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HomeMy WebLinkAboutSancon Engineering; 2013-02-27; PWM13-31UTILPWM13-31UTIL CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONTRACT NO. 55031 ($45,000 or Less) This agreement is made on the tS.l'f^ day of fhhrUCZrcf 2013, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Sancon Engineering, Inc. whose principal place of business is 5841 Engineer Drive Huntington Beach CA 92649 (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: Don Wasko/Clavton Dobbs. (City Project Manager) PREVAILING WAGES NOT REQUIRED. The City of Carlsbad is a Charter City. Carlsbad Municipal Code Section 3.28.130 supersedes the provisions of the California Labor Code when the public work is not a statewide concern. Payment of prevailing wages is at Contractor's discretion. 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 ofthe truth or falsity ofthe 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. REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT. NO. 55031 Page 1 of 11 City Attorney Approved 1/30/13 PWM13-31UTIL 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 from participating in contract bidding. Signature: ^^^^ Print Name: CHf\i^ Pl BEy^trp^lTO SJiC 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 insurers that have: (1) a rating in the most recent Best's Key Rating Guide of at least A-:V and (2) are admitted and authorized to transact the business of insurance in the State of California by the Insurance Commissioner. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than $500,000 Subject to the same limit for each person on account of one accident in an amount not less than $500,000 Property damage insurance in an amount of not less than $100,000 Automobile Liability Insurance in the amount of $100,000 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. 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 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within working days after receipt of Notice to Proceed. REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT. NO. 55031 Page 2 of 11 City Attorney Approved 1/30/13 PWM13-31UTIL CONTRACTOR'S INFORMATION. SANCON ENGINEERING, INC. (name of Contractor) 731797 (Contractor's license number) Class A-1/31/2015 (license class, and exp. date) 5841 Engineer Drive (street address) Huntington Beach, CA 92649 (city/state/zip) 714-891-2323 (telephone no.) 714-891-2524 (fax no.) chuck@sancon.com (e-mail address) 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/p^ bind Contractor to the terms and conditions of this Agreement. CONTRACTOR SANCON ENGINEERING, INC. CITY OF CARLSBAD, a municipal corporation of the State of California yy I (sign here) /t^icK (print name/title) By: — (sign here) (print name/title) Assistant City Monogefr Deputy City Mai^^^"^^-*-''-'^ Df?partment Piroctof r o /f' ^ -as authorized by the City Manag(^> Ijj ATTEST: BARBARA ENGLESON City Clerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation. Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City AttQmey BY:__ Assistant City REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT. NO. 55031 Page 3 of 11 City Attorney Approved 1/30/13 Check a License - License Detail - Contractors State License Board Page 1 of2 DEPARTMENT OF CONSUMER AFFAIRS . Contractors State License Board Contractor's License Detail - License # 731797 DISCLAIMER: A license status check provides Information taken from the CSLB license database. 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, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071.17 , only construction related civil judgments reported 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 database. License Number Business Information Entity Issue Date Expire Date License Status Extract Date 2/14/2013 Classifications Bonding 731797 SANCON ENGINEERING INC Business Phone Number: (714) 891-2323 5841 ENGINEER DRIVE HUNTINGTON BEACH, CA 92649 Corporation 01/27/1997 01/31/2015 ACTIVE This license is current and active. All information below should be reviewed. CLASS DESCRIPTiON A GENERAL ENGINEERING CONTRACTOR C33 PAINTING AND DECORATING D12 SYNTHETIC PRODUCTS CIO ELECTRICAL B GENERAL BUILDING CONTRACTOR CONTRACTOR'S BOND This license filed a Contractor's Bond with HANOVER INSURANCE COMPANY. Bond Number: BLF9304692 Bond Amount: $12,500 Effective Date: 11/25/2011 Contractor's Bond History BOND OF QUALIFYING INDIVIDUAL https://wvm2.cslb.ca.gov/0nlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum=73... 