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2100 - CT&T Concrete Paving, Inc. - FY 24-25 Concrete Replacement Project - 24009CONSTRUCTION CONTRACT FY 24-25 CONCRETE REPLACEMENT PROJECT - PROJECT NO. 24009 (CT&T CONCRETE PAVING INC.) PARTIES AND DATE This Contract is made and entered into this t °'� day of bo-OMM e(U14 (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 CT&T Concrete Paving Inc. with its principal place of business at 324 S. Diamond Bar Blvd., PMB 275, Diamond Bar, CA 91765 (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 FY 24-25 Concrete Replacement Project by the City on the terms and conditions set forth in this Contract. Contractor represents that it is experienced in providing such work services to public clients, that it and its employees or subcontractors have all necessary licenses and permits to perform the Services in the State of California, and that is familiar with the plans of City. 2.2 Project City desires to engage Contractor to render such services described herein as Project ("Project') as set forth in this Contract. 3. TERMS 3.1 Scope of Services and Term 3.1.1 General Scope of Services. Contractor promises and agrees to furnish to the City all labor, materials, tools, equipment, services, and incidental and customary work necessary to fully and adequately supply the professional construction services necessary 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. CT&T Concrete Paving Inc. Page 2 of 11 3.1.2 Term. The term of this Contract shall be from Effective Date shown above to December 10, 2025, 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 Director of Public Works, Sam Gutierrez, or his designee, to act as its representative for the performance of this Contract ("City's Representative"). City's Representative shall have the power to act on behalf of the City for all purposes under this Contract. Contractor shall not accept direction or orders from any person other than the City's Representative or his or her designee. 3.2.5 Contractor's Representative. Contractor hereby designates Jose Carvajal, 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. CT&T Concrete Paving 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) adequate life protection and life saving equipment and procedures; (B) instructions in CT&T Concrete Paving Inc. Page 4 of 11 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, the bonds shall further provide that no change or alteration of the Contract (including, without CT&T Concrete Paving Inc. Page 5 of 11 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:VI I 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 Three Hundred Firty-Four Thousand Nine Hundred Eighty -Eight Dollars and Twenty -Five Cents ($354,988.25) 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 CT&T Concrete Paving 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: CCT&T Concrete Paving Inc. 324 S. Diamond Bar Blvd., PMB 275 Diamond Bar, CA 91765 Attn: Jose Carvajal Tel: 909-629-8000 CITY: City of Rosemead 8838 E. Valley Boulevard Rosemead, CA 91770 Attn: Sam Gutierrez Tel: 626-569-2158 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. CTBT Concrete Paving 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 orthis 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 orother 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 CT&T Concrete Paving 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 CTBT Concrete Paving 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] CT&T Concrete Paving Inc. Page 10 of 11 CITY OF ROSEMEAD CT&T CONCR T AVING, INC. Den I<;*- . City Manager Date ignature Date Attest: 0 E_ricka Hernandez, City Clerk ate Approved as to Form: 4acffielhman, City Attomey Date Name: . S OS a �l/Q Print Title: /_G S , C1 CG/li [If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary, AND CORPORATE SEAL OF CONTRACTOR REQUIRED] Name: os '�-- /"� .." )"�? IG�� Title: SEE ATTACHED NOTARY CERTISCATE CALIFORNIA 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. accuracv. or validity of that document. STATE OF CALIFORNIA COUNTY OF LOS ANGELES On n Aja k- before me Public personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal Signature of Notary Public (Seal) Document Date: Number of Pages: F CGP9 23451355 C r PJ01 r FI O CI (LF( HIP -1 I.(�/ Lb [:Oofyl'Y (d top l ch 2, 20251 Description of Attached Document Title or Type of Document: C'Ull6 \\ TSUg Leo ar Document Date: Number of Pages: CALIFORNIA 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. accuracv. or validity of that document. STATE OF CALIFORNIA COUNTY OF LOS ANGELES On Ve C.before me Notary Public personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal Signature of Notary Public (Seal) IF A PATS. EE m' \ _y PIJU COMM l cnii-�;lRrSiA r CD Irl3 t (L f fti COUNPI til 6i, T i t xt ',1:drh 2. ?425 Description of Attached Document Title or Type of Document: Co1Z\S�.��_'� Document Date: Number of Pages: EXHIBIT A SCOPE OF CONTRACT SERVICES SEE ATTACHED BID SCHEDULE/PROPOSAL BIDDER: CT&T Concrete Paving Inc. CITY OF ROSEMEAD FY 24-25 CONCRETE REPLACEMENT PROJECT PROJECT No. 24009 SECTION 1 - BID SCHEDULE CONTRACT BID FORMS CBF -1 BIDDER: CT&T Concrete Paving Inc. BASE BID SCHEDULE SCHEDULE OF PRICES FOR FY 24-25 CONCRETE REPLACEMENT PROJECT PRn-TVrT Nn 9dn00 N0, ITEM DESCRIPTION EST. QTY. UNIT UNIT PRICE ITEM COST 1 Traffic control and mobilization. 1 LS $34,320 $ 3q, 92,a - Remove existing tree uplifting PCC assets. Work shall include tree stump removal to 2 a depth of 12" below soil grade and shall include soil backfill to cover up remaining 9 EA $ 3 $ 35 $ tree stump void. Tree locations as listed per Sheet 1 of project plans. Arborist Report: contractor shall hire and coordinate with an arborist that shall review up to 15 trees (selected in the field by City Engineer or authorized designee) 3 to provide recommendations for trimming 1 LS $ 3,135 $ of tree canopy, large tree root removal and root pruning for trees that will not be removed but require tree root pruning/root removal/canopy trimming. Install new 24 -inch box tree (lagerstroemia indica 'Muskogee' or Cercis canadensis'forest pansy). New trees to be installed at a distance of 2 feet away from 4 previously planted tree. Work shall 9 EA include restoration of parkway to match surroundings. Tree locations as listed per Sheet 1 of project plans. Tree planting per SPPWC Std. Plan 520-4. Misc. Asphalt Concrete Patch. Work includes remove existing AC pavement 5 section to 7" depth. Construct 3" AC Type C2 -PG 64-10 over 4" Type B -PG 64-10 over 8" scarified and compacted subgrade. 225 SF $ 33. a l $ 7, 4 14.7 5 Work locations per Sheet 2 of project plans. 