149,848.10 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: ADDITIONAL SCOPES OF WORK DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO PROJECT NAME: PAVEMENT REPAIR PROJECT PROJECT DESCRIPTION: PAVEMENT REPAIR APPROXIMATE CONSTRUCTION DATES: JAN 2020 AGENCY: CITY of CLAREMONT -- 207 HARVARD AVE, CLAREMONT,. CA 91711 CONTACT PERSON: ENRIQUE VILLALOBOS 909.399-5479 ORIGINAL CONTRACTAMOUNT: $105,000 FINAL CONTRACT AMOUNT: $120,727.40 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: FIELD QUANTITIES DIFFERED FROM BID SCHEDULE QUANTITIES, DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO PROJECT NAME: 2019.2620 PAVEMENT REHABILITATION PROJECT DESCRIPTION: VARIOUS PAVEMENT REHABILITATION APPROXIMATE CONSTRUCTION DATES: MAY 2020 - SEPTEMBER 2020 AGENCY: CITY OF ARCADIA- 240 W, HUNTINGTON DR, ARCADIA, CA 91007 CONTACT PERSON: JAN BALANAY 626.254-2726 ORIGINAL CONTRACT AMOUNT: $2;128,000 FINAL CONTRACT AMOUNT: $1,980,917.60 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT; PLEASE EXPLAIN: AGENCY HAD ADDITIONAL SCOPES IN ORIGINAL BID TO COVER FOR EXTRA WORK. DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO ONYX PAVING COMPANY, INC, 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 -TEL (714) 632.6699-- FAX (714) 632.1883 PROJECT NAME: DESERT VIEW AVENUE PROJECT PROJECT DESCRIPTION: CITYWIDE STREET IMPROVEMENTS APPROXIMATE CONSTRUCTION DATES: 2019 AGENCY: CITY OF DESERT HOT SPRINGS --11999 PALM DRIVE, DESERT HOT SPRINGS, CA 92240 CONTACT PERSON: DANIEL PORRAS 760.329-6411 ORIGINAL CONTRACT AMOUNT: $741,330.98 FINAL CONTRACT AMOUNT: $741,330.98 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: N/A DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO PROJECT NAME: TWEEDY LANE STREET IMPROVEMENT PROJECT PROJECT DESCRIPTION: STREET IMPROVEMENTS APPROXIMATE CONSTRUCTION DATES: JULY 2020 -AUG 2020 AGENCY: Cfl'Y OF DOWNEY-11111 BROOKSHIRE AVE, DOWNEY, CA 90241 CONTACT PERSON: DESI GUTIERREZ 562-622-3468 ORIGINAL CONTRACT AMOUNT: $308,000 FINAL CONTRACT AMOUNT: $308,000 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT,.PLEASE EXPLAIN: N/A DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO PROJECT NAME: CHICAGO AVE RECONSTRUCTION PROJECT PROJECT DESCRIPTION: STREET REHABIILITATION AND RECONSTRUCTION APPROXIMATE CONSTRUCTION DATES: AUG 2020 - OCT 2020 AGENCY: RIVERSIDE COUNTY TRANSPORTATION DEPARTMENT --3525 14TH STREET, RIVERSIDE, CA 92507 CONTACT PERSON: MEHRAN SANATI 9S1-255-2762 ORIGINAL CONTRACT AMOUNT: $1,424,000 FINAL CONTRACT AMOUNT: $1,445,396 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: ADD'L SCOPES OF WORK BY AGENCY DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO ONYX PAVING COMPANY, INC, 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 -- TEL (714) 632-6699 - FAX (714) 632-1883 PROJECT NAME: 2018/19 ARTERIAL AND MINOR STREETS MAINTENANCE PHASE 1&2 PROJECT DESCRIPTION! CITYWIDE STREET IMPROVEMENTS APPROXIMATE CONSTRUCTION DATES; AUG 2020 -- MARCH 2021 AGENCY: CITY OF RIVERSIDE - 3900 MAIN ST, RIVERSIDE, CA 92501 CONTACT PERSON: STEVEN HOWARD. 951-826-5311 ORIGINAL CONTRACT AMOUNT: $5,050,000 FINAL CONTRACT AMOUNT: N/A IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: IN PROGRESS 010 THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO PROJECT NAME! FY 18-19 RESIDENTIAL STREET REHABILITATION PROJECT DESCRIPTION: VARIOUS STREET IMPROVEMENTS APPROXIMATE CONSTRUCTION DATES: 07/18/2019 -12/11/2019 AGENCY: CITY OF PLACENTIA 40.1 E. CHAPMAN AVE, PLACENTIA, CA 92870 CONTACT PERSON: MASOUD SEPAHI 714-920.7604 ORIGINAL CONTRACT AMOUNT: $606,000 FINAL CONTRACT AMOUNT; $616,241,42 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: C/O DUE TO EXISTING FIELD CONDITIONS, DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO ONYX PAVING COMPANY, INC, 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 - TEL (714) 632.6690 -- FAX (714) 632.1883 LARGE PROJECT REFERENCES PROJECT NAME: RESIDENTIAL STREET IMPROVEMENT PROJECT PROJECT DESCRIPTION: STREET IMPROVEMENTS APPROXIMATE CONSTRUCTION DATES: SEPT 2020 - NOV 2020 CONSULTING COMPANY: CITY OF ANAHEIM -- 200 S. ANAHEIM BLVD, ANAHEIM, CA 92805 CONTACT PERSON: KAL LAMBAZ 714-765.6935 ORIGINAL CONTRACTAMOUNT: $1,711,000 FINAL CONTRACT AMOUNT: $1,733,320 IF FINAL AMOUNT I$ DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN:.0/O DUE TO ADDITIONAL SCOPES DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO PROJECT NAME: PAVEMENT REHABILITATION FOR VARIOUS LOCAL STREETS - CDBG FISCAL YEAR 19/20 PROJECT DESCRIPTION: CITYWIDE PAVEMENT REHABILITATION APPROXIMATE CONSTRUCTION DATES: JAN 2020 - MARCH 2020 CONSULTING COMPANY: CITY OF MORENO VALLEY CONTACT PERSON: QUANG NGUYEN 951-413-3159 ORIGINAL CONTRACT AMOUNT: $1,57.6,000 FINAL CONTRACT AMOUNT: $1,445.,035.72 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: REDUCTION IN QUANTITIES DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO PROJECT NAME: FY 2017.18 RESIDENTIAL STREETS REHABILITATION PROJECT PROJECT DESCRIPTION:_ CITYWIDE STREET REHABILITATION APPROXIMATE CONSTRUCTION DATES: MARCH 2020 -JUNE 2020 AGENCY. CITY OF WEST COVINA-1444 W. GARVEY AVE S., WEST COVINA, CA 91790 CONTACT PERSON: OKAN DEMIRCI OKAN.DEMIRCI@TRANSTECH.ORG ORIGINAL CONTRACT AMOUNT: $1,009,000 FINAL CONTRACT AMOUNT: $1,360,000 IF FINAL AMOUNT IS DIFFERENT FROM ORIGINAL AMOUNT, PLEASE EXPLAIN: SCOPES OF WORK CHANGED BY AGENCY DID THE AGENCY FILE ANY CLAIMS AGAINST YOU? NO ONYX PAVING COMPANY, INC. 2800 EAST LA CRESTA AVE, ANAHEIM, CA 92806 -- TEL (714) 632.6699 - FAX (714) 632-1883 REFERENCES GENERAL CONTRACTORS:._ .. JOBS PERFORMED: LOCATION.: _.AMOUNT: Fullmer Construction Centerpointe Morena Valley $3,187,914,00 1725 S, Grove Ave. Sycamore Bus. Park Riverside $999,708.00 Ontario, CA 91761 Hlllwood Hofer Ranch Ontario $603,600.00 Ph: 909.947.9467 Interchange A-E San Bernardino $1,288,615.00 Fax: 909-947-2970 San Michelle Logistics Moreno Valley $670,674.00 Contact: Casey Jones Terra Francesco Ontario $524,216,00 KCS West, Inc. BP Refinery Maintenance Shop Carson $896,357.00 901 Corporate Ctr, Or, 3rd fir Monterey Park, CA 9174 Ph: 323-269,0020 Fx:323m263.4576 Contact: Matthew Vawter CMC Engineering, Inc, Edison Romoland $1,623,480,00 1401 Warner Ave Tustin, CA 92780 Ph: 760-744.133 Fx: 714-247.1041 Contact: Gennady Lusardi.Construction FEDEX- OtayMesa San Diego $1,335,530.00 1570 Linda Vista Dr, Team Nissan Oxnard $669,075.00 San Marcos, CA 92064 Edge at Campus EI Segundo $541,385.00 Ph: 760-744-3133 Carmax Oxnard $606,443.00 Fax: 760-744.9064 Seabridge Oxnard $329,460.00 Contact Scott Staley ONYX PAVING COMPANY, INC, 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 -- TEL (714) 6326699 - FAX (714) 632-1883 Haagen Company, LLC Cmplre Polo Club Indio $1,036,745,00 12302 Exposition Blvd Los Angeles, CA 90064 Ph: 310-820.1200 Fx: 310-820-1225 Contact: Chris Fahey ARCO National Construction Co, Scannell FEDEX Burbank $1,125,958.00 900 N. Rock Hill Rd 5t. Louis, MO 6311.9 Ph: 314»963.0715 Fx: 314-963-1114 Contact: Chris Wilson Grant General Contractors Whittier Area Community Whittler $625,920.00 5051 Avenida Encinas Church Carlsbad, CA 52008 Crevler BMW Santa Ana $30,600,00 Ph: 760.4387500 Fx: 760.438.3056 Contact: Pete Burrows ONYX PAVING COMPANY, INC. 