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S and J Builders and Restoration Services Inc; 2018-01-18; PWM18-77GS
RECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2018-0141999 111111111111 lllll 111111111111111111111111111111 IIIII IIIII IIIII IIII IIII Apr 10, 2018 03:15 PM OFFICIAL RECORDS Ernest J. Dronenburg, Jr., SAN DIEGO COUNTY RECORDER FEES $0.00 (SB2 Atkins: $0.00) PAGES: 2 Space above this line for Recorder's use. PARCEL NO: 209-050-26-00 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 name of the undersigned is the 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 March 6, 2018. 6. The name of the contractor for such work or improvement is S&J Builders and Restoration Services, 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: 100-Yard Range Exhaust Duct Repair, Project No. PWM18-77GS. 8. The street address of said property is Safety Training Center, 5750 Orion Street, Carlsbad, CA 92010-7201. 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/Executive Manager of said City on ?YJu A c..b / l..p , 20 /'i?, 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·1fhA(YJ ;1) , 20 / 'iJ, at Carlsbad, California. ( CIX' OF CARLSBAD , ~~rf)L?JivW--.__~ BARBARA ENGLESON l) ~ ...._ City Clerk /!~ C \Users\hstro\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\HBHT6DBM\NOC -PWM18-77GS SJ Builders 100 Yard Range Duct Repair.doc CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS S&J Builders and Restoration Services, Inc. has completed the contract work required for Project No. PWM18-77GS, 100-Yard Range Exhaust Duct Repair. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS (Specify if City or CMWD) 100-Yard Range Exhaust Duct Repair (CITY) VALUE $41,335.55 CERTIFICATION OF COMPLETION OF IMPROVEMENTS 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. is hereby directed to commence maintaining the above described APPROVED AS TO FORM: CELIA BREWER, City Attorney By(;_}~ Deputy City Attorney C:IUserslpw1se\AppData\Local\Microsoft\W1ndows\Temporary Internet Files\Content.Outlook\Q0P4CL21\API PWM18-77GS SJ Builders 100 Yard Range Duct Repair.doc CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT 100-YARD RANGE EXHAUST DUCT REPAIR PWM18-77GS This agreement is made on the /~ day of -r-f-"'"""-'""""'.::;.&.<::....:;;.~f----' 20.J..% by the City of Carlsbad, California, a municipal corporation, (her · after called "Ci " , and S&J Builders and Restoration Services, Inc., a California corporation whose principal place of b i ess is 10815 Wheatlands Ave., Suite J, Santee, CA 92071 (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: Jason Kennedy (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. 100-Yard Range Exhaust Duct Repair Page 1 of 8 City Attorney Approved 9/27 /16 PWM18-77GS 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 subcontractor om participatin ·n contract bidding. Signature: ~~ Print Name: 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. 100-Yard Range Exhaust Duct Repair Page 2 of 8 City Attorney Approved 9/27/16 PWM18-77GS 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 forty-five (45) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within twenty (20) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. S&J BUILDERS AND RESTORATION SERVICES, INC., a California corporation Ill Ill Ill Ill Ill Ill Ill (name of Contractor) 689944 (Contractor's license number) Class B, C36 2/28/18 (license class. and exp. date) 1000018498 (DIR registration number) 6/30/2018 (DIR registration exp. date) 100-Yard Range Exhaust Duct Repair Page 3 of 8 10815 Wheatlands Ave., Suite J (street address) Santee, CA 92071 (city/state/zip) 619-449-2014, ext. 106 (telephone no.) 619-449-0887 (fax no.) swilson@sandjbuild.com (e-mail