3545Contract Number: 3545
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RESIDENTIAL SOUND INSULATION PROGRAM CONTRACT
BETWEEN
THE CITY OF EL SEGUNDO AND
S &L SPECIALTY CONTRACTING, INC.
This contract is entered into this 1St day of November, 2005, by and between the City of El
Segundo, a general law city and municipal corporation ( "the City ") and S &L Specialty
Contracting, 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 Eight
hundred fifty -seven thousand, one hundred ninety dollars and zero cents ($857,190.00) 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 two hundred and thirty one
(23 1) calendar days (the "Contract Time. ")
Residential Sound Insulation Program 1 Group 8 Construction Contract (11/01/2005)
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<SEGU�O
Contract Number: 3545
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 shall 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. TAXPAYER IDENTIFICATION NUMBER. The Contractor will provide the City with a
Taxpayer Identification Number.
6. 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.
7. 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.
8. INDEMNIFICATION. The Contractor agrees to indemnify 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.
9. 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
Residential Sound Insulation Program 2 Group 8 Construction Contract (11/01/2005)
Contract Number: 3545
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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.
10. 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.
11. 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
James S. O'Neill
City of El Segundo
City Hall
350 Main Street
El Segundo, CA 90245
The Contractor
James W. Leana
S &L Specialty Contacting, Inc.
472 South Salina Street
Suite 400
Syracuse, NY 13202
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 who
notices are to be given by giving notice in the manner prescribed in this paragraph.
12. NO THIRD PARTY BENEFICIARY. This Contract and every provision herein are 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.
13. 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.
14. 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. Precedence of documents as determined in the Standard Specifications.
Residential Sound Insulation Program 3 Group 8 Construction Contract (11/01/2005)
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Contract Number: 3545
15. 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.
16. 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.
17. 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.
18. 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.
19. CAPTIONS. The captions of the paragraphs of this Contract are for convenience of
reference only and will not affect the interpretation of this Contract.
20. TIME IS OF ESSENCE. Time is of the essence for each and every provision of the
Contract Documents.
21. COMMUNITY DEVELOPMENT BLOCK GRANT REQUIREMENT
This is a federally assisted construction contract and Federal labor standards, including Davis -
Bacon requirements, will be enforced. If Federal and State wage rates are applicable, then the
higher of the two will prevail.
[Signatures on next page]
Residential Sound Insulation Program 4 Group 8 Construction Contract (11/01/2005)
Contract Number: 3545
Agmk IN WITNESS WHERE OF the parties hereto have executed this contract the day and
year first hereinabove written.
CITY OF EL SEGUNDO:
A general law city and municipal corporation.
ATTEST:
By:
—Cft6 –�
Cindy Mortesen
City Clerk
APPROVED
MARK D. H]
By
Karl . Berger,
Assistant City 4
rmx
ATTORNEY
CONTRACTOR:
S &I
Taxpayer ID
Number
Contractor State
License Number
Contractor City
Business License
Number
14- 1825100
796968
23197
Residential Sound Insulation Program 5 Group 8 Construction Contract (11/01/2005)
THE AMERICAN INSTITUTE OF ARCHITECTS
3545•...:1
�unNnu•
,11
Bond #104528622
AIA Document A312
Performance Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR (Name and Address):
S & L Specialty Contracting Inc.
315 South Franklin Street
Syracuse, NY 13202
OWNER (Name and Address):
City of El Segundo
City Hall
350 Main Street
El Segundo, CA 90245
SURETY (Name and Principal Place of Business):
Travelers Casualty and Surety Company of America
499 Thornall Street
Edison, NJ 08837
CONSTRUCTION CONTRACT
Date: November 1, 2005
Amount: $857,190.00
Description (Name and Location): Residential Sound Insulation Program Group 8
BOND
Date (Not earlier than Construction Contract Date): November 11, 2005
Amount: $857,190.00
Modifications to this Bond: UeNone
AS PRINCIPAL
Company:
S & L Special
Signature: -.
