CONTRACT 4027 CLOSED4027 ..
ORIGINAL
PUBLIC WORKS CONTRACT
BETWEEN
THE CITY OF EL SEGUNDO AND
GENERAL LIGHTING & ELECTRIC, INC.
This CONTRACT is entered into this 7th day of December, 2009, by and
between the CITY OF EL SEGUNDO, a general law city and municipal corporation ( "the
City ") and GENERAL LIGHTING & ELECTRIC, 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
ELEVEN THOUSAND, NINE HUNDRED TEN DOLLARS AND ZERO CENTS
($11,910.00) 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 THIRTY (30) 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
Maryam M. Jonas
Principal Engineer
City of El Segundo
350 Main Street,
El Segundo, CA 90245
(310) 524 -2361
The Contractor
Tharathorn Sunnanon
President
General Lighting & Electric, Inc.
8132 Firestone Blvd. #814
Downey, CA 90241
(562) 634 -8962
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.
CITY OF EL SEGUNDO
ack WaXyt, City ge
ATTEST:
�Y y `�,G� ' --N
Cindy Mo serf,
City Clerk
APPROVED
MARK D. HE
I.�
KaN HlBerger,
Assistant City
GENERAL LIGHTING &
ELECTRIC, INC.
t
Taxpayer ID No.
I -D -5
Business License No.: _A3 *1 0
40 27
FAITHFUL PERFORMANCE BOND
INSTALLATION OF NEW LIGHTING POLES
AND CONDUITS AT JOSLYN CENTER
PROJECT NO. PW 09 -14
Bond No.
Bond Fee:
GENERAL LIGHTING & ELECTRIC INC. ( "PRINCIPAL ")
and , a corporation
incorporated under the laws of the State of 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 ELEVEN THOUSAND, NINE
HUNDRED TEN DOLLARS AND ZERO CENTS ($11.910.00), 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.
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 09 -14, 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. PW 09 -14, 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 ").
Specifications — Projects\PW Faithful Performance Bond (I/03)
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5. SURETY, for value received, agrees that no changes, extensions of time, alteration
or modification of SPECIFICATIONS NO. PW 09 -14 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.
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 AND SEALED this day of
PRINCIPAL's PRESIDENT
PRINCIPAL's SECRETARY
PRINCIPAL's MAILING ADDRESS:
120
SURETY's PRESIDENT
SURETY's SECRETARY
SURETY's MAILING ADDRESS:
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.
Specfficadons — Projects\PW faithful Performance Bond (//03)
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40 27 • ...:
LABOR AND MATERIALS BOND
INSTALLATION OF NEW LIGHTING POLES
AND CONDUITS AT JOSLYN CENTER
PROJECT NO.: PW 09 -14
Bond No.
Bond Fee:
GENERAL LIGHTING & ELECTRIC, INC. , as principal
( "PRINCIPAL ") and , a corporation
incorporated under the laws of the State of 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 ELEVEN THOUSAND NINE
HUNDRED TEN DOLLARS AND ZERO CENTS ($11,910.00), 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.
This bond is conditioned upon and guarantees payment by PRINCIPAL to contractors,
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 INSTALLATION OF NEW
LIGHTING POLES AND CONDUITS AT JOSLYN CENTER, SPECIFICATIONS NO. PW 09 -14
("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
1. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS
NO. PW 09- 14,and the public works contract executed for such Specifications, copies 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 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
or modification of SPECIFICATIONS NO. PW 09 -14, or of the obligation to be performed will in any
Specifications — Projecls\PW Labor Materials Bond ( I 103) I —F -1
4027 . , i,4,
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.
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 AND SEALED this day of
PRINCIPAL's PRESIDENT
PRINCIPAL's SECRETARY
PRINCIPAL's MAILING ADDRESS:
, 20
SURETY's PRESIDENT
SURETY's SECRETARY
SURETY's MAILING ADDRESS:
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.
LABOR AND MATERIALS BOND I -F -2 (0627/02) I _ F -2
CITY OF EL SEGUNDO - BID SHEET 4027 . A
INSTALLATION OF NEW LIGHTING POLES
AND CONDUITS AT JOSLYN CENTER
PROJECT NO. PW 09 -14
ITEM
NO.
ESTIMATED
QUANTITIES
UNIT PRICE
WRITTEN IN WORDS
UNIT PRICE
IN FIGURES
AMOUNT
1
150 LF
Install 3/4" conduits with electrical wire
#10 (18" min. cover for trenches) to
supply power to new poles from electrical
$ P5 Vo
$ �+f h0 .-
pull box for -rNeE.(� T NNsPNEb 9�-VVN
1400 r-0 Fifiiy DoiC0 -s lump sum
2
4 each
Provide electrical pull box for THd.�—
I.lun;ti�2i� llo��t�e� each
$ 300 ��
$ ` ' , 'Dn
Install new poles [pole type: 14 -ft round
tapered pole, 5" on the bottom and 2 -3/8"
on top] with single light fixture [fixture type:
architectural style, heavy -gauge die -cast
aluminum with aluminum coolie hat and
3
3 each
clear prismatic glass (polycarbonate) lens
the size of fixture is 20" high and 22" wide
()u
$ r
$ 6 g� -to
(coolie hat) with gray finish; lamp type:
250 watts metal halide mogul base;
ballast type: 250 wafts metal halide 480
volts] and pole base [base type: round
18" diameter, 4 -ft underground and 1 -ft
aboveground] to match existing poles for
Iwo jU0tAsj wp 'Tgejk Njilyi)tj�h ' each
TOTAL BID = $
TOTAL BID WRITTEN IN WORDS ���� �t�Ot��An�l� �tln�r; 40) I E�'
Q 1. 86
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4027 ..j _4
BIDDER'S INFORMATION
BIDDER certifies that the following information is true and correct:
Bidder's Name L- &14 -MN(;I ANb E LE-C: `k.iC ) JNC .