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 -- TEL (714) 632.6699 -- FAX (714) 632-1883 ASPHALT RUBBER HAT MIX REFERENCES: GENERAL CONTRACTORS; JOBS PERFORMED: LOCATION, AMOUNT: GMC ENGINEERING, INC. I(atella Ave. St. Improv Los Alamitos $120,000.00 1401 Warner Ave; Ste B. Various Projects Tustin, CA 92780 Ph; 714-247-1040 Fx: 714-247.1041 Contact: Gennady Chlzlk R.D OLSON CONSTRUCITON, INC. Lido House Hotel Newport Beach $193,105,00 2955 Main Street, 31d Floor Irvine, CA 92614 Ph:. 949-474.2001 Fx: 949-474-1534 Contact. Jeremy Dunn IF YOU HAVE ANY QUESTIONS, PLEASE FEEL FREE TO CONTACT COREY KIRSCHNER AT 714.632-6699 OR VIA EMAIL AT C0RE'Y@0NYXPAVING. NEr ONYX PAVING COMPANY, INC. 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 - TEL (714) 632-6699 - FAX (714) 632.1883 ONYX PAVING COMPANY, INC 2890 E. LA CRESTA AVE ANAHEIM, CA 92806 PHONE: (714) 632.6699 FAX: (714)632-1883 PRESIDENT: COREY R. KIRSCHNER BANK: BANKOFTHEWEST CREDIT REFERENCES DATE ESTABLISHED 1/4/90 CORP. TAX ID. JI 33.0394344 TYPE OF WORK - ASPHALT PAVING CONTRACTORS LIC, tt 630360-A INSURANCE AGENT: WOOD GUTMANN & BOGART 14029 SPRINGWATER I.% EASIVALE, CA 92880 4501 E. LA PALMA AVENUE, ANAHEIM, CA 92807 PHONES (714) 777-9620 BRYAN PLOESSEL 15901 RED HILL AVE., STE. 100, TUSTIN, CA 92780 PHONE: (714) 824-8384 MICHAEL TRAN SURETY AGENT: TURNER SURETY AND INSURANCE BROKERAGE, INC. 5 HUTTON CENTRE, STE, 730, SANTA ANA, CA 92707 PHONE: (714) 915-4032 JEREMY PENDERGAST CREDIT REFERENCES; MATICH CORP, P.O. BOX 10, HIGHLAND, CA 92346 (909) 382-7400 Steve Matich ALL AMERICAN P.O. BOX 2229, CORONA, CA 92878 (951) 736-7600 Carl KELTERITE CORP. 12231 PANGBORN AVE.DOWNEY, CA (562) 401-0011 Gladys VULCAN MATERIALS CO. 16013 E. FOOTHILL BLVD, IRWINDALE, CA91702 (858) 530-9414 Debbie GENERAL CONTRACTOR REFERENCES; FULLMER.CONSTRUCTION 1725 S, GROVE AVE„ ONTARIO, CA 91761 (909) 947-9467 Casey Jones BYROM-DAVEY, INC. 13220 EVENING CREEK DR. SOUTH 9103, SAN DIEGO (858) 513.7199 Steve Davey PACIFIC CONST, GROUP 17895 SKY PARK CIR., IRVINE, CA 92614 (949) 748.1500 Mark Bundy ERICKSON-HALL CONST, CO. 500 CORPORATE DR., ESCONDIDO, CA 92069 (760) 796-7700 Justin Sinnott ONYX PAVING COMPANY, INC, 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 —TEL (714) 632-6699 — FAX (714) 632-1883 RESUME Corey Kirschner has over 2.0 years of experience both as an estimator and CEO. Corey Is an experienced estimator and lead a majority of those years being the Chief Estimator before becoming CEO and President of Onyx Paving Company, Inc. Over the short period of time here at Onyx Paving, Corey has completed over 3,000 paving projects, allowing the company to gross over $50 million dollars In the previous year. Jay Kirschner, Senior Project Manager, holds a Bachelor's Degree from Chapman University and has 7 years of experience upholding the maintenance supervisor and lead estimator position for Onyx Paving. He leads our team,.wlth the project managers under his direct supervision, In managing our productions and coordinating our field mobilizations for all projects, Tyler Henry, Field Superintendent, serves as the core of all field related matters. He has over 20 years of paving experience performing jobs that stretches from San Diego County to Ventura County, Tyler has been with Onyx In completing all of our Public Works projects, Overseeing the on-site laborers, cement masons, and operating engineers Is one of his many responsibilities. BACKLOG ALLOCATION: Corey Kirschner, Jay Kirschner, and Tyler Henry oversee 100% of all current project In attached backlog. ONYX PAVING COMPANY, INC. 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 TEL (714) 632-5699 — FAX (714) 632-1883 Key Individual Respohsibilitles; Corey Kirschner Manage overall operations and resources of company Decision maker of corporation Jay_Klrschner Lead project management team with organization Overseeing overall project scheduling, budgeting, and dispatching on all projects Main point of communications between company and agencies .Tyler Henry - Lead and manage on-site labors and operators - Coordinate dally operations and project production Ensuring project quality expectations are met ONYX PAVING COMPANY, INC, 2890 EAST LA CRESTA AVE, ANAHEIM, CA 92806 - TEL (714) 632.6699 - FAX (714) 632-1883 A CONTRACTORS [�Ca STATE LICENSE ACTIVE l CENSE RD r.uv.n n sewn. user 0 r-,.,630360 ..,CORP BOPn.1.17un1 ONYX PAVING COMPANY INC 10131/2023Q�3�Ir2�23 VJWW.CS f� Ib.ca. ov e.onnenor. I kM ONYX FAMG COMPANY, INC, Lloemo # 630360 - DIR # 1000004798 UNANiHOUS WRITTEN CONSENT OF THIO BOARD OF DIRE, CTORS OF ONYX PAVING COMPANY, INC, (R California corporation) October 28, 2020 The undersigned director, constituting the entire board of directors (the "Board") of Onyx Paving Company, Inc., a California corporation (the "Corporadon"), hereby takes the following actions, adopts the following resolutions, and transacts the following business, by vrxitten consent without a meoting, as of the date above written, pursuant to Seotion 307(b) of the General Corporation Low of the State of California and the Corporation's Bylaws: Annroval of Loon ltansactlon yWEXREAS, Corey Kirschner is currently the Corporation's Chief lIxeoutivo Offtcex, and Chief Financial Ofticor (the"Officer") with authority to enter into contracts on behalf of the Corporation WHEREAS, the Corporation opportunides from time to time to bid on ya6us goverwnentel and non -govern mental projects; WHEREAS, Oftel' carofiil consideration, the Board has deiennined that the tenns and conditions of the proposed project to the forth of the bid attached hereto as ggjbiLt .A (the "projece) are just and equitable and fair as to the Corporation and that it is in the best interests of the Corporation and its stockholder to submit the bid and complete the Projeot subject to the texas agreed upon by the parties, NOW, TURTFORE, BE IT RESOLVED, the Board on behalf ofthe Corporation hereby approves and ratifies the Project in all respects, and hereby authorize and direct the Corporation to rtegoeate, execute; deliver andperfoym the temps of Q documents, r6quixed in eonnec#on with the Project, together with such changes thereto as way be approved by the Officer executing.the same onbehalf of the Corporation (pursuaut tothe authorization provided herein), such approval of the Officer to be conolusively evidended by its examen and delivery of same. RESOLVED AJRTHER, that the Officer may oxecuta'aad deliver any and all vVeermezats and any and all other documents and instruments, and take such fttrtlter actions as may be necessary or appropriate, for the financing of the Corporation, RESOLYED FURTHER, that the Officer is hereby authorized, directed, and empowered to execute and deliver any and all agreements and any and all other documents and instruments, and ta%o such furthor actions as may be necessary or appropriate, for the consummation of the Project, 2890 East La Cresta Ave, Anaheim, CA 92806 -PH: (714)612-6699 -FX (714) 632.1883 RESOLVED FURTHER, that the Officer, ha the game of tte Corporation, fs hara�y authorized, directed, and orapowered to negotiate, excouto and deliver to the'tpPllcable counter- party, my and al! documents with rospeot to the Txoject and other instruments as may be reasonably regaocd, and thq Officer on behalf of tho CorporatioA is. authorized from time to time to execute rehew4s os Wouslom or other iastztuitents as may beneWS ry. RESOLVPp-KMTID�R, that the authority given hereunder aha.Q be deemed retroactive and any and all acts authorfzed heretutder performed prior to the,possage ofthis resolution are herobyratifled and affirmed. T.4o Secretary of the Corporation is directed to Elle the original executed copy of tbfs Consent with theminntes of'proceedings'of the Corporation, [Signature page follows] ONYX PAVING COMPA n INC. Ltcease#630360—DIR# 1000004798 IN VaMSS Vi MREOF. the mdoralped has exeouted tbis Unantmow Written Comemt of the Board of Diriotors as of the date first above written Corey Kirsohner Request for Taxpayer (31veForm tothe )dentlffoatlori Number and Certiffoatlon taquestenlao not send to the IA& FAoto and the I Cheek appropriate box for federaltax oldstlRoallon of the person wtwae neem Is antored on line I. Chaoxanyone cllhO �aip aditiob no! 