address) City Attorney Approved 9/27/16 -z-- PWM18-77GS 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 S&J BUILDERS AND RESTORATION SERVICES, INC., a California corporation By: ~ (sign here) CITY OF CARLSBAD, a municipal corporation of the State of California Elaine Lukey lie Works Director, G,c:i.c ,v LJ, ,So0 ~(o<>«~ as authorize by the City Manager (print name/title) :~ '~_, TLJ;' & ~..J C/ZO I jZP-(£) (print name/title) 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: Deputy City Attorney 100-Yard Range Exhaust Duct Repair Page 4 of 8 City Attorney Approved 9/27/16 ~ PWM18-77GS 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 ()IA.c . ..t-;..,., 'r Ls~I A'l C. /-lc-.~ .... j ~ ~Y {owJ,'1-,'• :::::.,. (? Ok 3 "7 Z {111,,Jr-!,.,~ (A ""'j /0000~3S-Of 7IY7ff" ll~Jt>-/'f 36 .., 'f', o ~ I' ,o i....y c. ~ ... >.' o .. a. , F:-I"<.. t>ro kc. .J.. ""-' 5:... ""'~J f f.',<. O't>k.c..~ # /(Jt»60 :!J77:_ Z 7'2.34; f" /l•Jl-1, '-/ V Total % Subcontracted: yo The Contractor must perform no less than fifty percent (50%) of the work with its own forces 100-Yard Range Exhaust Duct Repair Page 5 of 8 City Attorney Approved 9/27/16 ___.,-- PWM18-77GS EXHIBIT B 100-Yard Range Exhaust Duct Repair Provide labor and materials necessary to remove and replace damaged exhaust duct located in the bullet trap area of the 100-Yard Firearms Range. This scope includes confined space safety requirements, electrical, and LED lighting installation. All work shall be per industry standards. Task #1: Shutdown and cap all fire suppression risers located in the vicinity of the filter bank to allow access to the exhaust duct. Remove and replace collapsed duct at the 100-yard range filter bank. Install new ductwork which shall be minimum 20-gauge galvanized sheet metal with internal "Duct Mate" connections. This requires and includes removal and reinstallation of the existing filter bank, filters, and pressure metering gauges. All connections to elbows and/or metal connections will be sealed and taped per industry standards. Task #2 -Provide labor and materials necessary to inspect and internally support the exhaust ductwork to prevent further duct collapse. This task may be limited to access due to the confined space and surrounding AR-500 ballistic steel sheath that surrounds the ductwork. This task requires a technician crawling inside the duct and attaching supports wherever and however the access will allow. All duct support materials shall be 16-gauge angle and/or 1/2" conduit piping, per industry standards. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Fire protection systems -Demo & Replace sprinkler head $ 2,406.15 drops to allow access to filter bank and ductwork. 2 LS 1 110 volt commercial wiring/conduit and box -rough in $ 1,533.08 only. 3 LS 4 Remove existing fluorescent light fixture and install city $ 302.16 supplied LED light fixtures. Remove and replace damaged exhaust duct. Install 4 LS 1 internal bracing and supports. $ 29,918.40 5 LS 1 Commercial supervision / project management. $ 1,056.00 6 LS 1 General laborer -(includes confined space $ 4,704.00 monitoring). Negative air fan / air scrubber (24 hour period) No 7 LS 1 monitoring. $ 447.36 TOTAL* $ 40,367.15 *Includes taxes, fees, expenses and all other costs. ---100-Yard Range Exhaust Duct Repair Page 6 of 8 City Attorney Approved 9/27 /16 EXHIBIT C LABOR AND MATERIALS BOND PWM18-77GS Bond no. 100376361 Initial premium $807.00 WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to S&J Builders and Restoration Services, Inc., (hereinafter designated as the "Principal"), a Contract for: 100-YARD RANGE EXHAUST DUCT REPAIR 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, S&J Builders and Restoration Services, Inc., as Principal, (hereinafter designated as the "Contractor"), and American Contractors Indemnity Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of FORTY THOUSAND THREE HUNDRED SIXTY SEVEN DOLLARS FIFTEEN CENTS ($40,367.15), 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. 