Form of Legal Entity (i.e., individual, partnership, corporation, etc.)
Ci Olt ec kwq p �)
If corporation, State of Incorporation (i.e., California)
Business 6aouf— itiew N61 leis E,0-ic, (A)�
Address 3�' FI�fJl� tiV rL�
y7 9 OA4
Telephone No. ��' �' , 531 V516
Facsimile No. 634 " 1,6.2-
State Contractor's License No. and Class
Original Date Issued , I�1 Expiration Date
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:
The date of any voluntary or involuntary bankruptcy judgments against any principal having an interest
in this proposal is as follows:
M flNl�-
All current and prior DBA's, aliases, and /or fictitious business names for any principal having an
interest in this proposal are as follows:
5ilZo M O b l -(T M" A yin
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4027.5,-
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, titles,
hands, and seals of all aforenamed principals this day of Ottl P,, r2, 20 &.
BIDDER
Cc7W� LGS ( .S
Subscribed and sworn to this , fz I"\e b"` S
w JVi(AbeAr 9a(4 H ' -Fo vvt Gu ivvkyw Iry v e' d 6, M& o :I "'C U s i s of
e 0c( "l ctl �, U-6 Vile- teCScvi L,-4C Okype ` r- ry ve -
I -C -5
q -�, '0�
150L '5 fkc-� y
RPM TYSON
Commission # 1696216
..,� Notary Pubic - CaNfomla
„ e . Los Angeles County
My Comm. Expires Sep
1.
2
3.
CONTRACTOR'S LICENSE DECLARATION
(Business and Professions Code Section 7028.151
BIDDER'S Contractor's License Number is:
�:tW� Class No
Cl -j 0
4027•, ..
The expiration date of BIDDER'S Contractor License is:
BIDDER'S 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 onVOV9I48eP , 20hC1, at %S A06-CO-5
(insert City and State where Declaration is signed).
�y
6
Signature
Typed Name:
Res
Title:
Name of Bidder:
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NON - COLLUSION AFFIDAVIT TO BE EXECUTED
BY BIDDER AND SUBMITTED WITH BID
State of California
) ss.
County of )
4027
T1111M 09`0 being first duly sworn, deposes and say that he or she is
oU � of r tuj4, Au ?L
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.
Signature
i M"THOPW (SVk0N A)a
Typed Name
'Pas fbVNy�
Title
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��eveqL_ L_�&4-rr" /Juc
Name of Bidder
Date
4027. 6
CERTIFICATION
Section 1861 OF THE LABOR CODE
(Workers' Compensation)
Pursuant to Section 1861 of the Labor Code, the BIDDER, in submitting his /her
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 or to undertake self- insurance in
accordance with the provisions of that code, and I will comply with such provisions before
commencing the performance of the work of this contract."
Signature of Bidder: I
Title: P14--&V�FV J
Business Name: CE >, t kGA V\fcb wNb J4.6y-1g1G, I rN C
Business Address: $� - FIQ.F-S —wtj
Telephone Number: l oSt 1 L�
Dated this t day of A�d'tlt tlll�- , 200q.
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4027
BIDDER'S CERTIFICATION OF SUBCONTRACTORS
As detailed in Section 2 -3.1 (Page II -B -3) of the City Standard Specifications, Bidder certifies
that he has listed below all subcontractors who will perform work in excess of one -half of one
percent (112 %) of the total bid price or certifies that the bidder is fully qualified to perform and
will perform that portion of the worlZ himself.
NAME, ADDRESS AND PHONE
NUMBER OF SUBCONTRACTORS SUBCONTRACTED WORK
(Make copies of this page if additional space is needed)
Signature of Bidder Date
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4027
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:
1. Project Title: No Tl�>' (,�
Location: VAkMeW s
�CrS Q� CI'n��r►1a'� c 9u ��s tcj'- Mx IlTk ne, A*vt :fir Ck
Name and address of owner
ff
Name and telephone number of person familiar with project
Type of Work: Joey* L� 5
Contract amount: $ Date completed:
Amount of work done by my /our firm under contract $
Did your firm have any financial interest in Project?
2. Project Title:
Location: MH
Name and address
r
&-�U '
�
Name and telephor
Type of Work:
- h [so i;o���
F�
owner
- OVY) 7b[ -Alit
number of person familiar with project
CttiG Lam' b-O"-
Contract amount: $ Date completed: S
Amount of work done by my /our firm under contract $
Did your firm have any financial interest in Project?�
3. Project Title:
Location:
IVb' toj �(
N
Name and address of owndr
doW - 018j ITIV)
Name and telephone number of person familiar with project
L,
Type of Work: u
Contract amount: $ Date completed:
Amount of work done by my /our firm under contract $
Did your firm have any financial interest in Project?�
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AS—
40 27 - ....