2/14/2013 Check a License - License Detail - Contractors State License Board Page 2 of 2 The Responsible Managing Officer (RMO) DI BENEDETTO NICHOLAS FREDERICK certified that he/she owns 10 percent or more ofthe voting stock/equity ofthe corporation. A bond of qualifying individual is not required. Effective Date: 05/01/2003 BQI's Bond Historv 2. The Responsible Managing Officer (RMO) PARSONS CHARLES BROWNING certified that he/she owns 10 percent or more ofthe voting stock/equity ofthe corporation. A bond of qualifying individual is not required. Effective Date: 07/07/2003 WORKERS' COMPENSATION This license has workers compensation insurance with TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Workers' Compensation Policy Number: DTJUB9818R93A12 Effective Date: 10/01/2012 Expire Date: 10/01/2013 Workers' Compensation Historv Personnel listed on this license (current or disassociated) are listed on other licenses. Personnel List Other Licenses Conditions of Use j Privacy Policv Copyright © 2010 State of California https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum=73... 2/14/2013 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 State of California County of On ilLi /3 Date before me, C-H/H^U^S 7^»/g>s<W^ ^ /\Jar/^ Here Insert Name and Title of the Officer personally appeared Aijfc^^; fl£^£DV7ro f i i&o*\.T>*frro Name(s) of Signer(s) CHARLES B.PARSONS P Commission # 1943036 t Notary Public • California 1 jg-^ Orange County g My Comm. Expires Jul 30. 20151 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) i^/are subscribed to the within instrument and acknowledged to me that h^/shfe/they executed the same in h/s/h6r/their authorized capacity (ies), and that by hts/h6r/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Place Notary Seal Above Signature: OPTIONAL Signature of Notary Public Though the information beiow 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: Slgner(s) Other Than Named Above: Capaclty(ies) Claimed by Signer(s) Signer's Name: • Corporate Officer — Title(s): • Individual • Partner — • Limited • General • Attorney in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNER Top of thumb here Signer's Name: • Corporate Officer — Title(s): • Individual • Partner — • Limited • General • Attorney in Fact • Trustee • Guardian or Conservator • Other: RIGHT THUMBPRINT OF SIGNER Top of thumb here ) 2010 National Notary Association • NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 PWM13-31UTIL 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 falls 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 pubKc 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. ofthe California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to be Subcontracted Business Name and Address License No., Classification & Expiration Date %of Total Contract 0 Total % Subcontracted: REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT NO. 55031 Page 4 of 11 City Attorney Approved 1/30/13 PWM13-31UTIL EXHIBIT B (ENTER SCOPE OF WORK, SPECIFICATIONS, CONTRACTOR'S PROPOSAL, ETC.) JOB QUOTATION ITEM NO. UNIT QTY DESCRiPTiON PRICE 1 Heavy cleaning of cast iron sewer pipe encasing 8" VCP to remove all residue and roots $3,600.00 2 Bypass sewer line system utilizing a vacuum tanker $2,500.00 3 Railroad track flaggers, permit and traffic control $3,700.00 4 Rehabilitate approximately 181' of 8" VCP sewer line from manhole 16C-56 to manhole 16C-62 on Tamarack at the railroad tracks with cured in place pipeline (CIPP) lining $18,795.00 5 Labor and Materials Bond - 1% of Bid # B13156 $285.95 6 Contingency $1,119.05 TOTAL* NOT TO EXCEED $30,000.00 Includes taxes, fee's, expenses and all other costs. REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT. NO. 55031 Page 5 of 11 City Attorney Approved 1/30/13 PWM13-31UTIL EXHIBIT "B" SCOPE OF SERVICES Perform rehabilitation of sewer pipeline with cured in place pipeline (CIPP) with a minimum thickness of 4.5 mm Setup traffic control and have flaggers in place. Railroad training/access decals on all hardhats Setup bypass vacuum tanker truck to process all sewage Clean pipeline before rehabilitation begins with combination truck/high velocity jet rodders Perform CCTV inspection of sewer pipeline prior to installing CIPP