Loading...
HomeMy WebLinkAboutRay White Cement; 2017-10-03; PKRC637Tracking#: CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT WALKWAY IMPROVEMENTS AT HOLIDAY PARK; CONT. NO. PKRC637 This agreement is made on the , 311. Y day of f) c_fc[p& , 20.L2., by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Ray White Cement whose principal place of business is 2380 Via Monserate, Fallbrook, CA 92028 (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: Kyle Lancaster (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. WAL'r<MJAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 1 of 8 City Attorney Approved 9/27/2016 Tracking#: 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 Carlsbad 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 Carlsbad to disqualify the Contractor or su ntractor from participating in ontract bidding. Signature: Print Name: DIANE WHITE REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, 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 quarterly 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 Carlsbad 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 Carlsbad Business License for the duration of the contract. WALKWAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 2 of 8 City Attorney Approved 9/27/2016 Tracking#: 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 15 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 45 working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. II II II II II II Ray White Cement (name of Contractor) 410673 (Contractor's license number) C-8, 8/31/2019 (license class. and exp. date) 1000003603 (DIR registration number) 6/30/2018 (DIR registration exp. date) WAL'r0NAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 3 of 8 2380 Via Monserate (street address) Fallbrook, CA 92028 (city/state/zip) 760-728-0170 (telephone no.) 760-728-5605 (fax no.) tom@raywhitecement.com (e-mail address) City Attorney Approved 9/27/2016 Tracking#: 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 By: ~~~ ' {sign h re) PRESIDENT CITY OF CARLSBAD, a municipal corporation of the State of California By: "--,,~ger, eputy City Manager or Department Director as authorized by the City Manager By: AfEST: \IiffYJc A.O. tm d,v/'01 BARBARA ENGLESON U City Clerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !!__g 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: CELIA A. BREWER, City Attorney BY: __ ~-'----"'="'-=-=e'.=--~""""""-=-" .::,,o.___ ~ City Attorney WALKWAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 4 of 8 City Attorney Approved 9/27/2016 Tracking#: 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 Expiration Date Contract Total % Subcontracted: '\ The Contractor must perform no less than fifty percent (50%) of the work with its own forces. WAU0NAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 5 of 8 City Attorney Approved 9/27/2016 EXHIBIT B SCOPE OF SERVICES Tracking#: Ray White Cement will replace existing walkways surrounding the Scout House and Kruger House playground areas at Holiday Park. 1. Scout House • Break, remove and dispose of existing asphalt walkways • Remove tree roots that have grown under the surface • Install 12" root barrier along fence where tree roots have encroached • Prepare subgrade for new concrete walkways • Form and pour new 4" thick concrete reinforced walkways • Install #3 rebar at 24" on-center each way within concrete walkways • Medium broom finish texture • City will remove fence mesh for bobcat access 2. Kruger House • Break, remove and dispose of existing asphalt walkways • Remove tree roots that have grown under the surface • Install 12" root barrier where tree roots have encroached • Prepare subgrade for new concrete walkway • Form and pour new 4" thick concrete reinforced walkways • Install #3 rebar at 24" on-center each way within concrete walkways • Medium broom finish texture with deep joints throughout • City will provide gate access JOB QUOTATION ITEM DESCRIPTION PRICE NO. 1 Scout House Walkway Replacement -945 Square Feet $16,395.00 2 Kruger House Walkway Replacement -625 Square Feet $12,930.00 3 Labor and Materials Bond $289.00 TOTAL $29,614.00 Agreement shall not exceed $29,614.00 WAL't<:NAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 6 of 8 City Attorney Approved 9/27/2016 Tracking#: EXHIBITC LABOR