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HomeMy WebLinkAboutBlair Rasmussen Construction; 2003-04-01; PKS02-03DOC # 2003-1020981 ClUG 21, 2003 1:39 PM Recording requested by: CITY OF CARLSBAD When recorded mail to: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad CA 92008 OFFICIAL am scyl DIEM COUNTY REOER'S OFFICE GREW J. SHITH, coLR(Ty RECORDER FEES: 0.00 Space above for Recorder's use NOTICE OF COMPLETION Notice is hereby given that: 1. The undersigned is owner of interest or estate stated below in the property hereinafter described. 2. The full name of the undersigned is 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 of improvement on the property hereinafter described was completed on July 14,2003. 6. The name of the contractor, if any, for such work of improvement is Blair Rasmussen Construction 7. The property on which said work of improvement was completed is in the City of Carlsbad, County of San Diego, State of California, and is described as follows: 8. The street address of said property is: Contract No. PKS02-03 La Costa Canyon Park Stairs Re-Reconstruction Project Pueblo Street & Rana Court, Carlsbad, California 92008 CITY OF CARLSBAD 1 Public works Director VERIFICATION OF CITY CLERK I, the undersigned say: I am the City Clerk of the City of Carlsbad, 1200 Carlsbad Village Drive, Carlsbad CA 92008; the City ManaQer of said City on ALIGIIST I % , 300 3 ,2003 accepted the above 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 b US T a! , 2003 at Carlsbad, California CITY OF CARLSBAD CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS The developer has constructed the improvements required for the La Costa Canyon Park Stairs Re-Reconstruction Project Contract No PKSO2-03 and has requested that the City of Carlsbad accept the public improvements. City forces have inspected the public improvements and found them to be satisfactory. The public improvements consist of: VALUE $74,000 IMPROVEMENTS Replace the existing wooden stairs at La Costa Canyon Park with concrete steps and galvanize steel handrails. PUBLIC WORKS DIRECTOR ,, CERTIFICATION A OF COMPLETION OF IMPROVEMENTS CITY MANAGER’S ACCEPTANCE 0 F PUBLIC IMPROVEMENTS The construction of the above described public improvements is deemed complete and hereby accepted. The City Clerk is hereby authorized to record the Notice of Completion and release the bonds in accordance with State Law and City Ordinances. The City of Carlsbad is hereby directed to commence maintaining the above described imtxovements. MROVED AS TO FORM: &ppS. Ronald R. Ball, City Attorney AUG 1 8 2003 Date CITY OF CARLSBAD CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Proiect CONTRACTOR'S PROPOSAL City Council City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 The undersigned declares he/she has carefully examined the location of the work, read the Notice Inviting Bids, examined the Plans, Specifications, Supplemental Provisions and addenda thereto, and hereby proposes to furnish all labor, materials, equipment, transportation, and services required to do all the work to complete Contract No. PKS02-03 in accordance with the Plans, Specifications, Supplemental Provisions and addenda thereto and that he/she will take in full payment therefor the following unit prices for each item complete, to wit: SCHEDULE "A" Item - No. Description Approximate Quantity Unit and Unit - Price - Total A-I Wood Stairs Demolition LS $ 4,969.44 $ 4,969.44 A-2 New Stairs re-construction as LS $ 74,924.21 $14,924.21 A-3 Vaiue Engineering- See attched per plans. Breakdown (-$5,'?74.15) Total amount of bid in words including Schedule "A: Seventy Four Thousand , One Hundred Nineteen Dollars and fifty cents. Total amount of bid in numbers including Schedule "A: $ 74 1 Price(s) given above are firm for 90 days after date of bid opening. Addendum(a) No(s). One hadhave been received and is/are included in this proposal. The Undersigned has carefully checked all of the above figures and understands that the City will not be responsible for any error or omission on the part ofthe Undersigned in preparing this bid. The Undersigned agrees that in case of default in executing the required Contract with necessary bonds and insurance policies within twenty (20) days from the date of award of Contract by the City Council of the City of Carlsbad, the City may administratively authorize award of the contract to the second or third lowest bidder and the bid securityof the lowest bidder may be forfeited. 4- kg Revised 07/29/02 Contract No. PKS02-03 Paae 8 of 58 Paaes The Undersigned bidder declares, under penalty of perjury, that the undersigned is licensed to do business or act in the capacity of a contractor within the State of California, validly licensed under license number 6 7 0 5 2 8 , classification R : HTr which expires on 11/13/2003 , and that this statement is true and correct and has the legal effect of an affidavit. A bid submitted to the City by a Contractor who is not licensed as a contractor pursuant to the Business and Professions Code shall be considered nonresponsive and shall be rejected by the City § 7028.15(e). In all contracts where federal funds are involved, no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with California law. However, at the time the contract is awarded, the contractor shall be properlylicensed. Public Contract Code 520104. The Undersigned bidder hereby represents as follows: 1. That no Council member, officer agent, or employee of the City of Carlsbad is personally interested, directly or indirectly, in this Contract, or the compensation to be paid hereunder; that no representation, oral or in writing, of the City Council, its officers, agents, or employees has inducted hidher to enter into this Contract, excepting only those contained in this form of Contract and the papers made a part hereof by its terms; and 2. That this bid is made without connection with any person, firm, or corporation making a bid fbr the same work, and is in all respects kir and without collusion or fraud. Accompanying this proposal is a Bid Bond (Cash, Certified Check, Bond or Cashier's Check) for ten percent (I 0%) ofthe amount bid. The Undersigned is aware of the provisions of section 3700 of the Labor Code which requires every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and agrees to comply with such provisions before commencing the performance of the work of this Contract and continue to comply until the contract is complete. The Undersigned is aware -of-the"-provisions of the Labor Code, Part 7, Chapter 1, Article 2, relative to the general prevailing rate of wages for each craft or type of worker needed to execute the Contract and agrees to comply with its provisions. IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (I) Name under which business is conducted (2) Signature (given and surname) of proprietor (3) Place of Business 152 10 Segovia Court (Street and Number) City and State San Dieqo , CA (4) Zip Code 92129 Telephone No. 858-672-7550 IF A PARTNERSHIP. SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) t$ Revised 07/29/02 Contract No. PKS02-03 Paae 9 of 58 Paaes . * CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ~GLSlijLLc * ~JSByc,~~~PLrlL~~t: Name and Title ai Officer (e.g.. ”Jane Ode. Notary Publc”y personally appeared I3 ‘\2_ccShLAS&Qfl Name(s) of Signer(s) 0 personally known to me Eproved to me on the basis of satisfactory evidence to be the person@ whose nameE) yare subscribed to the within instrument and acknowledged to me that hz/shecthey executed the same in &s/her/their authorized capacity(w$ and that by hb/Meir signaturewon the instrument the person&, or the entity upon behalf of which the person# acted, executed the instrument. fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: con -t-CfiCt-Z)r‘ A Q Cb?OZ~ Document Date: Number of Pages: Signer(@ Other Than Named Above: Capacity(ies) Claimed by Signer 0 Corporate Officer - Title@): 0 Partner - 0 Limited General 0 Guardian or Conservator Signer Is Representing: 0 1999 National Notary Asmiation * 9350 De Soto Ave.. P.O. Box 2402 * Chatswolth. CA 91 31 3-2402 - www.nailonalnotary.org Prod. No. 5907 Reorder: Call Toll-Free 1-800-8766327 (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. IF A CORPORATION. SIGN HERE (1) Name under which business is conducted (2) (Signature) (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of (4) Place of Business (Street and Number) City and State (5) Zip Code Telephone No. NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners, and managing partners: t3 Revised 07/29/02 Contract No. PKS02-03 Paae 10 of 58 Paaes Blair Rasmussen Construction General Contractors January 22,2003 City of Carlsbad La Costa Canyon Park Stair Reconstruction Schedule of Costs DescriDtion General Conditions Site fence Toilets Close out Docs Water City Licenses Bonds Insurance Supervision Demolition Landscape and Irrigation Repairs Site Grounds Protection Caissons Concrete Pre-cast Set Pre-cast Structural and Misc. Metals Paint Subtotal Labor Burden: Payroll Taxes I Workers Comp. OH & Profit Total Cost Value Engineering Utilize Modern Stairways as an equal to Stepstone Products Stepstone Modern Difference Delete painting. Let the galvanizing naturally gray out no repainting or maintenance required Delete