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:
AAA 601V 6S 6AI7 w4ifs AVE Mop. 44400b CA 1103 (0)'1� 'PA
f
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PROPOSAL GUARANTEE
BID BOND BID BOND# 70827395
INSTALLATION OF NEW LIGHTING POLES AND
CONDUITS AT JOSLYN CENTER
IN THE CITY OF EL SEGUNDO
SPECIFICATIONS NO.: PW 08 -14
KNOW ALL MEN BY THESE PRESENTS that, GENERAL LIGHTING AND ELECTRIC, INC.
,as BIDDER, and WESTERN SURETY COMPANY
, as SURETY, are held and firmly bound unto the City of El Segundo,
in the penal BUM Of TEN PERCENT BID DOLLARS ($ 107. ), 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 Segundo for the above stated project; if 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
day of Nov 20,09 .
BIDDER` GENERAL LIGHTING AND ELECTRIC, INC.
8132 FIRESTONE BLVD.
DO 90241
THARATHORN SUNNANON - PRESIDENT
SURETY` WESTERN SURETY COMPANY
101 S0. PHILLIPS AVENUE
SIOUX FALLS, SO DAKOTA 57
(800) 331;6053_ _ ,, .,�<
-IN -FACT
(866) 531 - -7516
ALLEN & ASSOCIATES INSURANCE
5417 WHITSETT AVE. #102
NORTH HOLLYWOOD, CA. 91607
(818) 769-•6241
Subscribed and swom to this 10 day of NOVENBER 20 09
NOTARY PUBLIC
Provide BIDDERISURETY name, address and telephone number and the name, title,
address and telephone number for authorized representative.
4027.,..:
Western Surety Company
PONVER OF ATTORNEY - CERTIFIED COPY
Bond No. 70627395
Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws
of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company "), does by these presents make,
constitute and appoint. Seipideh Sahar Ghahreman our
its true and lawful attorney(s) -in -fact, Kith full power and authority hereby conferred, to execute, acknowledge and leaver tor aria on ns
behalf as Surety, bonds for:
Principal: Genera_ L_ghting and Electric, Inc.
Obligee: Cit,/ of EL Segundo
Amount,: $500,000.00
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with
the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s) -in -fact
may do within the above stated limitations. Said appointment i made trader and by authority of the following bylaw of Western Surety
Company which remains in full force and effect.
"Section 7. All bonds, policies, undertalings, Powers of Attorney or other obligations of the corporation shall be oxccuted in the
corporate name cf the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other
officars as the Board of Director=_ may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation The. signature ofany snch officer and thr. corporate seal may he. printed by facsimile "
All authority hereby conferred shall expire and terminate, without notice, unless used before midniZht of February 10
2010 , but until such time shall be irrevocable and in full force and effect.
In Witness Whereof, Western Surety Company has caused these presents to be signed by its Senior Vice President, Paul T. Bruflat;
and its corpWi" ®rSBA affixed 1 to be axed this 10th day of Noyembor
W76iPaWT SURE COMPANY
e nior Vice President
ss
.�
On this 10th day of November in the Year 2009 before me, auutarypublic,pafores i app tired
Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of
'WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and deed of said corporation.
ih�Mti�1•titiM� \rM \M�yr4v
D. KRELL f
NOTARY PUBLIC (PS Notary Public - South Dakota
SOUTH DAKOTA f
;�r..►,.rruti�rr..w +tir�rr�ti
My Commission Expires November 30, 2012
I the candor= -igned officer of Western Surety Company, a stock corporation of the State of South Dalcotar, do hereby certify that the
attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as
set: fnrth in the Power of Attorney is now in fni-ce..
In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this
10th day of
Dioventioer 2009
WEST R SURE COMPANY
Paul T. Brufla nior Vice President.
Form F5306- 9.2006
4027.,
❑ Acknowledgment of Principal
❑X Acknowledgment of Surety (Attorney -in -Fact)
STATE OF CALIFORNIA
COUNTY OF Los Angeles ss
On 11/09/09 before me, DIANA GHAHREMANPOUR
date here insert name and title of the officer
personally appeared Sepideh Saha_ Ghahremanpour
mama(=) of cignf-r(,;)
who 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 capacitv(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.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.�Y OIANA,6N UR
COMM ♦ 1824800
WITNESS my hand and official seal. Noll" hblk - CNffon"
Los Argl&* CoMy
Signature (Seal) '0118211.6 't01'
DIANA GHAHRE POUR
(The balance of this page is intentionally left blank.)
Western Surety Company Form 1900.1 -2008
10'd 1L6
9e:00
4 0 2 7 • ., ..�
GENERAL LIGHTING & ELECTRIC, INC.
8132 Firestone Blvd. #814 - Downey, CA 90241 (562) 531.7516 • FAX (562) 634.8962
November 13, 2009
To: Arianne Bola
City of El Segundo
Fax: (310) 640 -0489
From: Tom Sunnanon
Ph: (866) 531.7516
Re: Customers Reference,
Cal State University, DONINGUEZ HILLS
1000 East Victoria Blvd
Carson, CA 90747
Emmit Williams — Director Procurement and Contracts
Phone # (310) 243 -2303 310 - QA'O- !)799
ABC Unified School District
16700 S. Norwalk Blvd,
Cerritos, CA 90703
Joshie Cox — Director of Facilities - Planning
Phone # (562) 926 -5566
US Postal Service
7001 S. Central Ave.
Los Angeles, CA
Jerry
Phone # (323) 7294158
City of El Segundo
Public Work 'Department
1.$0 Illinois St
El Segundo, CA 90245
Martin. Whitehead
(310) 524 -2713
City of 91 Segundo
The Lake at El Segundo
El. Segundo, CA 90245
Scott Morgan
(310) 322 -0202
T/T'd 68b00b90T2T:01 :WO U Tb:60 6002 -ET -(ION
4027...
