CONTRACT 3468 Public Works Contract CLOSEDORIGINAL
3468 . .
PUBLIC WORKS CONTRACT
BETWEEN
THE CITY OF EL SEGUNDO AND
BEST ROOFING & WATERPROOFING, INC.
This CONTRACT is entered into this 13th day of May, 2005, by and between the
CITY OF EL SEGUNDO, a general law city and municipal corporation ( "the City ") and
BEST ROOFING & WATERPROOFING, INC ( "the Contractor").
1. WORK.
A. The Contractor will provide all work required by the Contract Documents
(the 'Work"). The Contractor agrees to do additional work arising from
changes ordered by the City in accordance with the Contract Documents.
B. The Contractor and the City agree to abide by the terms and conditions
contained in the Contract Documents;
C. The Contractor will furnish all of the labor; supplies and materials;
equipment; printing; vehicles; transportation; office space and facilities; all
tests, testing and analyses; and all matters whatsoever (except as
otherwise expressly specified to be furnished by the City) needed to
perform and complete the Work and provide the services required of the
Contractor by the Contract Documents.
D. "Contract Documents" means the Notice Inviting Bids; Instructions to
Bidders; Supplementary Instructions to Bidders; Proposal; this Contract;
Standard Specifications; Supplementary Conditions; Exhibits; Technical
Specifications; List of Drawings; Drawings; Addenda; Notice to Proceed;
Change Orders; Notice of Completion; and all other documents identified
in the Contract Documents which together form the contract between the
City and the Contractor for the Work. The Contract Documents constitute
the complete agreement between the City and the Contractor and
supersede any previous agreements or understandings.
2. CONTRACT SUM. The City agrees to pay the Contractor a sum not to exceed
SIXTEEN THOUSAND NINE HUNDRED TWENTY -ONE DOLLARS ($16,921.00) for
the Work in the manner set forth in the Contract Documents. The City may adjust this
amount as set forth in the Contract Documents.
3. TIME FOR PERFORMANCE.
A. The Contractor will fully complete the Work within NINETEEN (19) working
days (the "Contract Time. ")
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B. The Contract Time will commence when the City issues a notice to
proceed. The Contract Documents will supersede any conflicting
provisions included on the notice to proceed issued pursuant to this
Contract.
C. The Contractor may not perform any Work until:
The Contractor furnishes proof of insurance as required by the
Contract Documents; and
ii. The City gives the Contractor a written, signed, and numbered
purchase order and notice to proceed.
D. By signing this Contract, the Contractor represents to the City that the
Contract Time is reasonable for completion of the Work and that the
Contractor will complete the Work within the Contract Time.
E. Should the Contractor begin the Work before receiving written
authorization to proceed, any such Work is at the Contractor's own cost
and risk.
4. DISPUTES. Disputes arising from this contract will be determined in accordance
with the Contract Documents and Public Contracts Code §§ 10240 - 10240.13.
5. THIRD PARTY CLAIMS. In accordance with Public Contracts Code § 9201, the
City will promptly inform the Contractor regarding third -party claims against the
Contractor, but in no event later than ten (10) business days after the City receives such
claims. Such notification will be in writing and forwarded in accordance with the "Notice"
section of the Contract Documents. As more specifically detailed in the Contract
Documents, the Contractor agrees to indemnify and defend the City against any third -
party claim.
6. TAXPAYER IDENTIFICATION NUMBER. The Contractor will provide the City with
a Taxpayer Identification Number.
7. PERMITS AND LICENSES. Unless otherwise provided, the Contractor, at its sole
expense, will obtain and maintain during the Contract Time, all necessary permits,
licenses, and certificates that may be required in connection with the Work.
8. OWNERSHIP OF DOCUMENTS. All documents, data, studies, drawings, maps,
models, photographs and reports prepared by the Contractor under the Contract
Documents are the City's property. The Contractor may retain copies of said
documents and materials as desired, but will deliver all original materials to the City
upon the City's written notice.
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9. INDEMNIFICATION. The Contractor agrees to indemnify, defend, and hold the City
harmless as set forth in the Contract Documents. The requirements as to the types and
limits of insurance coverage to be maintained by the Contractor as required by the
Contract Documents, and any approval of such insurance by the City, are not intended
to and will not in any manner limit or qualify the liabilities and obligations otherwise
assumed by the Contractor pursuant to the Contract Documents, including, without
limitation, to the provisions concerning indemnification.
10. INDEPENDENT CONTRACTOR. The City and the Contractor agree that the
Contractor will act as an independent contractor and will have control of all work and the
manner in which is it performed. The Contractor will be free to contract for similar
service to be performed for other employers while under contract with the City. The
Contractor is not an agent or employee of the City and is not entitled to participate in
any pension plan, insurance, bonus or similar benefits the City provides for its
employees. Any provision in this Contract that may appear to give the City the right to
direct the Contractor as to the details of doing the work or to exercise a measure of
control over the work means that the Contractor will follow the direction of the City as to
end results of the work only.
11.AUDIT OF RECORDS. The Contractor will maintain full and accurate records with
respect to all services and matters covered under this Contract. The City will have free
access at all reasonable times to such records, and the right to examine and audit the
same and to make transcript therefrom, and to inspect all program data, documents,
proceedings and activities. The Contractor will retain such financial and program
service records for at least three (3) years after termination or final payment under the
Contract Documents.
12. NOTICES. All communications to either party by the other party will be deemed
made when received by such party at its respective name and address as follows:
The City
City of El Segundo
City Hall
350 Main Street
El Segundo, CA 90245
The Contractor
Modji Tabazadeh, President
Best Roofing & Waterproofing Inc.
19027 S. Hamilton Ave
Gardena, CA 90248
Any such written communications by mail will be conclusively deemed to have been
received by the addressee three (3) days after deposit thereof in the United States Mail,
postage prepaid and properly addressed as noted above. In all other instances, notices
will be deemed given at the time of actual delivery. Changes may be made in the
names or addresses of persons to whom notices are to be given by giving notice in the
manner prescribed in this paragraph.
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13. NO THIRD PARTY BENEFICIARY. This Contract and every provision herein is for
the exclusive benefit of the Contractor and the City and not for the benefit of any other
party. There will be no incidental or other beneficiaries of any of the Contractor's or the
City's obligations under this Contract.
14. INTERPRETATION. This Contract was drafted in, and will be construed in
accordance with the laws of the State of California, and exclusive venue for any action
involving this Contract will be in Los Angeles County.
