Loading...
HomeMy WebLinkAboutJoseph Velton Jezisek dba The Door Co; 2022-02-14; PWM22-1763FACCITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FIRE STATION NO. 5 ROLL UP DOOR REPAIR DESCRIPTION OF WORK. PROVISIONS OF LABOR AND MATERIALS. CONTRACT DOCUMENTS. LABOR. GUARANTEE. PAYMENT. WAGE RATES. FALSE CLAIMS. REQUIRED INSURANCE. OR OR WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. BUSINESS LICENSE. INDEMNITY. JURISDICTION. CONTRACTOR’S INFORMATION. /// /// /// /// /// /// /// AUTHORITY. or or Otherwise EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR NONE SUBCONTRACTORS Portion of Project to be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract EXHIBIT B Fire Station No. 5 Roll Up Door Repair Notes: JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE TOTAL* $6,895 *Includes taxes, fees, expenses and all other costs. EXHIBIT C SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. N / A SUBRWVDADDLINSD AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY (Mandatory in NH) LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB COMMERCIAL GENERAL LIABILITY CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD CERTIFICATE OF EXEMPTION WORKERS’ COMPENSATION/EMPLOYERS’ LIABILITY INSURANCE I, , am the [insert name][title] of . I hereby certify that [name of company] [name of company] has no employees and is not required by law to maintain workers’ compensation or employers’ liability insurance. Should employ any person[name of company] during the term of the Agreement with the City of Carlsbad for ,[description of project or work that is being contracted] then workers’ compensation and employers’ liability insurance will be obtained. [Name] [Title and name of company or corporation] Sept. 1, 2021 Joseph V Jezisek Owner The Door Company The Door Company The Door Company ADA opener installation Joseph V Jezisek Owner The Door Company