OH & Profit associated with Value Engineering $600.00 $300.00 $150.00 $150.00 $400.00 $2,400.00 $1,600.00 $3,000.00 Amount $8,600.00 $3,654.00 $750.00 $600.00 $2,400.00 $10,098.00 $6,409.00 $1,200.00 $29,500.00 $2.300.00 $65,511 .OO $4,556.00 $9.826.65 $79,a93.65 $6,409.00 $3,688.00 $2,721 .OO $2,300.00 $753.15 Total for Value Engineering I $5,774.15 15210 Segovia Court, San Diego, CA 92129. Lic. # 670528 Email: brasmus2~,san.rr.com Phone: 858-382-7576 Fax: 858-672-7551 BIDDER'S BOND'TO ACCOMPANY PROPOSAL La Costa Canyon Park Stairs Re-Construction Project CONTRACT NO. PKS02-03 KNOW ALL PERSONS BY THESE PRESENTS: That we, BLAIR RAmSsEN CONSTRUCTION , as Principal, and AMERICAN CONTRACTORS INDEt$NITY as Surety are held and firmly bound unto the City of Carlsbad, California, in an amount as foltows:CONpANy (must be at least ten percent (10%) of the bid amount) SEVEN THOUSAND FIVE HUNDREnor which(S7.500.OC payment, well and truly made, we bind ourselves, our heirs, executors and administrators, successors or assigns, jointlyand severally, firmly by these presents. THE CONDITION Of THE FOREGOING OBLIGATION IS SUCH that if the proposal of the above- bounden Principal for: La Costa Canyon Park Stairs Re-Construction Project, Contract No. PKS02-03 in the City of Carisbad, is accepted by the City Council, and if the Principal shall duly enter into and execute a Contract including required bonds and insurance policies within twenty (20) days from the date of award of Contract by the City Council of the City of Carlsbad, being duly notified of said award, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect, and the amount specified herein shall be forfeited to the said City. .. ... ... ... ... ... . .. ... ... . .. ... .. . ... ... ... ... .. . ... .. . t$ Revised 07/29/02 Contract No. PKS02-03 Paae 12 of 58 Paaes In the event Principal executed this bond as an individual, it is agreed that the death of Principal shall not exonerate the Surety from its obligations under this bond. Executed by PRINCIPAL this 17TH day of JANUARY ,20 03 . PRINCIPAL: BLAIR RASMIJSSm CONSTRUCTION By: . (print name here) wm. (Title and Organization of Signatory) By: (sign here) (print name here) Executed by SURETY this 17m day of JANUARY ,20 03. SURETY: AMERICAN CONTRACTORS INDEMNITY COMPANY (name of Surety) io81 WINO -Dm RIO SOUTH, SUITE 107 (address of Surety) SAN DIEGO, CA 92108 (title and organization of signatory) SUSANNE ANDERSON FERNANJIEZ (printed name of Attorney-in-Fact) (Attach corporate resolution showing current power of attorney,) (Proper notarial acknowledgment of execution by PRINCIPAL and SUREW 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: RONALD R. BALL City Attorney By: uty City Attorney 8'd 4- p,# Revised 07/29/02 Contract No. PKS02-03 Paae 13 of 58 Paaes ISSL-ZLS-BSB uassnusea Jrela dS1:ZT zo EO 3=a ~ALIFORNIA ALLPURPOSE ACKNOWLEDGMENT No. 5907 I I I I t t State of l I Countyof .5/4y7 O[;Z~;, i I On f- I7 - 0.3 before me,,(USQnPt NAME. A.JQP%, TITLE OF OFFICER - E.G.. FG/l4ndeGah, .JANE DOE, NOTARY WBL6 ~ personally appeared &1,W ‘7 I whTAA5%q I I\El personally known to me - OR - 0 proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are 1 subscribed to the within instrument and ac- knowledged to me that he/she/they executed the same in his/her/their authorized signature(s) on the instrument the person(s). I I DATE 1 NAME(S) OF SIGNER(S) I I I capacity(ies), and that by his/her/their I l or the entity upon behalf of which the I I I COMM. # 1383562 person(s) acted, executed the instrument. I I I I I , OPTIONAL 1 Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF AllACHED DOCUMENT “El INDIVIDUAL 0 CORPORATE OFFICER l3,dh; (3m c! TITLE OR TYPE OF DOCUMENT -6) 0 PARTNER(S) 0 LIMITED 0 ATTORNEY-IN-FACT 0 - TRUSTEE(S) 0 GENERAL NUMBER OF PAGES - u GUARDIANKONSERVATOR 0 OTHER: I- / 7- d3 DATE OF DOCUMENT SIGNER IS REPRESENTING: WE OF PERSoN(S) OR ENTITYOES) SIGNER(S) OTHER THAN NAMED ABOVE - Q1993 NATIONAL NOTARY ASSOCIATION 8236 Remmet Ave., P.O. Box 7184 - Canoga Park CA 91309-7184 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No. 5907 County of SAN DIEGO On 1/17/03 before me, SUZANNE KELSO, NOTARY PUBLIC 9 DATE NAME. TlTLE OF OFFICER - E.G.. 'JANE DOE. NOTARY PUBLIC personally appeared Su~ AlpDEBsoN FERNAND= 9 NAME(S) OF SIGNER(S) personally known to me - OR - 0 proved to me on the basis of satisfactory evidence to be the person(s) whose name@) islare subscribed to the within instrument and ac- knowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person@) acted, executed the instrument. COMM. # 1383593 WlTNEm hand and official, seal. OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER 0 PARTNER(S) ATTORNEY-IN-FACT 0 TRUSTEE(S) 0 GUARDIAWONSERVATOR 0 OTHER SIGNER IS REPRESENTING: FUME OF PERsOIs(S) OR wTnv(6s) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE 81993 NATIONAL NOTARY ASSOCIATION 8236 Remmet Ave.. P.O. Box 7184 Cancga Park. CA 913047184 A American Contractors Indemnity Company 9841 Airpart Blvd., 9th Floor, Los Angel-, CaliMa90045 os1846 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Amexican Contractors Inddty Company of the State of California, a California corporation does hereby appoint, Susanne Anderson Fernandez Its true and lawful Attorney(s)-in-Fact, with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writin obli at0 in the nature thereof, issued in the course of its business and to bind the Company thereby, in an Amount not to exceed $ r, 006 068.00 . This Power of Attorney shall expire without further action. on January 16,2003. This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of AMERICAN CONTRACTORS INDEMNITY COMPANY at a meeting duly called and held on the 6th day of December, 1990. ‘‘RESOLVED that the Chief Executive Oflcec President or my vice President, Executive vice President, Secretary or Assistant Secretary, shall have thepower and authority I. To appoint Attorney&)-in-Fact and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obllgatoty in the nature thereof and, 2. To remove, at any time, any such Attorney-in-fact and mvoke the awthorlty given. RESOL V;ED FURTHER that the signatures of such oflcers and the seal of the Company may be afaed to any such Power of Attorney or cert!cate relating thereto by facsimile. and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company and any such power so extlcuted and certijied by facsimile sigwtures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undeitaking to which it is attached.” IN WITNESS WHEREOF, American Contractors Indemnity Company has caused its seal to be affixed hereto and executed by its President on the 1 st day of September, 2000. STATE OF CALIFORNIA § COUNTY OF LOS ANGELES § On this 1 st day of September, 2000 before me personally came Andy T. Faust, Jr., Corporate President of American Contractors Indemnity Company, to me personally known to be the individual and ofic6r described herein, and acknowledged that he executed the foregoing instrument and affixed the seal of said corporation thereto by authority of his office. WITNESS my hand and oficial seal I, JAMES H. FERGUSON, Corporate Secretary of American Contractors Indemnity Company, do hereby certify that the Power of Attorney and the resolution adopted by the Board of Directors of said Company as set forth above, are true and correct transcripts thereof and that neither the said Power of Attorney nor the resolution have hen revoked and they are now in full force and effect. IN WITNESS HEREOF, I have hereunto set my hand this lTTH day of JANUARY 3 ,200 -* Bond No. N/A Agency No. 9003 - JAMES H. FERGUSON,@oprate Secretary .. . DESIGNATION OF SUBCONTRACTOR AND AMOUNT OF SUBCONTRACTOR'S BID ITEMS CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Project The Bidder certifies that it has used the sub-bid of the followhg listed subcontractor in preparing this bid for the Work and that the listed subcontractor will be used to perform the portions of the Work as designated in the list in accordance with applicable provisions of the specifications and section 4100 et seq. of the Public Contracts Code "Subletting and Subcontracting Fair Practices Act." The Bidder further certifies that no additional subcontractor will be allowed to perform any portion of the Work in excess of than one-half of one percent (0.5%) of the Bidder's total bid or ten thousand dollars ($10,000) whichever is greater and that no changes in the subcontractors listed work will be made except upon the prior approval of the Agency. Full Company Name of Subcontractor: George and Krough Welding I Inc Subcontractor's Location of Business 1357 Las Villas Way Street Address Escondido, CA 92026 City State Zip *Subcontractor's Telephone Number including Area Code: ( 7 6 0 1 7 4 5- 5 3 6 8 *Subcontractor's California State Contractors License No, and Classifcation: 6 8 79 6 8 *Subcontractor's Carlsbad Business License No.: for SUBCONTRACTOR'S BID ITEMS* Bid 1 Amount of Subcontracted I Amount of Work In Bid 1 Amount of Contractor's I Bid Item Including Item Performed b Overhead & Profit In t Exdanation: Column I - Bid Item No. from the bid proposal, pages N/A through N/A, inclusive. Column 2 - The dollar amount of the item to be performed by the Subcontractor. Column 3 - The dollar amount of the item to be oerformed bv Contractor's