15. EFFECT OF CONFLICT. In the event of any conflict, inconsistency, or incongruity
between any provision of the Contract Documents, precedence will be as follows:
A. This Contract;
B. The Standard Specifications; and
C. Precedence of documents as determined in the Standard Specifications.
16. SEVERABILITY. If any portion of the Contract Documents are declared by a court
of competent jurisdiction to be invalid or unenforceable, then such portion will be
deemed modified to the extent necessary in the opinion of the court to render such
portion enforceable and, as so modified, such portion and the balance of this Contract
will continue in full force and effect.
17.AUTHORITY /MODIFICATION. The Parties represent and warrant that all necessary
action has been taken by the Parties to authorize the undersigned to execute this
Contract and to engage in the actions described herein. This Contract may be modified
by written amendment. The City's city manager, or designee, may execute any such
amendment on the City's behalf.
18.ACCEPTANCE OF FACSIMILE SIGNATURES. The Parties agree that this
Contract, agreements ancillary to this Contract, and related documents to be entered
into in connection with this Contract will be considered signed when the signature of a
party is delivered by facsimile transmission. Such facsimile signature will be treated in
all respects as having the same effect as an original signature.
19. COVENANTS AND CONDITIONS. The parties agree that all of the provisions
hereof will be construed as both covenants and conditions, the same as if the words
importing such covenants and conditions had been used in each separate paragraph.
20. CAPTIONS. The captions of the paragraphs of this Contract are for convenience of
reference only and will not affect the interpretation of this Contract.
21.TIME IS OF ESSENCE. Time is of the essence for each and every provision of the
Contract Documents.
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IN WITNESS WHEREOF the parties hereto have executed this contract the day
and year first hereinabove written.
M
BEST ROOFING & WATERPROOFING
INC. /
Modji Tabazadeh,
President
ATTEST:
6- �IamCVWIA Taxpayer ID No. 9K-- 37FX20
Cindy Mortesen,
City Clerk %
mi. .�
By: i / ,
Karl H. Berger,
Assistant City A
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Executed in Two Counterparts
FAITHFUL. PERFORMANCE BOND
Bond No. 0400687
Bond Fee: $118.00 Final Premium is Based on
Final Contract .Amount
Best Roofing & Waterproofing Inc DBA Best Contracting
Services Inc ("PRINCIPAL ") and
*See Below , a corporation incorporated under the laws of the State of New Jersey and
licensed by the State of California to execute bonds and undertakings as sole surety, as surety
( "SURETY "), are held and firmly bound unto the CITY OF EL SEGUNDO ( "CITY ") in the sum of
* *See Below ($ 16,921.00) dollars, which is a minimum one hundred percent
(100 %) of .the contract amount, lawful money of the United States, which may be increased or
decreased by a rider hereto executed in the same manner as this bond, for the payment of which
sum PRINCIPAL and SURETY bind themselves, their successors, and assigns, jointly and
severally, by this instrument. * *Sixteen Thousand. Nine Hundred
*International Fidelity Insurance Company Twenty One and No /100 Dollars
PRINCIPAL or SURETY will apply this bond for the faithful performance of any and all of the
conditions and stipulations set forth in this bond, SPECIFICATIONS NO. PW 05 -05, and the public
works contract executed with such Specifications. In the case of any default in the performance of
the conditions and stipulations of this undertaking, it is agreed that PRINCIPAL or SURETY will
apply the bond or any portion thereof, to 'the satisfaction of any damages, reclamation,
assessments, penalties, or deficiencies arising by reason of such default.
BOND CONDITIONS
1. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS
NO. PW05 -05 , a copy of which is on file with CITY's Engineering Division ( "Public Project"). Such
performance will be in accordance with CITY's plans and profiles (CITY DRAWING FILE NO.
which are made a part of this bond when said plans and profiles are approved by the City
Council and filed with CITY's Engineering Division.
2. PRINCIPAL's work on the Public Project will be done in accordance with
CITY's plans and specifications and with any permit issued by CITY. Should PRINCIPAL fail to
complete all required work within the time allowed, CITY may, at its sole discretion, cause all
required work to be done and the parties executing the bond will be firmly bound for the payment of
all necessary costs therefor.
3. PRINCIPAL will guarantee its work against any defective work, labor, or materials on
the Public Project for a period of one (1) year following the Public Project's completion and
acceptance by CITY.
4. This bond is conditioned upon and guarantees due compliance with all applicable law
including, without limitation, the El Segundo Municipal Code ( "ESMC ").
5. SURETY, for value received, agrees that no changes, extensions of time, alteration
or modification of SPECIFICATIONS NO. PW.05 -05 or of the obligation to be performed will in any
way affect its obligation on this bond, and it waives notice of any such change, extension of time,
alteration or modification of the contract documents or of the obligation to be performed.
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6. This bond consists of this instrument; the plans and specifications identified above;
and the following two (2) attached exhibits all of which are incorporated herein by reference:
A. A certified copy of the appointment, power of attorney, bylaws or
other instrument entitling or authorizing the persons executing this
bond to do so;
B. A certificate issued by the county clerk for the county in which
SURETY's representative is located conforming with California Code
of Civil Procedure § 995.640 and stating that SURETY's certificate of
authority has not been surrendered, revoked, cancelled, annulled, or
suspended, or in the event that it has, that renewed authority has
been granted; and
7. Should PRINCIPAL perform its obligations within the time allowed, PRINCIPAL's
obligation will be void upon the acceptance of the performance by CITY; otherwise this obligation will
remain in full force and effect.
SIGNED ND SEALED this 13th day of May , 2005
Best fing & Wate
DBP, s Contrac ces Internati Fide Insurance
PRINCIPAL's PR T SURE 's
Mojitaba Tabaz deh eside t Mark E. Shrec ngast, Attorney -in -Fact
PRINCIPAL's SECRETARY
PRINCIPAL's MAILING ADDRESS:
Best Roofing & Waterproofing Inc
DBA Best Contractinp- Services Inc
19027 S. Hamilton Avenue
Gardena, CA 90248
SURETY's SECRETARY
SURETY's MAILING ADDRESS:
International Fidelity Insurance Ccnl3any
1575 Treat Boulevard, Suite 208
Walnut Creek, CA 94596
NOTE: (1) ALL signatures must be acknowledged by a notary public.
Return two (2) originals to City Clerk's Office.
(2) Bond shall be effective for one (1) year after acceptance of the job.
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3468 . . I
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California
County of Los Angeles
On May 13, 2005 before me, Laura L. Hanna, Notary Public, personally appeared Mark E. Shreckengast
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
LAURA L. HANNA person, or the entity upon behalf of which the person acted, executed the
`COMM. # 1452703 instrument.