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Thq number shown on We form Is my correct taxpayer ldentlnoatlon number (art am wa ting for it number to be Issued to me); and WS 21 I sm not'sub eat to bapku vvithiiotdlrq bsoqueat ((a)I am exemppt from backup withholding, or (b) I hevenot baenc the IRillied8 has nhe oUBad mo ternet hpt 1 am no IonpefApwi hotI Ambackupe )g)g t to thhboid ngpi andhotr)frig as a resuN of a fellate to report all interest ordroWends, ar( ) A,1 am a U.S. crtizen or other U.S. person (defined below); and 4. The FATOAoode(e) entered on this form pf owh Indloenng that) am exempt from FATCA reportingiearreot aartifloetfoninslruoHone, Yau muel Dross cut Item 2 ebovelf you hayo boon notified by the IRS that youars aunondyecb)tot to backup wldrholding Wasuea You have railed lo>y" ili kReraet end dividends onyowhut retry ri Por real estate lransadlarra, Item 2 doesaotepprr.Formorlgage Interg paid, aotiftlionoraban donmentoraaouredpi tty,oanosilgtbnorde6t,contdbvllonufoenrndlvldualror4emanttrrangementpAgl,artdpenarallh other than Inlayed epd dMdonde, you a n requhadta aipn the oellHlOatlory but you tnuet provide yar.txxrectTlN, 81e tho bsetrubtlone for art , islet. A 6n • 9lsnetun of . _... _ .. , _ _.. ,,.,.. � 122 2D Zt General instruotl(ahs fjeolllin t�terenoes a'b to tho internal Revenue Code unless othenvlea noted. Faitfre deveiopmenta. For the latest lnformatron "I developments related to Form W9 and he Instructions, ouch as regIslttion enacted atter theywere publlshod, go o www.hm,00v/FormWe, Purpose of Form An "Idual or enlity form W-9 raO,0111 lj who is required to Via an InformatlonnoNtm wllhthe IR$ must obternyour correoltaxpayer Identilloation number ( flN which may be your social agcurllr number (994) in'dMdual taxpayer Identification number FT1i�Q, adop ion taxpryef 1denOfk:e9on number �lTltp, orempicyefldantlbagonnumber atd0unt rloWabt a on Inforrmation return �Sxm.pies ofttntormgtl ether returns lnaiude, but are not l)mltodto, the following. • Form 1 0994 pntenst earned or peld) aFor 1089 -DIV (dIvtdeads, lnalu&9 Was from atOOM Cr mutual ■ Form 11099•MISC (various types of Income, prizoa, awards, or gross preoeads) • Form 1099-B (stookorroutud fund sales and Certain other traneeotions'by rokuh) • Form io8g-8 ordcaede tomredeetole transmollone) e Form 109b -K (msrohantoardandthird party network i risoollons) a Form 1099 (orre modgege Interest), 1098-E (studenttoan tntorevt), 108d•T (1 11 • Form 1699.0 (aamg(ed debt) a Form 1089-A (eequfeRlonorabandonUnt of secured property) Use Form W-9 only If you are a U.S. person (Including a resident allen), to provide yburoomot TIN, be sWactto backup WW0ektq,om SFeWhAt isbackupwithholding. later. Oat,NoAmix Form' p?ev,10,2018) PATe (Nnvoomr'r) CERTIFICATE OF LIABILITY INSURANCE �n2nozl THIS CIV T(OATE IS ISSUED AS A MAT M OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CIRTiFICATG HOLDER. THltt ONATIFIOATI 13068 NOT AFFIRMATIVELY OR N90ATIVILY AMEND, EXTEND OR ACTOR THI COVERA01 AMR= BY THE POLIOICS 9ELOW. 'THIS ''c9R'I'iFIOA1H OF WoURANOR DOES NOT CONSTITUTE A CONTRACT 6f 01N 'FHB 189UINO *uRSR(S), AUTHORIZED REPRBQBNTATNI OA PRODUCER, ANu THH OER71FICATE HOLDER. MpQg l if the oeditloata Holder IB an ADDITIONAL, INSURED, the polioy(—W) mpatbe endarae . I B ON D, subJpal to Witounskndaanddtlobofthe"pggoy'"KAlnpollorasmay YQgolreenendoraan!0111. AetalomsntonthfecerUftcatedoeanot oon for riyhtstoihe B. •8ulte 100 _j OV4,s. mws U 00DUR ILAOOR pLMrtAPPU i1F8R: POLICY ddry`r' F-100 CNOSM1ELIAeILnY ANYALRO ALL ALL j (jOYVN „ey e- HIRWAUTOB AUTO$ UN9RiLLAl1AB ^.-- ��Q�•. OW144LIAO CLAP -MAO "e NE 0 ipNedTION 11PL01! R/'t RILFTY pYIN hppWAM A;.Mc_M dn idol h 1 L♦IL. A IUene� Invured6 ate-Pemti2ls FOnn #00 20 Is 0q018J 0418 OLP rhnaTyandNon AontllbutoryForm 9 29 01 94 13 GL1NeIVOFofbtilbro�eUorlFor iICOeS i oats OL Per Arof®otFomi0C0 980 4208 Boo Atlaohed... 8 e pnaohAd Irmero ep�eap n4WreH $s requiretl py vnitten 00nirrctsu�ect to the Parma& oandlllans of the SHOULD ANY OF THi,49OW P98ORI131D F000113 09 OANCIlLLBD WORE THE I IRA71 N DA POLFOAPRP, N010 Wl-L as OpUVaRGp IN AgpOROnyx Pav)rlCompany, Ina 2880 E. La Greets Ave. np,yorozeoneP,L hTATnlu Anehafm CA 92808 1988.2014 ACORD CORPORATION. All rlghte r"61ye ACORD 28 (2094/01) The ACORD name and logo aro repleterod roerke of ACORD Stato of California Secretary of State Statement of Information 0070477 (Dnnteetic Stook and Agrlcuktural Cooperative co FEES (FIIIng and Olsolosure), $26,00. FILED If thls Is an amendment, eee instruotlons, IMPORTANT - RSAD INSTRUCTION$ 113EPORE COMPLETING THIS FORM. In the office of the 8eoretaiy of State 1. COITPORA76NAM6 ofthe State of CaOfornle ONYX PAVING COMPANY, INC. Q0T►01 3018 2. CALIPoMiACORPORATENUMBER C18694i6 Trio spoklor n1ho Ura 0* No hen e t to e t ot9 Ilooble'rf 'entaddressofrecordIsa .O.9"address. 8A61eeVuollone a, 1 there ave 491110 0 sngea to the In ormallon contained In the, ae tat@rhent of lq ohms on flied with the Guilrorrilp aoretary of State, cr irb etetemant of lnformailon has been previously filed, this forfn must beeompl4ted In fte 9ntlrety If lh4ro htb been no change S any of the informafl0h oonfalned in the last 61atjrnj%t of iikMalldn filed with the Calliomfa Secretary ofeleto, OAeck U19 b6 nd.prooead to Ilgm 17. p to Addrase■ for the FA116wip (Do not ebbrLM616 the name of d . items 4 end flcanna b4P•4, Boxer.). A. ATRPOT'AOOR198OFPRIM,OIPA{,00��E�CUTIVe0FFl0!' CITY STATE ZIP CODE 2890 E. LAS CRESTA AVE„ ANAHEIM, CA 92.806 e. 8TRR8TADDR UOFPRINCIpACB11 h MOPPJ09INCALIFORNIA, IFANY ,rtY TT1Y1 RIPCODe LV E. LA G fI STA Al L ANAHf M, A:02805 _ e, MAIUNOAODRg80FCQRPORATIOAIFDIFFERENTTHAN ITEM 4 CITY 87ATe ZIPQODB Nam 114,SO din Iola Addrsae'se o the. AbIlgw)ng Offtders (Yho ebodration must Oalihelethres ofieels A carhp8rgble h11e (prthe spsciiro offl'certnbe edd however, the p[ea►Inidd HUs$ on this form must not be alleted, 7. OHIHPHfI6D1fTNHOFPIGER/ AODRES9 OITY STATS TIP CODE 0O.RW`FJR8GHNER 28901-IACRIrSTAAVE• ANAHEIM CA02806 A. SAORETARV ADDRIMS CITY STATE ZIP CODE COREY 19R$CH,NER 2890 E, LA CRESTAAVE., ANAHEIM, CA 82800 C CHIEF FINANCIAL 0001oefV ADDRUS Ally ;TAYN ZIP CODE lCORY KIRSCHNER 2@90 E. LA CRESTAAvE., ANAHq[M CA92806 Ram's;-and Compplet. dreases of All'Dliectors, IncludItig'Dlfeotore Who oro A to Cfnaora (The owporatton must haw al leastone drm6or,_AtkchaUUonoiPo4-o-4Vn4cossefY,)' 10, Nwe AoDR 88 rQIT1 STATE 210FQ009 COREY RSCHNER 2890E. LA CK9,STAAVE. ANAHEIM CA 92806' 11, NAMH • ADDRESS aiY STATE ZIP OODB 12 NAME ADDRESS G(TY STATH ZIPCODE 19. VM9Is OPVAC OIe90NTH6B0ARDOFDtRE0fOR31MANY, 1qgaept for 8gry o0 al Prooese f the agent le an InoTvldu6l, the agent must beside tq CaIIfOmI9 andltsm t6 moat be Completed vAkh