AND MATERIALS BOND Bond No.: 5238741 --------Premium: $289.00 WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Ray White Cement (hereinafter designated as the "Principal"), a Contract for: WALKWAY IMPROVEMENTS AT HOLIDAY PARK CONTRACT NO. PKRC637 in the City of Carlsbad, 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 Carlsbad 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, Ray White Cement as Principal, (hereinafter designated as the "Contractor''), and SURETEC INSURANCE COMPANY as Surety, are held firmly bound unto the City of Carlsbad in the sum of twenty-nine thousand six hundred fourteen dollars ($29,614.00), 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 Carlsbad, 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 performed 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 terms 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 work or to the specifications. WALKWAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 7 of 8 City Attorney Approved 9/27/2016 Tracking#: 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. t::-v-1 Executed by CONTRACTOR this ~,_; .--:l-Executed by SURETY this 1 ST day day (print name here) QfO (title and organization of signatory) . '1 By: /~{{J.'ic {J;i(,d:i_~ ( ign here) . (~1a[t: L;t_,-{1 t t2 (print name here) yJ,,u_,s rderi+ (title and organization of signatory) of ___ SE_P_T_E_M_B_E_R _____ , 20__!1_. SURETY: SURETEC INSURANCE COMPANY (name of Suretv) 3131 Camino Del Rio Nortn, Ste. 1450 San Diego, CA 92108 (address of Surety) 619-400-4100 (telephone number of Surety) By: l [_ l I_ ~.I.I\~ . t:,-'\L--v- (signature of Attorney-in-Fact) Jerome L. Hren (printed name of Attorney-in-Fact) (attach corporate resolution showing current power of attorney) (Proper notarial acknowledgment of execution by CONTRACTOR and SURETY must be attached.) (President or vice-president and secretary or assistant secretary must sign for corporations. If only one officer signs, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering that officer to bind the corporation.) APPROVED AS TO FORM: CELIA A BREWER City Attorney By: ~ Deputy City Attorney WALt<WAY IMPROVEMENTS AT HOLIDAY PARK CONT. NO. PKRC637 Page 8 of 8 City Attorney Approved 9/27/2016 POA #: 510016 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMP ANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Jerome L. Hren its true and lawful Attorney-in-fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment shall continue in force until 1213112019 and is made under and .by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relati,1g thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20th of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 12th day of April , A.D. 2017 . State of Texas ss: County of Harris ~"*'\\\\ll~Jlll/11111"" ~~~-~!Y:!.9~ ----~··..., ·,._00 /if/ ,.. '1 \~1 tiil w l~~ a:\ ~ / -::;I ~ ·· .. , J. . ./ ~ I ....... ; .. ··/ 11111t1n11u11,; SURETEC On this 12th day of April , AD. 2017 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMP ANY, the company described in and which executed the above instrnment; that he knows the seal of said Company; that the seal affixed to said instrnment is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. ,,,,.,.,,,, XENIA CHAVEZ ~,\ ... ~"!.~'-'/;~ ~f(.A.>~~ Notary Public, State of Texas -::.~)'.~-·l.? Comm. Expires 09-10-2020 ,,,,f,~f,t," Notary ID 129117659 avez, Notary Public y commission expires September 10, 2020 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMP ANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 18 t Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. 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 Riverside On September 1, 2017 before me, Jennifer H. Hoagland, Notary Public (insert name and title of the officer) personally appeared _J_e_r_o_m_e_L_._H_re_n ____________________ _ 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(sJ, or the entity upon behaff of whfch the person(s) acted, executed the fnstrument. 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. Signature ~\\~ ¾,J (Seal) CALIFORNIA ALL~PURPOSE ACKNOWLEDGMEN'f CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of S Qr\ D i Q_ ~ (J On \[e9.