Western Surety Company
POWER OF ATTORNEY - CERTIFIED COPY
Bond No. 70854183
Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws
of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company "), does by these presents make,
constitute and appoint Se ideh Sahar Ghahreman our
its true and lawful attorney(s) -in -fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its
behalf as Surety, bonds for:
Principal: General Lighting and Electric, Inc.
Obligee: City of E1 Segundo
Amount: $500,000-00
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with
the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s) -in -fact
may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety
Company which remains in full force and effect.
"Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile."
All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of
January 6
2011 , but until such time shall be irrevocable and in full force and effect.
In Witness Whereof, Western Surety Company has caused these presents to be signed by its Senior 2 Oice President, Paul T. Bruflat,
and its corggf„pk�gj?1 affixed to be axed this 6th day of January
a ;- ....... WEST R SURE COMPANY
m Paul T. Bruflat/Senior Vice President
i
�i'A
�a.. : 3* ss
COUNI? AIiA
On this 6th day of January in the year 2010 , before me, a notary public, personally appeared
Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of
WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and deed of said corporation.
{����titiMhMti�titititi•1M��Yh� +
i D. KRELL •
•
NOTARY PUBLIC /�::�\ f Notary Public - South Dakota
SOUTH DAKOTA i
My Commission Expires November 30, 2012
I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the
attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as
set forth in the Power of Attorney is now in force.
In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 6th day of
January 2010
WEST R SURE COMPANY
Paul T. Brufla enior Vice President
Form F6306-9 -2006
4 0 2 7 - ,, ...,
FAITHFUL PERFORMANCE BOND
INSTALLATION OF NEW LIGHTING POLSS
AND CONDUITS AT JOSLYN CENTER
PROJECT NO. PW 09.14
Sond No.
Bond Fee:
GENERAL LIGHTING & ELE-CT11 C INC ( "PRINCIPAL ")
and WES F-go 5uer--rKd C0k?Zf -1q a corporation
incorporated under the laws of the State of Souk 'bA%&,6 '6 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 ELEVEN THOUSAND, -NINE,
HUNDRED TEN DOLLARS AND ZI"RQ CENTS ($11,910-00, 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.
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 09 -14, 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. PW 09.14, 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 $ole 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 ").
1 -E -1
4027 • t.,0.
5. SURETY, for value received, agrees that no changes, extensions of time, alteration
or modification of SPECIFICATIONS NO. PW 09 -14 or of the obligation to be performed will in any
way affect its obligation on this bond, and it waives notioe of any such change, extension of time,
alteration or modification of the contract documents or of the obligation to be performed.
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;
S. 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.
SA�OR�iTE :
SIGNED AND SEALED this 4 day of JA tJ u AP,,J , 20 to
PRiNCIPAL's PRESIDENT SU TY's A
� L
PRI A ECRETARY
PRINCIPAL's MAILING ADDRESS: SURETY's MAILING ADDRESS:
gl3z t1 REd-roNE -6 LVD Io► So. `?N1LL%IFS ,A1,lE
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.
s,wIweWeeh RoNabWW /MN.hI'd.M hu HOW (!A3)
I -E -"Z
c..eR-
CWWICAU pursuant to 995.64o(a) Code of Civil Procedure
1. DEAN C. LOGAN-, County Clerk of the County
of
DO Ac. turn v �, Mate 016 CC-11fornia, in and for said County
HEREBY CERTIFY T
1711_�_Alw
hag 5 OTKY _IqS dn-a-d-m"70!�" ed by I e Califopfiia
to i.Mnsaci s ty ins ranee in
Insurance Commissionerauj)0rizing the w,
the Stator of Gafifom and thi�i based on -u, ILVID in the 06paftrnent of
Insur-aice authority has not li-TO"Id-JI-ed, re=voked, canceled,
annul.ed, or sule;,ci ioed.
WA
I have hemoulm'.0 hand and affixed the seal of
said County oil
UUUNTYCLERK
DeWity County Clerk
C. CHEW
4027- ,,...4
LABOR AND MATERIALS BOND
INSTALLATION OF NEW LIGHTING POLES
AND CONDUITS AT JOSLYN CENTER
PROJECT NO.: PW 09 -14
Bond No, -409
Bond Fee;
GENERAL
LIGHTING
& ELECTRIC. INC,
. as principal
( "PRINCIPAL ") and WE6'«0Zt3
6U".14
C.OM PAr-lLi
;, a corporation
incorporated under the laws of the State of SOUrr'A bAkd —,A 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 ELEVEN THOUSAND r
HUNDRED TEN DOLLARS AND.ZERO_C_ENTS ($111,010- ), 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 some 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.
