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HomeMy WebLinkAboutKL Painting Inc; 2019-07-22; PWM19-796GSRECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2019-0509775 111111111111 lllll 1111111111111111111111111 lllll 11111111111111111111111 Nov 06, 2019 11 :03 AM OFFICIAL RECORDS Ernest J. Dronenburg, Jr, SAN DIEGO COUNTY RECORDER FEES $0 00 (SB2 Atkins. $0.00) PAGES 1 Space above this line for Recorder's use. PARCEL NO: 205-111-27-00 NOTICE OF COMPLETION Notice is hereby given that: 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full names of the undersigned are City of Carlsbad, a municipal corporation. 3. The full address of the undersigned is 1200 Carlsbad Village Drive, Carlsbad, California 92008. 4. The nature of the title of the undersigned is: In fee. 5. A work or improvement on the property hereinafter described was completed on October 11, 2019. 6. The name of the contractor for such work or improvement is KL Painting, Inc. 7. The property on which said work or improvement was completed is in the City of Carlsbad, County of San Diego, State of California, and is described as follows: Project No. PWM19-796GS, Project Name Kruger, Scout, Holiday House Interior & Exterior Painting. 8. The street address of said property is 3215, 3225 & 3235 Eureka Place, Carlsbad Ca 92008, in the City of Carlsbad. CITY OF CA~AD j., ~{J, p~ £ k!irc. ~ Scott Chadwick, Citjanager VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Carlsbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on OC-lobec f) etA. , 2o_jj_, accepted the above described work as completed and ordered that a Notice of Completion be filed. I declare under penalty of perjury that the foregoing is true and correct. Executed on 0C.1flbt( 3/Hh, 20 J 'I, at Carlsbad, California. CITYOFCA~ I'.( ~ l~ BARBARA ENGLESON/ City Clerk Hectvr 61tne1-1 Dep~+j c,-1,j c,,, Jf Q:\Public Works\General Services\Agreements & Contracts\K L Painting\Kruger, Scout, Holiday House Interior & Exterior Painting -PWM19-796GS\5. NOC\2.NOC (Public and Private) -revised 2019-02-07.docx CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS KL Painting, Inc. has completed the contract work required for PWM19-796GS -Kruger, Scout, Holiday House Interior & Exterior Painting. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS Paint all wood and trim for exterior and interior wood. VALUE $48,898.00 CERTIFICATION OF COMPLETION OF IMPROVEMENTS ~w\t-Jw\A r "l,,,, ft, Jo ashoff,PublicWork~ Manager Date CITY MANAGER'S ACCEPTANCE OF PUBLIC IMPROVEMENTS The construction of the above described contract is deemed complete and hereby accepted. The City Clerk is hereby authorized to record the Notice of Completion and release the bonds in accordance with State Law and City Ordinances. The City of Carlsbad is hereby directed to commence maintaining the above described improvements. 1 1£1,,1 dz, f.i 10' ?-$ 'I CJ {:v,{' Scott Chadwick,&Jfy Manager Date APPROVED AS TO FORM: CELIA BREWER, City Attorney Q\Publ,c Works\General Services\Agreements & Contracts\K L Painting\Kruger, Scout, Holiday House Interior & Exterior Painting -P\NM19-796GS\5. NOC\3API -PWM19- 796GS -Kruger, Scout, Holiday House Interior & Exterior Painting .docx Project: #PWM19-796GS, Kruger, Scout, Holiday House Interior & Exterior Painting Change Order No. 02 \ CONTRACT CHANGE ORDER NO. 02 PROJECT: Kruger, Scout, Holiday House Interior & Exterior Painting CONTRACT NO. PWM19-796GS ACCOUNT NO. 3707000 9060 47091 9066 CONTRACTOR: KL Painting, Inc. ADDRESS: 2440 Lorna Lane Carlsbad, CA 92008 P.O. NO. P137720 The Contractor is directed to make the following changes as described herein. Changes shall include all labor, materials, equipment, contract time extension, and all other goods and services required to implement this change. Payment stated on this change order includes all charges, direct or indirect, arising out of this additional work including charges for field overhead, extended home office overhead, delays, disruptions, cumulative impacts, loss of efficiency, extended equipment costs and overtime premium costs and is expressly agreed between the City and the Contractor to be the complete and