100-Yard Range Exhaust Duct Repair Page 7 of 8 City Attorney Approved 9/27/16 ~ PWM18-77GS 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. Executed by CONTRACTOR this __ f_,_ .. _r;,/--"--'-[, __ day .-:--- of --~j_,,,._...,_,..__.... __ r---· 20~. CONTRACTOR: S & J Builders and Restoration Services, Inc. (print name here) CFO (title and organization of signatory) By: --'~9:_':;x""--'--~.tC..__.-2-·_· ..... (......,Q,,,,.....:'_ ....... _.:e,_.~---- (sign here) (\::'((4 (1 • (,1 ( \ -y, \~) (\. (print namehere) ~ Ce ~2 ,c\Qr\:! (title and organization of signatory) Executed by SURETY this _4_th _____ day of January 18 SURETY: American Contractors Indemnity Company (name of Surety) 801 S. Figueroa Street, Suite 700, Los Angeles, CA 90017 (address of Surety) 714-740-7000 ne number of Surety) By: re of Attorney-in-Fact) Ariel T. Heredia (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 Attom°J..I: By: :C--C~ Deputy City Attorney 100-Yard Range Exhaust Duct Repair Page 8 of 8 City Attorney Approved 9/27 /16 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Sai,1 D;t',lj 0 On 5a~\Y4r~S 3018 before me, Dit:UJl1i-~l,'bf, No~ (uiJti:c ·bate Here Insert Name and Title of the Officer personally appeared -=('-:,v?t:v==-i"""c.==--_~_la,_·_nc_· e._· _L_-V_1 1_· l_s_c_i_, ______________ _ Name(s) of Signer(s) -------------------------------------' who proved to me on the basis of satisfactory evidence to be the person~whose name~. · subs i ed to the within instru~nt and acknowledged to me that ~~~ executed the same in h er£ ir authorized capacity(i , and that _PY,,~ signature~ the instrument the perso~ or e entity upon behalf of which he person~ acted, executed the instrument DIANNE AGLIBOT l Commission No. 2195538 NOTARY PUBLIC. CALIFORNIA SAN DIEGO COUNTY 1 Gommission Expires May 5, 2021 Place Notary Sea/ Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ---------------OPTIONAL--------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: ___________________________ _ Document Date: __________________ Number of Pages: _____ _ Signer(s) Other Than Named Above: _______________________ _ Capacity{ies} Claimed by Signer(s) Signer's Name: ___________ _ D Corporate Officer -Title(s): ______ _ r-1 Partner -Limited D General D Individual [7 Trustee Attorney in Fact Guardian or Conservator Other: ______________ _ Signer Is Representing: _________ _ Signer's Name: ____________ _ Corporate Officer -Title(s): ______ _ D Partner Limited D General D Individual Attorney in Fact D Trustee Guardian or Conservator D Other: ______________ _ Signer Is Representing: ________ _ X,'GZ,~'%~~'<¥,.~"<¥;,~'%~~~~~~~~-~Y.~.·~~~~~~~~ ©2016 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 W-<'W-<¾'~~~~~c;·-~. ~· ~~~~~~~~~~~~~~~~~~~~~.~ 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 (.~c:in Di€()O ) On jai1t;1ttDJ, 5 JOI&' before me, Di CU1Vul A:nliln.;; (, N'o·~~J f vibt_''c.._. , Date Here Insert Name and Title of the Officer personally appeared Settv1 lh~tvlll S LU i I~ t01, \ Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person'l6( whose name~ s scrlbed. to the within instru~nt and acknowle~qE:d to me tha~ ~tt)(y executed the same in is It¥ r authorized capacity(, , and that p@~th);;f'r signatu~on the instrument the perso¥, the entity upon behalf of whic the person(~cted, executed the instrument N • DIANNE AGLIBOT··-1 .. commission No 2195538 i NOTARY PUBLIC -CALIFORNIA 0 SAN DIEGO COUNTY 1 Comrniss1on Exp1!BS May 5, 2021 Place Notary Seal Above l certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ---------------OPTIONAL--------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: ___________________________ _ Document Date: ___________________ Number of Pages: _____ _ Signer(s) Other Than Named Above: _______________________ _ Capacity(ies) Claimed by Signer(s} Signer's Name: ___________ _ Signer's Name: ___________ _ Corporate Officer -Title(s): ______ _ Corporate Officer -Title(s): ______ _ Partner -limited [J General D Partner -c: limited D General D Individual Attorney in Fact D Individual Attorney in Fact D Trustee Guardian or Conservator D Trustee Guardian or Conservator Other: ______________ _ Other: _____________ _ Signer ls Representing: ________ _ Signer Is Representing: ________ _ ~~~~~~~~~~~~~~~~~~~~~~-iK-~-~,,§, ',G' ;g,,~-~~~,:.~~~~'§<,~ ©2016 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of·---·-~~,1~~e ___ _ On ~.YAf!:•:·L~J!t_ before me, Angela K. Kim Notary Public Date Here Insert Name and Title of the Officer personally appeared ______________ A_ri_e_l _T_. H_e_re_d_i_a _____ _ Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person~ whose narne(&1 is~ subscribed to the within instrument and acknowledged to me that he/~~ executed the same in his~/tt:uiw<:authorized capacity~), and that by his&erttber signature~) on the instrument the person(x), or the entity upon behalf of which the person~) acted, executed the instrument. ,············i ANGELA K. KIM ~ •• Notary Public -California z ~ Orange County is 2 ,,.... • .......,., Commission# 2190918 My Comm. Expires Apr 11. 2021 Place Nota1y 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. ----------------OPTIONAL---------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: B0ndil i oo';]:_,.le-'~-lp.,,_._j _____ Document Date: ...... ___ _ Number of Pages: . . . _ Signer(s) Other Than Capacity(ies) Claimed by Signer(s) Signer's Name: 1\1i<'i r_1_1,_·1_,·r_lia ________ _ I Corporate Officer -Title(s): ______ _ I Partner -1 I Limited I General i Individual XI Attorney in Fact Trustee : Guardian or Conservator I Other: ____ ...... ·--··---- Signer Is Representing: Named Above: Signer's Name:_ Corporate Officer -Title(s): ___ _ · I Partner -r ) Limited I · General 1 Individual J Trustee I Other: I Attorney in Fact I l Guardian or Conservator Signer Is Representing: ___ _ ©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies"), do by these presents make, constitute and appoint: Paul S. Dito, Ariel T. Heredia, Kathy Ho, Angela K. Kim, Ted Lee or Aaron Rivas of Orange, California its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above, 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 riders, amendments, and consents of surety, providing the bond penalty does not exceed ******Three Million****** Dollars ($ **3,000,000.00** ). This Power of Attorney shall expire without further action on November 3, 20 I 9. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolve{/, 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 Attorney(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 on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/ or final estimates on engineering and construction contracts, and any and all notices and documents canceling or tem1inating the Company's liability thereunder, and any such instmmcnts so executed by any such Attorney-in-Fact shall he 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 relating 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. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this lst day of November, 2016. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY Corporate Seals UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY n~::Y-~-Vt ame . gm ar, ice res1 en 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 SS: On this !st day of November, 2016, before me, Sabina Morgenstein, a notary public, personally appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person 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. Sig,at,<e ~ (Seal) I, Kio Lo, Assistant Secretary of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthennore, the resolutions of the Boards ofDireetors, set out in the Power of Attorney are in full ~~~ ,II In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this '11 J\. day of__ ~f\,JVA.t:v\ 'io,ei. ,1\\!UIUl/f/lJ, ,,,,\,,,,~1,t~r.,,G,11,,,,,. ~ Corporate Seals ,,, .. ,~~11.:'c0+'0111},111,,,,, ,, SU It .._\ v '" ,. :-.''\\\\\\\~~~~.1111,,,/ ~ ..._..., •is ', ~''~f,.~ •.••.•. f!~/¼,._ ~ O'"" C ~ '" :,.\'i .,, ", ({~~)) ~,:·,·-,~ -*·---~,:,:~,:,Y ((Uf ~ ~,;,~j;,~ ,,.,1 c-4 ····"'··..,,~ ,"'" -,.. • 1-.,,,,t1,,,;:i.0"'r··~ti-,,~'"" · 1'··,,1~1!f.?,!~\;\'""'" liru111111n\'\\, ''1111111111~,1\ • "11"''111111t111\\\\''" Bond No. foo'},~1.,'L{_ Agency No. 9007 Kio Lo, Assistant Secretary ~ S&JBU-1 nD 1n·" ACORD·· CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) '---' 01/09/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer riahts to the certificate holder in lieu of such endorsementls). PRODUCER 619-220-8014 ~2~Y,CT Steve Henkelman JPL Insurance Group, Inc • PHONE 619-220-8014 j ri02, No): 619-220-8015 JPL Insurance Services ~c, No, Ext): 3033 5th Avenue, Ste. 325 ~th~l!ss: Steve@Jplmsurance.com San Diego, CA 92103 Steve Henkelman INSURER/SI AFFORDING COVERAGE NAIC# INSURER A: Financial Pacific Insurance Co 31453 INSUREDS & J Builders And Restoration INSURER B , Arch Specialty Ins Co 21199 Services, Inc INSURER c , Cypress Insurance Company 10855 10815 Wheatlands Ave. Ste. J Santee, CA 92071 INSURER D, California Automobile Ins Co. 38342 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN§~ , TYPE OF INSURANCE ~~Jl~ !\1,.1!~~ I POLICY NUMBER POLICY EFF , POLICY EXP LIMITS B T x I coMMERCIAL GENERAL L1AB1uTY 1 1 ' / e-E""'A"'cc..:H_,,o"'c""cu"'R,:.R""E"-Nc"'E~---1-$"--____ 1,~o~o~o~,o~o--c"lo ! : 1 rxi ,, I' 1 , /20 DAMAGE TO RENTED 100 000 ~ CLAIMS-MADE ~.J OCCUR y 12EMP9285805 10/15/2017 015 18 PREMl~pccurrence,,,•'-'-'$'-------'---1 [-!_ .. · CPL 12EMP9285805 10/15/2017 10/15/2018 -MEDEXP{Anvoneoersanl • $ S,OOO '~ -----------1· I I' . PERSONAL & ADY INJURY I $ 1,ooo,ooo G $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: , . , GENERAL AGGRE A TE ,c_ _____ ___, H POLICY [K] D LOC I '1 Ii PRODUCTS -COMP/OP A_,,GeoG,--'-'$'--___ 2_,_0_0_0,_0_0__,0 OTHER: Pollution < $1 MIL/$2MIL D ~ 'I COMBINED SINGLE LIMIT s 1 000 000 AUTOMOBILE LIABILITY 1 , I 1· ~[Ea aoode,,.,,nt\,__ ____ J-'L-~--'--' ---i P, ANYAUTO y ! ,BA040000032483 • 03/01/2017,• 03/01/2018 BODILYINJURY/Peroers.onl $ OWNED ! SCHEDULED , AUTOS ONLY AUTOS , I I I .· BODILY INJURY {Per acc1dentl $ , -1· HIRED r= NON-OWNED I iPROPERTYJ)AMAGE $ i ~ AUTOS ONLY AUTOS ONL y I , I' Par accident, , i i i I < B ~ UMBRELLA ~JAB I X. I OCCUR I : I I I 1-=-'EA°"C'.'.'H",0c,,C:;e.CU,,.,R_.,R,,,Ec.!NC,c:,E~--+-' ,,_$ ----,--,,~--=-c-=-1 I I EXCESS LIAB n CLAIMS-MADE! I 112EMX0523004 1· 10/15/20171 •. 10/15/2018 e-AC"G-,,GecR,,cE,,,,GA':'.T'..=E~----+-"-1$ ____ 2_,o_o_o_,0_0-lo i OED I I RETENTION s I ~ C I WORKERS COMPENSATION , AND EMPLOYERS' LIABILITY ! ~~M;~~fM'i!i1iw~~~1m;wif ECUTIVE I {Mandatory in NH) 1 ~~;~~(ti':18~ ~~~PERA TIONS below B :Professional Liabi A /Bailees ! Y/NI. I y LlN/Aj 1 I I I /sJWC922387 I !12EMP9285805 160497187 I X I ~f~TUTE I I ~~H-i I 01/01/2018. 01/01/2019 EL EACH ACCIDENT $ I I EL DISEASE -EA EMPLOYEE $ E.l. DISEASE -POLICY LIMIT < • 10/15/2017110/15/2018 Agg/Occ 1 10/15/2017. 