Name and Title:
(Any additional
(FOR INFORMATION ONLY -
AGENT or BROKER:
R. H. Hunt & Associates, Inc.
15 Meridian Road
Eatontown, NJ 07724
Tel: 732 - 578 -9408
0 See Page 3
SURETY
(Corporate Seal) Company: (Corporate Seal)
Travelers Casualty and Surety Company of America
Signature:
Name and Title: Richard H. Hunt, Attorntsy -in -Fact
r on page 3)
ame, Address and Telephone)
OWNER'S REPRESENTATIVE (Architect, Engineer or
other party):
AIA DOCUMENT A312 - PERFORMANCE BOND AND PAYMENT BOND - DECEMBER 1984 ED. - AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312 -1984 1
THIRD PRINTING - MARCH 1987
I The Contractor and the Surety, jointly and severally, bind
themselves, their heirs, executors, administrators,
successors and assigns to the Owner for the performance
of the Construction Contract, which is incorporated herein
by reference.
2 If the Contractor performs the Construction Contract, the
Surety and the Contractor shall have no obligation under
this Bond, except to participate in conferences as provided
in Subparagraph 3.1.
3 If there is no Owner Default, the Surety's obligation
under this Bond shall arise after:
3.1 The Owner has notified the Contractor and the
Surety at its address described in Paragraph 10 below
that the Owner is considering declaring a Contractor
Default and has requested and attempted to arrange a
conference with the Contractor and the Surety to be
held not later than fifteen days after receipt of such
notice to discuss methods of performing the
Construction Contract. If the Owner, the Contractor
and the Surety agree, the Contractor shall be allowed a
reasonable time to perform the Construction Contract,
but such an agreement shall not waive the Owner's
right, if any, subsequently to declare a Contractor
Default; and
3.2 The Owner has declared a Contractor Default and
formally terminated the Contractor's right to complete
the contract. Such Contractor Default shall not be
declared earlier than twenty days after the Contractor
and the Surety have received notice as provided in
Subparagraph 3.1; and
3.3 The Owner has agreed to pay the Balance of the
Contract Price to the Surety in accordance with the
terms of the Construction Contract or to a contractor
selected to perform the Construction Contract in
accordance with the terms of the contract with the
Owner.
4 When the Owner has satisfied the conditions of
Paragraph 3, the Surety shall promptly and at the Surety's
expense take one of the following actions:
4.1 Arrange for the Contractor, with consent of the
Owner, to perform and complete the Construction
Contract; or
4.2 Undertake to perform and complete the
Construction Contract itself, through its agents or
through independent contractors; or
4.3 Obtain bids or negotiated proposals from qualified
contractors acceptable to the Owner for a contract for
performance and completion of the Construction
Contract, arrange for a contract to be prepared for
execution by the Owner and the contractor selected
with the Owner's concurrence, to be secured with
performance and payment bonds executed by a
qualified surety equivalent to the bonds issued on the
Construction Contract, and pay to the Owner the
amount of damages as described in Paragraph 6 in
excess of the Balance of the Contract Price incurred
by the Owner resulting from the Contractor's default;
or
4.4 Waive its right to perform and complete, arrange
for completion, or obtain a new contractor and with
reasonable promptness under the circumstances:
1 After investigation, determine the amount for
which it may be liable to the Owner and, as
soon as practicable after the amount is
determined, tender payment therefor to the
Owner; or
�
• • .
2 Deny liability in whole or in part n no iN Ify the
Owner citing reasons therefor.
5 If the Surety does not proceed as provided in Paragraph
4 with reasonable promptness, the Surety shall be deemed
to be in default on this Bond fifteen days after receipt of an
additional written notice from the Owner to the Surety
demanding that the Surety perform its obligations under
this Bond, and the Owner shall be entitled to enforce any
remedy available to the Owner. If the surety proceeds as
provided in Subparagraph 4.4, and the Owner refuses the
payment tendered or the Surety has denied liability, in
whole or in part, without further notice the Owner shall be
entitled to enforce any remedy available to the Owner.
6 After the Owner has terminated the Contractor's right to
complete the Construction Contract, and if the Surety
elects to act under Subparagraph 4.1, 4.2, or 4.3 above,
then the responsibilities of the Surety to the Owner shall
not be greater than those of the Contractor under the
Construction Contract, and the responsibilities of the
Owner to the Surety shall not be greater than those of the
Owner under the Construction Contract. To the limit of the
amount of this Bond, but subject to commitment by the
Owner of the Balance of the Contract Price to mitigation of
costs and damages on the Construction Contract, the
Surety is obligated without duplication for:
6.1 The responsibilities of the Contractor for correction
of defective work and completion of the Construction
Contract;
6.2 Additional legal, design professional and delay
costs resulting from the Contractor's Default, and
resulting from the actions or failure to act of the Surety
under Paragraph 4; and
6.3 Liquidated damages, or if not liquidated damages
are specified in the Construction Contract, actual
damages caused by delayed performance or non-
performance of the Contractor.