final costs hereof. The requirements of the specifications, where pertinent and not in conflict with this change order, shall apply to these changes. Pursuant to the Standard Specifications for Public Works Construction, perform the following: Item 1: Contractor to provide all labor, equipment and materials to reinstall missing plywood and repair drywall and paint in two storage closets located in the Scout House. Total cost not to exceed ...................................................................... $950.00 TOTAL INCREASE TO CONTRACT COST .................................................... $950.00 TIME FOR COMPLETION OF ALL WORK UNDER THIS CONTRACT SHALL BE INCREASED BY ZERO (0) WORKING DAYS AS A RESULT OF THIS CHANGE ORDER. Ill Ill Ill Ill Ill Ill Ill Project: #PWM19-796GS, Kruger, Scout, Holiday House Interior & Exterior Painting Change Order No. 02 RECOMMENDED BY: APPROVED BY: MUNICIPAL PROJECTS MANAGER (DATE) ,·~~ ~NGINEERING MANAGER APPROVED AS TO FORM: DISTRIBUTION: INSPECTION FILE (ORIGINAL), PURCHASING, CONTRACTOR (DATE) Project: #PWM19-796GS, Kruger, Scout, Holiday House Interior & Exterior Painting Change Order No. 01 CONTRACT CHANGE ORDER NO. 01 PROJECT: Kruger, Scout, Holiday House Interior & Exterior Painting CONTRACT NO. PWM19-796GS ACCOUNT NO. 3707000 9060 47091 9066 CONTRACTOR: KL Painting, Inc. ADDRESS: 2440 Lorna Lane Carlsbad, CA 92008 P.O. NO. P137720 The Contractor is directed to make the following changes as described herein. Changes shall include all labor, materials, equipment, contract time extension, and all other goods and services required to implement this change. Payment stated on this change order includes all charges, direct or indirect, arising out of this additional work including charges for field overhead, extended home office overhead, delays, disruptions, cumulative impacts, loss of efficiency, extended equipment costs and overtime premium costs and is expressly agreed between the City and the Contractor to be the complete and final costs hereof. The requirements of the specifications, where pertinent and not in conflict with this change order, shall apply to these changes. Pursuant to the Standard Specifications for Public Works Construction, perform the following: Item 1: Contractor to provide all labor, equipment and materials to apply a new application of stucco to the east and a portion of the south elevations of the Scout House. Total cost not to exceed ...................................................................... $600.00 TOTAL INCREASE TO CONTRACT COST .................................................... $600.00 TIME FOR COMPLETION OF ALL WORK UNDER THIS CONTRACT SHALL BE INCREASED BY ZERO (0) WORKING DAYS AS A RESULT OF THIS CHANGE ORDER. Ill Ill /II Ill Ill Ill Ill Project: #PWM19-796GS, Kruger, Scout, Holiday House Interior & Exterior Painting Change Order No. 01 RECOMMENDED BY: q 'll \C\ MUNICIPAL PROJECTS MANAGER (DATE) APPROVED AS TO FORM: DISTRIBUTION: INSPECTION FILE (ORIGINAL), PURCHASING, CONTRACTOR {{ V1 (VI v;, wui,i<~ (DATE) (DATE) PWM19-796GS CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT KRUGER, SCOUT, HOLIDAY HOUSE INTERIOR & EXTERIOR PAINTING; CONT. NO. 4709 This agreement is made on the !)()09. day of_++-.......... "-"'-'....,.,.'------- of Carlsbad, California, a municipal corporation, (herei California corporation whose principal place of busines (hereinafter called "Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor's proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by: Ron Haugland (City Project Manager). WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777. 5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. Kruger, Scout, Holiday House Exterior Painting; Cont. No. 4709 Page 1 of 8 City Attorney Approved 9/27/16 PWM19-796GS FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Car1sbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five years and that debarment by another jurisdiction is grounds for the City of Car1sbad to disqualify the Contractor or subcon!f.a~o om ~g in contract bidding . . ,.,.. Signature: Print Name: Kody Kinney REQUIRED INSURANCE. The successful contractor shall provide to the City of Car1sbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers' Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers {LASLI) with a rating in the latest Best's Key Rating Guide of at least "A:X"; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners {NAIC) latest quarter1y listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than ........ $1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ....... $1,000,000 Property damage insurance in an amount of not less than ........ $1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non- scheduled. The automobile insurance certificate must state the coverage is for "any auto" and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that thirty (30) days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Car1sbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Car1sbad Business License for the duration of the contract. Kruger, Scout, Holiday House Exterior Painting; Cont. No. 4709 Page 2 of 8 City Attorney Approved 9/27/16 PWM 19-796GS INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within fifteen (15) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within forty-five (45) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Ill Ill Ill Ill Ill Ill Ill KL Painting, Inc. (name of Contractor) 899963 (Contractor's license number) C-33 1/31/2020 (license class. and exp. date) 1000049048 (DIR registration number) 6/30//2020 (DIR registration exp. date) Kruger, Scout, Holiday House Exterior Painting; Cont. No. 4709 Page 3 of 8 2440 Lorna Lane (street address) Carlsbad, CA 92008 (city/state/zip) 760-613~9891 (telephone no.) 760-683-3332 (fax no.) klpainting@gmail.com (e-mail address) City Attorney Approved 9/27/16 PWM19-796GS AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR KL PAINTING, INC., a California corporation By: ~/"/--·-7 I/ -,r . ~ / (sign~ Kody Kinney / President, CFO (print name/title) By: (sign here) (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California anager, Public City Manager If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !f.E. corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: Kruger, Scout, Holiday House Exterior Painting; Cont. No. 4709 Page 4 of8 City Attorney Approved 9/27/16 PWM19-796GS EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to Business Name and Address DIR Registration License No., %of be Subcontracted No. Classification & Total Exoiration Date Contract NCi~·; Total % Subcontracted: _8_.:,,_·_-___ _ The Contractor must perform no less than fifty percent (50%) of the work with its own forces Kruger, Scout, Holiday House Exterior Painting; Cont. No, 4709 Page 5 of8 City Attorney Approved 9/27/16 PWM19-796GS EXHIBITB Kruger, Scout, Holiday House Interior & Exterior Painting Contractor to provide all materials, tools and labor required to paint exterior and interior of the Kruger House located at 3215 Eureka Place, Carlsbad, CA 92008, Scout House located at 3225 Eureka Place, Carlsbad, CA 92008 and Holiday House located at 3235 Eureka Place, Carlsbad, CA 92008 in Holiday Park, Carlsbad, CA. Scope of work included as follows: Exterior: 1. Scrape and sand off all chipping and peeling paint from wood siding, trim and stucco. 2. Bondo or caulk cracks and holes in all siding, trim and stucco. 3. Prime all raw wood and patch work before finish with two coats. 4. Power wash all of exterior. 5. Paint all trim on house including eaves, fascia, gutters, windows, door and jambs and all siding. 6. Mask and protect all areas not to be painted. 7. Paint all wood and trim as is (after power washing). 8. All paint colors to match existing. 9. All Material to be Sherwin Williams products (or equivalent). 10. All paint, materials, labor and taxes are included in this estimate. Interior: 1. Paint all ceilings and walls throughout to match existing color, two coats finish paint. 2. Paint all doors and jambs throughout to match existing color, two coats finish paint. 3. Mask and protect all areas not to be painted. 4. KL Painting to do drywall repair and patching before finish paint. 5. KL Painting to remove all electrical faceplates and reinstall when paint is complete. 