10/15/2018 Bailees , I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As respects General Liability The City of Carlsbad, its officials, employees and volunteers are additional insured, including primal'.Y. and non- contributory wordin9. As respects auto liability, Citv of Carlsbad has been added as additional insured, so that all communication regarding non-payment of premium will be mailed direct to you, whether it is 30-day for CERTIFICATE HOLDER CANCELLATION CARLSBA 1,000,000 1,000,000 1,000,000 $2MIL/$1MIL 257,500 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad/CMWD ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Complaince Services AUTHORIZED REPRESENTATIVE PO Box 4668-ECM #35050 :?;P~~ ,New York, NY 10163-4663 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1NOTEPAD: HOLDER CODE CARLSBA 1NSURED'S NAME S & J Builders And Restoration S&JBU-1 OPIO:AJ underwriting reasons or 10-day for non-payment of premium. All Forms attached and apply when required by written contract. Umbrella extends General, Professional and Pollution liabiity, and workers• compensation only. PAGE 2 Date 01/09/2018 I! THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED/ PRIMARY COVERAGE INCLUDING COMPLETED OPERATIONS (COVERAGES A, B, D & F) This endorsement modifies insurance provided under the Environmental Multiline Policy It is agreed that Section Ill -WHO IS AN INSURED is amended to include the following: Under Coverages A,B,D and F the person or organization shown in the schedule below shall be an Additional Insured, but only to the extent liability arises out of YOUR WORK for that Additional Insured and not due to any actual or alleged independent liability of said Additional Insured. This Endorsement does not apply to BODILY INJURY or PROPERTY DAMAGE arising out of the sole negligence or willful conduct of, or for defects in design furnished by the Additional Insured. With respect to the coverage afforded to the Additional Insured, this insurance is primary and non- contributory, and our obligations are not affected by any other insurance carried by such Additional Insured whether primary, excess, contingent or on any other basis. This Endorsement does not increase the Company's limits of liability as specified in the Declarations of this policy. Additional Insured: ANY PERSON OR ORGANIZATION FOR WHOM YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE WRITTEN CONTRACT MUST BE EFFECTIVE PRIOR TO THE DATE OF THE LOSS OCCURRENCE All other terms and conditions of this Policy remain unchanged. Policy Number: 12 EMP 92858 05 Named Insured: S & J BUILDERS AND RESTORATION SERVICES, INC.; S & J BUILDERS AND RESTORATION SERVICES PARTNERSHIP This endorsement is effective on the inception date of this Policy unless otherwise stated herein: Endorsement Effective Date: 10/15/2017 00 EMP0101 00 01 14 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04108 (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. BLANKET WAIVER Person/Organization Job Description All CA Operations SCHEDULE Blanket Waiver -Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Waiver Premium 2372.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/01/2017 Insured Insurance Company WC 99 04108 (Ed. 9-14) Cypress Insurance Company Policy No. SJWC816720 Endorsement No. Premium$ Countersigned by _______________ _ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY NOTICE OF CANCELLATION OR MATERIAL CHANGE This endorsement modifies insurance provided under the Environmental Multlline Policy In consideration of the premium charged, it is hereby agreed that the Policy is amended by the following additions: 1. The following is added to Section V, COMMON CONDITIONS: We shall provide 30 days written notice (except 10 days for non payment of premium) prior to a MATERIAL CHANGE OF POLICY TERMS or Cancellation of the