8225 Garvey Ave: Remove existing broken 6 PCC roadway panel surrounding manhole and construct new PCC roadway panel (12" thick) as listed per Sheet 3 of project 250 SF $ 43-1 $ l o '7 W, CBF -2 BIDDER: CT&T Concrete Paving Inc. N0, ITEM DESCRIPTION EST. UNIT UNIT ITEM QTY. PRICE COST plans. PCC shall be 4,000 PSI. Work shall include setting manhole to finished roadway grade. Concrete roadway headers: Remove existing and construct 1.5' wide, 12" thick SZ c c 7 concrete headers at either side of colored 100 LF $ 1a9- $ 12, 882. crosswalk. Locations at listed per Sheet 3 of project plans. PCC shall be 4,000 PSI. Remove existing and construct new PCC ADA curb ramps as listed per Sheet 4 of project plans and per SPPWC, Std. Plan 8 No: 111-5. Case and type is to be c a` $ $ determined by City representative. Work 15 EA shall include AC slot patch (reconstruction of 1 Foot Strip X 8" Deep of AC Pavement Section). PCC shall be 3,250 PSI. Remove existing driveway approach and construct driveway approach to match surrounding sidewalk grade. Driveway 9 locations as listed per Sheet 5 of project $ o� $ 17, -Zlv `1 'w plans and to be constructed per SPPWC 820 SF Std. 110-2. Curb and gutter paid under a separate bid item. PCC shall be 3,250 PSI. Remove existing and construct new PCC curb and gutter, as listed per Sheet 6 of project plans and to be constructed per 10 SPPWC, Std. Plan No: 120-3, A2-8, :2 $ } �* $ A �� complete and in place. Work shall include 450 LF AC slot patch (reconstruction of 1 Foot Strip X 8" Deep of AC Pavement Section). PCC Shall be 3,250 PSI. Remove existing and construct new PCC Sidewalk, 4" thick, as listed per Sheet 7 of 11 Project plans and to be constructed per 4,700 SF $ ja 79 $ 0, 113. SPPWC, Std. Plan No. 112-2 & 113-2, complete and in place. PCC shall be 3,250 PSI. Remove existing and construct new PCC E12Alley gutter/ Alley cross gutter, as listed $ 3 + 15 $ oto 4 %D o0 per Sheet 8 of project plans and to be 600 SF CBF -3 BIDDER CT&T Concrete Paving Inc. NO. ITEM DESCRIPTION EST. QTY, UNIT UNIT PRICE ITEM COST c constructed per SPPWC, Std. Plan No: 122- 3 & 123-3. PCC shall be 4,000 PSI. rvv-e- Rv-e Ca js practices (BMPs), Public Convenience and Bid Schedule as applicable, and no additional TOTAL BASE BID AMOUNT IN NUMBERS $-354, 91?8• �5 and/or separate compensation will be allowed. TOTAL BASE BID AMOUNT IN WORDS: Thew. RLL*, &'/' F -W E,, - rte✓ .� eQ, All am -tet ' 71dy -5i c DO 10 ri rvv-e- Rv-e Ca js The award of Contract shall be based on the TOTAL BASE BID AMOUNT only. In the case of discrepancies in the amount of bid, unit prices shall govern over extended amounts, and words shall govern over figures. Full compensation for the items listed to the A. Mo bilization i right as Items Ate, C, D and E are considered inclusive in each Bid Item listed above in C. NPDES, W WECP, and Best Management th the Base Bid Schedule and Additive Alternate practices (BMPs), Public Convenience and Bid Schedule as applicable, and no additional Safety D. Construction Staking by Land Surveyor and/or separate compensation will be allowed. E. Clearin and Grubbin 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 mimes) 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. The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party, whichever is earlier. The undersigned also agrees that if there is a discrepancy CBF -4 BIDDER: CT&T Concrete Paving Inc. between the written amount ofthe 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 Ten Percent of Total Bid Amt Dollars ($ 10% of Total Bid Aml ) 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 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. 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 anv of the remaining data submitted herewith into a contract arising out of this Bid. 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 tinder the contract. CBF -5 BIDDER: CT&T Concrete Paving Inc. EXAMINATION OF SPECIFICATIONS AND SITE OF WORK The Bidder declares that he/she has carefully read and examined the project plans, specifications. bid documents, and he/she has made a personal examination of the site (indicate name of the person, representing the bidder, who inspected the site and date below) and that he/she understands the exact scope of the Project. Name of Person who inspected the site: Jose Carvajal Date of Inspection: 11/25/2024 ADDENDA ACKNOWLEDGMENT The Bidder acknowledges receipt of the following Addenda and has included their provisions in this Proposal: Addendum No. Dated Addendum No. Dated Addendum No. Dated Addendum No. CBF -6 BIDDER: CT&TTConcrete Paving Inc. PUBLIC CONTRACT CODE STATEMENT AND QUESTIONAIRE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. CBF -7 BIDDER: CTBT Concrete Paving Inc. PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. CBF -8 By:� Signature Jose Carvajal Type or Print Name President Title Bidder's/Contractor's State of Incorporation: Partners or Joint Venturers: Bidder's License Number(s): 875627 Department Industrial Relations Registered No. 1000025154 NOTES: BIDDER: CT&T Concrete Paving Inc. 324 S. Diamond Bar Blvd, PMB 275 Business Street Address Diamond Bar, CA 91765 City, State and Zip Code 909-629-8000 Telephone Number California N/A 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 orjoint venture, give full names of all partners or joint venturers. As further discussed in the Instructions to Bidders, Bidder will be required to provide evidence that the person signing on behalf of the corporation, partnership or joint venture has the authority to do so. CBF -9 BIDDER: CT&T Concrete Paving Inc. SECTION 2 BID DATA FORMS CBF -10 BIDDER: CUT Concrete Paving, Inc. 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 name and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT _CT&T Concrete Paving Inc. as Principal, and Contractors Bonding and Insurance as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of the Total Bid Amount ($ 10°k of Total Bid Amount ), 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 FY 24-25 CONCRETE REPLACEMENT PROJECT as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated December 4, 2024 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 attorneys' fees to be fixed by the court. SIGNED AND SEALED, this 25th day of_ CT&T Concrete Paving, Inc. (SEAL) Principal By: --S By: ignature CBF - 11 November 20 24 Contractors Bonding and Insurance Company (SEAL) Surety 12�,00l Signature E it Youn ttomey-in-Fact ARIZONA NOTARY ACKNOWLEDGMENT State of Arizona County of Maricopa On this NOV 2 5 1014 before me Danielle Hanson [Name of Notary Public] personally appeared Emilie Young whose identity was proven [Name of Signer] to me on the basis of satisfactory evidence to be the person who he or she claims to be, and acknowledged that he or she signed the above/attached document. o Jaz S' 41 DANIELLE E IRIS HANSON a NotaryPublic- Arizona Mancopa County Corr ,on My Commission Expires "'g us 2C?i (Seal) [Affix Seal Here] Witness my hand and official seal. Signature of Notary Public POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: 800-645-2402 Know All Men by These Resents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make, constitute and appoint: Yung T. Mullick, P Austin Neff, Irene Luona Emilie Young— Danielle Hanson Christine Woolford Alexander R Holsheimer. Than Lou. Joseph P. McGrady. iointy or severely in the City of Mission Vieio , State of California its true and lawful Agent(s) and Attomey(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( $25.000.000.00 ) for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to -wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Sr. Vice President with its corporate seal affixed this 27th day of September 2024 . RLI Insurance Company GNIG'•.'