This bond is conditioned upon and guarantees payment by PRINCIPAL to contractors,
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 INSTALLATION OF NEW
LIGHTING POLES AND CONDUITS AT JOSLYN CENTER, SPECIFICATIONS NO. PW 09 -14
( "Public Project ")., the public works contract executed for such Public Project, and for all work or
labor of any kind performed forthe 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
1. PRINCIPAL will construct the public Improvements Identified in SPECIFICATIONS
NO, PW 09- 14,and the public works contract executed for such Specifications, copies of which is an
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 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
or modification of SPECIFICATIONS NO. PW 09.14, or of the obligation to be performed will in any
an.enoMffl —Pa•WM Lab,i�Maww ( i M) I -F -1
4027 . , ,
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.
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 CI'T'Y; otherwise this obligation will
remain in full force and effect.
SIGNED AND SEALED this .T day of :TA n)u A P-q
PRINCIPAL's MAILING ADDRESS:
1813? �� iZE-T oA145 aL ✓C
4t 814
2j o t—z t-') E, C.A "10 Z I
SURETY'S MAILING ADDRESS:
Ical So. `P4%%L.L%PS AyE..LAE
S%ocAV 5- 5-+1044
AI_LS Q
NOTE: (1) A _ 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.
cmm Aw w7cmmA 9*0W42041M I -F -2
4027 .
❑ Acknowledgment of Principal
❑X Acknowledgment of Surety (Attorney -in -Fact)
STATE OF CALIFORNIA
95
COUNTY OF Los Angeles
�J N \ANA G � p, R,E 1A Ar.1 Po v �.
Onl A^luAR`k —4 % CA a before me, here insert naive and title of the officer
date
personally appeared Sepideh Sahar Ghahremanpour
names) of signers)
who 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.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct. DIANA GNMMIAN 05
CMnnMaion • 1>li�N00
WITNESS my hand and official sea , MoVh Pd�lic
iN Ans" Co"
Signature
(Seal) C� i s N t
(The balance of this page is intentionally left blank.)
10
Western Surety Company Form 1900.1 -2008
4027 • , ..
❑ Acknowledgment of Principal
❑X Acknowledgment of Surety (Attorney -in -Fact)
STATE OF CALIFORNIA
9S
COUNTY OF Los Angeles
On WLtA, Lg -4 2
. '0No before me, �j�A
date here insert name and title of the officer
personally appeared Aj?, rx- NA P— tJ 5LA t-S r.1AIJ of-�
name(s) of signer(s)
who 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.
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.
Signature (Seal)
DIANA ONAHREMANPOUR
IS GmMssbn # 1824800
NeNry P" • cam""
Los Anon County
CwA. Noy 26.2012
(The balance of this page is intentionally left blank.)
Western surety Company Form 1900.1.2008
Fm:The Liberty Company Insurance BrokTo:General Lighting & Electrical Revised Certiflcal2:58 0112811 OGMT -08 Pg02 -02
4027-.- DATE (MMIDDIYV Y)
Ac CERTIFICATE OF LIABILITY INSURANCE 1/282010
PRODUCER (898)918 -3960 FAX: (R66)265 -1577 ONLYCANDFICONFERSSNOERIGHTS UPON THE RICERTFCATE
The Liberty Company Insurance Brokers, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
21820 Burbank Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite #269
Woodland Hills CA 91367
IN5UREO
General Lighting and Electric, DBA: Strom
8132 Firestone Blvd #814
Downev
CA 90241
INSURERS AFFORDING COVERAGE NAIC #
INSURER A. Golden. Eagle. Insurance Corp.
INSURER B'
INSURER C
INSURER D.
INSURER E
a�
COVERAGES
FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN DIN G
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE
RESPECT TO WHICH THIS CER ?IFICATC MAY BE ISSUED OR
ONDITIONS OF SUCH
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AN O C
MAY PERTAIN, THE INSURANCE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID
CLAIMS.
POLICIES. AGGREGATE
-- " - - - - -- - - -`- - - -- - -
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
_
INSR ADD'L POLICY NWdDER
AT Y DATE � M
1,000,000
T
EACH OCCURRENCE S
GENERAL LIABILITY
DAMAGETOAENIEO-
PREMISES (Ea occurrence) _ S 1 OO , 0.00
X COMMERCIAL GENERAL LIABILITY
1/15/2010 MEDEXP (Any oneperson) 5
A ! X ' CLAIMS MADE X ;OCCUR CHP9a18H36
.1/15/2011
PERSONAL E ADV INJURY S 1,000,000
- " -
GENERAL AGGREGATE S 2,,0100, 0100
REPLACES CERTZFICE DATED
.. "..
PRODUCTS - COMP /OP AGG
GEN'I. AGGREGATE LIMIT APPLIES PER 1 -27 -10 TO REFLECT
X 'POLICY PRO- LOC RENEWAL INFORMATION
AUTOMOBILE LIABILITY
UT ABILITY
_.. .. �:
COMBINED SINGLE LIMIT S
(Ea accid ent)
ANY AUTO
-
ALL OWNEO AUTOS
BODILY INJURY S
j (Per person)
,..
SCHEDULED AUTOS
! _.....
- Hu1EU AUTOS
BODILY INJURY S
- (Per acccerl)
NON- OV'INEO AUTOS
PROPERTY DAMAGE g
(Per accident)
AUTO ONLY - EA ACCIDENT S
- -_- -
-, GARAGE LIABILITY
- --
E;.ACC S
-
ANY AUTO
OTHER THAN
AUTO ONLY'. AGG'3
EACH OCCURRENGIE 5 _ 1,000,000
EXCESS f UMBRELLA LIABILITY
:- -
S
:
X OCCUR CLAIMS MADE
AGGREGATE _.. _._ _.....