own forces. Column 4 - The dollar amount of the Contrador's overheid and profit for workdone by both the Contractor's and the Subcontractor's forces on the item. Total dollar amount of Columns 2, 3, and 4 must be equal to the dollar amount in the bid price of the item on bid proposal pages N/A through N/A inclusive. Page 1 of 3 pages of this Subcontractor Designation brm * Pursuant to section 4104 (a)(2)(A) California Public Contract Code, receipt of the portions of the information preceded by an asterisk required on this document may be submitted by the Bidder up to 24 hours after the deadline for submitting bids contained in the "Notice Inviting Bids;" DESIGNATION OF SUBCONTRACTOR AND AMOUNT OF SUBCONTRACTOR'S BID ITEMS CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Project The Bidder certifies that it has used the sub-bid of the following listed subcontractor in preparing this bid for the Work and that the listed subcontractor will be used to perform the portions of the Work as designated in the list in accordance with applicable provisions of the specifications and section 4100 et seq. of the Public Contracts Code "Subletting and Subcontracting Fair Practices Act." The Bidder further certifies that no additional subcontractor will be allowed to pelform any portion of the Work in excess of than one-half of one percent (0.5%) of the Bidder's total bid or ten thousand dollars ($10,000) whichever is greater and that no changes in the subcontractors listed work will be made except upon the prior approval of the Agency. Full Company Name of Subcontractor: Modern Stairways 8 Inc Subcontractor's Location of Business 3239 Bancroft Drive Street Address Spring Valley, Ca 91977-3351 City State Zip *Subcontractor's Telephone Number including Area Code: ( 6 19 4 6 6 i 4 88 *Subcontractor's California State Contractors License No. and Classifcation: *Subcontractor's Carlsbad Business License No.: N/A Supply only! SUBCONTRACTOR'S BID ITEMS* Bid Item Including Item Performed by Overhead & Profit In Exdanation: Column 1 - Bid Item No. from the bid proposal, pages NIA through MA, inclusive. Column 2 - The dollar amount of the item to be performed by the Subcontractor. Column 3 - The dollar amount of the item to be performed by Contractor's own forces. Column 4 - The dollar amount of the Contractor's overhead and profit for work done by both the Contractor's and the Subcontractor's forces on the item. Total dollar amount of Columns 2, 3, and 4 must be equal to the dollar amount In the bid price of the item on bid proposal pages N/A through N/A inclusive. Page of 2 pages of this Subcontractor Designation krm * Pursuant to sectlon 4104 (a)(2)(A) California Public Contract Code, receipt of the portions of the information preceded by an asterisk required on this dowment may be submitted by the Bidder up to 24 hours after the deadline for submitting bids contained in the "Notice Inviting Bids" DESIGNATION OF SUBCONTRACTOR AND AMOUNT OF SUBCONTRACTOR'S BID ITEMS CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Project The Bidder certifies that it has used the sub-bid of the followi.ng listed subcontractor in preparing this bid for the Work and that the listed subcontractor will be used to perform the portions of the Work as designated in the list in accordance with applicable provisions of the specifications and section 4100 et seq. of the Public Contracts Code "Subletting and Subcontracting Fair Practices Act." The Bidder further certifies that no additional subcontractor will be allowed to perform any portion of the Work in excess of than one-half of one percent (0.5%) of the Bidder's total bid or ten thousand dollars ($10,000) whichever is greater and that no changes in the subcontractors listed work will be made except upon the prior approval of the Agency. Full Company Name of Subcontractor: S-es Subcontractor's Location of Business 2 62 5 S . Sante Fe AV-~ Street Address San Marcos, CA 92069 City State Zip *Subcontractor's Telephone Number including Area Code: ( ti 1 - 39 *Subcontractor's California State Contractors License No. and Classitcation: 624663 *Subcontractor's Carlsbad Business License No.: 1196813 SUBCONTRACTOR'S BID ITEMS* I Bid I Amount of Subcontracted I Amount of Work In Bid 1 Amount of Contractor's 11 Bid Item Including 1 Item Performed by I Overhead & Profit In I Em I Subcontractor's Overhead Contractor Excluding Bid Item Exdanation: Column 1 - Bid Item No. from the bid proposal, pages NIA through N/A, inclusive. Column 2 - The dollar amount of the item to be performed by the Subcontractor. Column 3 - The dollar amount of the item to be performed by Contractor's own forces. Column 4 - The dollar amount of the Contractor's overhead and profit for work done by both the Contractor's and the Subcontractor's forces on the item. Total dollar amount of Columns 2, 3, and 4 must be equal to the dollar amount in the bid price of the item on bid proposal pages NIA through NIA inclusive. Page of 3 pages of this Subcontractor Designation hrm * Pursuant to section 4104 (a)(2)(A) Callfomia Public Contract Code, receipt of the portions of the information preceded by an asterisk required on this document may be submitted by the Bidder up to 24 hours after the deadline for submitting bids contained in the "Notice Inviting Bids;" DESIGNATION OF OWNER OPERATOWLESSOR AND AMOUNT OF OWNER OPERATOWLESSOR WORK La Costa Canvon Park Stairs Re-Construction Proiect CONTRACT NO. PKSOZ-03 The Bidder certifies that it has used the sub-bid of the following listed Owner Operator/Lessor in preparing this bid for the Work and that the listed Owner Operator/Lessor will be used to perform the portions of the Work as designated in the list in accordance with applicable provisions of the specifications and section 4100 et seq. of the Public Contracts Code "Subletting and Subcontracting Fair Practices Act." The Bidder further certifies that no additional Owner Operator/Lessor will be allowed to perform any portion of the Work in excess of than one-half of one percent (0.5%) of the Bidder's total bid or ten thousand dollars ($10,000) whichever is greater and that no changes in the Owner OperatodLessors listed work will be made except upon the prior approval of the Agency. Full Owner Operator/Lessor Name: N /A Owner Operator/Lessor Location of Business Street Address City State Zip "Owner Operator/Lessor Telephone Number including Area Code: ( I I *Owner Operator/Lessor City of Carlsbad Business License No.: OWNER OPERATOWLESSOR WORK ITEMS Including Owner Contractor Excluding Operator/iessor's Overhead & Profit Exdanation: Column 1 - Bid Item No. from the bid proposal, pages NIA through NIA, inclusive. Column 2 - The dollar amount of the item to be performed by the Owner Operator/Lessor. Column 3 - The dollar amount of the item to be performed by Contractor's own forces. Column 4 - The dollar amount of the Contractor's overhead and profit for work done by both the Contractor's and the Owner Operator/Lessots forces on the item. Total dollar amount of Columns 2, 3, and 4 must be equal to the dollar amount in the bid price of the item on bid Proposal pages N/A through N/A, inclusive. Page 1 of 1 pages of this Owner Operatorllessor brm * Pursuant to section 4104 (a)(2)(A) California Public Contract Code, receipt of the portions of the information preceded by an asterisk reauired on this document may be submitted by the Bidder up to 24 hours after the deadline for submitting bids contained in the "Notice InGting Bids." 4-f %# Revised 07/29/02 Contract No. PKS02-03 Paae 17 of 58 Paaes BIDDERS STATEMENT OF FINANCIAL RESPONSIBILITY (To Accompany Proposal) CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Proiect Copies of the latest Annual Report, audited financial statements or Balance Sheets may be submitted under separate cow marked CONFDENTIAL. Please See Attached *3 b Revised 07/29/02 Contract No. PKS02-03 Paae 18 of 58 Paaes . "I E: F i h) "I s t ; 0 R cn cn "I rn 69 03 01 h) -L 0 a h) ur 6969 -. 9 ... 