•...............pp, w "'., °��„ cp ,,, Contractors Bonding and Ins ncc Company ;.,•0 "......,cry -;`fig :.. .., �'tto°s 0prOG�J�. '= CJ.GORrTie a— By. '�i�� = 'u :SEAL;*,; ` `.SEAL;` Eric Raudins Sr. Vice President Slate of Illinois ) n"NOea `%%[L IEN pts•`' J} SS , , County of Peoria CERTIFICATE On this 27th day of Sentember , 2024 , before me, a Notary Public, personally appeared Eric Raudins , who being by me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntary act and deed of said corporation. r By: Jill A. Scott Notary Public JILL a Scon Matey vabik State of OMa 0e. Mr cola.. Upre, Seat.,, 22. 2025 I, the undersigned officer of RLI Insurance Company and/or Contractors Bonding and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that the Resolution of the Company as set forth in the Power of Attorney, is now in force. In testimony whereof. I have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bondins and Insurance Company this 25th day of November 2024 . RLI Insurance Company Contractors Bonding and Insurance Company Jeffrey DUicP V V Corporate Secretary 00665902021+ A0058D19 CALIFORNIA ALL- PURPOSE CERTIFICATE OF 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 Los Angeles On1J -Z-I 4'�zo z.y before me, Daniel A. Butler A Not rn lie cv�,.. � � InerB�• N11 rAillle yl( I O O ICef ' personally appeared S�se �c>r:i�a who proved to me on the basis of satisfactory evidence to be the person(s) whose names) Is re subscribed to the within instrument and acknowledged to me that (e )she/they executed the same in Is er/their authorized capacity(ies), and that by Is er/their signatures) on the instrument the person(e), 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. � I�� #240 NNotary Public - LOS k9m County `'My Coaan.Espkes MayZ 20X Notary Public Signature (Notary Public Seal) DESCRIPTION OF THE ATTACHED DOCUMENT (Tile ordesedplon ofaftached document) (Tile or description of attached document continued) of Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other wveiv.NotaryClasses.com 800-873-9865 INSTRUCTIONS FOR COMPLETING THIS FORM rhtsform complier with entreat Califm'nia stahnes regarding nmarr wording and, ifneeded shordd be completed and attached to die docsnneni. Acknowledgnrmns from other states error be completed for documents bring sent to that state so long as die to, ding does not require the California notary to riolate California rrotary law. • State and County information must be the State and County where the document signers) personally appeared before the notary public for acknowledgment. • Date of notarization mail be the date that the signer(s) personally appeared which must also be the mine date the acknowledgment is completed. • 'rhe notary public must print his or her name as it appears within his or her commission followed by a comma mid then your title factory public). • Print the names) of document signera) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing ol)' incorecl fora (i.e. Wshchhe5— is /ere ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document rocordine. • The notary seal impression must be clear and photographically reproducible. Impression must not cmcr tcan or lines. If seal impression smudges, re•scal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match Lim signature on file with the office of the county clerk. 4 Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate oftteer, indicate the Lille (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. BIDDER: CT&T Concrete Paving 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 I 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 - 12 BIDDER: CTBT Concrete Paving Inc. 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [**Duplicate Next 2 Pages if needed for listing additional subcontractors.**] Name and Location of Subcontractor KIM License No.: 10445-�- Department of Industrial Relation Registration No. Name and Location of Subcontractor Name: 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 Address: License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Address: License No.: Department of Industrial Relation Registration No. CBF -13 Description of Work to be Subcontracted Trej5 00,2$27q Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted BIDDER: CTBT Concrete Paving Inc. 2.0 REFERENCES The following are the names. addresses and telephone numbers for three public agencies for which BfDDER has performed similar work within the past two (2) years: 2. 3. City of Beaumont, 550 E. 6th Street, Beaumont, CA 92223 Name and Address of Owner Dustin Christensen, 951-572-3192 Name and telephone number of person familiar with project $428,355.00 Citywide Sidewalk Improvements Contract amount Type of Work City of Azusa, 213 E. Foothill Blvd, Azusa, CA 91702 Name and Address of Owner Christina Curial, 626-812-5247 Name and telephone number of person familiar with project 08/16/2024 Date Completed $1,796,307.30 Foothill Blvd Pavement Rehabilitation Project, Phase 1 08/16/2024 Contract amount Type of Work Date Completed City of Laguna Hills, 24035 EI Toro Road, Laguna Hills, CA 92653 Name and Address of Owner Joe Ames, 949-707-2655 dame and telephone number of person familiar with project $607,850.00 Citywide Sidewalk Repairs & Concrete Construction 05/08/2024 Contract amount Type of Work Date Completed CBF -14 4. BIDDER: CT&T Concrete Paving Inc. City of Monterey Park, 320 W. Newmark Ave, Monterey Park, CA 91754 Name and Address of Owner Peter Shiau, 626-877-1928 Name and telephone number of person familiar with project $1,571,233.00 Concrete Improvements Project 12/1/2023 Contract amount Type of Work Date Completed CBF - 15 BIDDER: CT&T Concrete Paving Inc. SECTION 3 NON - COLLUSION AFFIDA VIT CBF -16 BIDDER: CT&T Concrete Paving Inc. NON -COLLUSION AFFIDAVIT In accordance with Public Contract Code Section 7106, the undersigned, being first duly swom, deposes and says that he or she holds the position listed below with the bidder, the party making 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, of- 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. —Signature Jose Carvajal Typed or Printed Name President Title CT&T Concrete Paving Inc. Bidder Subscribed and sworn before me This Z-7"—day of ()e v < ,,L �, 201-' ��_� Notary Public in and for the State of California My Commission Expires: aw Zn� 11-OZ(o (Seal) DANIELA.BUTLER mms# 240200 7roPa Nuu W asN- California y Los Angeles Canty My Comm. Expires May 2, 2026 A notary public or other officer completing this certificate verifies only the identity of the indi- CBF - 17 vidual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. CERTIFICATE OF AMENDMENT OF ARTICLES OF INCORPORATION The undersigned certify that: 1. They are the president and the secretary, respectively, of Carvajal Trucking & Tractor, Inc. a California corporation. 