Policy to CITY OF CARLSBAD P.O. BOX 4668 -ECM35050 NEW YORK, NY 10163 2. The following is added to Section VII, DEFINITIONS: MATERIAL CHANGE OF POLICY TERMS means a change of the Declarations regarding: a. A change in the POLICY PERIOD, or b. A removal of a Coverage Section. or c. A removal of any Named Insured or Insured specifically identified by name in the policy, or d. A reduction of the amount of Limits of Liability. which reduction is not the result of payment of CLAIMS or CLAIM EXPENSES, or e. A reduction in the amount of the Policy Aggregate, which reduction is not the result of payment of CLAIMS or CLAIM EXPENSES. All other terms and conditions of this Policy remain unchanged. Additional Premium: $100 Surplus Lines Tax: $3.00 Stamping Fee: $.20 Policy Number: 12 EMP 92858 05 Named Insured: S & J BUILDERS AND RESTORATION SERVICES, INC.; S & J BUILDERS AND RESTORATION SERVICES PARTNERSHIP This endorsement is effective on the inception date of this Policy unless otherwise stated herein: Endorsement Effective Date: 10/24/2017 00 EMP0068 00 08 04 Page 1 of 1 WC 00 00 00 C (Ed. 1-15) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY PART SIX-CONDITIONS A. Inspection We have the right, but are not obliged to inspect your workplaces at any time. Our inspections are not safety inspections. They relate only to the insurabil- ity of the workplaces and the premiums to be charged. We may give you reports on the conditions we find. We may also recommend changes. While they may help reduce losses, we do not undertake to perform the duty of any person to provide for the health or safety of your employees or the public. We do not warrant that your workplaces are safe or healthful or that they comply with laws, regulations, codes or standards. Insurance rate service organiza- tions have the same rights we have under this provision. B. Long Term Policy If the policy period is longer than one year and six- teen days, all provisions of this policy will apply as though a new policy were issued on each annual anniversary that this policy is in force. C. Transfer of Your Rights and Duties Your rights or duties under this policy may not be transferred without our written consent. If you die and we receive notice within thirty days af- ter your death, we will cover your legal representa- tive as insured. D. Cancelation 1. You may cancel this policy. You must mail or de- liver advance written notice to us stating when the cancelation is to take effect. 2. We may cancel this policy. We must mail or de- fiver to you not less than ten days advance writ- ten notice stating wti.en the cancelation is to take effect. Mailing that notice to you ~t your maj!ing add.ress showri inJtero 1 of the lnf;OtJll.atlon Page will be sufficient to ~prove notice~ . . . .... 3. The policy period will end on the day and hour stated in the cancelation notice. 4. Any of these provisions that conflict with a law that controls the cancelation of the insurance in this policy is changed by this statement to com- ply with the law. E. Sole Representative The insured first named in Item 1 of the Information Page will act on behalf of all insureds to change this policy, receive return premium, and give or receive notice of cancelation. Page 6 of 6 @ Copyright 2013 Natlonal Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC990410B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. BLANKET WAIVER Person/Organization Job Description All CA Operations SCHEDULE Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Waiver Premium 2234.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/01/2018 Insured Insurance Company Cypress Insurance Company WC990410B (Ed. 9-14) Policy No. SJWC922387 Endorsement No. Premium$ Countersigned by _______________ _