6. Staff of building to remove all things from walls and ceilings., 7. All paint colors to match existing except at Holiday House where colors will be determined. 8. All material to be Sherwin Williams products (or equivalent). 9. All paint, material, labor an taxes are included in this estimate. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Kruger House, Scott House, Holiday House -Exterior $30,200 2 LS 1 Kruger House, Scott House, Holiday House -Interior $16,400 3 LS 1 Labor and Materials Bond $1,748 TOTAL* $48,348 *Includes taxes, fees, expenses and all other cost Kruger, Scout, Holiday House Exterior Painting; Cont. No. 4709 Page 6 of8 City Attorney Approved 9/27/16 Bond Number: USCX372X1883 Premium: $1,571.00 EXHIBITC LABOR AND MATERIALS BOND PWM19-796GS WHEREAS, the City Council of the City of Car1sbad, State of California, has awarded to KL Painting, Inc., a California corporation (hereinafter designated as the "Principar), a Contract for. KRUGER, SCOUT, HOLIDAY HOUSE INTERIOR & EXTERIOR PAINTING CONTRACT NO. 4709 in the City of Car1sbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Car1sbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, KL PAINTING, INC., as Principal, (hereinafter designated as the "Contractor"), and United Surety Insurance Company as Surety, are held firmly bound unto the City of Car1sbad in the sum of FORTY EIGHT THOUSAND THREE HUNDRED FORTY EIGHT Dollars ($48,348), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Car1sbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies. or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor perfonned under this Contract. 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 subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the tenns of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the wori( or to the specifications. Kruger, Scout, Holiday House Exterior Painting, Cont. No. 4709 Page 7 of 8 City Attorney Approved 9/27/16 PWM19-796GS In the event that COntractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. SIGNED AND SEALED, this --=27~t=h ___ day of ____ __;J::..::u=-=-n=e'-------· 20~ _.1,..;K .. L .... P ..... a ... io ... t ... jn,Lllg,.., .... luo-"'c._, _____ (SEAL) United Surety Insurance Company (SEAL) ~,..,b_ 1,L By:---~-~-~~------- (Signature) (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY -ATTACH ATTORNEY-IN-FACT CERTIFICATE) APPROVED AS TO FORM: CELIA A. BREWER City Attorney~ By: . Deputy City Attorney Kruger, Scout, Holiday House Exterior Painting; Conl No. 4709 Page 8 of 8 City Attorney Approved 9/27116 ' ~ ' Callfomia 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 ---"O-'-'ra"-n"'"g'""e ___________ _ S.S. On June 27, 2019 before me, Debbie McGilligan, Notary Public personally appeared ~K~e..,lly,_.A~S~p~e~c~b1~-------------------- N/A who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/amt subscribed to the within instrument and acknowledged to me that he/s~ey executed the same in his/bue:ridlhe.r authorized capacity(ies), and that by his/bll!'dheJ.r 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 PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seaL l!Jad l "AtL/4~ DEBBIE MCGILLIGAN Notary Public . California Orange County CemiTl!')SI.,;') # ?lr\.1383 z z )> ,f OPTIONAL INFORMATION ------------- Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of UCSX372X 1883 Payment Bond -KL Painting Inc -City of Carlsbad containing _2_ page~ and dated June 27 2019 The signer(s) capacity or authority is/are as: :J lndiv1dual(s) Xi Attorney-in-fact ::::} Corporate Officer(s) ______________ _ [J Guardian/Conservator [J Partner -Limited/General [J Trustee(s) [J Other _________________ _ representing: --~U~n~it=e~d~S~u=r=e__,ty~l~n=s=ur=a~n=c=e~C~o~m~pa=n'"'"y,,_____ Method of Signer Identification 1 Proved to me on tho basis of satisfactory cv1dcnce ~.::. form(s) of identification . credible witness(es) Notarial event is detailed 1n notary Journal on Page#____ Entry#···--·-· Notary contac1· Other .... : Add1t,onal Signer ~ .. S,gner(s) Thumbpnnts(s) •T.TTD•. D UNITED CASUALTY AND SURETY INSURANCE COMPANY us casualty and Surety Insurance Company United Surety