a CalKomta alroet ecidrees, a P.O. UK eddreaa Is not acceptable, If tbo 9genl Is e60lher oorparadon, the agent rrW have on fta with the California Secretary of elate a conift- a owsyshtto 0iftwo C' retl a C4414 400119111006 and Item 16 must belellblank 14, NAMI! Of AGENT FOR 8911MCE OF PROCUS OORBY KIRSCrHNER It STREVADDRUSOFA0RNTFOR SERVICE OFPROCESS INCAMFOAMA,IFANINDMOUAL CIV STATE 21P CODE 28901. LA CRESTAAVE„ ANAHEIM, CA 92808 e of Nuejnals In, DIE 0 AV�Ng6E CESeoPTHeCORpoRAnoN m BY NOTHIS STATW9NT OF INFORMATION TO T'HO CALIFORNIA BMRETARY OF STAT@, YHe co"oRATION OERTIFIea THE INFORMATION CONTAINED HEAMN;INOWDINCANY A'ITACHMENTa,I8TRVeAND CORRECT, 1010112018 AFSHIN HAKIM ATTORNEY State of California. Secretary of Stfit® Statement of Information 0888167 (Domeatia Stock and Agricultural Cooperattve Corporatlone) FILED FEES (Flling and Disclosure). $28.00. If tht® Is an amenornent, sea Instructions. IM C.RrANT - RLAR IN31IR IONS BEFOFiS COMPLETING THIS FORM In the offloo of the Secretary of State 1. CORPORATE NAME of the State of Cavrornla ONYX PAVING COMPANY, INC. JAN -03 2020 2, CALIFORNIA 46ORPORAtE NUMBER 0'(859078 Thlb SpeCe ra Piing Uae Only No Chance Staleinent Note lloaWs' a ent address of record Is a P.O. Box addfigs. sed ina6ucl ons.) a, if Mors havo peed ianycheogsa to too on coritalaod In tho last statement d Alto rmat an filed with the aNfora a Seore ry of Surto, cr no etilem7md Ant of Iplotlon hila beep pravleusly filed,1140orrn must be completed In Its entirety. c(I fte 1n any of the Information cdntalned In the last Slatemont of Inlormallon filed with the CSIEforn)s Cwolary © if ryda bash no oft3tate, ohsok Ihb boitgad proceed to Item I7. om to Addr4ssAa or th9 altowln Oo not sWevlsle the name of the cAtv. Items 4 and 6 cannot be P.O, 9oxee. 4. B'rRERTADDRE830FPRINCIPALEXECUTIVEOFFICE Gn7 STATE ZIP CODE b, STREBTADDRES80PPRINCIPALBUSINEaSOFPIDEINCALIFORNIA,IFANY t;ITit STATE ZIP CODE 0. OULINGADDRE98oFCORPOkvTl N, FOIPF ENTTNANrEEM4 Crit STATE ZIPCODE dill. '1 a d Calif 1919 Addrastlea the FoNawing lfloer'e (rhe obrpgrallon must 11611:1106a three' rs.Wpar.=6taAUo?6r the gpedllc' offlcerhia T -h sdde •-6oweVar the p4LOWd 111160/1 this form mddt not be sltamd, T. CHIEPd(dGUilvLttlt'p1Gt!RJ ADDRESS BITS" STATE' ZIPCODE a, SECRETARY ;;"PRESS CITY ATw.. xIPCODe B, CHIFFFINANGIALMOEN AWESS AITY STATE ZIP COOS Namg9 and Complete Addrseaba 61AII Diraotora, Including D reptofa ho ere Afeo 0&ors Ifhe eeTpEirdgon must have at ladst one dlr9oMn•AlteohaddlUonal ee,Ifnaceeee ,) •(e, NARI& ADDRESS 4" STATE IIP CODE 11, NAMA ADDRESS Oit'f STAT$ ZIP CODE it NAME: ADDRESS -MY STATE ZIP CODE iD, NUMA6ROFVACANdl#$ONT emoAROOF6IRE0TOR8IFANYr Agiflt for Ser0bkof roeeea If IW egentle on Indlvlduel, Ihe; egeryt must reside In CatlfbMla gnd Item i6 must bg completed with a 0 street addr9as, a A.O. Box.sdd4�rose la not accgpletile, I! ihs agent is another corporallon, the agent mull have on Via wph the CalYgmla Sacrelary of State a oertkloale umanlb061116tlaCo' BBondCodsas0don1606andflom16mustbateltblonk, 14. NAWOFAOENTFOASERVI0FOFPAOQ0$ 48. 6171WAADREl1GOFAGRNTFQRSERVIOSOFPROCH881NCALIFORNIA, [PAN INOIVIDUAL CITY STATE ZIP OWE oat uel tie ' id, bCdAgeTHE TYPE OFSUSIHESSOFTHE CORPORVION 17. SY SUBMITTING THIS BTA19MENT OF INFORMATION TO THE CALIFORNIA SECRaTARY OR STATS TH,E CORPO61ioN dt:RTIPIP,B THS INFORMATION CONTAINEDH@REIN,INCLUDINGANYATTACHMENTS, ISTRUEANDCORACT. 0110=020 ANA BARBRA RAYPON . OFFICE MANAQERICONTROLLER _ DATA? 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(hereinafter "Contractor"), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22 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 March 22nd, 2022 (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 Onyx Paving Company, Inc. the undersigned Contractor, as Principal, and Harco National Insurance Company a corporation organized and existing under the laws of the State of Illinois , 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 Nine Hundred Twenty Seven Thousand and 00/100 dollars, ($ 927,000.00 ), 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 this 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 PERFORMANCE BOND - 1 City'of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 46 of 124 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. IN WITNESS WHEREOF, we have hereto set our hands and seals this 29th day on March 12022 . Onyx Paving Company, Inc. Principal/Contractor President Harco National Insurance QomQany Surety By: WOW A476. At orney-in-Fact Kerissa Ricciardi The rate of premium on this bond is $11 per thousand. The total amount of premium charged, $10, 555.00 (The above must be filled in by corporate surety.) PERFORMANCE BOND - 2 CitV'of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 48 of 124 CERTIFICATE AS TO CORPORATE PRINCIPAL I, COREY KIRSCHNER ,certify that I am the CORPORATE Secretary of the corporation named as principal to the within bond; that COREY KIRSCHNER who signed the said bond on behalf of the principal was then PRESIDENT AND SECRETARY 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) S nature /7 l 22 Date NOTE: A copy of the power of attorney to local representatives of the bonding company may be attached hereto. PERFORMANCE BOND - 4 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 March 29, 2022 before me, Deanne K. Dodge-Krows, Notary Public (insert name and title of the officer) personally appeared Kerissa Ricciardi who proved to me on the basis of satisfactory evidence to be the person(s}whose names/ar.D. subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(isej, and that by his/her/Heir signatureW on the instrument the persorlW, or the entity upon behalf of which the personal 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. DEANNE K. DODGE-KROWS1 WITNESS my hand and official seal. a3%' COMM.M2318077 EE G ly NOTARY PUBLIC -CALIFORNIA _ \^�ORANGE COUNTY My Comm. Expires Jan. 8, 2024 Signature (Seal) POWER OF ATTORNEY Bond # 0808563 HARCO NATIONAL INSURANCE COMPANY INTERNATIONAL FIDELITY INSURANCE COMPANY Member companies of IAT Insurance Group, Headquartered: 4200 Six Forks Rd, Suite 1400, Raleigh, NC 27609 KNOW ALL MEN BY THESE PRESENTS: That HARCO NATIONAL INSURANCE COMPANY, a corporation organized and existing under the laws of the State of Illinois, and INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing under the laws of the State of New Jersey, and having their principal offices located respectively in the cities of Rolling Meadows, Illinois and Newark, New Jersey, do hereby constitute and appoint KERISSA RICCIARDI, JAMES BALDASSARE, JR., JEREMY PENDERGAST Santa Ana, CA their true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instrument(s) in pursuance of these presents, shall be as binding upon the said HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY, as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed, and may be revoked, pursuant to and by authority of the By -Laws of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY and is granted under and by authority of the following resolution adopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duly held on the 13th day of December, 2018 and by the Board of Directors of HARCO NATIONAL INSURANCE COMPANY at a meeting held on the 13th day of December, 2018. "RESOLVED, that (1) the Chief Executive Officer, President, Executive Vice President, Senior Vice President, Vice President, or Secretary of the Corporation shall have the power to appoint, and to revoke the appointments of, Attorneys -in -Fact or agents with power and authority as defined or limited in their respective powers of attorney, and to execute on behalf of the Corporation and affix the Corporation's seal thereto, bonds, undertakings, recognizances, contracts of indemnity and other written obligations in the nature thereof or related thereto; and (2) any such Officers of the Corporation may appoint and revoke the appointments of joint -control custodians, agents for acceptance of process, and Attorneys -in -fact with authority to execute waivers and consents on behalf of the Corporation; and (3) the signature of any such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation, to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY have each executed and attested these presents on this 31st day of December, 2021 ,."