000 -Loo 0100 -. -lu rub, -La .. lu01 4-L "I s ? R 0 c 7J z "I D rn cn cn "I cn (D gt? 2 !i2 2696969w69 -L-l w 0 9 PPPPWP h) ooooluo 0 000000 d "I t in0000 luoooo BIDDER'S STATEMENT OF TECHNICAL ABILITY AND EXPERIENCE (To Accompany Proposal) La Costa Canyon Park Stairs Re-Construction Proiect The Bidder is required to state what work of a similar character to that included in the proposed Contract he/she has successfully petformed and give references, with telephone numbers, which will enable the City to judge hislher responsibility, experience and skill. An attachment can be used. CONTRACT NO. PKS02-03 4- $4 Revised 07/29/02 Contract No. PKS02-03 Paae 19 of 58 Paaes Blair Rasmussen Construction General Contractors January 22,2003 City of Carlsbad 405 Oak Avenue Carlsbad, CA 92008 Attention: Paul Meadows. Blair Rasmussen Construction is a general contracting firm specializing in commercial building and telecommunication construction projects. Commitment to having a “hands on” approach has helped establish a strong and loyal customer base. We have performed work for clients as varied as School Districts, County of San Diego, Port of San Diego, Mira Costa College and private concerns. In 1998 Blair Rasmussen suspended building construction operations to pursue an exclusive contracting position with Siemens and later provided construction management services to SBA Consulting for the Sprint Wireless rollout in Southern California. The completion of the SBA Consulting project has us focusing on the original concept of commercial building projects. Blair Rasmussen Construction is in the process of increasing management and manpower to service the commercial construction industry. The majority of civil work is performed with in-house forces. Further alliances are in place with industry-respected contractors to handle specialty and heavy workload demands. We are fblly bonded and insured with $2 million liability and $1 million workers compensation coverage. Surety bonding for larger projects is available on request. Respectfblly, Blair Rasmussen, Owner Blair Rasmussen Construction BhR- 15210 Segovia Court, San Diego, CA 92129. Lie. # 670528 Email: brasmus2@,san.rr.com Phone: 858-672-7550 Fax: 858-672-7551 January, 2003 Blair Rasmussen Construction General Contractors Work History of Blair Rasmussen Major Projects while with Loyal Construction in Canada Year Project Name and Location 1986 Manitoba Milk Board, Winnipeg, Canada 1988 Bank of Montreal, Winnipeg, Canada 1988 Royal Bank, Winnipeg, Canada 1992 St. Viators, R.C. Church, Dauphin, Canada 1992 B.C Buildings Test Lab, Nelson, Canada 1990 KFC Store, Winnipeg, Canada Misc. Projects Completed as Blair Rasmussen Construction in San Diego Year Project Name and Location 1995 Poway Unified School District Restroom Add., Poway 1995 Techneglas Inc. Warehouse Repairs, San Diego 1996 Poway Unified School District Sun Shades, Poway 1996 Vista Unified School District Gym. Doors, Vista 1996 Oscal Inc. Tenant Improvement, Rancho Bernard0 1996 Port of San Diego, 10th Ave Restroom, San Diego 1996 Port of San Diego, Caterair Renovation, San Diego 1996 Port of San Diego, Airport Security Gates, San Diego 1996 San Dieguito High School District, Offices, Encinitas 1997 Miracosta College Guard Station, Cardiff by the Sea 1997 County of San Diego, COC Annex Renov., San Diego 1997 Poway Unified School District Mesa Verde, Poway 1997 City of Escondido, Joslyn Center Alter. Escondido 1997 Poway Unified School District Poway High, Poway 1997-2000 Siemens Telecom Networks. Employee / RME 2000-1 SBA Consulting. Employee / Construction Manager 2001-2 Temak Construction, Wireless Consulting, California Current Work on Hand Year Project Name and Location 2002 St. Clares Wheelchair Lift, Escondido 2002 Poway Unified School District Finance Office, Poway 2003 Ryan Co., Heber Sewer & Water Bldg Interiors, Heber 2003 Ryan Co., Western Reg.Office Bldg Interiors,San Diego 2003 Otay Water Dist. Adin. Bldg. Enhancements, San Diego 2003 FST Consulting. Tenant Improvements, San Diego Value $700,000.00 $800,000.00 $500,000.00 $600,000.00 $1,450,000.00 $450,000.00 Value $12,500.00 $9,950.00 $22,785.00 $55,000.00 $16,327.00 $46,531 .OO $59,584.00 $37,360.00 $47,486.00 $61,551 .OO $49,390.00 $31,375.00 $9,200.00 $9,500.00 Value $39,985.00 $23,427.00 $50,536.00 $9,190.80 $66,439.00 $9,600.00 15210 Segovia Court, San Diego, CA 92129. Lic. # 670528 Email: brasmus2~,san.rr.com Phone: 858-382-7576 Fax: 858-672-7551 Blair Rasmussen Construction Brief Client List Port of San Diego Vista Unified School District Poway Unified School District Oscal Inc. County of San Diego The Ryan Company Mira Costa College STC Wireless Resources City of Escondido City of Encinitas Fire Department Otay Water District a Blair Rasmussen Construction Current Proiects City of Escondido, St. Clare’s Wheel Chair Lift Installation. 0 Poway Unified School District, Finance Ofice Renovations. The Ryan Company, Interior Finishes for Heber Public Utility District, Heber. Poway Unified School District, TV and VCR Installations to Various School Classrooms. The Ryan Company, Interior Finishes for Western Regional Offices. Otay Water District, Administration Building Enhancements Blair Rasmussen Construction General Contractors January, 2003 Professional References for Blair Rasmussen The Ryan Company 8245 Ronson Road San Diego, CA 921 11 Mark Jennette, Director of West Coast Operations 858-576-9507 xt. 104 Poway Unified School District 13626 Twin Peaks Road Poway, CA 92064 Donald Nielsen, Maintenance Control Supervisor George Greer, Assistant Director of Facilities 858-679-2523 858-679-2518 Oscal Incorporated 10455 Sorrento Valley Rd. Suite 210 San Diego, CA 92121 Vike Ovanessoff, Vice President Real Estate 858-587-1555 xt. 401 City of Escondido 201 N. Broadway Escondido, CA Rich Buquet, Projects Administrator 760-839-4579 15210 Segovia Court, San Diego, CA 92129. Lic. # 670528 Email: brasmus2@,san.rr.com Phone: 858-382-7576 Fax: 858-672-7551 NON-COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID PUBLIC CONTRACT CODE SECTION 7106 CONTRACT NO. PKS02-03 La Costa Canvon Park Stairs Re-Construction Proiect State of California ) Countyof San Diego ) ) ss. Blair Rasmussen , being first duly sworn, deposes (Name of Bidder) and says that he or she is Owner (Title) of Blair Rasmussen Construction (Name of Firm) the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. I declare under penal of perjury that the fore ing is true and correct and that this affidavit was executed on the day of ,20 03 . * Signature of Bidd4 Subscribed and sworn to before me on the 2-2, day of &% flac,vC, ,2063. (NOTARY SEAL) ' Signature of Notary BIDDERS DISCLOSURE OF DISCIPLINE RECORD (To Accompany Proposal) CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Proiect Contractors are required by law to be licensed and regulated by the Contractors’ State License Board which has jurisdiction to investigate complaints against contractors if a complaint regarding a patent act or omission is filed within four years of the date of the alleged violation. A complaint regarding a latent act or omission pertaining to structural defects must be filed within 10 years of the date of the alleged violation. Any questions concerning a contractor may be referred to the Registrar, Contractors’ State License board, P.O. Box26000, Sacramento, California 95826. Have you ever had your contractor’s license suspended or revoked by the California Contractors’ State license Board two or more times within an eight year period? xx Yes no Has the suspension or remcation of your contractors license ewr been stayed? xx no Have any subcontractors that you propose to perform any portion of the Work ever had their contractor’s license suspended or revoked by the California Contractors’ State license Board two or more times within an eight year period? xx no Has the suspension or revocation of the license of any subcontractor’s that you propose to perform any portion of the Work ever been stayed? Yes no If the. answer to either of 1. or 3. above is yes fully identify, in each and every case, the party disciplined, the date of and violation that the disciplinary action pertain to, describe the nature of the violation and the disciplinary action taken therefor. (If needed attach additional sheets to prowde full disclosure.) Page of pages of this Disclosure of Discipline form 1 <$ Revised 07/29/02 Contract No. PKS02-03 Paae 22 of 58 Paaes .. BIDDER'S DISCLOSURE OF DISCIPLINE RECORD (CONTINUED) (To Accompany Proposal) CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Proiect 6) If the answer to either of 2. or 4. above is yes fully identify, in each and every case, the party who's discipline was stayed, the date of the violation that the disciplinary action pertains to, describe the nature of the violation and the condition (if any) upon which the disciplinary action was stayed. (If needed attach additional sheets to proLide full disclosure.) BY CONTRACTOR: Blair Rasmussen Construction Blair Rasmussen, Owner (print name/title) Page 2 of 2 pages of this Disclosure of Discipline form 4- tS Revised 07/29/02 Contract No. PKS02-03 Paae 23 of 58 Paaes BIDDER'S STATEMENT RE DEBARMENT (To Accompany Proposal) CONTRACT NO. PKS02-03 La Costa Canyon Park Stairs Re-Construction Project I) Have you or any of your subcontractors ever been debarred as an irresponsible bidder by another jurisdiction in the State of California? xx no 2) If yes, what wadwere the name@) of the agency(ies) and what wadwere the period@) of debarment@)? Attach additional copies of this page to accommodate more than two debar- ments. party debarred party debarred agency agency period of debarment period of debarment BY CONTRACTOR: \s By: Blair Rasmyssen Construction T -v (sign here) Blair Rasmussen, Owner (print namehitle) Page 1 of 1 pages of this Re Debarment brm Revised 07/29/02 Contract No. PKS02-03 Paae 21 of 58 Paaes CONTRACT PUBLIC WORKS La Costa Canyon Park Stairs Re-Construction Project This agreement is made this aT day of ",4!2fL, 2003, by and between the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Rasmussen Construction whose principal place of business is 1521 0 Seaovia Court, San Dieso, CA 92129 (hereinafter called "Contractor"). City and Contractor agree as follows: 1. Description of Work. for: La Costa Canyon Park Stairs (hereinafter called "project") 2. Provisions of Labor Contractor shall perform all work specified in the Contract documents Re-construction Contract NO. PKS-02-03 and Materials. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents. 3. Contract Documents. The Contract Documents consist of this Contract, Notice Inviting Bids, Contractor's Proposal, Bidder's Bond, Designation of Subcontractors, Designation of Owner Operator/Lessors, Bidder's Statements of Financial Responsibility, Technical Ability and Experience, Re Debarment, Non-collusion Affidavit, Escrow Agreement, Release Form, the Plans and Specifications, the Supplemental Provisions, addendum(s) to said Plans and Specifications and Supplemental Provisions, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, and all bonds for the project; all of which are incorporated herein by this reference. Contractor, her/his subcontractors, and materials suppliers shall provide and install the work as indicated, specified, and implied by the Contract Documents. Any items of work not indicated or specified, but which are essential to the completion of the work, shall be provided at the Contractor's expense to fulfill the intent of said documents. In all instances through the life of the Contract, the City will be the interpreter of the intent of the Contract Documents, and the City's decision relative to said intent will be final and binding. Failure of the Contractor to apprise subcontractors and materials suppliers of this condition of the Contract will not relieve responsibility of compliance. 4. Payment. For all compensation for Contractor's performance of work under this Contract, City shall make payment to the Contractor per section 9-3 PAYMENT of the Standard Specifications for Public Works Construction (SSPWC) 1997 Edition, and the 1998 and 1999 supplements thereto,jhereinafter designated "SSPWC", as issued by the Southern California Chapter of the American Public Works Association, and as amended by the Supplemental Provisions section of this contract. The Project Manager will close the estimate of work completed for progress payments on the last working day of each month. 5. Independent Investigation. Contractor has made an independent investigation of the jobsite, the soil conditions at the jobsite, and all other conditions that might affect the progress of the work, and is aware of those conditions. The Contract price includes payment for all work that may be 4- $# Revised 04/22/02 Contract No. PKS-03-02) Page 25 of 60 Pages done by Contractor, whether anticipated or not, in order to overcome underground conditions. Any information that may have been furnished to Contractor by City about underground conditions or other job conditions is for Contractor's convenience only, and City does not warrant that the conditions are as thus indicated. Contractor is satisfied with all job conditions, including underground conditions and has not relied on inbrmation furnished by City. 6. Hazardous Waste or Other Unusual Conditions. If the contract involves digging trenches or other excavations that extend deeper than four feet below the surface Contractor shall promptly, and before the following conditions are disturbed, notib City, in writing, of any: A. Hazardous Waste. Material that Contractor believes may be material that is hazardous waste, as defined in section 251 17 of the Health and Safety Code, that is required to be removed to a Class I, Class II, or Class Ill disposal site in accordance vith provisions of existing law. B. Differing Conditions. Subsurface or latent physical conditions at the site differing from those indicated. C. Unknown Physical Conditions. Unknown physical conditions at the site of any unusual nature, different materially from those ordinarily encountered and generally recognized as inherent in work of the character provided for in the contract. City shall promptly investigate the conditions, and if it finds that the conditions do materially so differ, or do involve hazardous waste, and cause a decrease or increase in contractor's costs of, or the time required for, performance of any part of the work shall issue a change order under the procedures described in this contract. In the event that a dispute arises between City and Contractor whether the conditions materially differ, or involve hazardous waste, or cause a decrease or increase in the contractor's cost of or time .required for, performance of any part of the work, contractor shall not be excused from any scheduled completion date provided for by the contract, but shall proceed with all work to be performed under the contract. Contractor shall retain any and all rights provided either by contract or by law which pertain to the resolution of disputes and protests beheen the contracting parties. 7. Immigration Reform and Control Act. Contractor certifies it is aware of the requirements of the Immigration Reform and Control Act of 1986 (8 USC sections 1101-1 525) and has complied and will comply with these requirements, including, but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors, and consultants that are included in this Contract. 8. Prevailing Wage. Pursuant to the California Labor Code, the director of the Department of Industrial Relations has determined the general prevailing rate of per diem wages in accordance with California Labor Code, section 1773 and a copy of a schedule of said general prevailing wage rates is on file in the office of the City Engineer, and is incorporated by reference herein. Pursuant to California Labor Code, section 1775, Contractor shall pay prevailing wages. Contractor shall post copies of all applicable prevailing wages on the job site. 9. Indemnification. 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 relating 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 em p,# Revised 07/29/02 Contract No. PKS02-03 Paae 26 of 58 Paaes expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. Contractor shall also defend and indemnify the City against any challenges to the award of the contract to Contractor, and Contractor will pay all costs, including defense costs for the City. Defense costs include the cost of separate counsel for City, if City requests separate counsel. Contractor shall also defend and indemnify the City against any challenges to the award of the contract to Contractor, arising in whole or in part from alleged inaccuracies or misrepresentation by the Contractor, whether intentional or otherwise, and Contractor will pay all costs, including defense costs for the City. Defense costs include the cost of separate counsel for City, if City requests separate counsel. IO. Insurance. Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, his or her agents, representatives, employees or subcontractors. Said insurance shall meet the City's policy for insurance as stated in Resolution No. 91-403. (A) Coverages And Limits Contractor shall maintain the types of coverages and minimum limits indicted herein: a. Comprehensive General Liability Insurance: $1,000,000 combined single limit per occurrence for bodily injury and property damage. If the policy has an aggregate limit, a separate aggregate in the amounts specified shall be established for the risks for which the City or its agents, officers or employees are additional insured. b. Business Automobile Liability Insurance: $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 auto insurance certificate must state the coverage is for "any auto" and cannot be limited in anymanner. c. Workers' Compensation and Employers', Liability Insurance: Workers' compensation limits as required by the Labor Code of the State of California and Employers' Liability limits of $1,000,000 per incident. Workers' compensation offered by the State Compensation Insurance Fund is acceptable to the City. (B) Additional Provisions. Contractor shall ensure that the policies of insurance required under this agreement with the exception of Workers' Compensation and Business Automobile Liability Insurance contain, or are endorsed to contain, the bllowing provisions. a. The City, its officials, employees and volunteers are to be covered as additional insured as respects: liability arising out of activities performed by or on behalf of the Contractor; products and completed operations of the contractor; premises owned, leased, hired or borrowed by the contractor. The coverage shall contain no special limitations on the scope of protection afforded to the City, its officials, employees or volunteers. All additional insured endorsements must be evidenced using separate documents attached to the certificate of insurance; one for each company affording general liability, and employers' liability coverage. b. The Contractor's insurance coverage shall be primary insurance as respects the City, its officials, employees and volunteers. Any insurance or self-insurance maintained by the City, its officials, employees or volunteers shall be in excess of the contractor's insurance and shall not contribute with it. e :. $8 Revised 07/29/02 Contract No. PKS02-03 Paae 27 of 58 Paaes c. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its officials, employees or volunteers. d. Coverage shall state that the contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. (C) Notice Of Cancellation. Each insurance policyrequired by this agreement shall be endorsed to state that coverage shall not be nonrenewed, suspended, voided, canceled, or reduced in coverage or limits except after thirty (30) days' prior written notice has been given to the City by certified mail, return receipt requested. (D) Deductibles And Self-insured Retention (S.I.R.) Levels. Any deductibles or self-insured retention levels must be declared to and approved by the City. At the option of the City, either: the insurer shall reduce or eliminate such deductibles or self-insured retention levels as respects the City, its officials and employees; or the contractor shall procure a bond guaranteeing payment of losses and related investigation, claim administration and deknse expenses. (E) Waiver Of Subrogation. All policies of insurance required under this agreement shall contain a waiver of all rights of subrogation the insurer may have or may acquire against the City or any of its officials or employees. (F) Subcontractors. Contractor shall include all subcontractors as insured under its policies or shall furnish separate certificates and endorsements for each subcontractor. Coverages for subcontractors shall be subject to all of the requirements stated herein. (G) Acceptability Of Insurers. Insurance is to be placed with insurers that have a rating in Best's Key Rating Guide of at least A-:V. Insurers must also be authorized to transact the business of insurance by the State of California Insurance Commissioner as admitted carriers as evidenced by a listing in the official publication of the Department of Insurance of the State of California and/or under the standards specified by the City Council in Resolution No. 91-403. (H) Verification Of Coverage. Contractor shall furnish the City with certificates of insurance and original endorsements affecting coverage required by this clause. The certificates and endorsements for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The certificates and endorsements are to be in forms approved by the City and are to be receiwd and approved by the City before the Contract is ewcuted by the City. (I) Cost Of Insurance. The Cost of all insurance required under this agreement shall be included in the Contractor's bid. I I. Claims and Lawsuits. All claims by contractor for $375,000 or less shall be resolved in accordance with the provisions in the Public Contract Code, Division 2, Part 3, Chapter 1 , Article 1.5 (commencing with section 20104) which are incorporated by reference. A copy of Article 1.5 is included in the Supplemental Provisions 1 section. The contractor shall initially submit all claims over $375,000 to the City using the informal dispute resolution process described in Public Contract Code subsections 20104.2(a), (c), (d). Notwithstanding the provisions of this section of the contract, all claims shall comply with the Government Tort Claim Act (section 900 et seq., of the California Government Code) for any claim or cause of action for money or damages prior to filing any lawsuit for breach of this agreement. (A) Assertion of 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. 4- 64 Revised 07/29/02 Contract No. PKS02-03 Paae 28 of 58 Paaes (6) False Claims. Contractor acknowledges that if a false claim is submitted to the City, it may be considered fraud and the Contractor may be subject to criminal prosecution. (C) Government Code. 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 ofthe truth or falsity of the information. (D) Penalty Recovery. If the City of Carlsbad seeks to recover penalties pursuant to the False Claims Act, it is entitled to recowr its litigation costs, including attorneys fees. (E) Debarment for False Claims. 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 br a period of up to five years. (F) Carlsbad Municipal Code. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to $Ise claims are incorporated herein byreference. (G) Debarment from Other Jurisdictions. Contractor hereby acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontrac- tor from participating in future contract bidding. (H) Jurisdiction. Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out California. I have read and understand all provisions of Section I1 abo 12. Maintenance of Records. Contractor shall maintain and make available at no cost to the City, upon request, records in accordance with sections 1776 and 1812 of Part 7, Chapter 1, Article 2, of the Labor Code. If the Contractor does not maintain the records at Contractor's principal place of business as specified above, Contractor shall so inform the City by certified letter accompanying the return of this Contract. Contractor shall notify the City by certified mail of any change of address of such records. 13. Labor Code Provisions. The provisions of Part 7, Chapter 1, commencing Mith section 1720 of the Labor Code are incorporated herein byreference. 14. Security. Securities in the form of cash, cashier's check, or certified check may be substituted for any monies withheld by the City to secure performance of this contract for any obligation established by this contract. Any other security that is mutually agreed to by the Contractor and the City may be substituted for monies withheld to ensure performance under this Contract. 15. Provisions Required by Law Deemed Inserted. Each and every provision of law and clause required by law to be inserted in this Contract shall be deemed to be inserted herein and included herein, and if, through mistake or otherwise, any such provision is not inserted, or is not correctly inserted, then upon application of either party, the Contract shall forthwith be physically amended to make such insertion or correction. 16. Additional Provisions. Any additional provisions of this agreement are set forth in the em %# Revised 07/29/02 Contract No. PKS02-03 Paae 29 of 58 Paaes "General Provisions" or "Supplemental Provisions" attached hereto and made a part hereof NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED (CORPORATE SEAL) CONTRACTOR: CITY OF CARLSBAD a municipal corporation of ATTEST: " (print name and title) LORRAINE M. WOOD, City Clerk By: (sign here) (print name and title) 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 the corporate seal empowring that officer to bind the corporation. APPROVED AS TO FORM: RONALD R. BALL City Attorney By: a Revised 07/29/02 Contract No. PKS02-03 Paae 30 of 58 Paaes CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of SGL- D Date before me, @dZLLd ( - Gd[ M \r- &&~wJ%~L Name and Title of Olficer (e.g., "Jane doe. Notary Public") personally appeared %\aG ut s kMSM Name@) of Signer@) 0 personally known to me j3' proved to me on the basis of satisfactory evidence to be the person# whose name0 islafe subscribed to the within instrument and acknowledged to me that h_elskdthey executed the same in hislberlhir authorized capacity&@, and-that by l&s/he&eir signaturep) on the instrument the persow), or the entity upon behalf of which the person($ acted, executed the instrument. Notory Publii - Cdifanb Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: [*,I fK%C t yzbk IJmks Document Date: Signer(+ Other Than Named Above: Capacity(ies) Claimed by Signer 0 Corporate Officer - Title(s): 0 Partner - 0 Limited 0 General 0 Attorney-in-Fact 0 Guardian or Conservator Signer Is Representing: 0 1999 National Notary Assouaton - 9350 De Solo Ave.. P.O. Box 2402 - Chatswodh, CA 91313-2402 - www.natlonalnotary.org Prod, No. 5907 Reorder: Call Toll-Free 1-800-876-6827 Dec 23 02 05:13p Blair Rasmussen BONDi167590 PREMIUM INCLUDED IN PERFORMANCE BOND 858-672-7551 LABOR AND MATERIALS BOND P-8 WHEREAS, the City Council of the City of Carlsbad, State of California, by Resolution No. PKSO3-02 , adopted 2AZ!!ARY 7, 2003 , has awarded to %AIR RASMUSSEN CONSTRUCTION (hereinafter designated as the "Principal"), a Contract for: La Costa Canyon Park Stairs Re- Construction Project, Contract No. PKS02-03 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 PrincipaI or any of their 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 fo 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, BUIR R&mssEN CONS~uCTION I as Principal, (hereinafter designated as the "Contractor"), and as Surety, are held firmly bound unto the City of Carlsbad in the sum of 50/100 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 Coiitractor or hidher 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 3181 , 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 3248. This bond shall inure to the benefit of any of the persons named in California Civil Code section 3181, 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 thereunder 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. 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. 