7 The Surety shall not be liable to the Owner or others for
obligations of the Contractor that are unrelated to the
Construction Contract, and the Balance of the Contract
Price shall not be reduced or set off on account of any
such unrelated obligations. No right of action shall accrue
on this Bond to any person or entity other than the Owner
or its heirs, executors, administrators or successors.
8 The Surety hereby waives notice of any change,
including changes of time, to the Construction Contract or
to related subcontracts, purchase orders and other
obligations.
9 Any proceeding, legal or equitable, under this Bond may
be instituted in any court of competent jurisdiction in the
location in which the work or part of the work is located and
shall be instituted within two years after Contractor Default
or within two years after the Contractor ceased working or
within two years after the Surety refuses or fails to perform
its obligations under this Bond, whichever occurs first. If
the provisions of this Paragraph are void or prohibited by
law, the minimum period of limitation available to sureties
as a defense in the jurisdiction of the suit shall be
applicable.
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. •AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312 -1984 2
THIRD PRINTING • MARCH 1987
10 Notice to the Surety, the Owner or the Contractor shall
be mailed or delivered to the address shown on the
signature page.
11 When this Bond has been furnished to comply with a
statutory or other legal requirement in the location where
the construction was to be performed, any provision in this
Bond conflicting with said statutory or legal requirement
shall be deemed deleted herefrom and provisions
conforming to such statutory or other legal requirement
shall be deemed incorporated herein. The intent is that
this Bond shall be construed as a statutory bond and not
as a common law bond.
12 DEFINITIONS
12.1 Balance of the Contract Price: The total amount
payable by the Owner to the Contractor under the
Construction Contract after all proper adjustments
have been made, including allowance to the
Contractor of any amounts received or to be received
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
3545•,
by the Owner in settlement of insurance or other
claims for damages to which the Contractor is entitled,
reduced by all valid and proper payments made to or
on behalf of the Contractor under the Construction
Contract.
12.2 Construction Contract: The agreement betwen
the Owner and the Contractor identified on the
signature page, including all Contract Documents and
changes thereto.
12.3 Contractor Default: Failure of the Contractor,
which has neither been remedied nor waived, to
perform or otherwise to comply with the terms of the
Construction Contract.
12.4 Owner Default: Failure of the Owner, which has
neither been remedied nor waived, to pay the
Contractor as required by the Construction Contract or
to perform and complete or comply with the other
terms thereof.
(Space is provided below for additional signatures of added parties, other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corporate Seal) Company: (Corporate Seal)
Signature:
Name and Title:
Address:
Signature:
Name and Title:
Address:
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DtC:tMbtK IU04 tU. • Al/:w
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312 -1984
THIRD PRINTING • MARCH 1987
s�
THE AMERICAN INSTITUTE OF ARCHITECTS
3545•..,
Bond # 104528622
AIA Document A312
Payment Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR (Name and Address):
S & L Specialty Contracting, Inc.
315 South Franklin Strret
Syracuse, NY 13202
OWNER (Name and Address):
City of El Segundo
City Hall
350 Main Street
El Segundo, CA 90245
CONSTRUCTION CONTRACT
Date: November 1, 2005
Amount: $857,190.00.00
Description (Name and Location)
SURETY (Name and Principal Place of Business):
Travelers Casualty and Surety Company of America
499 Thornall Street
Edison, NJ 08837
Residential Sound Insulation Program — Group 7
BOND
Date (Not earlier than Construction Contract Date): November 11, 2005
Amount: $857,190.00
Modifications to this Bond: ✓ None ❑ See Page 6
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corporate Seal) Company: (Corporate Seal)
S & L Sped It y Con sting, C. Travelers Casualty and Surety Company of America
Signature 'It -r-
Signature;
Name and Ti Name and Title: Richard H. Hunt, Attorney -rn -Fact
(Any addition I signat es app ar o page 6)
(FOR INFORMATIO e ONLY - Narita, Address and Telephone)
AGENT or BROKER: OWNER'S REPRESENTATIVE (Architect, Engineer or
R.H. Hunt & Associates, Inc. other party):
15 Meridian Road
Eatontown, NJ 07724
Tel: 732 - 578 -9408
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312 -1984 4
THIRD PRINTING • MARCH 1987
1 The Contractor and the Surety, jointly and severally, bind successors and assigns to the Owner to pay for labor,
themselves, their heirs, executors, administrators, materials and equipment furnished for use in the
performance of the Construction Contract, which is
incorporated herein by reference.