..,f, 4I NSU ".. O?•4 APORqj����:: STATE OF NEW JERSEY STATE OF ILLINOIS County of Essex County of Cook r� Kenneth Chapman Executive Vice President, Harco National Insurance Company and International Fidelity Insurance Company On this 31st day of December, 2021 , before me came the individual who executed the preceding instrument, to me personally known, and, being by me duly sworn, said he is the therein described and authorized officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies; that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, at the City of Newark, A •0V�''. New Jersey the day and year first above written. 0 Shirelle A. Out���ley a Notary Public of New Jersey My Commission Expires April 4, 2023 CERTIFICATION I, the undersigned officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Sections of the By -Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect. IN TESTIMONY WHEREOF, I have hereunto set my hand on this day, March 29th, 2022 A02699 Irene Martins, Assistant Secretary City' of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 CITY OF ROSEMEAD Document Control Page 49 of 124 VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22 PROJECT No. 21032 PAYMENT BOND City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 50 of 124 This Bond was issued in three (3) Bond No. 0808563 identical counterparts PAYMENT (MATERIAL & LABOR) BOND WHEREAS the CITY OF ROSEMEAD (hereinafter "Obligee") has awarded to Onyx Paving 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 VARIOUS RESIDENTIAL STREET RESURFACING, FY 2021-22 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 March 22nd, 2022 , (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 Onyx Paving Company, Inc. , the undersigned Contractor, as Principal and Harco National Insurance Company , a corporation organized and existing under the laws of the State of Illinois 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 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 Nine Hundred Twenty Seven Thousand and 00/100 dollars, ($ 927,000.00 ), 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 PAYMENT BOND - 1 City of Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 51 of 124 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. 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 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 29th day on March , 20 22 . Onvx Pavina Comoanv. Inc. Principal/Contractor By: President Harco National Insurance Com an Surety By: At orney-in-Fact Kerissa Ric rdi PAYMENT BOND - 2 CiVof Rosemead, Bid Package, Various Residential Resurfacing, FY 2021-22, Project No. 21032 Document Control Page 48 of 124 CERTIFICATE AS TO CORPORATE PRINCIPAL I, COREY KIRSCHNER certify that I am the CORPORATE Secretary of the corporation named as principal to the within bond; that COREY KIRSCHNER who signed the said bond on behalf of the principal was then PRESIDENT AND SECRETARY 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) Signature Date NOTE: A copy of the power of attorney to local representatives of the bonding company may be attached hereto. PERFORMANCE BOND - 4 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 March 29, 2022 before me, Deanne K. Dodge-Krows, Notary Public (insert name and title of the officer) personally appeared Kerissa Ricciardi who proved to me on the basis of satisfactory evidence to be the person(&s Whose name,*is/aFe-- subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in his/her/t4eirauthorized capacity(•i.es), and that by his/her/their- signature(4on the instrument the person�sj or the entity upon behalf of which the person -W 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 a d official seal. /r COMM.#DEANNE K. DODGE-DGE-7 KROWS U L) NOTARY PUBLIC•CALIFOR NIA _ � � � ORANGE COUNTY My Comm. Expires Jan. 8, 2024 Signature (Seal) POWER OF ATTORNEY Bond # 0808563 HARCO NATIONAL INSURANCE COMPANY INTERNATIONAL FIDELITY INSURANCE COMPANY Member companies of IAT Insurance Group, Headquartered: 4200 Six Forks Rd, Suite 1400, Raleigh, NC 27609 KNOW ALL MEN BY THESE PRESENTS: That HARCO NATIONAL INSURANCE COMPANY, a corporation organized and existing under the laws of the State of Illinois, and INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing under the laws of the State of New Jersey, and having their principal offices located respectively in the cities of Rolling Meadows, Illinois and Newark, New Jersey, do hereby constitute and appoint KERISSA RICCIARDI, JAMES BALDASSARE, JR., JEREMY PENDERGAST Santa Ana, CA their true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instrument(s) in pursuance of these presents, shall be as binding upon the said HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY, as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed, and may be revoked, pursuant to and by authority of the By -Laws of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY and is granted under and by authority of the following resolution adopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duly held on the 13th day of December, 2018 and by the Board of Directors of HARCO NATIONAL INSURANCE COMPANY at a meeting held on the 13th day of December, 2018. "RESOLVED, that (1) the Chief Executive Officer, President, Executive Vice President, Senior Vice President, Vice President, or Secretary of the Corporation shall have the power to appoint, and to revoke the appointments of, Attorneys -in -Fact or agents with power and authority as defined or limited in their respective powers of attorney, and to execute on behalf of the Corporation and affix the Corporation's seal thereto, bonds, undertakings, recognizances, contracts of indemnity and other written obligations in the nature thereof or related thereto; and (2) any such Officers of the Corporation may appoint and revoke the appointments of joint -control custodians, agents for acceptance of process, and Attorneys -in -fact with authority to execute waivers and consents on behalf of the Corporation; and (3) the signature of any such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation, to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY have each executed and attested these presents on this 31st day of December, 2021 w,,,F, Mi8G,Q''�•�: qfr jINa�S�I .