NOTARY PUBLIC, CALIFORNIA ;
LAS ANGELES COUNTY
My Comm. EXPUee Nov. 23, 2007 WITNESS my hand and official seal.
Place Notary Seal Above
Optional
ignature 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
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:
_Individual
_Corporate Officer - Title(s):
—Partner--Limited—General
X Attorney -in -Fact
_Trustee
_Guardian
Other:
Signer is Representing:
Number of Pages
_.........rte AA-V AWti IgnrRAF- T
CALIFOIF�Ir1l�► ALL' fvnrtir.i� -,-- --
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State of California
ss.
County of Los Angeles
®� 3 0 Monica Handsome, Notary Public
On f O , before me, Name and Title of Officer (e.g., Jane Doe, Notary Public")
Date
Moli Tabazadeh
personally appeared Name(s) of Signer(s)
MANILA HP.NDSoME
Commission # 1470203
Notary Public - California v
Los Angeles County
My Comm. Expires Mar 11, 2008
Place Notary Seal Above
I$ personally known to me
Ll proved to me on the basis of satisfactory
evidence
to be the personal whose namefft is /!e
subscribed to the within instrument and
acknowledged to me that he /art executed
the same in his/h&ffiWw& authorized
capacity(0), and that by his /htvWiwic
signature(Ij on the instrument the person($, or
the entity upon behalf of which the person(d)
acted, executed the instrument.
WITNESS my hand an official eal.
�,,�WnatAeublic
OPTIONAL
Though the and could prevent nt fraudulent removal and reattachment of this form to another document.
document
document
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above: _
Capacity(lies) Claimed by Signer
Signer's Name: •
❑ Individual Top of thumb here
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
o...., ni., som Reorder: Call Toll-Free 1.800.876.6827
O 1999 National Notary Association • 9350 be solo Ave.. P.O. Box 2402 • Chatsworth, GA VI JIJ -1— - •••,.
3468 - . . i.
Executed in Two Counterparts
LABOR AND MATERIALS BOND
Bond No. 0400687
Bond Fee: Premium included on
Performance Bond
Best Roofing & Waterproofing Inc
DBA Best Contracting Services Inc as principal ( "PRINCIPAL ") and
*SeeBelowQkW, xJMxEtxxSWW1M, a corporation incorporated under the laws of the State of
* *See Belowti and licensed by the State of California to execute bonds and undertakings as sole
surety, as surety ( "SURETY "), are held and firmly bound unto the CITY OF EL SEGUNDO ( "CITY ")
in the sum of ` ** *See Below ( $16,921.00 ) dollars, which is a minimum
one hundred percent (100 %) of the contract, lawful money of the United States, which may be
increased or decreased by a rider hereto executed in the same manner as this bond, for the
payment of which sum PRINCIPAL and SURETY bind themselves, their successors, and assigns,
jointly and severally, by this instrument, ** *Sixteen Thousand Nine
*International Fidelity Insurance Company * *New Jersey Hundred Twenty One and No /100
This bond is conditioned upon and guarantees payment by PRINCIPAL to contractors, Dollars
subcontractors, and persons renting equipment; payment by PRINCIPAL and all PRINCIPAL'S
subcontractors for all materials, provisions, provender, or other supplies, and equipment used in,
upon, for or about the performance of the work contemplated in THE SCOPE OF WORK, Pa 05-05
("Public Project"), the public works contract executed for such Public Project, and for all work or
labor of any kind performed for the Public Project. In the case of any default in the performance of
the conditions and stipulations of this undertaking, it is agreed that PRINCIPAL or SURETY will
apply the bond or any portion thereof, to the satisfaction of any damages,. reclamation_,
assessments, penalties, or deficiencies arising by reason of such default.
BOND CONDITIONS
PW 05 -05
1. PRINCIPAL will repair the public improvements identified, in THE SCOPE OF WORK.
Such performance will be in accordance with applicable plumbing, electrical and mechanical codes
which are made. a part of this bond when said Scope of Work is approved by the City Council.
2. PRINCIPAL will pay all contractors, subcontractors, and persons renting equipment.
3. PRINCIPAL will pay for all materials and other supplies, for equipment used in, on,
for or about the performance of the Public Project, and will pay for all work and labor thereon.
4. This bond is conditioned upon and guarantees due compliance with all applicable law
including, without limitation, the El Segundo Municipal Code ( "ESMC ").
5. SURETY, for value received, agrees that no changes, extensions of time, alteration
g
or modification of SPECIFICATIONS NO. NA o l he obligation to be performed will in anyway
affect its obligation on this bond, and it waives notice of any such change, extension of time,
alteration or modification of the contract documents or of the obligation to be performed.
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6. This bond consists of this instrument; the plans and specifications identified above;
and the following TWO (2) attached exhibits all of which are incorporated herein by reference:
A. A certified copy of the appointment, power of attorney, bylaws or other instrument
entitling or authorizing the persons executing this bond to do so; and
B. A certificate issued by the county clerk for the county in which SURETY's
representative is located conforming with California Code of Civil Procedure §
995.640 and stating that SURETY'S certificate of authority has not been
surrendered, revoked, cancelled, annulled, or suspended, or in the event that it
has, that renewed authority has been granted.
7. Should PRINCIPAL perform its obligations within the time allowed, PRINCIPAL's
obligation will be void upon the acceptance of the performance by CITY; otherwise this obligation will
remain in full force and effect.
SIGNED 6ND SEALED this 13th day of
Best ing & Watel c
DBA B46st Contract' seryjces c A
PRINCIPAL's PREINT
Mojitaba Tabazade P sident
PRINCIPAL's SECRETARY
PRINCIPAL's MAILING ADDRESS:
Best Roofing & Waterproofing Inc
DBA Best Contractini Services "Tnc
19027 S. Hamilton Avenue
Gardena, CA 90248
May , 2005
SURETY'$ M
Mark E- ...Shre
SURETY's SECRE
. ..
t,.Attorney -in -Fact
SURETY'S MAILING ADDRESS:
International Fidelity Insurance Company
1575 Treat Boulevard, Suite 208
Walnut.Creek, CA 94596
NOTE: (1) ALL signatures must be acknowledged by a notary public.
Return two (2) originals to City Clerk's Office.
(2) Bond shall be effective for one (1) year after acceptance of the job.