Insurance Company POWER OF ATTORNEY Agency No. 171372 KNOW ALL MEN BY THESE PRESENTS: That United Casualty and Surety Insurance Company, a corporation of the State of Nebraska, and US Casualty a~d Surety Insurance Company and United Surety Insurance Company, assumed names of United Casuaity and Surety Insurance Company (collectively, the Companies). do by these oresents make, constitute and appoint: Kelly A. Specht, Kandis Gregory, Richard P. Ford, Thomas C. Buckner, Michael Herranen, Bethany Mercer its true and lawful Attorney(s)-in-Fact, each in their separate caparny if more than one is named above, with full power and authority hereby conferred i~ ,ts name. place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety. This Power of Attorney shall expire without further action on December 31", 2023. This Power of Attorney is granted under and by authority of the following rr,olcnuns adopted by the Board cf Directors of the Compani~s at a meeting duly called and held on the 1 •· day of July, 1993: Resolved that the President. Treasurer, or Secretary be and they are hereby Jut homed and e~powered to .:Jppo1n! Attorneys-:n-Fact of the Como,1ny, 1n ,ts nan•e and a\ its acts to cr.ccute and acknow1edge far and on ,ts behalf as Surety any a,d a:1 bo"'lds. rccogrHZJrce~. contr~cts of 1nocmn1ty, wa1vcr'i. of c,tarion and ali othrr wr,t1ng.-. obligaro')' tn the nature thereof, with power to attach thereto the seal cf tht' Company. Any such wntmg!li so e~ecutcd b-, such Attorneys-in-Fact snail be b:nd,ng upon the Company as 1f they had been duly executed and acknowledged by the regu1a·ly e ected Of'lcers of the Company 1n their own proper persons. ~.,at t~C' s,anaturc of any officer author1ll'd by Rcsoluuons of th,s 8-odrc anc tnc Company seal may be affixed by facs1rr1lc to any power of attorney or special oowcr of anorney or certificavon of either g,ven for the uec1,;t1on of any bond, L.ndert.JkH"'·R, recoR:ri11ance or other W"lttt."'I obilg.ano-, in the nature thereo'; such s,,.,aturt a.,d H•a . when )O u)ed being ht"reby adopted by the Company as the orig,"'lal s,gnatu·e cf s...ic,.. ofhccr ,1nd the or1g1n.>I seat of the Comp,1ny, to be valid and b1rdirtg upon tne Company with the ume force and effect as though manually aft11,rc1 IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereunto affixed, this 23rd day of May, 2019 ... -... , Corporate Seals Commonwealth of Massachusetts County of Suffolk ss: ,;[.\I UNITED CASUALTY AND SURETY INSURANCE COMPANY US Casualty and Surety Insurance Company United Surety Insurance Company Michael J. Scholl, President On this 23rd day of May, 2019, before me, Thomas P. Carrigan, J•., a notary public, personally appeared Micnael J. Scholl, President of United Casualty and Surety Insurance Company, US Casualty and Surety lnsurar.ce Company and United Surety Insurance Company, who proved to me on the basis of satisfactory evidence to be the person whose name ,s subscribed to the within instrument and acknowledged to me that he e.ecuted the same in his authorized capacity, and that by his signature on the instrument the person(s), or the entity on behalf of which the person(s} acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the Commonwealth of \/1assachusetts that the foregoing paragraph is true and co•rect. WITNESSmyhar.dandseal. ~ / _'_.,? _____ ,_/....,.. __ -~ ___ (Seal) THOMAS P. CARRIGAN, JR. Thomas P. Carrigan, Jr., Notary Public Commission Expires: 10/31/2025 Notary Public, Commonweallh of Massachusetts My Commission Expires Cktober 31. 2025 I, Joel R. Chachkes, Chief Financial Officer of United Casualty and Sure:y Insurance Corrpany, US Casualty and Surety Insurance Company and United Surety Insurance Co11"pany do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, wh,ch is st•II ,n 'ull force and effect; furthermore, the resolunons of the Board of Directors, set out :n the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of sa:d Comparies at Boston, Massachusetts this ---=2=-7~t"'h.,__day of ----~ne_ ___ -2019 Corporate Seals .:(__._' -------. J~e-1_,~,_, C-h-a-chke~: Chief Financial Offi-_c_e_r_~---- TO CONFIRM AUTHENTICITY OF THIS BOND OR DOCUMENT