A X DEDUCTIBLE CU8798892
1/15/2010 1/15/2011 -
5
RETENTION S
WC STATU- OTH-
WORKERS COMPENSATION
TORY, LIMITS ER -- --
AND EMPLOYERS' LIABILITY YIN
E.L. EACH ACCIDENT S _...
'. ANY PROPRVETORIPARTNERIEXECUTIVE ❑
OFFICER /MBER EXCLUDED?
EM
' E.L. DISEASE - EA EMP:OYEE 5 _ _....
-
(Mandatory in NH)-
I! yes, loscroe under
E L DISEASE - POLICY LIMIT 5
SPECIAL PROVfS1DNS bebw
-; OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLESI EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
10 day notice of cancellation will be sent for nonpayment
of premium
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of E1 Segundo
DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 30 * DAYS WRITTEN
Department of Puhl iC Work S
NOTICE TO THE CERTIFICATE- HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
ATTN: Maryam Jonas
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
350 Main Street
PR ENTATIVES.
El Segundo, CA 90245 -3813
UTH 12 REPRESENTATIVE
e�
ACORO 25 (2009101)
INS026 (200901)
U 1913tS-2UUM AL.VRU The ACORD name and iogo are registered marks of ACORD
JAN -28 -2010 12:49 96% P.02
402
A� ® - DATE (MMIDDIYYYY)
CERTIFICATE OF LIABILITY INSURANCE 12/16/2009
PRODUCER (888) 918 -3960 FAX: (866) 265 -1577 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The Liberty Company Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Y P Y HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
21820 Burbank Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite #269
Woodland Hills CA 91367 INSURERS AFFORDING COVERAGE I NAIC #
-
INSURED INSURER A en Eagle Gold Ea l Insurance Corp. 10836
I -
od Fire & Casualty 11673 dwo
General Lighting and Electric 'INSURER 8 Re _ -_
DBA: Strom Lighting Services INSURER c
8132 Firestone Blvd #814 INSURER D --
Downey CA 90241 ! INSURER E
COVERAGES
ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN
OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT
DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS -.
- — - - -- _ — -- - POLICY EFFECTIVE POLICY EXPIRATION
I... POLICY NUMBER
INS ADD'L DAT MM/ /YY Y T M / /YY LIMITS
CIE
Attn : Maryam Jonas
RA
I EACH OCCURRENCE is 1,000,000
Department of Public Works
_- l DAMAGE TO RENTED
X GENERAL COMMERCIAL GENERAL LIABILITY �_PREMISES(Eaoccurrence) �.$ 100,000
A
X CLAIMS MADE X OCCUR CBP9818836 1/15/2009 1/15/2010 MED EXP (Any one person) { $ 5,000
El Segundo, CA 90245 -3813
—
PERSONAL & ADV INJURY _$ 1,000,000
GENERAL AGGREGATE $ 2,000,000
AUTHORIZED REPRESENTATIVE
Yoana M. Cruz
PRODUCTS - COMP /OP AGG i $ 2,000,000
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GENT AGGREGATE LIMIT APPLIES PER
r �
—i PRO- I
X POLICY LOC
AUTOMOBILE LIABILITY ',, COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO
B
�ALL OWNED AUTOS CAA000596 12/22/2009 2/22/2010 BODILY INJURY $
(Per person)
X SCHEDULED AUTOS
i
X HIRED AUTOS BODILY INJURY $
(Per accident)
X NON -OWNED AUTOS �
I PROPERTY DAMAGE $
(Per accident)
ICI
GA RAGE LIABILITY
AUTO ONLY - EA ACCIDENT i . $
_
ANY AUTO
f)
OTHER THAN EA ACC 1 $ _
AUTO ONLY.
I.
J
AGG $
EXCESS / UMBRELLA LIABIILITY
II- EACH OCCURRENCE
OCCUR j CLAIMS MADE
waft
AGGREGATE $
19
I DEDUCTIBLE
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$
RETENTION
WC
WORKERS COMPENSATION
! R L M TS.I'' _ ER.
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETOR /PARTNER /EXECUTIVE F__1
j
!, E L EACH ACCIDENT 1. $
OFFICER /MEMBER EXCLUDED?
E L DISEASE - EA EMPLOYE $
(Mandatory in NH)
If yes, describe under
!, E L DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of EL Segundo is named as additional insured per blanket gold endorsement GECG 602 (09/04) with respects to
General Liability.
*10 day notice of cancellation in the event of non - payment of premium.
CERTIFICA It MULUtK
(310) 640 -0489
SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EXPIRATION
City of El Segundo
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN
Attn : Maryam Jonas
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Department of Public Works
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
350 Main Street
El Segundo, CA 90245 -3813
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Yoana M. Cruz
�rSn o AT'IAAI A11 r r.'f. r cn efl
ACORD 25 (2009101) __._ _._...._.__ _ -- J
INS025 (200901) The ACORD name and logo are registered marks of ACO
4027..,..