2. Article One of the Articles of Incorporation of this corporation is amended to read as follows: First: The name of the Corporation is CT&T Concrete Paving, Inc. 3. The foregoing amendment of Articles of Incorporation has been duly approved by the board of directors. 4. The foregoing amendment of Articles of Incorporation has been duly approved by the required vote of shareholders in accordance with Section 902, California Corporations CodRo a total number of outstanding shares of the corporation is . The number of shares voting in favor of the amendment equaled or exceeded the vote required. The percentage vote required was more than 50%. We further declare under penalty of perjury under the laws of the State of California that the matters set forth in this certificate are true and correct of our own knowledge. DATE: I '-jIre-sident _ Jose arvajal /F�yP P enry /�/I/ ecre ary Jose Carvajal (Typed Name of Secretary) Secretary of State AMDT-STOCK (REV 09/2006) JOINT CONSENT TO ACTION IN LIEU OF SPECIAL MUTING OF SHAREHOLDERS AND DIRECTORS OF CARVAJAL TRUCKING AND TRACTOR, INC. The undersigned constituting the shareholders and directors of Carvajal Tnrcldng and Tractor, Inc. (the "Company") hereby unanimously consents to the following resolutions: RESOLVED, that the name of the Company be changed from Carvajal Trucking and Tractor, Inc. to CT&T Concrete Paving, Inc. RESOLVED, that the Company is authorized to file a Certificate of Amendment reflecting the name change. 2015 CERTIFICATE OF AMENDMENT OF ARTICLES OF INCORPORATION Jose Carvajal certifies that: AO641153 ENDOMOO ofORSED - Fl"Orateryo sEtD Of the State of Cel]fornla FEB 2 8 2005 1. He is the President and Secretary of CT & T CONSTRUCTION, INC., a California corporation. 2. The name of the corporation is amended to read as follows: The name of this corporation is CARVAJAL TRUCKING AND TRACTOR, INC. 3. The foregoing amendment of Articles of Incorporation has been duly approved by the Board of Directors. 4. The foregoing amendment has been duly approved by the required vote of shareholders in accordance with Section 902 of the Corporations Code. The corporation has only one class of shares and the number of outstanding shares is 40,000. The number of shares voting in favor of the amendment equaled or exceeded the vote required, The percentage vote required was more than 50%. I further declare under penalty of perjury under the laws of the State of California that the matters set forth in this certificate are true and correct of my own knowledge. Dated: February Ar, 2006 4L Jose C vajal, Presidenu c Secretary L W iG b T2{ 9Concrete Paving, CORPORATE RESOLUTION OF SIGNING AUTHORITY RESOLUTION OF: _CT&T Concrete Paving, RESOLVED that the execution of Deeds, powers of attorney, transfers, assignments, contracts, obligations, certificates, and other instruments of whatever nature entered into by the Company directly or through a transfer agent or registrar for any stock company, acting in its capacity as a corporate director or exercising any and all other powers conferred upon it by the letters Patent incorporating it or by the law pertaining to such matters, shall be signed by any one of the persons listed below: I, „Jose Carvajal the undersigned Secretary of _CT&T Concrete Paving, Inc._ HEREBY CERTIFY that the foregoing is a true and correct copy of a Resolution of the Board of Directors of said Company passed by a resolution of the said board dated on _10/27/2017_ and that said Resolution is still in full force and effect. Secretary PREMIUM: $5,112.00 BOND NO. RCB0050041 PREMIUM SUBJECT TO CHANGE BASED EXECUTED IN DUPLICATE ON FINAL CONTRACT AMOUNT PERFORMANCE BOND WHEREAS the CITY OF ROSEMEAD (also herein "Obligee") has awarded to CT&T Concrete Paving, Inc. (hereinafter "Contractor"), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the FY 24-25 CONCRETE REPLACEMENT PROJECT and all other required structures and facilities within the rights-of-way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth in that certain contract for the said Public Work dated (hereinafter the "Public Work Contract"); and WHEREAS, the Contractor is required by said Public Work Contract to perform the terms thereof and to provide a bond both for the performance and guaranty thereof, NOW, THEREFORE, we CT&T Concrete Paving, Inc. , the undersigned Contractor, as Principal, and Contractors Bonding and Insurance Company a corporation organized and existing under the laws of the State of Illinois and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the CITY OF ROSEMEAD in the sum of Three Hundred Fifty -Four Thousand Nine Hundred Eighty -Eight and 25/100 dollars, ($ 354,988.25 ), 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 attomeys' 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 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 10th day on December 2024 CT&T Concrete Paving, Inc. Principal/Contractor By: resident Contractors Bonding and Insurance Company Surety By: L Attorney -in- t E e -Young The rate of premium on this bond is $14.40 per thousand. The total amount of premium charged, $ 5,112.00 (The above must be filled in by corporate surety.) PERFORMANCE BOND - 2 CALIFORNIA ALL- PURPOSE CERTIFICATE OF 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 Los Angeles } On 12ACe4,,hrj tm?J4 before me, Daniel A. Butler, ( Publi personally appeared ID-cZ �arv'Aa( eAac who proved to me on the basis of satisfac ry evidence to be the person(s) whose names) Is re subscribed to the within instrument and acknowledged to me that IBe she/they executed the same in Is er/their authorized capacity(ies), and that by Is er/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(,&) 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 gh wNle ".eunEa (� CanmiWmM1401aa7 Jl� Notary Pubfic Caliimiia �^ C My Comm. Expires May 2, 2015 Notary Public Signat re (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATI DESCRIPTION OF THE ATTACHED DOCUMENT (Title a description of attached document) (Title a description of attached document continued) Number of Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer de ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other w.vvv.NotaryClasses.com 800-873-9895 INSTRUCTIONS FOR COMPLETING THIS FORM ON This form complies with current California statures regarding noun, wording and. if needed, should be completed and attached to the document. Acknowledgments from other states map be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary 10111. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers) personally appeared which must also be the same date the acknowledgment is completed. • The notary public most print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the names) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forts by crossing off incorrect forms (i.e. Irershe/they,- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression most be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, reseal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. 4 Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. •, Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. CERTIFICATE AS TO CORPORATE PRINCIPAL �7ose, Carraj , certify that I am the Secretary of the corporation named as principal to the within bond; Nat who signed the said bond on behalf of the principal was then 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 ARIZONA NOTARY ACKNOWLEDGMENT State of Arizona County of Maricopa On this DEC 1 0 2024 , before me personally appeared Emilie Y [Name of Signer] Danielle Hanson [Name of Notary Public] whose identity was proven to me on the basis of satisfactory evidence to be the person who he or she claims to be, and acknowledged that he or she signed the above/attached document. DANIELLE IPIS HANSON Nolary Public-Arl¢ona Maricopa County t" Commission a 653538 \� a� ✓ o ,r My Commission Expires August 11, 2027 (Seal) [Affix Seal Here] Witness my hand and official seal. POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: 800-645-2402 Know AR Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make, constitute and appoint: Yung T. Mullick- P. Austin Neff, Irene Luong. Emilie Young, Danielle Hanson Christine Woodford Alexander R Holsheimer. Than Luu, Joseph P. McGrady. iointy or severely in the City of Mission Viejo State of California its true and lawful Agent(s) and Attorney(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( 525.000.000.00 ) for any single obligation. The acknowledgment and execution of such bond by the said Attomey in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to -wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Sr. Vice President with its corporate seal affixed this 27th day of September 1 2024 . amu,u,,,, RLI Insurance Companyr/�/sy�r�n Company �yrwumµ%. .JAr,110ECp CootractorsBondingsodln'C�r"� - a�g <Cj'/v' ',Oproq�ts, b�`_ °•_l wppoa,SrE '7y SEAL' ¢ :SEAL ' By: Eric Raudins Sr. Vice President `A State of Illinois SS County of Peoria On this 27th day of September 2024 , before me, a Notary Public, personally appeared Eric Raudins . who being by me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors Bonding and Insurance Company and acknowledged said instroment to be the voluntary act and deed of said corporation.. At6i�- By: Ul. Jill A. Scott Notary Public JILL aSCOTT a Notary pobb< ' State of Ohio �y y,' 0 Seoteobas II. 2025 CERTIFICATE 1, the undersigned officer of RLI Insurance Company and/or Contractors Bonding and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable; and furthermore, that the Resolution of the Company as set forth in the Power of Attorney, is now in force. In testimony whereof, 1 have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bonding and Insurance Company this 10th day of December 2024 . RLI Insurance Company Contractors Bonding and Insurance Company By: gd4" D iia% Jeffrey DUMP U u Corporate Secretary 04SWW20222 A0058D19 PREMIUM INCLUDED IN BOND NO. RCB0050041 PERFORMANCE BOND COST EXECUTED IN DUPLICATE PAYMENT (MATERIAL & LABOR) BOND WHEREAS the CITY OF ROSEMEAD (hereinafter "Obligee") has awarded to CT&T Concrete Paving, Inc. (hereinafter "Contractor"), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the FY 24-25 CONCRETE REPLACEMENT PROJECT and all other required structures and facilities within the rights-of-way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth in that certain contract for the said Public Work dated (hereinafter the "Public Work Contract"); and WHEREAS, said Contractor is required to furnish a bond in connection with said Public Work Contract providing that if said Contractor or any of his or its subcontractors shall fail to pay for any materials, provisions, or other supplies, or terms used in, upon, for or about the performance of the Work contracted to be done, or for any work or labor done thereon of any kind, or for amounts due under the provisions of 3248 of the California Civil Code, with respect to such work or labor, that the Surety on this bond will pay the same together with a reasonable attorney's fee in case suit is brought on the bond. NOW, THEREFORE, we CT&T Concrete Paving, Inc. , the undersigned Contractor, as Principal and Contractors Bonding and 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 Three Hundred Fifty -Four Thousand Nine Hundred Eighty -Eight and 25/100 dollars, ($354,988.25 ), said sum being not less than 100% of the total amount payable by said Obligee under the terms ofthe 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 ifthe 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 - I 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 10th day on December , 20 24 . CT&T Concrete Paving, Inc. Principal/Contractor By: PRsicfe7nt Contractors Bonding and Insurance Company Surety By: �Atto�meyin-Fa Emili oung PAYMENT BOND -2 CALIFORNIA ALL- PURPOSE CERTIFICATE OF 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 Los Angeles } On Qt"�t(i.- I FO ; 702y before me, Daniel A. Butler, A Notary Public we insert name an a o e cer lbs �r ( personally appeared e << who proved to me on the basis of satisfac ory evidence to be the person(s) whose name(.