2 With respect to the Owner, this obligation shall be null
and void if the Contractor:
2.1 Promptly makes payment, directly or indirectly, for
all sums due Claimants, and
2.2 Defends, indemnifies and holds harmless the
Owner from claims, demands, liens or suits by any
person or entity whose claim, demand, lien or suit is for
the payment for labor, materials or equipment furnished
for use in the performance of the Construction Contract,
provided the Owner has promptly notified the
Contractor and the Surety (at the address described in
Paragraph 12) of any claims, demands, liens or suits
and tendered defense of such claims, demands, liens
or suits to the Contractor and the Surety, and provided
there is no Owner Default.
3 With respect to Claimants, this obligation shall be null
and void if the Contractor promptly makes payment,
directly or indirectly, for all sums due.
4. The Surety shall have no obligation to Claimants under
this Bond until:
4.1 Claimants who are employed by or have a direct
contract with the Contractor have given notice to the
Surety (at the address described in Paragraph 12) and
sent a copy, or notice thereof, to the Owner, stating
that a claim is being made under this Bond and, with
substantial accuracy, the amount of the claim.
4.2 Claimants who do not have a direct contract with
the Contractor:
.1 Have furnished written notice to the Contractor
and sent a copy, or notice thereof, to the
Owner, within 90 days after having last
performed labor or last furnished materials or
equipment included in the claim stating, with
substantial accuracy, the amount of the claim
and the name of the party to whom the
materials were furnished or supplied or for
whom the labor was done or performed; and
.2 Have either received a rejection in whole or in
part from the Contractor, or not received within
30 days of furnishing the above notice any
communication from the Contractor by which
the Contractor has indicated the claim will be
paid directly or indirectly; and
.3 Not having been paid within the above 30
days, have sent a written notice to the Surety
(at the address described in Paragraph 12)
and sent a copy, or notice thereof, to the
Owner, stating that a claim is being made
under this Bond and enclosing a copy of the
previous written notice furnished to the
Contractor.
5 If a notice required by Paragraph 4 is given by the
Owner to the Contractor or to the Surety, that is sufficient
compliance.
6 When the Claimant has satisfied the conditions of
Paragraph 4, the Surety shall promptly and at the Surety's
expense take the following actions: 3545
6.1 Send an answer to the Claimant, with a copy to the
Owner, within 45 days after receipt of the claim, stating
the amounts that are undisputed and the basis for
challenging any amounts that are disputed.
6.2 Pay or arrange for payment of any undisputed
amounts.
7 The Surety's total obligation shall not exceed the amount
of this Bond, and the amount of this Bond shall be credited
for any payments made in good faith by the Surety.
8 Amounts owed by the Owner to the Contractor under the
Construction Contract shall be used for the performance of
the Construction Contract and to satisfy claims, if any, under
any Construction Performance Bond. By the Contractor
furnishing and the Owner accepting this Bond, they agree
that all funds earned by the Contractor in the performance of
the Construction Contract are dedicated to satisfy
obligations of the Contractor and the Surety under this
Bond, subject to the Owner's priority to use the funds for the
completion of the work.
9 The Surety shall not be liable to the Owner, Claimants or
others for obligations of the Contractor that are unrelated to
the Construction Contract. The Owner shall not be liable for
payment of any costs or expenses of any Claimant under
this Bond, and shall have under this Bond no obligations to
make payments to, give notices on behalf of, or otherwise
have obligations to Claimants under this Bond.
10 The Surety hereby waives notice of any change,
including changes of time, to the Construction Contract or to
related subcontracts, purchase orders and other obligations.
11 No suit or action shall be commenced by a Claimant
under this Bond other than in a court of competent
jurisdiction in the location in which the work or part of the
work is located or after the expiration of one year from the
date (1) on which the Claimant gave the notice required by
Subparagraph 4.1 or Clause 4.2.3, or (2) on which the last
labor or service was performed by anyone or the last
materials or equipment were furnished by anyone under the
Construction Contract, whichever of (1) or (2) first occurs. If
the provisions of this Paragraph are void or prohibited by
law, the minimum period of limitation available to sureties as
a defense in the jurisdiction of the suit shall be applicable.