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PfJWER OF ATTORNEY 3
"ERNATIONAL. FIDELITY INSURANCE COMPANY
HOME OFFICE: ONE NEWARK CENTER, 20TH FLOOR
NEWARK, NEW JERSEY 07102 -5207
FOR BID BOND /RIDER /CONSENTS /AFMAVITS
KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing
laws of the State of New Jersey, and having its principal office in the City of Newark, New Jersey, does hereby constitute and appoint
MARK E. SHRECKENGAST, JULIE M ORMONDROYD
Los Angeles, CA.
_ .......... ........ ... ..... _ ..
its true and lawful attorneys) -in -fact to execute seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and
other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, stature, rule, regulation, contract or otherwise, and
the execution of such instrument(s) in 'pursuance of these presents, shall be as binding upon the said INTERNATIONAL FIDELITY INSURANCE
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 revoked, pursuant to and by authority of Article 3- Section 3, of the By -Laws adopted by the Board of
Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting called and held on the 7th day of February, 1974.
The President or any Vice President, Executive Vice; President, Secretary or Assistant Secretary, shall have power and authority
(1) To appoint Attorneys -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 obligatory in the nature thereof and,
(2) To remove, at any - ;time, any such attorney -in -fact and revoke the authority given.
Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of said Company adopted at a meeting
duly called and held on the 29th day of April, _1982;of which the following is a true excerpt:
Now therefore the signatures of such officers and the seal of the Company may be affixed 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 bmdmg 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.
TY /H�. IN TESTIMONY WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY has caused this instrument to be
PO signed and its corporate seal to be affixed by its authorized officer, this 29th day of August, A.D. 2003.
SEAL �``�C11 INTERNATIONAL FIDELITY INSURANCE CO NY
STATE OF NEW JERSEY
6 Z
1904 p County of Essex
Secreta
On this 29th day of August 2003, before me came the individual who executed the preceding instrument, to me personally known, and, being by me duly
sworn, said the he is the therein described and authorized officer of the INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seal affixed to
said instrument is the Corporate Seal of said Company; that the said Corporate Seal and his signature were duly affixed by order of the Board of Directors of
said Company.
IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal,
at the City of Newark, New Jersey the day and year first above written.
NOTARY
O PUBLIC _
yir Ar
A NOTARY PUBLIC OF NEW JERSEY
CERTIFICATION My Commission Expires Nov. 21, 2005
I, the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the
Power of Attorney and affidavit,! and the copy of the Section of the By -Laws of said Company as set forth in said Power of Attorney, with the ORIGINALS ON
IN THE HOME OFFICE OF SAID COMPANY, and4hat the 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
3468
.�ORDIIy,O`�
COUNTY OF LOS ANGELES
' REGISTRAR- RECORDER/COUNTY CLERK
e
12400 IMPERIAL HWY. — P.O. BOX 53592, NORWALK, CALIFORNIA 90650- 562 - 462 -2177
CONNY B. WCORMACK
Registrar- Recorder /County Clerk
Certificate of the Clerk in Re Surety
(1057A C.C.P.)
STATE OF CALIFORNIA,
COUNTY OF LOS ANGELES
I, Conny B. McCormack, Registrar - Recorder /County Clerk for the County of Los Angeles of the
State of California, do hereby certify:
That International Fidelity Insurance Company
has been certified by the insurance commissioner of the State of California as an insurer admitted
to transact Surety insurance in this State, as required by Sections 12070 to 12072 of the insurance
code.
I further certify that according to the records in this office, said authority has not been surrendered,
revoked, cancelled, annulled or suspended.
IN WITNESS WHEREOF, I have
for the County of Los Angeles thif
rtn.to_set_my hand and affixed the seal of the State of California,
day of August 05._
CONNY B. McCO ACK
Registrar Recorder / unty Clerk
eputy
S.BARRETT
34 68
PROPOSAL
COPY
FOR THE
CLUBHOUSE ROOF REPAIRS
WITH ANNUAL MAINTENANCE AGREEMENT
IN THE CITY OF EL SEGUNDO
SPECIFICATIONS NO.: PW 05-05
TO THE CITY OF EL SEGUNDO:
In accordance with the City of El Segundo's Notice Inviting Sealed Bids, the undersigned BIDDER
hereby proposes to furnish all materials, equipment, tools, labor, and incidentals required for the
above stated project as set forth in the Plans, Specifications, and contract documents therefor, and
to perform all work in the manner and time prescribed therein.
BIDDER declares that this proposal is based upon careful examination of the work site, Plans,
Specifications, Instructions to Bidders, and all other contract documents. Submittal of this bid shall
be considered evidence that the BIDDER has satisfied himself regarding the contract documents,
access and any other field conditions which may effect bid prices. If this proposal is accepted for
award, BIDDER agrees to enter into a contract with the City of El Segundo at the unit and /or lump
sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a
contract in the manner and time prescribed will result in forfeiture to the City of El Segundo of the
proposal guarantee accompanying this proposal.
BIDDER understands that a bid is required for the entire work, that the estimated quantities setforth
in the Bid Schedule are solely for the purpose of comparing bids, and that final compensation under
the contract will be based upon the actual quantities of work satisfactorily completed. THE CITY OF
EL SEGUNDO RESERVES THE RIGHT TO INCREASE OR DECREASE THE AMOUNT OF ANY
QUANTITY SHOWN AND TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the
unit and /or lump sum prices bid include all apparent expenses, taxes, royalties, and fees. In the
case of discrepancies in the amounts bid, unit prices shall govem over extended amounts, and
words shall govern over figures.
If awarded the Contract, the undersigned further agrees that in the event of the BIDDER'S default in
executing the required contract and filing the necessary bonds and insurance certificates within ten
working days after the date of the City of El Segundo's notice of award of contract to the BIDDER,
including sending by U.S. Mail a Public Works Contract for signature by the Awardee, the proceeds
of the security accompanying this bid shall become the property of the City of El Segundo and this
bid and the acceptance hereof may, at the City of El Segundo's option, be considered null and void.
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EQUA&I'Vib ZIPORTUNITY COMPLIANCE
BIDDER certifies that in all previous contracts or subcontracts, all reports which may have been
due under the requirements of any agency, State, or Federal equal employment opportunity
orders have been satisfactorily filed, and that no such reports are currently outstanding. .
AFFIRMATIVE ACTION CERTIFICATION
BIDDER certifies that affirmative action has been taken to seek out and consider minority
business enterprises for those portions of the work to be subcontracted, and that such affirmative
actions have been fully documented, that said documentation is open to inspection, and that said
affirmative action will remain in effect for the life of any contract awarded hereunder. Furthermore,
BIDDER certifies that affirmative action will be taken to meet all equal employment opportunity
requirements of the contract documents.