±fmbty Sj'dDll: beforeme, S[lrc1h Schock /nottfftj fttbl/( Date Here Insert Name and Title ofthe Officer personally appeared --~~~C_\ \._,-,.Q-lc_1 h_l_~_e __ C_{_V1_d_~D~1_a-111J~~-L1J~h~1_f-( ___ _ Name@) of Signer(i) who proved to me on the basis of satisfactory evidence to be the pers®~ whose name(§} is/w subscribed to the within instrument and acknowledged to me that he/sheA.b§y executed the same in his/her/t@r authorized capacity~). and that by his/her/tlie} signature<sj'on the instrument the person{t), or the entity upon behalf of which the person(~ acted, executed the instrument. Place Notary Seal Above 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. Signature k//ai1 ~ htrCA Signature of Notary Public ---------------oPnONAL--------------- Though this section is optional, completing this information can de alteration of the document or fraudulent reatta6J:iment of this form to an unintende document. Descri~ion of Attached Document\ Title or ype of Document: ____ _,,_ ________ Documen Date: _______ _ Number \ Pages: ___ Signer(s) Named Above: ____________ _ Capacity(ies), Claimed by Signer(s) Signer's Name-: D Corporate Officer -Title(s): ______ _ D Partner -D Ll ited D General Signer's Name: ___ ____,, ________ _ D Corporate Officer -Titl D Partner -D Limited eneral D Individual Attorney in Fact D Individual D Attorne in Fact D Trustee Guardian or Conservator D Trustee D Guardian r Conservator D Other:----~.-----------Other: _______________ _ Signer Is Representing: ..,.._ ________ _ · ner Is Representing: ____ .....,_ ____ _ ©2014 National Notary Association· www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 ~Allstate. Y::,u're in goo:J hands, ~& ~ BU114R·3 Cl CW A021011 CERTIFICATE OF INSURANCE This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies. Alteration of this certificate does not change the tem1S, exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at the policy inception. Subsequent paid claims may reduce these limits. Certificate Holder: CITY OF CARLSBAD, MINOR PUBLIC WORKS ALGA NORE AND POINSETTIA PARK ARE NAMED AS ADDITIONAL INSURED AS RESPECTS TO THE GENERAL LIABILITY WHEN REQUIRED BY WRITTEN 799 PINE AVE STE 200 CARLSBAD, CA USA 920082428 Named Insured: RAY WHITE CEMENT PO BOX 489 FALLBROOK CA 920B8-0489 Automobile Liabilitv Insurer Name: Allstate Insurance Company Polic 1 Number: 648690744 1 --Any Auto 2 -Owned Autos Only 3 -Owned Priv. Pass. Autos Only 4 --Owned Autos Other Than Priv. 5 -Owned Autos Subject to 6-Owned Autos Subject to a Compulsory UM Law Pass. Autos Only No Fault X 7 --Soecificallv Described Autos X B -Hired Autos Onlv X 9 -Nonowned Autos Onlv Policy Effective Date : 10-01-2016 j Policy Expiration Date: 10-01-2017 Limits of $2,000,000 Combined Single Limit (each accident) Insurance: Bl Per Person Bl Per Accident l PD Per Accident Description of Operations/LocationsNehicles/Endorsements/Soecial Provisions Interested Party Type: Additional Insured -Proi ect Owner THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer: B.JASON PERRY Authorized Representative: Date: 07-18-16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Cl CW A021011 Allstate Insurance Company Page 1 of 1 Additional Insured Copy ~Allstate. BU114R-3 You're ,n good hands. /pOLICY NUMBER: 648690744 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless -modified by this-endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: RAY WHITE CEMENT Endorsement Effective Dam: 10-01-2016 SCHEDULE Name Of Person(s) Or Organization(s): CITY OF CARLSBAD, MINOR PUBLIC WORKS ALGA NORE AND POINSETTIA PARK ARE NAMED AS ADDITIONAL INSURED AS RESPECTS TO THE GENERAL LIABILITY WHEN REQUIRED BY WRITTEN CONTRACT AS PER THE ATTACHED FORM/WAIVER OF SUBROGATION APPLIES AS RESPECTS TO ... 799 PINE AVE STE 200 CARLSBAD, CA USA 920082428 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I -Covered Autos Coverages of the Auto Dealers Coverage Form. CA20481013 © Insurance Services Office, Inc., 2011 h:lditional Insured Copy Page 1 of 1 RAYWHl1 OP ID: C2 ACORD· CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) ~-09/11/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL V AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVEL V OR NEGATIVEL V AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ~2~~AcT Tony Yahyai Wateridge Insurance Services iJl78iEo Ext): 858-452-2200 I FAX 10717 Sorrento Valley Rd. (AJC, No): 858-452-6004 San Diego, CA 92121 E-MAIL ADDRESS: Tony Yahyai INSURER(S) AFFORDING COVERAGE NAIC# 1NsuRER A: Falls Lake Fire and Casualty 15884 INSURED Ray White Cement INSURERB: PO Box 489 INSURERC: Fallbrook, CA 92088 INSURERD: INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 ~· POLICJ~ 1~~r6i~ LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ~ D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ ~ PERSONAL & ADV I !,.JURY $ ~ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ ~ DPRO DLoc PRODUCTS · COMP/OP AGG $ POLICY JECT OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ---i I ANY AUTO BODILY INJURY (Per person) $ ..