lMAIL" CONFIRMBOND@UNITEDCASUALTY.COM ~ DATE (MM/DD/YYYY) I ACORD. CERTIFICATE OF LIABILITY INSURANCE ~ 06/05/2019 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: (858) 642-0200 Fax: (858) 642-0205 CONTACT ALL COMMERCIAL INSURANCE SERVICES, LLC. NAME: ALL COMMERCIAL INSURANCE SERVICES, LLC. PHONE (858) 642-0200 I~~ Nol: (858) 642-0205 6790 TOP GUN STREET #3 IA/C No Extl: E-MAIL www.2insure.biz SAN DIEGO CA 92121 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# Agency Lie#: OC64552 INSURER A : NATIONWIDE MUTUAL INSURANCE CO 23787 INSURED INSURER B : INFINITY SELECT INSURANCE COMPANY 20260 KL PAINTING, INC. 2440 LORNA LANE INSURERC : NAT'L UNION FIRE INS CO OF PITTSBURGH PA CARLSBAD CA 92008 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER· 3346749 REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IMM/DD/YYYY\ IMM/DD/YYYYl A X COMMERCIAL GENERAL LIABILITY ACP7885050387 05/27/19 05/27/20 EACH OCCURRENCE $ 1,000,000 -□CLAIMS-MADE l~occuR DAMAGE TO RENTED $ 100,000 PREMISES (Ea occurence) -MED. EXP (Any one person) $ 5,000 -PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 R 0PR~ □ POLICY X JECT LOG PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY 504590622685001 06/27/19 06/27/20 COMBINED SINGLE LIMIT 1,000,000 B -(Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ --ALL OWNED SCHEDULED AUTOS X AUTOS BODILY INJURY (Per accident) $ -X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ -AUTOS (per accident) $ C UMBRELLA LIAB ~OCCUR EBU011211885 05/27/19 05/27/20 EACH OCCURRENCE $ 2,000,000 -X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 OED I !RETENTION$ $ WORKERS COMPENSATION I PER I I OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y/N E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE □ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $ If yes, describe under E.L. DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Agreement Number: PWL 19-733GS / Agreement Name : Safety Center Gate Painting The City of Carlsbad is included as Additional Insured with respect to general liability as per the attached endorsement. *10 Day Notice of Cancellation for Non-Payment/30 Day Notice of Cancellation for all other causes CERTIFICATE HOLDER CANCELLATION City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 4668 -ECM #35050 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 REPRESENTATIVE New York, NY 10163-4668 Attention: Mark Rubin ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD / POLICY NUMBER: ACP 7885050387 COMMERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) THE CITY OF CARLSBAD 1635 FARADAY AVE CARLSBAD, CA 92008 Location(s) Of Covered Operations ALL LOCATIONS AT WHICH ONGOING OPERATIONS ARE BEING PERFORMED FOR THE ADDITIONAL PERSON(S) OR ORGANIZATION(S) Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 2010 0413 ACP GLO 7885050387 5IEX 19088 © Insurance Services Office, Inc., 2012 INSURED COPY Page 1 of 2 47 0003449 CG 2010 0413 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not applicable Limits of Insurance Declarations. increase the shown in the All terms and conditions apply unless modified by this endorsement. Page 2 of 2 ACP GLO 7885050387 5IEX 19088 © Insurance Services Office, Inc., 2012 INSURED COPY CG 2010 0413 47 0003450 STATE COMPENSATION INSURANCE FUND ISSUE DATE: 10-01-2018 CITY OF CARLSBAD 1635 FARADAY AVE CARLSBAD CA 92008-7314 POLICYHOLDER COPY P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE GROUP: POLICY NUMBER: 1907534-2018 CERTIFICATE ID: 57 CERTIFICATE EXPIRES: 10-01-2019 10-01-2018/10-01-2019 SP This is to certify that we have issued a valid Workers' Compensation insurance policy in a form apprdved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. ~ti£::/ IL,.,. xii~-~ Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2018-10-01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: CITY OF CARLSBAD ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2018 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2018-10-01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF CARLSBAD EMPLOYER KL Painting, Inc 3809 CARNEGIE DR OCEANSIDE CA 92056 (REV.7-2014) SP PRINTED [P1R,HO] 10-01-2018 SP