4 Dec 23 02 05: 13p Blair Rasmussen Executed by CONTRACTOR this 9~0 day of JANUARY t20" 03 CONTRACTOR: BLAIR RASMTJS- CONSTRUCTION (print name here) (%wuPL ' (title and organization of signatory) (sign here) (print name here) 959-672-7551 P.9 Executed by SURETY this 9" day of JANUARY SURETY: ,20&. AMERICAN CONTRACTORS INDEMNITY COMPANY (name of Surety) 1081 CBMINO DEL RIO SOUTH x107 (title and organization of signatory) (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: RONALD R. BALL City Attorney CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of } SS. NOTARY On 1-9-03 , before me, , Date personally appeared b, Name@) ol Signer(s) 8 personally known to me 0 proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Place Notary Seal Above OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the documenl and could prevent fraudulent removal and reattachment of this form to another 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 Signer’s Name: 0 Individual 0 Corporate Officer - Tile(s): 0 Partner - 0 Limited General 0 Attorney in Fact 0 Trustee U Guardian or Conservator El Other: Signer Is Representing: 8 1997 National Notary Associatan - 9350 De S&o Ave., PO. Box 2402 - Chatsworth, CA 913132402 Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 A American Contractors Indemnity Company Los Angeles, California POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That AMERICAN CONTRACTORS INDE" C0"W. a California Corporation (the "Company"), and having its principal office in Los Angeles, California does hereby constitute and appoint: Corrine Brawn as its true and lawful Attorney(s)-in-fact, in amount of S? ~ooo~ooo~oo , to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings. recognizances, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instrument(s) in pursuance of these presents, shall be as binding upon the said AMERICAN CONTRACTORS INDEhlNITY COMPANY, as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office. This Power of Attorney is executed. and may be certified to and may be revoked. pursuant to and by authority of resolutions adopted by the Board of Directors of AMERICAN CONTRACTORS INDJ3MNlTY COMF'ANY, at a meeting called and held on the 6th day of December, 1990. RESOLVED that the Chief Executive Officer, President or any Vice President, Executive Vice President, Secretary or Assistant Secretary, shall have power and authority. 1. To appoint Attorney@)-in-fact and to authorize them to execute on behalf of the Company, and attach the Seal of the Company 2. To remove, at any time, any such Attorney-in-fact and revoke the authority given. thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and, RESOLVED FURTHER, that the signature of such officers and the seal of the Company may be affured to any such power of attorney or any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, AMERICAN CONTRACTORS INDEMNITY COMPANY has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer this 9th day of Mav 9 2ooo. By: STATE OF CALIFORNIA COUNTY OF LOS ANGELES On personally known to me 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, May 9, 2000 before me. Deborah Reese , personally appeared Andy Faust -~ executed the instrument. WITNESS my hand and official seal. CERTIFICATION I, the undersigned officer of AMERICAN CONTRACTORS INDEMNITY COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the resolution adopted by the Board of Directors of said Company as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY, and that same are correct transcripts thereof and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect. IN TESTMOW WHEREOF. I have hereunto set my hand this 9TH JANUARY day of 2003 9 %" #- 3- James H. FergusonvSecretary p. 10 Dee 23 02 05:13p Blair . *. BONDi167590 FAfTHFUL pREMIUH:$2224.00 B5a-672-7551 BLAIR RASMUSSEN CONSTRUCTION , (hereinafter in the City of Carlsbad, in strict conformity with the contract, the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad, all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond for the faithful performance and warranty of said Contract; NOW, THEREFORE, WE, BLAIR RASMUSSEN CONSTRUCTION , as Principal, (hereinafter designated as the "Contractor"), and AMERICAN CONTRACTORS INDEMNITY COMPANY , as Surety, are held and firmly bound unto the City of Carlsbad, in the sum of so/loo Dollars ($ 74-50 ), said sum being equal to one hundred percent (1 00%) of the estimated amount of the Contract, to be paid to City or its certain attorney, its successors and assigns; 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. SE- POUR THOUSAND, OME HDNDRED THE CONDiTlON OF THIS OBLIGATION IS SUCH that if the above bounden Contractor, their heirs, executors, administrators, successors or assigns; shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions, and agreements in the Contract and any alteration thereof made as therein provided on their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City of Carlsbad, its oficers, employees and agents, as therein stipulated, .then this obligation shall become null and void; otherwise it shall remain in full force and effect. As a part of the obligation secured hereby and in addition to the face amount specified therefor, there shall be included costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by the City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. 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 thereunder 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. Dcc 23 02 05: 14p Blair Rasmussen 958-672-7551 p. 11 In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Suretyfrom its obligations under this bond. Executed by CONTRACTOR this qm day of JANUARY 3 20 03. CONTRACTOR: BLAIR RASMUSSEN CONSTRUCTION mf Contractor) (print name here) (Title and Organization of Signatory) (sign here) (print name here) ~ ~ ~- - ~- Executed by SURETY this ~TH day of JANUARY ,20 03 . SURETY: AWWICAN CONTRACTORS INDJMNITY COMPANY &NO DEL RIO gOUTH 5107 1081 name of Suret ) SAN DIEGO, CA 92108 (fddre% of Surety) 619-2q742900 \ LgWN ATTORNEY-IN-FACT nam of Attorney-in-Fact) (Attach corporate resolution showing current power of attorney.) (Title and Organization of signatory) (Proper notarial acknowiedgment of execution by CONTRACTOR and SUREN 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 empowring that officer to bind the corporation.) APPROVED AS TO FORM: RONALD R. BALL City Attorney By: CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of } ss. 1-9-03 NOTARY On , before me, , Dale personally appeared m, Name@) of Signer(s) 3 personally known to me 0 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@), or the entity upon behalf of which the person(s) acted, executed the instrument. Place Nolaary Seal Above OPTIONAL V Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer@) Other Than Named Above: Capacity(ies) Claimed by Signer 0 Individual 0 Corporate Officer - Title(s): E Partner - 0 Limited 0 General Attorney in Fact i7 Guardian or Conservator Signer Is Representing: 0 1997 National Notary Associtia, 9350 De Solo Ave.. P.O. Box 2402 * Chatsworth. CA 9131 3-2402 Prod. No. 5907 Reorder Call Toll-Free 1-800-876-6827 A American Contractors Indemnity Company Los Angeles, California POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That AMERICAN CONTRACTORS INDEMNITY COMF’ANY, a California Corporation (the “Company”), and having its principal office in Los Angeles, California does hereby constitute and appoint: Corrine Braan as its me and lawful Attorney(s)-in-fact, in amount of 3 ~ooo~ooo*oo , to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings. recognizances, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instruaent(s) in pursuance of these presents, shall be as binding upon the said AMERICAN CONTRACTORS INDEMNITY COMF’ANY. as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office. This Power of Attorney is executed, and may be certified to and may be revoked, pursuant to and by authority of resolutions adopted by the Board of Directors of AMERICAN CONTRACTORS INDEh4NTIY COMPN, at a meeting called and held on the 6th day of December, 1990. RESOLVED that the Chief Executive Officer, President or any Vice President, Executive Vice President, Secretary or Assistant Secretary, shall have power and authority. 1. To appoint Attorney(s)-in-fact and to authorize them to execute on behalf of the Company, and attach the Seal of the Company 2. To remove, at any time, any such Attorney-in-fact and revoke the authority given. thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and. RESOLVED FURTHER. that the signature of such officers and the seal of the Company may be flied to any such power of attorney or any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, AMERICAN CONTRACTORS INDEMNITY COMPANY has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer this 9th day of Mav ,2ooo. 0 s mowolulED AMERICANCONTRACT0 5 SEPT.26.1990 T By: &ZY- Andy Faust, President STATE OF CALIFORNIA COUNTY OF LOS ANGELES On personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed tbe 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. WITNESS my hand and official seal. *qlmd May 9, 2000 before me, Deborah Reese , personally appeared Ad-t &h?aAc ASCK CERTIFICATION I, the undersigned officer of AMERICAN CONTRACTORS INDEMNITY COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the resolution adopted by the Board of Directom of said Company as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID COMPANY, and that same are correct transcripts thereof and of the whole of the said originals. and that the said Power of Attorney has not been rcvoked and is now in full force and effect. IN T”0NY WHEREOF, I have hereunto set my hand this 9TH day of JANUARY 2003 I 9F” &- 3- James H. FergusonqSecretary License Detail Page 1 of 2 ~~li~or~i~ Home Monday, January 27,2003 Contractor License # 670528 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before relying on this information, you should be aware of the following limitations: CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject to public complaint disclosure, an