----; ALL OWNED ~ SC'-IEDULED BODI Ly INJURY (Per acc,den'.) $ ------' AUTOS ~ AUTOS I NON-OWNED PROPERTY DAMASE $ ~ HIRED AUTOS AUTOS (?er accident) t-- I $ : UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ I EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION $ $ WORKERS COMPENSATION I ~firuTE I I 0TH AND EMPLOYERS' LIABILITY ER A Y/N FLA001536-00 10/01/2016 10/01/2017 1,000,000 ANY PROPRIETORIP.ARTNER/EXECUTIVE D E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) EL DISEASE· EA EMPLOYEE $ 1,000,00C If yes, describe under DESCRIPTION OF OPERA Tl ONS below EL DISEASE· POLICY LIMIT $ 1,000,00C DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES !ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: City of Carlsbad, 540F Holiday Park. CERTIFICATE HOLDER CANCELLATION CARLSC1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad ACCORDANCE WITH THE POLICY PROVISIONS. 799 Pine Avenue Suite 200 Carlsbad, CA 92008 AUTHORIZED REPRESENTATIVE I ~· © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 9/8/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Silva and Sons Insurance Services Inc. CONTACT Dennis Silva NAME: 26323 Jefferson Ave, Suite C PHONE 888-7 45-8259 I FAX 951-763-8000 Murrieta, CA 92562 ,,.,,. No."•": (A/C Nol: E-MAIL Dsilva@Silva-lns.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# www.Silva-lns.com Lie #0H99310 INSURER A: Rockhill Insurance Comoanv 28053 INSURED INSURER B: National Union Fire Ins Co of Pittsburgh PA 19445 Ra~ White Cement Liberty Mutual Insurance Company 23043 23 0 Via Monserate INSURERC: Fallbrook CA 92028 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER· 37631837 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE I •••~n lun,n POLICY NUMBER IMM/DDNYYYI IMM/DDNYYYl A d_ COMMERCIAL GENERAL LIABILITY I I RCGLPG00502-03 10/1/2016 10/1/2017 EACH OCCURRENCE $ 1,000,000 D CLAIMS-MADE w OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence l $ 50,000 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 [ZJPRO-DLOC PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: Per Project Aggregate $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ '--(Ea accident\ ANY AUTO BODILY INJURY (Per person) $ '--OWNED ~ SCHEDULED BODILY INJURY (Per accident) $ ~ AUTOS ONLY '--AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ '--AUTOS ONLY ~ AUTOS ONLY (Per accident\ $ B UMBRELLA LIAB ~ OCCUR EBU080744761 10/1/2016 10/1/2017 EACH OCCURRENCE $ 1000000 ~ I EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 OED I I RETENTION $ $ WORKERS COMPENSATION I PER I I OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ C COMMERCIAL PROPERTY BFS56226606 1/15/2017 1/15/2018 LEASED/RENTED EQIUPMENT $50,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF CARLSBAD, 540F HOLIDAY PARK CITY OF CARLSBAD, IT'S OFFICERS, OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS are named additional insured as respects to the General Liability when required by written contract as per the attached form / Waiver of Subrogation applies as respects to General liability per attached form / Primary and Non-Contributory endorsement applies as respects to General Liability as per attached form. / Per Project Aggregate applies as respects to General liability per attached form CERTIFICATE HOLDER CANCELLATION CITY OF CARLSBAD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: PARKS & RECREATION ACCORDANCE WITH THE POLICY PROVISIONS. 