NONCOLLUSION AFFIDAVIT
BIDDER declares that the only persons or parties interested in this proposal as principals are
those named herein; that no officer, agent, or-employee of the City of El Segundo is personally
interested, directly or indirectly, in this proposal; that this proposal is made without connection to
any other individual, firm, or corporation making a bid for the same -work --and that this proposal is
in all respects fair and without collusion or fraud.
I -C -2
3468
CITY OF EL SEGUNDO — BID SHEET
CLUBHOUSE ROOF REPAIRS
WITH ANNUAL MAINTENANCE AGREEMENT
Project No.: PW 05-05
ITEM
NO.
ESTIMATED I
QUANTITIES
DESCRIPTION. I
(UNIT PRICE WRITTEN IN WORDS)
AMOUNT
1
JOB
Clubhouse Roof Repairs
Fourteen Thousand One Hundred Twenty One
14,121.00
Dollars
2
JOB
Annual Maintenance Agreement First Year (April 30,
2005 — September 30, 2005)
Two Thousand Eight Hundred Dollars
2,800.00
3
JOB
Annual Maintenance Agreement Second-Year
(October 1, 2005 — September 30, 2006)
Thousand Eight Hundred Dollars
$ 2,800.00
.Two
4
JOB
Annual Maintenance Agreement Second Year
(October 1, 2006 — September 30, 2007)
Two Thousand Eight Hundred Dollars
$ 2,00.00
TOTAL BID ITEMS 1 THRU 4 $ 22,521.00
TOTAL BID WRITTEN IN WORDS
Twenty 11wo Thousand Five Hundred Twenty One Dollars
I -C -3
3468 .
BIDDER'S INFORMATION
R ♦ j
BIDDER certifies that the following information is true and correct:
Bidder's Name Best Roofing & Waterproofing Inc dba BEST Contracting Services Inc
Form of Legal Entity (i.e., individual, partnership, corporation, etc.)
Corporation
If corporation, State of Incorporation (i.e., California) Californta
Business Address
Address
19027 S. Hamilton Avenue
Gardena, CA 90248
Telephone No. (310) 328 -6969
FAX No. ( 310) 328 -9176
State Contractor's License No. and Class 456263 A, B, C17, C201 C39, C43
Original Date Issued September 17, 1982 Expiration Date May 31, 2006
The following are the names, titles, addresses, and phone numbers of all individuals, firm
members, partners, joint venturers, and /or corporate officers having principal interest in this
proposal:
Nbdji Tabs - President, 19027 S. H3td1ton Ave, Gn-&m, CA 9D248 -(310) -V8-%%
Seal Dbazadeh - CEa/Se=tary, 19027 S. Hamilton fie., Ga ia, CA 90248 (310) 328 -6969
Fatwgh 7&azaddi - TvestTMer, 19027 S. ar d.l.ton Ae, Gardera, CA 90248 (310) 382 - 69619
The date of any voluntary or involuntary bankruptcy judgements against any principal having an
interest in this proposal are as follows:
None
All current and prior DBA's, alias, and /or fictitious business names for any principal having an
interest in this proposal are as follows:
BEST Contracting Services Inc
I -C-4
34 6 8 ..
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, titles,
hands, and seals of all aforenamed principals this 14th day of March •20 OS
BIDDER
Best Roofing & Waterproofing Inc dba BEST Contracting Services Inc
19027 S. Hamilton Avenue
Gardena, CA 90248
(310) 328 -6 9
Sean tabazadAi,A`a ecretary -- I `
Subscribed and swom to this 14th day of March —120 OS
NOTARY PUBLIC
MONICA HANDSOME
MONICA HANDSOME
Commission # 1470203 z
Notary Public - California 5_
-�, los Angeles County
My Comm. Expires Mar 11.2008
I -C -5
34 6 8 .
PROPOSAL GUARANTEE
BID BOND
CLUBHOUSE ROOF REPAIRS
WITH ANNUAL MAINTENANCE AGREEMENT
IN THE CITY OF EL SEGUNDO
SPECIFICATIONS NO.: PW 05 -05
Best Roofing & Waterproofing Inc
KNOW ALL MEN BY THESE PRESENTS that DBA Best Contracting Services Inc
as BIDDER, and International Fidelity Insurance Company
as SURETY, are held and firmly bound unto the City of El Segundo, in the penal sum of
Ten Percent of the Amomt of the Bid DOLLARS (S 10% ), which is ten (10 %)
percent of the total amount bid by BIDDER to the City of El Segundo for the above stated
project, for the payment of which sum, BIDDER and SURETY agree to be bound, jointly and
severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to
submit a bid to the City of El Segundc for the above stated project, 9 said bid is rejected, or If
said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and
time specified, then this obligation shall be null and void, otherwise 'it shall remain in full force
and effect in favor of the City of El Segundo.
IN WITNESS WHEREOF the parties •hereto have set their names, titles, hands, and seals this
15 th day of March 2005 .
Best Roofing & Waterproof' g In DBA Best Contracting Services Inc
BIDDER' 19027 S./'Eianrilton Avenu Gard a, CA 90248 (310) 328 -6969
By: i Sean T zadeh, CID /Secretary
Kevin Chambers
In rn o 1 elity Insu ance Company Bond Manager
SURETY` { Bo yard, ^Suite nut Creek, CA 94596; (925) 256 -8760
By: 44 / V
Mar rec ng st, Attorney-in-Fact
** See Attached - Surety A -Purpose Notary Acknowledgment Form
Subscribed and sworn to this V day-of , 20_,
NOTARY PUBLIC
• Provide BIDDERISURETY name, address and telephone number and the name,
title, address and telephone number for authorized representative.
I-C-6
CONTRACTOR'S LICENSE DECLARATION
(Business and Professions Code Section 7028.15)
1. BIDDER'S Contractor's License Number is:
456263
34 68 .
Class No.: A, B, C17, C20, C39, C43
2. The expiration date of BIDDER'S Contractor License is:
May 31 , 20 06
3. BIDDER ACKNOWLEDGES THAT section 7028.15(e) of the Business and Professions
Code provides as follows:
"A licensed contractor shall not submit a bid to a public agency unless his or her
contractor's license number appears clearly on the bid, the license expiration date is
stated, and the bid contains a statement that representations herein are made under
penalty of perjury. Any bid not containing this information, or a bid containing information
which is subsequently proven false, shall be considered non - responsive and shall be
rejected by the public agency." -
The undersigned declares, under penalty of perjury, that the representations made by the
undersigned in this bid proposal are.true and correct.