12 Notice to the Surety, the Owner or the Contractor shall
be mailed or delivered to the address shown on the
signature page. Actual receipt of notice by Surety, the
Owner or the Contractor, however accomplished, shall be
sufficient compliance as of the date received at the address
shown on the signature page.
13 When this Bond has been furnished to comply with a
statutory or other legal requirement in the location where the
construction was to be performed, any provision in this Bond
conflicting with said statutory or legal requirements shall be
deemed deleted herefrom and provisions conforming to
such statutory or other legal requirement shall be deemed
incorporated herein. The intent is that this
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA ® A312 -1984
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006
THIRD PRINTING • MARCH 1987
Bond shall be construed as a statutory bond and not as a
common law bond.
14 Upon request by any person or entity appearing to be a
potential beneficiary of this Bond, the Contractor shall
promptly furnish a copy of this Bond or shall permit a copy
to be made.
15 DEFINITIONS
15.1 Claimant: An individual or entity having a direct
contract with the Contractor or with a subcontractor of
the Contractor to furnish labor, materials or equipment
for use in the performance of the Contract. The intent
of this Bond shall be to include without limitation in the
terms "labor, materials or equipment" that part of
water, gas, power, light, heat, oil, gasoline, telephone
service or rental equipment used
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
3545
in the Construction Contract, architectural and
engineering services required for performance of the
work of the Contractor and the Contractor's
subcontractors, and all other items for which a
mechanic's lien may be asserted in the jurisdiction
where the labor, materials or equipment were
furnished.
15.2 Construction Contract: The agreement between
the Owner and the Contractor identified on the
signature page, including all Contract Documents and
changes thereto.
15.3 Owner Default: Failure of the Owner, which has
neither been remedied nor waived, to pay the
Contractor as required by the Construction Contract or
to perform and complete or comply with the other
terms thereof.
(Space is provided below for additional signatures of added parties, other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corporate Seal) Company:
Signature:
Name and Title:
Address:
Signature:
Name and Title:
Address:
(Corporate Seal)
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA ® A312 -1984 6
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006
THIRD PRINTING • MARCH 1987
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA 3
54 5
TRAVELERS CASUALTY AND SURETY COMPANY
FARMINGTON CASUALTY COMPANY
Hartford, Connecticut 06183 -9062
POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S) -IN-FACT
KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,
corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford,
County of Hartford, State of Connecticut, (hereinafter the "Companies ") hath made, constituted and appointed, and do by these
presents make, constitute and appoint: Richard H. Hunt, of Eatontown, New Jersey, their true and lawful Attorney(s) -in -Fact,
with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the
following instrument(s): by his /her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other
writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to
bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the
Companies, and all the acts of said Attorney(s) -in -Fact, pursuant to the authority herein given, are hereby ratified and confirmed.
This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are
now in full force and effect:
VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any
Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact
and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe
to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in
the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such
appointee and revoke the power given him or her.
VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President
may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is
in writing and a copy thereof is filed in the office of the Secretary.
VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional
undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any
Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any
Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, if
required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or
by one or more Company officers pursuant to a written delegation of authority.
This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by
authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY
COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY
COMPANY, which Resolution is now in full force and effect:
VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice
President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any
power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for
purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney
or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and
certified by such facsimile signature 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.