liner. Prohibit construction residue from entering sewer line system Reinstate all laterals as needed Perform a final CCTV inspection of sewer pipeline when install is completed Clean worksite Remove bypass vehicle Breakdown traffic control LOCATION • Manhole No. 16C-56 to manhole 16C-62 • Tamarack at Railroad Tracks FEE • Not to Exceed $30,000 REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT. NO. 55031 Page 6 of 11 City Attorney Approved 1/30/13 O Searches EXHIBIT "B" Sewer Atlas Scale 1: 388.26 Results ^ Measure Totahi ^ [3 0 Info Type 0 1 Length: 183.717 ft EXHIBIT "B" Sewer Atlas Storm Water Atlas Water Atlas Results ^ D Measure Totai:i lxl fi) 0 Info Type 0 1 Length: 181.795 ft SANCON ENGINEERING. INC. EXHIBIT "B" GENERAL ENGINEERING CONTRACTOR Tel: (714) 891-2323 STATE CONTRACTORS LICENSE #731797 Fax: (714) 891-2524 BID # B13156 Date: January 16, 2013 Toi City of Carlsbad Attention: Don Wasko Phone: 760-438-2722 Email: don.wdsko@carlsbadca.gov Project: Tamaracic Ave Lining Owner / Agency: City of Carlsbad Based on Information furnished to Sancon plus a review of the job site, piease find below our proposal to rehabilitate approximately 181' of 8" VCP Sewer from MH 16C-56 to MH 16C-52 per the following: Our proposal idfiludfiS: Confined Space Entry Procedures 8i Equipment, Traffic Control per WATCH only Certified |>ayroll if required, Standard Insurance coverage up to $4 Million Pre-video of sewer main just prior to lining to confirm and document immediate acceptability for lining. Install Sancon CIPP liner at 4.5 mm thickness for '^Fullv Deteriorated" Pine Conditions Robotic reinstatement of active HCs (1 anticipated) Procurement of "No Fee Electronic" Encroachment Permit Final video Inspection to confirm successful CIPP liner installation and lateral reinstatement. Assumptions / Notes: • Water services shall be shut off during our work to prevent liner damage and to prevent private property damage as a result of using water while sewer services are blocked. If water services are not shut off homeowner/Agency will be responsible for any private property damage as a result of backups Into private laterals / property. • Due to changes In host pipe material, offsets at transitions, wrinkles, and blisters In the liner may occur and shall be deemed acceptable for this project • Normal working hours M - F 7 AM to 5PM • Agency to provide a mobile water meter or similar source for our work • This quotation shall become part of any future Contract, Agreement or Purchase order This proposal excludes: • Excludes BMP's, Survey and Staking, Preparing As-bullts, Infiltration control, 3^** Party Testing • Cleaning, bypass, R/R insurance, R/R Flaggers & training. Sancon can perform these services at the prices below. If Agency or Others clean the line and the segment Is not linable as-ls once Sancon Is on-site, specialty cleaning will be done at the T&M rate shown below. • Excludes excavation type point repairs of any kind. If required. Including pit construction / restoration. • Standby or work outside of our scope will be billed at $165.00 / manhour which is Inclusive of equipment Price: $18,795.00 LS Lining of 8" VCP $3,600.00 LS Heavy Cleaning of Cast Iron $2,500.00 LS Bypass using Vacuum Tanker $3,700.00 LS R/R Flaggers and Permit Please call me If you have any questions at 714-891-2323. PRICE IS BASED ON ONE MOBILIZATION. ADDITIONAL MOBILIZATIONS BILLED AT: $2,250.00 EACH. BOND, IF REQUIRED, WOULD ADD 1% TO TOTAL BID PRICE. PRICE IS BASED ON RETENTION BEING WITHELD A MAXIMUM OF 90 DAYS AFTER COMPLETION OF OUR WORK. PRICE IS FIRM FOR A PERIOD OF THIRTY DAYS FROM RECEIPT. PAYMENT TERMS NET 30 DAYS OR PER CONTRACT. Resi3edfullyjubmitt Accepted By: <^5Z^C_>^^-— Date: Dan Chronlster Sancon Engineering, INC. PO: 5841 Engineer Drive Huntington Beach, CA 92649 Page 9 of 11 PWM13-31UTII EXHIBIT C LABOR AND MATERIALS BOND ^o. 1973820 WHEREAS, the City of Carlsbad, State of California, has administratively awarded to Sancon Engineering, Inc., (hereinafter designated as the "Principal"), a Contract for: REHABILITATE SEWER LINE SECTION ON TAIWARACK AT RAILROAD TRACKS CONTRACT NO. 55031 in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Offtee 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 fall 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, SANCON ENGINEERING, INC., as Principal, (hereinafter designated