icon will appear below. Click on the icon to obtain additional complaint information. Per B&P 7071.17, only construction related civil judgments known to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license data base. Extract Date: 01/27/2003 * * * Business Information * * * BLAIR RASMUSSEN CONSTRUCTION 15210 SEGOVIA COURT SAN DIEGO, CA 92129 Business Phone Number: (858) 672-2957 Entity: Sole Ownership Issue Date: 05/04/1993 Expire Date: 11/13/2003 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * * * * Certifications * * * lcertl HOME IMPROVEMENT CERTIFICATION [El Description 0 1/27/2003 License Detail Page 2 of 2 * * * Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 142868 in the amount of $7,500 with the bonding company AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 11/05/2001 Contractor's Bonding History * * * Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 1689883 Effective Date: 09/07/2002 Expire Date: 09/01/2003 Workers Compensation History Personnel ~___ List License Number Request Contractor Nama Request Personnel Name Request " Salesperson Request Sa~~~~.er~~o.P?a.meRequest 0 2002 State of California. Gray Davis. Governor. Cqnditiomof.Use Privacy Policy 01/27/2003 1542 OWNER FIRM OR CORPORATION NAME BUSINESS NAME MAILINGADDRESS CITY AN0 STATE General Contractors-Nonresidential Buildings, ( RASMUSSEN BLAIR BLAIR RASMUSSEN CONSTRUCTION BLAIR RASMUSSEN 1521 0 SEGOVIA CT SAN DIEGO. CA 92129-1301 EXPIRATION DATE BUUR RASMUSSEN CONSTRUCTION SAN DIEGO, CA 92/29 152 10 SEGOVfA CT . CA LC# 670528“ ISSL-ZLS-BSB BIDDER’S CERTIFICATE OF INSURANCE FOR GENERAL LIABILITY, EMPLOYERS’ LIABILITY, AUTOMOTIVE LIABILITY AND WORKERS’ COMPENSATION (To Accompany Proposal) La Costa Canyon Park Stairs Re-Construction Project CONTRACT NO. PKS02-03 As a required part of the Bidder’s proposal the Bidder must attach either ofthe following to this page. 1) Certificates of insurance showing conformance with the requirements herein br each of: Comprehensive General Liability Automobile Liability Workers Compensation Employer’s Liability 2) Statement with an insurance carrier’s notarized signature stating that the carrier can, and upon payment of fees and/or premiums by the Bidder, will issue to the Bidder Policies of insurance for Comprehensive General Liability, Automobile Liability, Workers Compensation and Employer’s Liability in conformance with the requirements herein and Certificates of insurance to the Agency showing conformance with the requirements herein. All certificates of insurance and statements of willingness to issue insurance for auto policies offered to meet the specification of this contract must: 1 ) Meet the conditions stated in The Notice Inviting Bids, the Standard Specifications for Public Works Construction and the Supplemental Provisions for this project for each insurance company that the Contractor proposes. 2) 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 auto insurance certificate must state the cowage is for “any auto“ and cannot be limited in any manner. Hard Copies of Insurance and Workers Compensation Coverage will be forwarded directly from my agencies e Qg Revised 07/29/02 Contract No. PKS02-03 Paae 20 of 58 Paaes PAGE f If 30011Ol Date Entered: 2/13/2003 - -~ I CERTIFICATE OF LlA8lLlTY INSURANCE a 113 /a001 wIc eRRTTFICAT€ IS ISSUE0 AS A MAWER OF IHFORMATlON .. ___- ~ __ ~ ~.JS CCRWICATE DOES NOT AMEND, €-NO OR un CONFERS NO BIGHTS UPON THE CERTIFICATE @TER THe COVERAQE AFFORDED BY THE POLICIES BELOW. I JfW.23.2083 11:lZAM SCIF(323)266-5857 No.893 P.2 POLICYHOLDER COPY STATE P.O. Box 420807, SAN FRANCISCO, CA 84142.0807 FUN I=) CERTIFICATE OF WORKERS’ COMPENSATION INSURANCE COMPRNSA’7)ON INSURANCt L~ANUARY 21, 7003 GROUP: POLICY NUMBER mFICATE ID: 4 a.6agtm-2002 CERTIFICATE EXPIRES 09-01.-2003 A.M. Best's Rating for Century-National Insurance Company Page 1 of 1 03090 - Century-National Insurance Company A.M. Best #: 03090 NAlC #: 26905 Best's Rating A- (Excellent)* Financial Size Category VI1 ($50 million to $100 million) *Ratings as of 02/14/2003 03:49:40 PM E.S. T. or purchase the complete Best's ComDanv Report for in-depth analysis. Rating Category (Excellent): Assigned to companies that have, in our opinion, an excellent ability to meet their ongoing obligations to policyholders. Important Notice: Best's Ratings reflect our opinion based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet strength, operating performance and business profile. These ratings are not a warranty of an insurer's current or future ability to meet its contractual obligations. View our entire notice for a complete details. Companies interested in placing a Best's Security Icon on their web site to promote their financial strength may register online. Copyright 0 2002 by A.M. Best Company! Inc. ALL RIGHTS RESERVED prior written permission of the A.M. Best Company. Refer to our terms of use for additional details. No part of this information may be distributed in any electronic form or by any means, or stored in a database or retrieval system, without the http://www3.ambest.com/ratings/rating.asp?AMBNum=03090&Refnum=03090&Site=rat... 02/14/2003 A.M. Best's Rating for RLI Insurance Company Page 1 of 1 04210 I RLI Insurance Company ~ Jump to this company's web site. Member of RLI Group View a list of aroup members or the qroup's rating A.M. Best #: 04210 NAlC #: 13056 Best's Rating A (Excellent)* Financial Size Cateaorv IX ($250 million to $500 million) 'Ratings as of 02/14/2003 03:49:40 PM E.S.T. or read the complete Best's Company Report for in-depth analysis. * Compliments of RLI Insurance Company Rating Category (Excellent): Assigned to companies that have, in our opinion, an excellent ability to meet their ongoing obligations to policyholders. Important Notice: Best's Ratings reflect our opinion based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet strength, operating performance and business profile. These ratings are not a warranty of an insurer's current or future ability to meet its contractual obligations. View our entire notice for a complete details. Companies interested in placing a Best's Security Icon on their web site to promote their financial strength may register online. Copyright 0 2002 by A.M. Best Company, Inc. ALL RIGHTS RESERVED No part of this information may be distributed in any electronic form or by any means, or stored in a database or retrieval system, without the prior written permission of the A.M. Best Company. Refer to our terms of use for additional details. http://www3.ambest.com/ratings/rating.asp?AMBNum=O421O&Refnum=O42lO&Site=rat... 02/14/2003 : Company Profiles Page 1 of 1 CompanyList For more information on any company, click the Company Name "Info" link. To view all companies in the same group, click the NAIC group number. Company Name RLI INSURANCE COMPANY (Info) Record 1 New Search 1 Last Revised - January 08,2003 08:30 PM Copyright 0 California Department of Insurance Disclaimer http://cdinswww.insurance.ca.gov/pls/wu_co_prof/idb_co_list$co_list_mc.actionquery 03/25/2003 : Company Profiles Page 1 of 1 CompanyList !!m In For more information on any company, click the Company Name "Info" link. To view all companies in the same group, click the NAIC group number. Company Name CENTURY-NATIONAL INSURANCE COMPANY(1nfo) Name Record 1 New Search I Last Revised - January 08,2003 08:30 PM Copyright 0 California Department of Insurance Disclaimer http://cdinswww.insurance.ca.gov/pls/wu_co_prof/idb_co_list$co_list_mc.actionquery 03/25/2003 : Company Profiles Page 1 of 1 CompanyList For more information on any company, click the Company Name "Info" link. To view all companies in the same group, click the NAIC group number. Company Name AMERICAN CONTRACTORS INDEMNITY COMPANY0 Record 1 Last Revised - January 08,2003 08:30 PM Copyright 0 California Department of Insurance Disclaimer http://cdinswww.insurance.ca.gov/pls/wu_co_prof/idb_co_list$co_list_mc.actionquery 03/25/2003 A.M. Best's Rating for American Contractors Indemnity Company 1101 9 - American Contractors Indemnity Company A.M. Best #: 1 101 9 NAlC #: 1021 6 Best's Rating A- (Excellent)* Financial Size Cateaorv V ($10 million to $25 million) 'Ratings as of 03/25/2003 11:44:48 AM E.S.T. Page 1 of 1 or purchase the complete Best's Companv Report for in-depth analysis. Rating Category (Excellent): Assigned to companies that have, in our opinion, an excellent ability to meet their ongoing obligations to policyholders. Important Notice: Best's Ratings reflect our opinion based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet strength, operating performance and business profile. These ratings are not a warranty of an insurer's current or future ability to meet its contractual obligations. View our entire notice for a complete details. Companies interested in placing a Best's Security Icon on their web site to promote their financial strength may register online. Copyright 0 2003 by A.M. Best Companv, Inc. ALL RIGHTS RESERVED No part of this information may be distributed in any electronic form or by any means, or stored in a database or retrieval system, without the prior written permission of the A.M. Best Company. Refer to our terms of use for additional details. http://www3.ambest.com/ratings/rating.asp?AMBNum=l1019&Refnum=l1019&Site=rat ... 03/25/2003