(11-00 Standard)
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3545
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
HARTFORD, CONNECTICUT 06183
FINANCIAL STATEMENT AS OF DECEMBER 31, 2004
CAPITAL STOCK $6,000,000
CASH & INVESTED CASH
$ 2,721,251
UNEARNED PREMIUMS
$ 517,322,210
BONDS
2,103,575,828
LOSSES
542,595,315
STOCK
11,873,755
LOSS ADJUSTMENT EXPENSES
97,587,047
OTHER INVESTED ASSETS
-
COMMISSIONS
19,228,115
INVESTMENT INCOME DUE AND ACCRUED
24,085,845
TAXES, LICENSES AND FEES
10,738,457
PREMIUM BALANCES
139,148,258
OTHER EXPENSES
18,724,529
REINSURANCE RECOVERABLE
48,827,434
CURRENT FEDERAL AND FOREIGN INCOME TAXES
43,827,236
CURRENT FEDERAL INCOME TAX RECOVERABLE
' -
PAYABLE FOR SECURITIES
-
NET DEFERRED TAX ASSET
37,424,124
PAYABLE TO PARENT, SUBSIDIARIES 6 AFFILIATES
35,395,260
RECEIVABLE FOR SECURITIES
300,000
OTHER ACCRUED EXPENSES AND LIABILITIES
139,342,853
RECEIVABLE FROM PARENT, SUBSIDIARIES a AFFILIATES
-
TOTAL LIABILITIES
$ 1,424.761,023
OTHER ASSETS
(72,723,020)
CAPITAL STOCK
$ 6,000,000
PAID IN SURPLUS
303,297,402
OTHER SURPLUS
561,175,050
TOTAL SURPLUS TO POLICYHOLDERS
$ 670,472,452
TOTAL ASSETS
52,295,233,475
TOTAL LIABILITIES 8 SURPLUS
$2,295,233,475
STATE OF CONNECTICUT )
COUNTY OF HARTFORD )SS.
CITY OF HARTFORD
LAWRENCE A. SIUTA, BEING DULY SWORN, SAYS THAT HE IS CHIEF FINANCIAL OFFICER - BOND, OF THE TRAVELERS CASUALTY AND
SURETY COMPANY OF AMERICA, AND THAT TO THE BEST OF HIS KNOWLEDGE AND BELIEF, THE FOREGOING IS A TRUE AND
CORRECT STATEMENT OF THE FINANCIAL CONDITION OF SAID COMPANY AS OF THE 31st DAY OF DECEMBER, 2004.
SUBSCRIBED AND SWORN TO BEFORE ME THIS
24TH DAY OF MARCH, 2005
�►\�c. TErgF�
B %-\C'
►1..,Oh'NE C7lG�
A.
CHIEF FINANCIAL OFFICER - BOND
NOTARY PUBLIC
MY COMMISSION EXPIRES JUNE 30, 2006
354 5 •
SURETY DISCLOSURE STATEMENT AND CERTIFICATION
pursuant to N.J.S.A. 2A:44 -143
(for use when surety(ies) have a certificate from U.S. Secretary of the Treasury in accordance with 31 U.S.C. Section 9305)
Travelers Casualty and Surety Company, Travelers Indemnity Company, Standard Fire Insurance Company, Travelers
Casualty Insurance Company of America, Travelers Casualty and Surety Company of America, Farmington Casualty
Company, surety(ies) on the attached bond, hereby certifies(y) the following:
1) The surety(ies) meets (meet) the applicable capital and surplus requirements of R.S.17:17 -6 or R.S. 17:17 -7 as of the Surety's most
current annual filing with the New Jersey Department of Insurance.
2) The capital and surplus, as determined in accordance with the applicable laws of this State, of the surety(ies) participating in the
issuance of the attached bond is (are) in the following amounts as of the calendar year ended December 31, 2004 (most recent
calendar year which capital and surplus amounts are available), which amounts have been certified on a Consolidated Certification
by KPMG Peat Marwick LLP, Hartford, Connecticut and are included in the Annual Statement on file with the New Jersey
Department of Insurance, 20 West State Street CN -325, Trenton, New Jersey 08625 -0325.