` STATE OF NEW JERSEY STATE OF ILLINOIS County of Essex County of Cook Kenneth Chapman Executive Vice President, Harco National Insurance Company and International Fidelity Insurance Company On this 31st day of December, 2021 , before me came the individual who executed the preceding instrument, to me personally known, and, being by me duly sworn, said he is the therein described and authorized officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies; that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. . IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, at the City of Newark, A , OG%. New Jersey the day and year first above written. ' ro`4 ° OTA< Iuaor- � . ( I� ""'`tel '^-' Q• 6001,' j�a5,��� Shirelle A.Outley a Notary Public of New Jersey CERTIFICATION My Commission Expires April 4, 2023 I, the undersigned officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Sections of the By -Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect. IN TESTIMONY WHEREOF, I have hereunto set my hand on this day, March 29th, 2022 A02699 aQ� Irene Martins, Assistant Secretary Onyx Paving Company, Inc. EXHIBIT B 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. Contractor shall maintain commercial general liability insurance with coverage at least as broad as Insurance Services Office form CG 00 01, in an amount not less than $1,000,000 per occurrence, $2,000,000 general aggregate, for bodily injury, personal injury, and property damage, and a $2,000,000 completed operations aggregate. The policy must include contractual liability that has not been amended. Any endorsement restricting standard ISO "insured contract" language will not be accepted. Automobile liability insurance. Contractor shall maintain automobile insurance at least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with Work to be performed under this Agreement, including coverage for any owned, hired, non -owned or rented vehicles, in an amount not less than $1,000,000 combined single limit for each accident. Workers' compensation insurance. Contractor shall maintain Workers' Compensation Insurance (Statutory Limits) and Employer's Liability Insurance (with limits of at least $1,000,000) for Contractor 's employees in accordance with the laws of the State of California, Section 3700 of the Labor Code In addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance and Employer's Liability Insurance in accordance with the laws of the State of California, Section 3700 for all of the subcontractor's employees. Excess or Umbrella Liability Insurance. (Over Primary) Contractor shall obtain and maintain an umbrella or excess liability insurance policy that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automobile liability, and employer's liability. Such policy or policies shall include the following terms and conditions: Contractor shall obtain and maintain an umbrella or excess liability insurance policy that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automobile liability, and employer's liability. Such policy or policies shall include the following terms and conditions: Onyx Paving Company, Inc. • A drop down feature requiring the policy to respond in the event that any primary insurance that would otherwise have applied proves to be uncollectable in whole or in part for any reason; • Pay on behalf of wording as opposed to reimbursement; • Concurrency of effective dates with primary policies; and • Policies shall "follow form" to the underlying primary policies. • Insureds under primary policies shall also be insureds under the umbrella or excess policies. Builder's risk insurance. Upon commencement of construction and with approval of Agency, Contractor shall obtain and maintain builder's risk insurance for the entire duration of the Project until only the Agency has an insurable interest. The Builder's Risk coverage shall include the coverages as specified below. The named insureds shall be Contractor and Agency, including its officers, officials, employees, and agents. All Subcontractors (excluding those solely responsible for design Work) of any tier and suppliers shall be included as additional insureds as their interests may appear. Contractor shall not be required to maintain property insurance for any portion of the Project following transfer of control thereof to Agency. The policy shall contain a provision that all proceeds from the builder's risk policy shall be made payable to the Agency. The Agency will act as a fiduciary for all other interests in the Project. Policy shall be provided for replacement value on an "all risk" basis for the completed value of the project. There shall be no coinsurance penalty or provisional limit provision in any such policy. Policy must include: (1) coverage for any ensuing loss from faulty workmanship, Nonconforming Work, omission or deficiency in design or specifications; (2) coverage against machinery accidents and operational testing; (3) coverage for removal of debris, and insuring the buildings, structures, machinery, equipment, materials, facilities, fixtures and all other properties constituting a part of the Project; (4) Ordinance or law coverage for contingent rebuilding, demolition, and increased costs of construction; (5) transit coverage (unless insured by the supplier or receiving contractor), with sub -limits sufficient to insure the full replacement value of any key equipment item; (6) Ocean marine cargo coverage insuring any Project materials or supplies, if applicable; (7) coverage with sub -limits sufficient to insure the full replacement value of any property or equipment stored either on or off the Site or any staging area. Such insurance shall be on a form acceptable to Agency to ensure adequacy of terms and sublimits and shall be submitted to the Agency prior to commencement of construction. 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 Vll. 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 policies shall provide or be endorsed to provide that Agency and its officers, officials, employees, agents, and volunteers shall be additional insurer under such policies Onyx Paving Company, Inc. using standard ISO endorsement No. CG 2010.. 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. 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. Onyx Paving Company, Inc. 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. 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 Onyx Paving Company, Inc. 