Executed on March 14. , 20 05, at Gardena,'. California
(insert City and State where Declaration is signed).
S
Sean Tabazadeh
Typed Name
CEO /Secretary
Title
Best Roofing & Waterproofing Inc dba
BEST Contracting.Services Inc
Name of Bidder
I -C -7
NON - COLLUSION AFFIDAVIT TO BE EXECUTED
BY BIDDER AND SUBMITTED WITH BID
State of California }
ss.
County of Los Angeles
Sean Tabazadeh being fBrEices-%, sworn , deposes and say that he or she is
CFA /Secretary of EE Best �51iFj r Cantractim 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 a6y manner, directly or indirectly, sought by agreement,
communication, or conference with anyone to fix the bid price - of the BIDDER, or 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.
Best Roofing & Waterproofing Inc dta
zad ,CEO /Secretary BEST Contracting Services Inc
Sig ture Name of Bidder
Sean Tabazadeh.
Typed Name
CEO /Secretary
Title
I -C -8
March 14, 2005
Date
3468 .
R R �
CERTIFICATION
Section 1861 OF THE LABOR CODE
(Workers' Compensation)
Pursuant to Section 1861 of the Labor Code, the BIDDER, in submitting his.
PROPOSAL, shall sign the following certification:
"I am aware of the - provisions of Section 3700 of the Labor Code which require every
employer to be insured against liability for workers' compensation ndertake self- insurance
in accordance with the provisions of that code, and I will coMORY 7such provisions before
commencing the performance of the work of this contras /
Signature of Bidder
Title:
Business Name:
Business Address:
k
zadeh
Best ' Roofing ,& Waterproofing Inc dba BEST Contracting Services In
19027 S. Hamilton Avenue
Gardena, CA 90248
Telephone Number. (310) 328 -6969
Dated this 14th day of March , 20 05
I -C -9
3468,
DESIGNATION OF SUBCONTRACTORS
BIDDER proposes to subcontract certain portions of the work which are in excess of one -half of
one percent of the bid and to procure materials and equipment from suppliers and vendors as
follows:
NAME, ADDRESS AND PHONE
NUMBER OF SUBCONTRACTORS,
SUPPLIERS, AND VENDORS
None
memo]
PORTION OF WORK, MATERIALS,
OR EQUIPMENT
3468 ,
REFERENCES
The following are the names, addresses, and telephone numbers for three (3) public agencies
for which BIDDER has performed similar work as the prime contractor or major subcontractor
within the past two (2) years:
Project Title:
Blanket Maintenance Contract
Location: City of Los Angeles, 3900 Chevy Chase, Los Angeles, CA 90011
City of Los Angeles (seen above)
Name and address of owner
Ken Reeser Sr. (213) 473 -3517
Name and telephone number of person familiar with project
Type of Work:
Roofing / Waterproofing
Contract amount: $ 3 million + Date completed: Ongoing
Amount of work done by my /our firm under contract $ Ongoing
Did your firm have any financial interest in Project?
2. Project Title:
Blanket Maintenance Contract
No
Location: Dept. of Airports, Los Angeles, Ontario, Van Nuys, Palmdale
Dept. of Airports, 7411'World Way West., Los Angeles, CA 90045
Name and address of owner
India Griffen (310) 646 -3263
Name and telephone number of person familiar with project
Type of Work: Roofing / Waterproofing
Contract amount: $ 1.2 million . ' Date completed: , Ongoing
Amount of work done by my /our firm under contract $ Ongoing
Did your firm have any financial interest in Project? No
3. Project Title: Roofing Replacement District Wide Unit Price Contract
Location: Santa Ana, CA
Santa Ana USD., 1601 E. Chestnut Ave., Santa Ana, CA 92701 -6322
Name and address of owner
Fred Escalera (714) 556 -5501
Name and telephone number of person familiar with project
Type of Work: Reroofing
Contract amount: S 500,000.00 Date completed: Ongoing
Amount of work done by my /our firm under contract $ Ongoing
Did your firm have any financial interest in Project? No
*; Also see attached reference list Maintenance Agreements
I -C -11 (Page 1 of 2)
3468 .
4. Project Title:
Location:
Name and address of owner
Name and telephone number of person familiar with project
Type of Work:
Contract amount: $
Date completed:
Amount of work done by my /our firm under contract $
Did your firm have any financial interest in Project?
5. Project Title:
Location:
Name and address of owner`
Name and telephone number of person familiar with project
Type of Work:
Contract amount: $ Date completed:
Amount of work done by my /our firm under contract $,
Did your firm have any financial interest in Project?
The following are the names, addresses, and telephone numbers for all brokers and sureties
from whom BIDDER intends to procure insurance bonds:
International Fidelity Agent: Summit Surety Insurance Services
1575 Treat Blvd, #208 1490 Colorado Blvd
Walnut Creek, CA 94596 Los Angeles, CA 90041
(925) 256 -8760
(323) 256 -0126
I -C -11 (Page 2 of 2)
Best Roofing & Waterproofing, Inc
A Partial List of Our Corporate Maintenance Agreements
Owner /General Contractor: Project.
City of Los Angeles
3900 Chevy Chase
Los Angeles, CA 90011
Ken Reeser Sr
(213) 473 -3517
Department of Airports
7411 World Way West
Los Angeles, CA 90045
India Griffen
(310) 646 -3263
Alan Steven Associates
c/o CB Richard Ellis /Jones Lang Lasalle
4090 21 st Avenue SW
Cedar Rapids, IA 52404 -6308
Kent' Minor
319 - 390 -0419
Honeywell Systems and Engines
2525 W 190th Street M -S 23 -1 -80
Torrance, CA 90504
Ihsan Faraj
(310) 512 -2824
Toyota Motor Sales USA, Inc.
19001 South Western Avenue
Torrance, CA 90505
Mr. Larry Carda
310 -468 -5413
3468.,,
Blanket Maintenance Contract
40+ departments
(IDQ)
Blanket Maintenance Contract
LAX, Ontario, Van Nuys and Palmdale
Airports
(IDQ)
Maintenance Agreement for
Bank of America, Washington Mutual,
Best Buy Electronics, etc, etc.