Surety Companv
Capita[
Surplus
Travelers Indemnity Company
$10,000,000
$4,639,341,956
Travelers Casualty and Surety Company
$25,000,000
$3,343,509,864
Standard Fire Insurance Company
$5,000,000
$924,701,700
Travelers Casualty and Surety Company of America
$ 6,000,000
$870,472,452
Travelers Casualty Insurance Company of America
$ 6,000,000
$424,000,131
Farmington Casualty Company
$ 6,000,000
$228,042,718
3) With respect to each surety participating in the issuance of the attached bond that has received from the U.S. Secretary of the
Treasury, a certificate of authority pursuant to 31 U.S.C. Section 9305, the underwriting limitation established there on July 1,
2005 (most recent calendar year available) is as follows:
Surety Company
Limitation
Travelers Indemnity Company
$463,934,000
Travelers Casualty and Surety Company
$224,499,000
Standard Fire Insurance Company
$92,470,000
Travelers Casualty and Surety Company of America
$87,047,000
Travelers Casualty Insurance Company of America
$42,400,000
Farmington Casualty Company
$22,804,000
4) The amount of the bond to which the statement and certification is attached is $ A57.,1g0-nQ
5) If, by virtue of one or more contracts of reinsurance, the amount of the bond indicated under Item 4 above exceeds the total
underwriting limitation of all sureties on the bond as set forth in Item 3 above, then for each such contact of reinsurance:
a) The name and address of each such reinsurer under that contract and the amount of the reinsurer's participation in the contact
is as follows:
and;
Reinsurer Address Amount
b) Each surety that is party to such contract of reinsurance certifies that each reinsurer listed under Item 5(a) satisfies the credit
for reinsurance requirement established under P.L.1993, c.243(C.17:5113-1 et seq.) and any applicable regulations in effect as
of the date on which the bond to which this statement and certification is attached shall have been filed with the appropriate
public agency.
CERTIFICATE
I, Lawrence A. Siuta, as Attorney -in -Fact for Travelers Casualty and Surety Company, a corporation domiciled in Connecticut, DO
HEREBY CERTIFY that, to the best of my knowledge, the foregoing statements made by me are true, and ACKNOWLEDGE that, if
any of those statements made by me are false, this bond is VOIDABLE.
i
(Signature of certifying agent /of icer)
Lawrence A. Siuta
(Print name of certifying agent /officer)
Chief Financial Officer, Bond
(Title of certifying agent/officer)
0. M 20.7 au4_a .1$
TRAvE-tRS) Fax•3'249491.8 Feb 16 _.
JJ s • �.
N9 55; -16
STAVE OF CALIF ORNU
DEPARTMENT OF INSURANCE
SAN FIU.NCTSCO
Amended
Certificate of A.uthoritry
Tice is To C`z'ars, That, purmW to the insurance Code of the State of CeIifornia,
Travelers Casualty and Surety Company of America
of Hartford, Connecticut , organized under the
laws of Connecticut , subject to its Articles of lncorporatfon or
other ft6ndanunial organizational documents, is hereby authorized to transact within this State,
subject to all provisions of thi, Certificate, the follouAng classes of insurance: Fire, Marine,
Surety, Disability, plate Glass, Liability, Workers' Compensation,
Common Carrier Liability, $oiler and Machinery, $urglary, Cradit,
Sprinkler, Team and Vehicle, Automobile, Aircraft, and Miscellaneous
as such classes are now or may hereafter be defined in the lasurance Yaws of the State of Califomia.
TMS CaUnCAT'E is expressly conditioned upon the holder hereof now and hereafter being in
full compliance with all, and not in violation of any, of the applicable laum and lawful requirements
trade under authority of the laws of the State of Calif vmia as long as such laws or requirements are
in effort and applicable, and as such laws and'raquirements now are, or may hereafter be changed
er at»endea.
IN Wmvees W or, e$ectiue as of the........1 t ..... .. ......day
195. I have hereunto act
my hand and caused my official seal to be affixed
day of_•?ui12.._._ - .1o.3.I..
t-�
By
ls�
of State mint be aoaotnpl ded es required
yrosaptly altar isanatsoe Of this COM04te of Authority. Fsllute to do so wSil be a vietyos of Ins.
and w1B be'potmde for r•voido5 this C "Woate of Authority pumutatt to the covenants made in
therefor sad tlha oondkkmz contained herein.
. M �
Code
t. 701
$2 quo
3b45•,
A>uT,�PFC'
Ciient : inna7
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMmonr)
11/02/05
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Allied North America Insurance
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
13rokerage of New York, LLC
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
390 North Broadway
INSURERS AFFORDING COVERAGE
Jericho, NY 11753
-- - -
INSURERA American Home Assurance Compan y
INSURED
S & L Specialty Contracting, Inc.
INSURER B:
INSURER C:
472 South Salina Street, Suite 400
—
INSURER D: _.