Insured: General Lighting Electric
Policy #CBP9818836
COMMERCIAL LIABILITY GOLD ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SECTIONI - COVERAGES
COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY
2. Exclusions
Item 2.g. 2) is replaced with the following:
2.g. 2) A watercraft you do not own that is:
a) less than 50 feet long; and
b) Not being used to carry persons or property for a charge.
Item 2.g. 6) is added:
6) An aircraft in which you have no ownership interest and that you have chartered with
crew.
The last paragraph of 2. Exclusions is replaced with the following
Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to
premises while rented to you, temporarily occupied by you with the permission of the owner, or
managed by you under a written agreement with the owner. A separate limit of insurance applies to this
coverage as described in Section III - Limits of Insurance.
SECTION I - COVERAGES
COVERAGE C. MEDICAL PAYMENTS
If Medical Payments Coverage is provided under this policy, the following is changed:
3. Limits
The medical expense limit provided by this policy shall be the greater of:
a. $10,000; or
b. The amount shown in the declarations.
Coverage C. Medical Payments is primary and not contributing with any other insurance, even if that
other insurance is also primary.
GECG 602 (09/04) Includes copyrighted material of insurance Services Offices Inc. with its permission page I of 6
4027 - .,...r
The following is added:
COVERAGE D. PRODUCT RECALL NOTIFICATION EXPENSES
Insuring Agreement
We will pay "product recall notification expenses" incurred by you for the withdrawal of your products,
provided that:
a. Such withdrawal is required because of a determination by you during the policy period, that the use or
consumption of your products could result in "bodily injury" or "property damage "; and
b. The "product recall notification expenses" are incurred and reported to us during the policy period
The most we will pay for "product recall notification expenses" during the policy period is $100,000.
SUPPLEMENTARY PAYMENTS - COVERAGES A AND B
Item b. and d. are replaced with:
b. The cost of bail bonds required because of accidents or traffic law violations arising out of the use
of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these
bonds.
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or
defense of the claim or "suit' including actual loss of earnings up to $500 a day because of time off
from work.
SECTION II -WHO IS AN INSURED
Item 4. is replaced with:
4. Any subsidiaries, companies, corporations, firms, or organizations you acquire or form during the policy
period over which you maintain a controlling interest of greater than 50% of the stock or assets, will
qualify as a Named Insured if:
a) you have the responsibility of placing insurance for such entity; and
b) coverage for the entity is not otherwise more specifically provided; and
c) the entity is incorporated or organized under the laws of the United States of America.
However; coverage under this provision does not apply to "bodily injury" or "property damage" that
occurred before you acquired or formed the entity, or "personal injury" or "advertising injury" arising out
of an offense committed before you acquired or formed the entity.
Coverage under this provision is afforded only until the end of the policy period, or the twelve (12)
month anniversary of the policy inception date whichever is earlier.
SECTION III - LIMITS OF INSURANCE
Paragraph 2 is amended to include:
The General Aggregate Limit of Insurance applies separately to each "location" owned by you, rented to you,
or occupied by you with the permission of the owner.
GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its pennission Page 2 of 6
4 U 2 7 • . *,
Paragraph 6. is replaced with the following:
6. Subject to 5. above, the Fire Damage Limit is the most we will pay under Coverage A for damages
because of "property damage" to premises while rented to you, temporarily occupied by you with
permission of the owner, or managed by you under a written agreement with the owner, arising out of
any one fire, explosion or sprinkler leakage incident.
The Fire Damage Limit provided by this policy shall be the greater of:
a. $500,000. or
b. The amount shown in the Declarations.
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS
Item 2. a. is replaced with:
2. Duties In The Event of Occurrence, Offense, Claim or Suit
a. You must promptly notify us. Your duty to promptly notify us is effective when any of your executive
officers, partners, members, or legal representatives is aware of the 'occurrence ", offense, claim, or
.,suit ". Knowledge of an "occurrence", offense, claim or "suit' by other employee(s) does not imply
you also have such knowledge. To the extent possible, notice to us should include:
1) How, when and where the "occurrence" or offense took place;
2) The names and addresses of any injured persons and witnesses; and
3) The nature and location of any injury or damage arising out of the 'occurrence ", offense, claim
or "suit'.
Item 4. b. 1) b) is replaced with:
b. Excess Insurance
1) b) That is Fire, Explosion or Sprinkler Leakage insurance for premises while rented to you,
temporarily occupied by you with permission of the owner, or managed by you under a
written agreement with the owner; or
Item 6. is amended to include:
6. Representations
d. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will
not deny coverage under this Coverage Part because of such failure. However, this provision does
not affect our right to collect additional premium or exercise our right of cancellation or non - renewal.
Item 8. is replaced with:
8. Transfer of Rights Of Recovery Against Others To Us
a. If the insured has rights to recover all or part of any payment we have made under this Coverage
Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At
our request, the insured will bring suit or transfer those rights to us and help us enforce them.
GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 3 of 6
40 L 7 - , ,A
b. If required by a written "insured contract', we waive any right of recovery we may have against any
person or organization because of payments we make for injury or damage arising out of your
ongoing operations or "your work" done under that written "insured contract' for that person or
organization and included in the "products- completed operations hazard'.
Item 10. and Item 11. are added:
10. Cancellation Condition
If we cancel this policy for any reason other than nonpayment of premium we will mail or deliver
written notice of cancellation to the first Named Insured at least 60 days prior to the effective date of
cancellation.