&) Is re subscribed to the within instrument and acknowledged to me that CEDshe/they executed the same in Is er/their authorized capacity(ies), and that by Is er/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(,) 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. law WITNESS my hand and official seal, c� «?aos o, Notary Pubk-calftnia LmAngelesCwnty Expir My Comm. Expres May 2, 2046 Notary blic Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM That form California complies with current stannet regarding notary wording mid. DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded, should be completed mod attached to the document. Acknowledgments from other states map be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary /mr. (Tills or descripflon of attached document) • State and County information must he the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. (Tfle a description of attached document continued) • nate of notarization most be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages _Document Date commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is/ere) or circling the correct forms. Failure tocorrectly indicate this El Individual (s) information may lead to rejection ofdocmnent recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a (Title) sufficient area permits, otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public most match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact 0 Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretarv). wanv.NotatyClasses.cont 800-873-9365 Securely attach this document to the signed document with a staple. CERTIFICATE AS TO CORPORATE PRINCIPAL I, ,Joje e,-- V, certify certify that I am the __$.ecve d-!1 Secretary of the corporation named as principal in the attached bond, TGfr Ca%r2ip who signed the said bond on behalf of the principal was then p✓egi �� 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. PAYMENT BOND - 4 ARIZONA NOTARY ACKNOWLEDGMENT State of Arizona County of Maricopa On this DEC 1 0 2024 before me Danielle Hanson [Name of Notary Public) personally appeared Emilie Young whose identity was proven [Name of Signer] to me on the basis of satisfactory evidence to be the person who he or she claims to be, and acknowledged that he or she signed the above/attached document. of 1. rqr DANIELLE IPiS HANSON Nolary Public-A�iiona r Maricopa County CommissionC "5_ My Cornmiss,rn Expires AugUs. 11. 2027 (Seal) [Affix Seal Here] Witness my hand and official seal. POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: 800-645-2402 Know AR Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make, constitute and appoint: Yung T. Mullick. P. Austin Neff, Irene Luong, Emilie Young_ Danielle Hanson. Christine Woolford Alexander R Holsheimer, Thao Lou. Joseph P. McGrady. joints or severely in the City of Mission Viejo . State of California its true and lawful Agent(s) and Attomey(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( $25.000.000.00 1 for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to -wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Sr. Vice President with its corporate seal affixed this 27th day of September - 2024 . `say..-........qip, . ........•`.. 00 10 :mom- `--d?9 J 001"'014re =� SEAL;:,i' SEAL , State of Illinois &IN L I, SS County of Peoria J} On this 27th day of September 2024 . before me, a Notary Public, personally appeared Eric Raudins . who being by me duly swom, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntary act and deed of said corporation.. By: ^� Jill A. Scott Notary Public 10JILL nuascorr 3 �: Notary Yubb< �_ State a Onb 1�yJ,` My EO.M. E"ires .t. o`T Sea[eabv 22. 2025 RLI Insurance Company���/��.... Contractors Bonding and [nL//�sy�rpCompany By: r Eric Raudins Sr. Vice President CERTIFICATE 1, the undersigned officer of RLI Insurance Company and/or Contractors Bonding and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable; and furthermore, that the Resolution of the Company as set forth in the Power of Attorney, is now in force. In testimony whereof, 1 have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bonding and Insurance Company this 10th day of December 2024 . RLI Insurance Company Contractors Bonding and Insurance Company By: '✓ - sC*- Jeffrey D(Yickf U u�Corporate Secretary 045WO20212 A0058D19 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 thatwill 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: • 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 VII. General conditions pertaining to provision of insurance coverage by Contractor. Contractor and City agree to the following with respect to insurance provided by Contractor: 1. Contractor agrees to have its insurer endorse the third party General liability 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 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 Contractorand 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. Certificate(s) are to reflect that the insurer will provide 30 days notice to City of any cancellation of coverage. Contractor agrees to require its insurer to modify such certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of cancellation imposes no obligation, or that any party will "endeavor" (as opposed to being required) to comply with the requirements of the certificate. 9. It is acknowledged by the parties of this Contract that all insurance coverage required to be provided by Contractor or any subcontractor, is intended to apply first and on a primary, noncontributing basis in relation to any other insurance or self insurance available to City. 10. Contractor agrees to ensure that subcontractors, and any other party involved with the project who is brought onto or involved in the project by Contractor, provide the same minimum insurance coverage required of Contractor. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Contractor agrees that upon request, all Contracts with subcontractors and others engaged in the project will be submitted to City for review. 11. Contractor agrees not to self -insure or to use any self-insured retentions or deductibles on any portion of the insurance required herein and further agrees that it will not allow any contractor, subcontractor, Architect, Engineer or other entity or person in any way involved in the performance of work on the project contemplated by this Contract to self -insure its obligations to City. If Contractor's existing coverage includes a deductible or self-insured retention, the deductible or self- insured retention must be declared to the City. At that time the City shall review options with the Contractor, which may include reduction or elimination of the deductible or self-insured retention, substitution of other coverage, or other solutions. 12. The City reserves the right at any time during the term of the contract to change the amounts and types of insurance required by giving the Contractor ninety (90) days advance written notice of such change. If such change results in substantial additional cost to the Contractor, the City will negotiate additional compensation proportional to the increased benefit to City. 13. For purposes of applying insurance coverage only, this Contract will be deemed to have been executed immediately upon any party hereto taking any steps that can be deemed to be in furtherance of or towards performance of this Contract. 14. Contractor acknowledges and agrees that any actual or alleged failure on the part of City to inform Contractor of non-compliance with any insurance requirement in no way imposes any additional obligations on City nor does it waive any rights hereunder in this or any other regard. 