Maintenance Agreement for
various division which takes up a couple of
city blocks
Maintenance Agreement for
various facilities covering 3.5 city blocks
Notes: We have just been awarded a 3 -year term contract for Sony Pictures and Television and
and 2 -year term contract for British Petroleum Refinery. We also have agreements
with ITT Cannon, Alpha Therapeutics, City of Torrance, and Cal Air
3468•..IJj
State -f Califcrnla
CONTRACTORS STATE LICENSE BOARD
"" ACTIVE LICENSE
c,mwsKr
AffAn
456263 �.. CORP
BEST ROOFING & WATERPROOFING
INC DBA BEST CONTRACTING
SERVICES INC
�-•-tb C39 B A C43 C20
�•�•• -a• 05/3112006
Any utat+9a of byalnNl addresslnWW must be reWled NOM Rgsrts wiewt 90 dare•
Ths %j wee is not trenslarrable. and shall be returnd to ON Registrar
upon damwd when suspwtded. revoked, of expiration an data edyItts" .
Ths Packet card is valid IMouph
It Ntr+d. drop in any maiNmc.
Postage Woranted by:
Conracmrs State License Baard,
P.O. Box 29000
S/adamanto. CA 9592
Licons" Signsure
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Best Roofing Waterproofing, Inc.
Trade References
Bank: Cal Fed Bank Contact: Arthur Zavala
2377 Crenshaw Blvd• Torrance, CA 90501 Phone: (310) 781.6582
Address: Torrance, CA 90501
Contact: Arthur Zavala - Branch Mr
BONDING
Bond company: Intema5onal Fide Insurance _Contact:
Mark Shreckengast
1575 Trot Blvd, Suite 208 Phone: (925) 2564780
Walnut Creek. Ca 94596
Bonding Agent: Contact: Mark Shrecken ast
7447 North —F uOr �1 Suite 208 Phone• (323) 258-0126
Los Ojos Cs
INSURANCE
may, A W ,O.Wo"es ComPenae600
Company: I,ockton Insurance Brokers, Ina. contact: Amber Magruder
725 S Fi St, 3Stb Fl phone: (213)1559-0U5* —
Los An ejos, Ca 90017
SUPPLIERS
Company Name:
Company Name:
ABC Su Com Contact:
19105 S F ueroa Phone:
Gardena Ca 90248
Scott
(310) 323.8881 —
Chris McCsr'dl
(3101217 -9152
Company Name: South Coast Shin jo Contact: Ross Riddle
2220 E South Street Phone: 1562) 634-7100
Long Beach, Ca 80805
Company Name: Roofers Mart Contact: Dave Dennise
PO Box 428 Phone: (909) 598 -8408
Walnut, Ca
Summit Surety Insurance Services
1490 COLORADO BOULEVARD
LOS ANGELES, CALIFORNIA 90041
(323) 256 -0126 Fax (323) 256 -7485
CALIFORNIA LICENSE 4OB99789
February 9, 2005
Mr. Sean Tabazadeh
Best Roofing & Waterproofing Inc
DBA Best Contracting Services Inc
19027 S. Hamilton Avenue
Gardena, CA 90248
Re: Letter of Bondability
Dear Sean:
Thank you for the recent financial update which you shared with us and congratulations on another
profitable year! In consideration of helping Best Roofing & Waterproofing Inc DBA Best Contracting
Services Inc prequalify for future projects, I will take this opportunity to summarize your current
relationship with Summit Surety Insurance Services and International Fidelity Insurance Company.
International Fidelity Insurance Company has agreed to evaluate Surety parameters in excess of the
following levels within the past year: $7,500,000 single job /$30,000,000 aggregate backlog. These are
not limitations of current support levels, but rather guidelines which the Surety has set forth.
International Fidelity Insurance Company is a California Admitted Surety Insurer, maintains an AM
Best Rating of A -VI and is listed on the Federal Register Circular 570.
It is our intent to execute performance and payment bonds for projects within these parameters at the
time of award subject to our normal underwriting criteria. You understand, of course, that any
arrangement for the final bond or bonds is a matter between Best Roofing & Waterproofing Inc DBA
Best Contracting Services Inc and the Surety. We assume no liability to third parties if for any reason
we do not execute these bonds.
I would encourage you to have interested parties contact me directly at (323) 256 -0126 ext. I I if they
would like to discuss specifics regarding Best Roofing's ability to bond future work or our excellent
relationship with your organization.
Summit Surety Insurance Services, as Agent for
INTERN TIONAL FIDELITY 91SURANCE COMPANY
Mark E. Shrecked kst
Attorney
Mailing Address: P.O. Box 41999, Los Angeles. California 90041
3468 ,,r
CALIFORNIA Al- L- PURPOSE ACKNOWLEDGMENT
State of Califomia
County of Los Angeles
On February 09, 2005 before me. Julie M. Ormondroyd . Notary Public, personally appeared Mark E. Shreckengast
Place Notary Seal Above
Optional
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, executed the
instrument.
WITNESS my hand and official seal.
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
Signer's Name:
_Individual
_Corporate Officer - Title(s):
Partner - -Limited General
X Attorney -in -Fact T
_Trustee
_Guardian
Other:
Signer is Representing:
. 1 f•
DATE (MMIDD/YY)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12/01/2005 04/11/2005
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRn Insurance Brokers, Inc. i ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Figueroa Street, 35th R. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ense #0714705
geles CA 90017 INSURERS AFFORD ING COVERAGE
(213) 689 -0065
INSURED Best Roofing and Waterproofing, Inc.
1026961 DBA Best Contracting Services, Inc.
19027 S. Hamilton Ave
Gardena CA 90248
1
.OVERAGES BESR001 N3
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
MAY PERTAINMEN I TERM RCAO FORDED MANY POLICIES DESCRIBED HEREIN MS SUBJECTRTO ALL THE TERMS. EXCLUSIONS CERTIFICATE
AND CONDITIONS OF SUCH
wnr_ocf eTr I IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ^ - "^^` c en icv FYOIRATIONI .�
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY , GL274965618
CLAIMS MADE Y, , OCCUR
X ProDertY Damage
X Contractual Liab.