799 PINE AVENUE, SUITE 200 CARLSBAD CA 92008 AUTHORIZED REPRESENTATIVE -z:;2---:~ I Dennis Silva © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 37631837 I 16-17 GL XS Insurance I Diane W~ite I 9/8/2017 8:37:42 AM (PDT) I Page 1 of 5 This certificate cancels and supersedes ALL previously isSl.:.ed certi::ica~es. / RCGLPG00502-03 COMMERCIAL GENERAL LIABILITY CG 24 0410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization to which you are obligated by virtue of written contract to provide insurance such as is afforded by this policy, but only with respect to (1) occurrences taking place after such written contract has been executed and (2) occurrences resulting from work performed by you during the policy period, or occurrences resulting from the conduct of your business during the policy period. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV - COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may l1ave against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 0410 93 Copyright, Insurance Services Office, Inc., 1992 37631837 I 16-17 GL XS Insurance I Diane White I 9/8/2017 8:37:42 AM (PDT) I Page 2 of 5 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 1 D RCGLPG00502-03 COMMERCIAL GENERAL LIABILITY CG 20 33 07 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability aris- ing out of your ongoing operations performed for that insured. A person's or organization's status as an insured under this endorsement ends when your operations for that insured are completed. B. With respect to the insurance afforded these addi- tional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injuryfl, "property damagefl or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, re- ports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural or engi- neering activities. Coverage provided by this policy to the Additional lnsured(s) shall be primary insurance and any other insurance maintained by the Additional lnsured(s) shall be excess and non-contributory, but only if required of the Named Insured and by written contract. CG 20 33 07 98 Copyright. Insurance Services Office, Inc., 1997 37631837 j 16-17 GL XS Insurance I Diane White I 9/8/2017 8:37:42 AM (PDT) I Page 3 of 5 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 1 D RCGLPG00502-03 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -(FORM 8) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Any person or organization to which you are obligated by virtue of a written contract to provide insurance such as is afforded by this policy, but only with respect to ( 1) occur- rences taking place after such written contract has been executed and (2) occurrences re- sulting from work performed by you during the policy period, or occurrences resulting from the conduct of your business during the policy period. A person or organization that qualifies as an "insured" under the above paragraph of this Endorsement shall be an additional insured solely with respect to such additional insured's liability for "bodily injury," property damage" or "personal and advertising injury" caused in whole or in part by your acts or omissions in the performance of "your work" for the addi- tional insured on or at "commercial construction projects." For the purposes of this Endorsement, "commercial construction projects" are defined as buildings or structures constructed for commercial use and also include apartments, hotels, homes for the aged, dormitories or barracks. However, "commercial construction projects" shall not include any building or structure which, in whole or in part, contains individual owner occupied units or dwellings. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. Coverage provided by this policy lo the Additional lnsured(s) shown in the Schedule shall be primary insurance and any other insurance maintained by the Additional lnsured(s) shall be excess and non-contributory, but only if required of the Named Insured and by written contract. CG 2010 11 85 Copyright, Insurance Services Office, Inc., 1984 37631837 I 16~17 GL XS Insurance I Diane White j 9/8/2017 8:37:42 AM (PDT) I Page 4 of 5 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 1 D This RCGLPG00502-03 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT-AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. The General Aggregate Limit under LIMITS OF INSURANCE (SECTION Ill) applies separately to each of your projects away from premises owned by or rented to you. CG 25 0311 85 Copyright, Insurance Services Qffice, Inc., 1984 16-17 GL XS Insurance I Diane Whit.e I 9/8/2017 8:37:42 AM (PDT) I Page 5 of 5 cancels and supersedes ALL previously issued certificates.