11. Liberalization
If we adopt a change in our forms or rules which would broaden your coverage without an extra
charge, the broader coverage will apply to this policy. This extension is effective upon the approval
of such broader coverage in your state.
SECTION V- DEFINITIONS
The following definitions are added or changed:
9. "Insured contract'
a. Is changed to:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that
indemnifies any person or organization for damage by fire, explosion or sprinkler leakage to
premises while rented to you, or temporarily occupied by you with permission of the owner, or
managed by you under a written agreement with the owner is not an "insured contract'.
23 and 24 are added.
23. "Location means premises involving the same or connecting lots, or premises whose connection is
interrupted only by a street, roadway, waterway or right -of -way of a railroad.
24. 'Product recall notification expenses" means the reasonable additional expenses (including, but not
limited to, cost of correspondence, newspaper and magazine advertising, radio or television
announcements and transportation cost), necessarily incurred in arranging for the return of products,
but excluding costs of the replacement products and the cash value of the damaged products.
The following Provisions are also added to this Coverage Part:
A. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT
Paragraph 2. under SECTION II - WHO IS AN INSURED is amended to include as an insured any person
or organization when you and such person or organization have agreed in writing in a contract, agreement
or permit that such person or organization be added as an additional insured on your policy to provide
insurance such as is afforded under this Coverage Part. Such person or organization is not entitled to any
notices that we are required to send to the Named Insured and is an additional insured only with respect
to liability arising out of:
a. Your ongoing operations performed for that person or organization; or
b. Premises or facilities owned or used by you.
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4 C� � 7 • ,, ..y
With respect to provision 1.a. above, a person's or organization's status as an insured under this
endorsement ends when your operations for that person or organization are completed.
With respect to provision 1.b. above, a person's or organization's status as an insured under this
endorsement ends when their contract or agreement with you for such premises or facilities ends.
2. This endorsement provision A. does not apply:
a. Unless the written contract or agreement has been executed, or permit has been issued, prior to the
"bodily injury", "property damage" or "personal and advertising injury";
b. To "bodily injury" or "property damage" occurring after:
(1) All work, including materials, parts or equipment furnished in connection with such work, in the
project (other than service, maintenance or repairs) to be performed by or on behalf of the
additional insured(s) at the site of the covered operations has been completed; or
(2) That portion of "your work" out of which the injury or damage arises has been put to its intended
use by any person or organization other than another contractor or subcontractor engaged in
performing operations for a principal as a part of the same project;
c. To the rendering of or failure to render any professional services including, but not limited to, any
professional architectural, engineering or surveying services such as:
(1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders or drawings and specifications; and
(2) Supervisory, inspection, architectural or engineering activities;
d. To "bodily injury ", "property damage" or "personal and advertising injury" arising out of any act, error or
omission that results from the additional insured's sole negligence or wrongdoing;
e. To any person or organization included as an insured under provision B. of this endorsement;
f. To any person or organization included as an insured by a separate additional insured endorsement
issued by us and made a part of this policy.
B. ADDITIONAL INSURED — VENDORS
Paragraph 2. under SECTION II - WHO IS AN INSURED is amended to include as an insured any person or
organization (referred to below as "vendor ") with whom you agreed, in a written contract or agreement to
provide insurance such as is afforded under this policy, but only with respect to "bodily injury" or "property
damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's
business, subject to the following additional exclusions:
1. The insurance afforded the vendor does not apply to:
a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by
reason of the assumption of liability in a contract or agreement. This exclusion does not apply
to liability for damages that the vendor would have in the absence of the contract or
agreement;
b. Any express warranty unauthorized by you;
c. Any physical or chemical change in the product made intentionally by the vendor;
GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 5 of 6
4027.6,41-
d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or
substitution of parts under instructions from the manufacturer, and then repackaged in the
original container;
e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed
to make or normally undertakes to make in the course of business, in connection with the
distribution or sale of the products;
f. Demonstration, installation, servicing or repair operations, except such operations performed
at the vendor's premises in connection with the sale of the product;
g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a
container, part or ingredient of any other thing or substance by or for the vendor; or
h. To "bodily injury" or "property damage" arising out of any act, error or omission that results from the
additional insured's sole negligence or wrongdoing.
2. This insurance does not apply to any insured person or organization, from whom you have acquired such
products, or any ingredient, part or container, entering into, accompanying or containing such products.
GECG 602 (09/04) Includes copyrighted material of Insurance Services Offices Inc. with its permission Page 6 of 6
e�
CERTHOLDER COPY 4027 SC ,
STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142 -0807
COMPENSATION
INSURANCE
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 04 -01 -2008 GROUP; 000824
POLICY NUMBER: 0000885 -2008
CERTIFICATE ID: 126
CERTIFICATE 04- 01-2008/04 -01 -2010
CITY OF EL SEGUPDO SC
350 MAIN ST
EL SEGUNDO CA 80245 -3813
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration,
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the Insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
tTH:0RIZE6D REPRESENTATI PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER DCCURRENCE.
ENDORSEMENT #1800 - THARATHORN SUNNANON, PRESIDENT - EXCLUDED.
ENDORSEMENT #2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04 -01 -2008 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
EMPLOYER
GENERAL LIGHTING AND ELECTRIC, INC SC
8132 FIRESTONE BLVD # 814
DOWNEY CA 90241
M0408
PRINTED : 03- 17-2009
iREV.2 -05)