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 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. ACORO® CERTIFICATE OF LIABILITYI INSURANCE DATE (MM/DD/YYYY) 3/30/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Burnham WGB Insurance Solutions CA Insurance License OF69771 15901 Red Hill Avenue CONTACT NAME: Michael Tran PHONE FAX M. • 714-824-8384 , C No): 714-573-1770 ADDRESS: mtran W bib.com INSURERS AFFORDING COVERAGE NAIC# Tustin CA 92780 INSURERA: Zurich American Insurance Co. 16535 BKO59627044 INSURED ONYXP-1 INSURER B: Scottsdale Insurance Company 41297 Onyx Paving Company, Inc. 2890 E. La Cresta Avenue INSURER C: AMERICAN ZURICH INS CO 40142 INSURER D: Ohio Casualty Insurance Co. 24074 Anaheim CA 92806-1816 INSURER E : INSURER F Cr1VPRAMPR CFRTIFICATF NUMRFR' 774RFi7n23 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 LTRJ= TYPE OF INSURANCE ADDL SUER Wvo POLICY NUMBER MM/DDY� MMIDD//YYYY LIMITS D X COMMERCIAL GENERAL LIABILITY BKO59627044 3/1412022 3/14/2023 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR DAMAGETO ENT PREMISES EaRoccurEDrence $100,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY I A PRO- JECT El LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER: C AUTOMOBILE LIABILITY BAP106300603 10/1/2021 10/1/2022 COMBINED SINGLE LIMIT $2,000,000 Ea accident 2 000 000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED 1HIREDAUTOS AUTOS PROPERTY DAMAGE $ Paraccldent 1 $ L I 1 B UMBRELLA LIAB X OCCUR XLS0123586 3/14/2022 3/14/2023 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 X FJCCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE WC106300503 10/1/2021 10/1/2022 PEI X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Certificate holder(s) is/are named as additional insured per the attached endorsements as required by written contract subject to the terms & conditions of the policy: GL Additional Insured Form #CG 20 10 04 13 and CG 20 37 04 13 GL Additional Insured State -Permits Form #CG 20 13 04 13 GL Primary and Non -Contributory Form #CG 20 01 04 13 GL Waiver of Subrogation Form #CG 88 10 04 13 GL Per Project Form #CG 88 70 12 08 See Attached... L;tK I It-IL;A I t MULUtK L,,RNUCLLA I IUIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Rosemead 8838 E Valley Blvd AUTHORIZED REPRESENTATIVE Rosemead CA 91770 ©1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ONYXP-1 LOC #: ,aco ADDITIONAL REMARKS SCHEDULE Page 1 of 1 v AGENCY NAMED INSURED Burnham WGB Insurance Solutions Onyx Paving Company, Inc. 2890 E. La Cresta Avenue Anaheim CA 92806-1816 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: U THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Auto Additional Insured, Primary & Non -Contributory, and Waiver of Subrogation Form #U -CA -424-F CW 04 14 WC Waiver of Subrogation Form #WC 04 03 06 RE: Job #22-024. Various Residential Street Resurfacing, FY 2021-22. Certificate Holder Vesting: Citv of Rosemead ..J ACORD 101 (2008/01) IV AV .y.. _. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 6K059627044 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): BLANKET s Location(s) Of Covered Operations ALL PROJECTS AND LOCATIONS AS REQUIRED BY WRITTEN CONTRACT N Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to include as an additional insured the person(s) these additional insureds, the following addi- or organization(s) shown in the Schedule, but tional exclusions apply: only with respect to liability for "bodily in- This insurance does not apply to "bodily in- jury", "property damage" or "personal and jury" or" property damage" occurring after: advertising injury" caused, in whole or in 1. All work, including materials, parts or part, by: equipment furnished in connection with 1. Your acts or omissions; or such work, on the project (other than ser - 2. The acts or omissions of those acting on vice, maintenance or repairs) to be per - formed by or on behalf of the additional your behalf; insured(s) at the location of the covered ° in the performance of your ongoing operations has been completed; or operatons for the additional insured(s) at the 2. That portion of "your work" out of which location(s) designated above. the injury or damage arises has been put a However: to its intended use by any person or or- t. The insurance afforded to such additional ganization other than another contractor insured only applies to the extent permit- or subcontractor engaged in performing ted by law; and operations for a principal as a part of the 2. If coverage provided to the additional in- same project. sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader 1 than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: BKO59627044 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) BLANKET Location And Description Of Completed Operations ALL PROJECTS AS REQUIRED BY WRITTEN CONTRACT ALL LOCATIONS AND JOBS AS REQUIRED BY WRITTEN CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily in- jury" or "property damage" caused, in whole or in part, by "your work" at the location des- ignated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -com- pleted operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BKO59627044 COMMERCIAL GENERAL LIABILITY CG 20 13 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS RELATING TO PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART �= SCHEDULE " State Or Governmental Agency Or Subdivision Or Political Subdivision: BLANKET o Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to However: include as an additional insured any state or 1. The insurance afforded to such additional governmental agency or subdivision or politi- insured only applies to the extent permit - cal subdivision shown in the Schedule, sub- ted by law; and " ject to the following additional provision: 2. If coverage provided to the additional in - This insurance applies only with respect to sured is required by a contract or agree - the following hazards for which the state or ment, the insurance afforded to such governmental agency or subdivision or politi- additional insured will not be broader cal subdivision has issued a permit or au- than that which you are required by the thorization in connection with premises you contract or agreement to provide for such own, rent or control and to which this insur- additional insured. ance applies: B. With respect to the insurance afforded to 1. The existence, maintenance, repair, con- these additional insureds, the following is struction, erection or removal of advertis- added to Section III - Limits Of Insurance: ing signs, awnings, canopies, cellar If coverage provided to the additional insured entrances, coal holes, driveways, man- is required by a contract or agreement, the holes, marquees, hoist away openings, most we will pay on behalf of the additional sidewalk vaults, street banners or decora- insured is the amount of insurance: tions and similar exposures; or 1. Required by the contract or agreement; 2. The construction, erection or removal of or elevators; or 2. Available under the applicable Limits of " 3. The ownership, maintenance or use of Insurance shown in the Declarations; any elevators covered by this insurance. whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. CG 20 13 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BKO59627044 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance avail- able to an additional insured under your poli- cy provided. that: (1) The additional insured is a Named In- sured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribu- tion from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BKO59627044 COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT NON -OWNED AIRCRAFT NON -OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY -ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 8 Page 1 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily) injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8 POLICY NUMBER: BKO59627044 COMMERCIAL GENERAL LIABILITY CG 88 70 12 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONSTRUCTION PROJECT(S) - GENERAL AGGREGATE 41MIT (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. For all sums which the insured becomes legally obligated to pay as damages caused by 'occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I - Coverage C Medical Payments, which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to you: 1. A separate Construction Project General Aggregate Limit applies to each construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations . 2. The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard", and for medical expenses under Cov- erage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. - Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Construction Project General Aggregate Limit for that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by 'occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I - Coverage C Medical Payments, which cannot be attrib- uted only to ongoing operations at a single construction project away from premises owned by or rented to you: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Construction Project General Aggregate Limit. D. If the applicable construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III - Limits Of Insurance not otherwise modified by thisendorsement shall continue to apply. CG 88 70 12 08 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II — Covered Autos Liability Coverage: The following are also "insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment — Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II — Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. ; U -CA -424-F CW (04-14) Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ZURICH Coverage Extension Endorsement Policy No. I Eff. Date of Pol. Exp. Date OfPDI. Eff. Date of End. Producer No. Add'l. Prem Retum Prem. BAP 1063006-03 1 10/01/2021 10/01/2022 39774000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II — Covered Autos Liability Coverage: The following are also "insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment — Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II — Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. ; U -CA -424-F CW (04-14) Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II — Covered Autos Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section II — Covered Autos Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. 2. The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV — Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and b. Any: (1) Overdue lease or loan payments at the time of the "loss'; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans. F. Towing and Labor Paragraph A.2. of the Physical Damage Coverage Section is replaced by the following: We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage — Increased Loss of Use Expenses The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: U -CA -424-F CW (04-14) Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified,, Causes Of Loss Coverage is provided for any covered "auto'; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to $750 for "loss" to personal effects which are: (1) Personal property owned by an "insured"; and (2) In or on a covered "auto". b. Subject to Paragraph a. above, the amount to be paid for "loss" to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for 'loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same 'loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph B.4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 6.2.c. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for 'loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an "insured"; and (b) Are in a covered "auto" at the time of 'loss". The most we will pay for such 'loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such 'loss". U -CA -424-F CW (04-14) Page 3 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. K. Airbag Coverage The Exclusion in Paragraph B.3.a. of Section III — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 13.4.a. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply to the accidental discharge of an airbag. L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you by us, the following applies for each covered "auto" on a per vehicle basis: 1. If the deductible on this policy or Coverage Form is the smaller (or smallest) deductible, it will be waived; or 2. If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. M. Physical Damage — Comprehensive Coverage — Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss" from any one cause is $5,000 or the deductible shown in the Declarations, whichever is greater. N. Temporary Substitute Autos — Physical Damage 1. The following is added to Section I — Covered Autos: Temporary Substitute Autos — Physical Damage If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following types of vehicles are also covered "autos" for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner, as a temporary substitute for a covered "auto" you do own but is out of service because of its: 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss'; or 5. Destruction. 2. The following is added to the Paragraph A. Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos — Physical Damage We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any U -CA -424-F CW (04-14) Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy. Include, as soon as practicable: (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit"; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. If you report an "accident", claim, suit or loss to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos — Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance — Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or elected or appointed official with your permission while being operated within the course and scope of that "employee's" employment by you or that elected or appointed official's duties as respect their obligations to you. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (2) Make an error, omission, improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto — World Wide Coverage Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, T. Bodily Injury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U -CA -424-F CW (04-14) Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. U. Expected Or Intended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section II — Covered Auto Liability Coverage is replaced by the following: Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. V. Physical Damage —Additional Temporary Transportation Expense Coverage Paragraph AA.a. of Section III — Physical Damage Coverage is replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section: In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or "auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum of $2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement. To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas, either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source. X. Return of Stolen Automobile The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section: If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto" to you. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. All other terms, conditions, provisions and exclusions of this policy remain the same. U -CA -424-F CW (04-14) Page 6 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: V1/C106300503 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA NDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0 mium otherwise due on such remuneration. Person or Organization ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR FOR THAT PERSON AND/OR ORGANIZATION. WC 252 (4-84) WC 04 03 06 (Ed. 4-84) Schedule- Job cheduleJob Description % of the California workers' compensation pre - Page 1 of 1