GEN'L AGGREGATE LIMIT APPLIES PER'.
v1 ?Bp; �R
AUTOMOBILE LIABILITY
A X j ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIREDAUTOS
I X NON -OWNED AUTOS
GARAGE LIABILITY
7 ANY AUTO
I BUA2074965604
NOT APPLICABLE
EXCESS LIABILITY
OCCUR E CLAIMS MADE NOT APPLICABLE
❑ UMBRELLA
DEDUCTIBLE FORM
RETENTION 5
B IWORKERS COMPENSATION AND WC274965585/99
EMPLOYERS' LIABILITY
I
t
1OTHER
12/01/2004
12/01/2004
12/01/2005
12/01 /2005
COMBINED SINGLE LIMIT
$ 1,000,000
(Ea accident)
BODILY INJURY
I s XXXXXXX
(Per person)
BODILY INJURY
g XXXXXXX
(Per accident)
PROPERTY DAMAGE
$ XXXXXXX
(Per accident)
OTHER THAN
AUTO ONLY: AGG
EACH OCCURRENCE
AGGREGATE
i
YuC STATU- OTH•I
12/01/2004 12/01/2005 HX TORY LIMITS ER .
I E.L. EACH ACCIDENT
E L. DISEASE - EA EMPLOYEE!
E L. DISEASE - POLICY LIMIT '
I
DESCRIPTION OF OPERATIONSILOCATIONSN I HICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: PW OS -OS Clubhouse Roof Repairs with Annual Maintenance Agreement. Where required by and only to the extent of the written contract, the City of
El Segundo, its officers, officials, employees, agents and volunteers are Additional Insureds under the Auto &General Liability policies per attached endorsements,
but solely as respects liability arising out of Named Insured's work for the Additional Insured(s) in connection to above captioned project.
;ERTIFICATE HOLDER I x I ADDITIONAL INSUNtaU' Inauncra cc 7DATE 227�602 OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOORE THE EXPIRATION WRITTEN
City of EI Segundo THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Attn: City Clerk TICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
350 Main Street POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
EI Segundo CA 90245 EPRESENTATIVES. THORIZED REPRESENTATIVE
ACORD 25 -S (7197) For questions regarding this certificate, contact the number listed in the'Producer section above and specify the client code 'aESR 01'.
® AfORD CORPORATION 1988
Fax Server 7/25/2005 2:36 PM PAGE
.. u„ ..� ww +.�••�� i in a, v, u irm rL.. ,'nw L- 41 1 dAw "I" WVLI t-. rl.7
GENERAL LIABILITY
ADDITIONAL INSURED ENDORSEMENT
CiTY OF EL SEGUNDO
In consideration of the premium charged and notwithstanding any inconsistent statement in the policy to which this
endorsement Is attached or any endorsement now or hereafter attached thereto, it is agreed as follows:
1. ADDITIONAL INSURED. The City of El Segundo, its officers, agents and employees are Included as additional
insured with named Insuredgregardlesstoiwhether liability is suits attributable b e named insured ore combination ofthe named
and the additional insured.
2. CONTRIBUTION NOT REQUIRED. Any other insurance maintained by the City of El Segundo is excess of this
insurance and will not contribute with it.
3. SEVERABIUTY OF INTEREST. This Insurance applies separately to each Insured against whom claim is
made or organization as brought (Iured do t not affect the
rightpwhich such liability. The Inclusion of any person or organization would have as a
cleunant if not so inducted.
4. CANCELLATION NOTICE. With respect to the Interests of the City of El Segundo, this Insurance may not be
canceled, reduced in coverage or limits or non - renewed, except after thirty (30) days prior written notice by
�FGISTEREO OR CERTIFIED MAIL has been given to the Public Works Director of El Segundo addressed ae
follows: Public Works Department, El Segundo City Hall, 350 Main Street, El Segundo, CA 90245
5. APPLICABILITY. The insurance pertains to the operations and/or tenancy of the named insured under all
written agreements in force with the City of El Segundo unless checked here ( ) in which case only the
following specific agreements with the City of El Segundo are covered:
6, MAILING ADDRESS: Completed endorsements shall be issued to the City-of El Segundo as follows:
PUSUC WORKS DEPARTMENT
El Segundo City Hall
350 Main Street
El Segundo, CA 90245
7. CLAIMS: Underwriter's representative for claims pursuant to this insurance:
Except as stated above, nothing herein shall be held to waive, alter or extend any of the limits, conditions, agreements, or
exclusions of the policy to which this endorsement is attached.
i r- &C*JidGL or- UVC:0 L (printltype name), warrant that I have authority to bind the below - listed Insurance
company and by my signature h n do so bind this company to this endorsement
a. Signature:
/wtharized JeOftentative
(original signsture required on copy
rumishod to the City Attorney)
TITLE: A�COJNT AOIC/t 1/�1 tSt RiiRTO Q
9. ORoANIZA nON LOGtCTO t.l l ►.41:. tBiZOtLl: i t► aC
ADDRESS: `7a& `%.
i�OC A"woeLew, G. 40o17
TELEPHONE: a l k 484 • µ%93
(area code) (telephone number)
Page 1 of 2
FOM,% WMO8 P4041012 (10.21471
JUL -25 -2005 14:28 94% P.04
tax Server
/ /G5 /LUUO L:db PM VAUt 5 /UU5
I11'1 YI91u11'll \V` , 1'IVY Va I I
1o. Includes (check as applicable):
44road Form Liability Endorsement
44road Form Property Damage
(0srsenal Injury
Vindspeadent Contractors
j)wrwnlsss and Operations
( Kxploslon Hazard
RcouspawUnderomund Hazard
U4gMductefComp1etad Operations
() Watercraft L101111y
(i 5",e keepsea Leal Uability
() incidental Medical Malpractice
l 1 Conbadual Uebll(ty
(q'()wnod Automobiles �r ,a ���, ^%rO
4waed Automobiles'
(WPin LLepat Liability
(I --
..racy -+ -+ WJ" I .WJ
P'06%W w Ie 0^40749(bs604 cr -,44)
(1
11. Type Coverage: b�� mil" �..1 /►�rdl L.l't`i
12. Limps of Liabgity: '0 ti 000 i O00 / d r cone 000A do►�
13. Policy Perlod: From: (8 ' O 1 - O td' To: 1 1 - O 1 - 6$
14. () Deductible (.Self- Insured Retention (check which) of S 4.61 00
applies to 4' 0•81�'*y coverage. O Psr Clalm w4r0ccurrence
16. Other provisions:
1H. Names Insured and Address: (�E'$1 (SOOiri ~" V►l�'T>C.RQPOtJ(`I �' 1 MG.
C- 140%0-41 VTO
17, insurance Company: Cor.l T t 1J {teJ'TA.L,. C�►CMI►IR. -Ty �t: ^��
1!. Policy Number. a4. ea749 �,56�8
19. Endorsement Number:
20. Effective onto of Endorsement: 01- ':0O4
Page 2of2
TOTAL P.04
JUL -25 -2005 14:28 94% P.05