15.Contractor will renew the required coverage annually as long as City, or its employees or agents face an exposure from operations of any type pursuant to this Contract. This obligation applies whether or not the Contract is canceled or terminated for any reason. Termination of this obligation is not effective until City executes a written statement to that effect. 16. Contractor shall provide proof that policies of insurance required herein expiring during the term of this Contract have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. A coverage binder or letter from Contractor's insurance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City within five days of the expiration of the coverage. 17.The provisions of any workers' compensation or similar act will not limit the obligations of Contractor under this Contract. Contractor expressly agrees not to use any statutory immunity defenses under such laws with respect to City, its employees, officials and agents. 18. Requirements of specific coverage features or limits contained in this section are not intended as limitations on coverage, limits or other requirements nor as a waiver of any coverage normally provided by any given policy. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue, and is not intended by any party or insured to be limiting or all-inclusive. 19.These insurance requirements are intended to be separate and distinct from any other provision in this Contract and are intended by the parties here to be interpreted as such. 20. The requirements in this Section supersede all other sections and provisions of this Contract to the extent that any other section or provision conflicts with or impairs the provisions of this Section. 21. Contractor agrees to be responsible for ensuring that no contract used by any party involved in any way with the project reserves the right to charge City or Contractor for the cost of additional insurance coverage required by this Contract. Any such provisions are to be deleted with reference to City. It is not the intent of City to reimburse any third party for the cost of complying with these requirements. There 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 LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/09/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER McRae Associates Insurance Services CONTACT Mariana Pichardo 1265 N. Manassero St Suite 303 Anaheim, CA 92807noortless: PNONE (714)779-6999 ac Na; (714)779-6903 mariana mcraeinsurance.Insure INSURERS AFFORDING COVERAGE NAICS License #:0637431 INSURERA: TRAVELERS PR PERTY CASUALTY COMPANY OF AMERICA 25674 DTE-CO-2X94621A-TIL-2410/01/2024 INSURED CT & T CONCRETE PAVING, INC. 324 S DIAMOND BAR BLVD. PMB 275 DIAMOND BAR, CA 91765 INSURERS: TRAVEL ERS PROPERTY CASUALTY COMPANY OFAMERICA 25674 INSURER C: GRiAT AMERIAN INSURANCE 22136 INSURER D: THE TRAVELERS INDEMNITY COMPANY OF CONNETIC T 25682 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00001005-2065134 RFVIRION NIIMRFR• An 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. ILNSR TR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMA) POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y Y DTE-CO-2X94621A-TIL-2410/01/2024 10/01/2025 EACHOCCURRENCE $ 1,000,000 REMISES Eao ummce $ 3------ -P MED EXP Any one person $ 5,000 PERSONAL & ADV INJURY $ 'I'000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [j] jECT r] LOC GENERAL AGGREGATE E 2,000,000 PRODUCTS-COMP/OP AGO $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y Y 10-2X930002-24-26-13 10/01/2024 10/01/2025 COMBINED tSINGLELIMITEa $ 1000000 X ANY AUTO BODILY INJURY (Per person) $ X OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per..IdZt E A UMBRELLA LULB X OCCUR Y Y CUP-2X94920A-24-26 10/01/2024 10/01/2025 EACH OCCURRENCE S 6,000,000 EXCESS DAB CLAIMS -MADE AGGREGATE $ 6,000,000 DED RETENTION$ $ A WORKERS COMPENSATIONILII AND EMPLOYERS'RS'LL Y / N ANY PROPRIETO OFFICER/MEM ER EXC UDEDV ECUTIVE F-1NIA (Mandatory In NH) DIf ESCdewribe under RIPTION OF OPERATIONS below Y UB -2X937955.24 -26-G 10/01/2024 10/01/2025 X PERTATUTE ER OT SH - E.L. EACH ACCIDENT E 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE- POLICY LIMIT $ 1,000,000 C PROPERTY/INLAND MAR Y Y MACE2289310201 04/27/2024 04/27/2025 SCHEDULED EQUIPM NT $129,692 D OWNERS & CONTR. PROT Y Y 2X94621A 12/08/2023 12/08/2024 EACH OCC/ GEN 49CKIILL / $2 MILL DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: ALL OPERATIONS THE CITY OF ROSEMEAD , ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE-MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. continued on ACORD 101 Additional Remarks Schedule THE CITY OF ROSEMEAD 8838 E VALLEY BLVD ROSEMEAD , CA 91770 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED All rights ACORD 25 (2016/031 The ACORD name and loco are reaistered marks of ACORD Printed by MPC on 12/09/2024 at 11:59AM AGENCY CUSTOMER ID: 00001005 _ LOC M ACCMV V ADDITIONAL REMARKS SCHEDULE Page 2 of AGENCY McRae Associates Insurance Services NAMED INSURED CT & T CONCRETE PAVING, INC. POLICY NUMBER NIA CARRIER Multiple Carriers NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (continued from Description of Operations) `SHOULD ANY OF THE ABOVE-DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THERE OF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED. 02008 The ACORD name and logo are registered marks of ACORD Printed by MPC on December 09, 2024 at 11:59AM Policy Number: 810 -2X930002 -24-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or ,limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL:WSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is 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 busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 02015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. viith its permission. COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION 11 — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. Page 2 of 4 ® 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION 111— PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex - We will pay up to $400 for "loss" to wearing ap- inand executed pt required of you rior t written contract arel and other personal property which is: signedP Y "accident" P P P P Y or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 @ 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How - N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 C2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: 810 -2X930002 -24-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.S., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part S. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non- contributory. CA T4 99 02 16 u 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number. DTE-CO-2X94621A-TIL-24 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — a. With respect to liability for bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work' to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 04 19 0 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 9 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 Policy Number: DTE-CO-2X94621A-TIL-24 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured —Unnamed Subsidiaries C. Incidental Medical Malpractice B. Blanket Additional Insured — Governmental D. Blanket Waiver Of Subrogation Entities — Permits Or Authorizations Relating To E. Contractual Liability—Railroads Operations F. Damage To Premises Rented To You PROVISIONS a. An organization other than a partnership, joint A. WHO IS AN INSURED — UNNAMED venture or limited liability company; or SUBSIDIARIES b. A trust; The following is added to SECTION 11 — WHO IS as indicated in its name or the documents that AN INSURED: govern its structure. Any of your subsidiaries, other than a partnership, B joint venture venture or limited liability company, that is not shown as a Named Insured in the Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: a. Before you maintained an ownership interest of more than 50% in such subsidiary; or The following is added to SECTION II — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury", "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II — Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products -completed operations hazard". CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE 1. The following replaces Paragraph b. of the definition of "occurrence" in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician or paramedic; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the violation of a penal statute or ordinance relating to the sale of pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. D. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the execution of the contract or agreement. E. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: c. Any easement or license agreement; Page 2 of 3 ® 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with As permission. 2. Paragraph f.(1) of the definition of "insured contract' in the DEFINITIONS Section is deleted. F. DAMAGE TO PREMISES RENTED TO YOU The following replaces the definition of "premises damage" in the DEFINITIONS Section: "Premises damage" means "property damage" to: COMMERCIAL GENERAL LIABILITY a. Any premises while rented to you or temporarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. CG D3 16 02 19 m 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Policy Number: DTE-CC-2X94621A-11L-24 Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and "our" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under Section It — Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V — Definitions. SECTION I — COVERAGES COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance: and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. COMMERCIAL GENERAL LIABILITY (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory' (2) The "bodily injury" or "property damage" occurs during the policy period; and (3) Prior to the policy period, no insured listed under Paragraph 1, of Section II — Who Is An Insured and no "employee" authorized by you to give or receive notice of an "occurrence" or claim knew that the "bodily injury" or "property damage" had occurred. in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. c. "Bodily injury" or "property damage" which occurs during the policy period and was not, prior to the policy period, known to have occurred by any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim, includes any continuation, change or resumption of that "bodily injury" or "property damage" after the end of the policy period. d. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; No other obligation or liability to pay sums or (2) Receives a written or verbal demand or claim for damages because of the "bodily perform acts or services is covered unless injury" or "property damage"; or explicitly provided for under Supplementary Payments. (3) Becomes aware by any other means that b. This insurance applies to "bodily injury" and "bodily injury" or "property damage" has "property damage" only if: occurred or has begun to occur. CG T1 00 02 19 ® 2017 The Travelers Indemnity Company, All rights reserved. Page 1 of 21 Includes copyrighted material of Insurance services Office, Inc. with its permission. COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. trtstienttsf:, �j� inktJ r "� _=. damage"zfflr: rang ursr and sial j, q �.=fAr °4'1s,ca€t .�att ", n1 su '� Cttf"aof tfaaC.'�"er= 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Partas advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. if the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. 7'--I.ti ned$ �stc k1�s��to they f �tts.6, and ait ilgts,or d s --this C ovgrege Pam the .TbfarnetF t_,srired: this insurance applies:' a. As � .,AIatl3ed. Insured were the only P1a�ited�lttsure#i; end b Separately tct citJnslf against wflorn claim is.inaisbroudh -Tracif5 Ri9h 5''Df RecorreiS e9ains.tothefs' r:�: j � l r ose UngMare are rans erred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding websites, only that part of a website that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 ® 2017 The Travelers Indemnity Company , All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance services Office, Inc. with its permission. TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — POLICY NUMBER: UB -2X937955 -24-26-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium. Schedule Person or Organization As required by written contract Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Policy No. UB -2X937955 -24-26-G Endorsement No. 10/01/2024 Premium Insurance Company Countersigned by Travelers Property Casualty Company Page 1 of 1 FM WRAE ASSOCIATES INSURANCE SERVICES 10/01/2024 To whom this may concern, Please be advised that if we get notified by any of the insurance companies listed on the certificate that the insured, CT & T Concrete Paving, Inc. will be receiving a notice of cancellation for any of the below reasons a written notice will be mailed or delivered to you. 1) 10 days before the effective date of cancellation if they cancel for non-payment of premium or 2) 30 days' notice of cancellation will state the effective date of cancellation. The policy will end on that date. If you have any questions or concerns please feel free to contact our office. Than o , Patrick McRae I License No 007,131 AA.:n ntc.... 1949 Nr KA.........,... Q-;1^ 9n4 nn..M:... 4J;16 ! A OOGnT r914, 790 loon F,.... 10,41 776 Aon4 C .....J...._.,.�,.,,a. .6.,. L. r.,.; ...,r