as the "Contractor"), and HANOVER INSURANCE COMPANY as Surety, are held firmly bound unto the City of Carlsbad in the sum of Thirty Thousand Dollars ($30,000), 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 woric 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 Civii 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 speciflcattons 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. REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT. NO. 65031 Page 10 of 11 City Attorney Approved 1/30/13 PWM13-31UTIL 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 Hth of Feb. ,20 1-3 day CONTRACTOR: SANCON ENGINEERING, INC. (n^pfi^f Contractor) (sign here) (print name here) (title and organization of signatory) 8v: (sign here) (print name here) Executed by SURETY this Hth day of Feb. ^20 1-3. SURETY: HANOVER INSURANCE COMPANY (name of Surety) 2 MacArthur Place, 2nd Floor Santa Ana, CA 92707 (address of Surety) 714-415-3808 By: (telephor)e ni|iyi|ier of Surety) ^yv—^ (signatui)^ of Attorhi^y-in-Fact) Michael R. Langan (printed name of Attorney-in-Fact) (attach corporate resolution showing current power of attorney) (title and organization of signatory) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation. Agreement must be signed by one corporate officer from each ofthe 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 seaetary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: ELIA A. BREWER, City Attorney K\PJoy Assistant City Attorne^ REHABILITATE SEWER LINE SECTION ON TAMARACK AT RAILROAD TRACKS CONT. NO. 55031 Page 11 of 11 City Attorney Approved 1/30/13 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 State of California County of <^<2^NJte€. On g/ wj <S before me, Date Here Insert Name and Title of the Officer' personally appeared r^itt^^ T:> ; t^g^p.'hgTro ^ aA(Lx<^^\fLCi>te:T^£jrC> Name{s) of Signer(s) m I 1036 ( CHARLES B.PARSONS Commission # 1943036 Notary Public - California J~ N89^^ Orange County 5 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) i^/are subscribed to the within instrument and acknowledged to me that h6/sWe/they executed the same in hi^/h^rAheir authorized capacity(ies), and that by hiifi/hfer/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and officiakseal. Place Notary Seal Above Signature: OPTIONAL Signature of Notary Public 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(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: • Corporate Officer — Title(s): • Individual • Partner — • Limited • General • Attorney in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: RIGHT THUWBPPINT OF SIGNER Top of thumb here Signer's Name: • Corporate Officer — Title(s): • Individual • Partner — • Limited • General • Attorney in Fact • Trustee • Guardian or Conservator • Other: RIGHT THUIVIBPR'NT OF SIGNER Top of thumb here ) 2010 National Notary Association • NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of LOS ANGELEg } On me, Dafe personally appeared Michael Langan Kendra Michelles Boots, Notary Public. Here Insert Name and Title of the Officer Name(s) oi Signer(s) KENDRA MICHELLE BOOTS I COMM. # 1951463 < who proved to me on the basis of satisfactory evidence to be the personj^ whose name^ is/^subscribed to the within instrument and acknowledged to me that he/9liai!lihi@> executed the same in his/HSSWiD authorized capacityO©), and that by his/l®^|jeir signature(^ on the instrument the person(i^, or the entity upon behalf of which the person^ acted, executed the Instrument I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Place Notary Seal Above Signatun OPTIONAL Though Ure 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: PAYMENT BOND Number of Pages: Signer(s) Other Than Named Above: Capaclty(ies) Claimed by Signer(s) Signer's Name: • Individual • Corporate Officer —Title(s): • Partner — • Limited • General • Attorney in Fact • Trustee O Guardian or Conservator • Other: Signer ts Representing: RiGHTTHUMBPRlf^ OF SIGNER Top of thumb here HANOVER INSURANCE COMPA Signer's Name: • Individual • Corporate Officer — Title(s): • Partner — O Limited • General • Attorney in fiact O Trustee • Guardian or Conservator • Other: Signer Is Representing: RlGHTTHU^^BPRl^^T OF SIGNER Top of thumb here ©2007Natic»ialNotaryAssociafion«9350DeSmoAvB.,RO.Box2402»Chatst«>rth.GA 91313-2402•www.N^aional^totarv.org ltem#5907 Reorder:Ca»Trtl-Free1-800-87&«827