Syracuse, NY 13202 -2481
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
SR POLICY NUMBER
DATE IN Y) DATE M TYPE OF INSURANCE
EACH OCCURRENCE i
GENERAL LIABILITY I
I FIREDAMAGE(Anyonefire) S
COMM EflCIAL GENERAL LIABILRN ;
-r— MED EXP (Any one parson) $
CLAIMS MADE 7 OCCUR --
-- . i PERSONAL 3 ADV INJURY
GENERALAGGREGATE
PRODUCTS • COMP/OP AGG S
_.._
1 GEN L AGGREGATE LIMIT APPLIES PER: I
I II POLICY PRO• -... LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(En accident)
$
ANY AUTO
ALL OWNED AUTOS
_ --
BODILY INJURY
(Per person)
S
-
J SCHEDULED AUTOS
-
1 HIRED AUTOS
1
I
BODILY INJURY
(Per accident)
$
NON-OWNED AUTOS
�--
-
PROPERTY DAMAGE
S
(Per accident)
_ -j - - ---
AUTO ONLY - EA ACCIDENT
S
GARAGE LIABILITY
1-7 ANY AUTO
EA ACC
S -
IS
AUTO ONLY: AGG
EACH OCCURRENCE
S
EXCESS LIABILITY -�
i
ATE
OCCUR I j CLAIMS MADE
S
DEDUCTIBLE
;E.L.EACH
S
RETENTION $
WC2 6 7 5 7 8 7
12/01/04
12 / 0 1 / 0 5
STATU• OTH-
-.
ACCIDENT
$1 000 r 000
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
E.L. DISEASE • EA EMPLOYEE
$l 000 0 0 0
E.L. DISEASE - POLICY LIMIT
1 $1 0 0 0 0 0 0
OTHER
� I
DESCRIPTION OF OPERATMWLOCAMONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
8
City of E1 Segundo - Residential Sound Insulation Program GROUP
Foregoing per policy form.
City of E1 Segundo
City Hall
350 Main Street
E1 Segundo; CA 90245
ACORD26- S(7/87)1 of 2 #S336202/M294681
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL =AIL3- 0- ._DAYSWRITTEN
NOTK:ETOTHE CERTIFICATE HOLDER NAMED TOTHELEFT
l+
ETC III ACORD CORPORATION 1988
c) &e�
3545.
IMPORTANT
It the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD26-SUAM2 of 2 #S336202/M294681
-3545•..%.
A a( CERTIFICATE OF LIABILITY INSURANCE
11/14/2005) DATE
PRODUCER (973)812 -9855 FAX (973)812 -9860
C&H Agency, Inc.
PO Box 324
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
783 North Riverview Drive
Totowa, N3 07512
INSURED
S & L Specialty Contracting, Inc.
INSURERA: American Home Assurance Co. (AIG )
19380
INSURERB: Arch Insurance Company (Hartan)
11150
INSURER C:
GENERAL LIABILITY
472 South Salina Street, Suite 400
INSURER D:
Syracuse, NY 13202 -2481
INSURER E:
DAMAGE TO RENTED
FR !Fa nnri
$ 50,00(
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN,
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
DD'
TYPE Of INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE
POLICY EXPIRATION
DATE (MMIDONYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,00C
DAMAGE TO RENTED
FR !Fa nnri
$ 50,00(
X COMMERCIAL GENERAL LIABILITY
GL7047177
03/17/2005
03/17/2006
MED EXP (Any one person)
$
CLAIMS MADE F_X� OCCUR
PERSONAL & ADV INJURY
$ 1,000.00
A
GENERAL AGGREGATE
$ 4,000,00(
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$ 4,000,000
POLICY X jET LOC
AUTOMOBILE
LIABILITY
CA8261997
03/17/2005
03/17/2006
COMBINED SINGLE LIMIT
$
(Ea accident)
1,000,000
X
ANY AUTO
BODILY INJURY
$
X
ALL OWNED AUTOS
X
SCHEDULED AUTOS
(Per person)
A
X
HIRED AUTOS
BODILY INJURY
$
(Per accident)
X
NON -OWNED AUTOS
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTOONLY: AGG
EXCESSIUMBRELLA LIABILITY
ULP0005384 -00
03/17/2005
03/17/2006
EACH OCCURRENCE
$ 10,000,00
AGGREGATE
$ 10,000,00
X OCCUR CLAIMS MADE
$
B
$
DEDUCTIBLE
$
X 10,00
RETENTION $
WC STATU- OTH-
CRY
WORKERS COMPENSATION AND
E.L. EACH ACCIDENT
$
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER /EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
1 $
If yes, describe under
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
E: City of E1 Segundo, Residential Sound Insulation Program - GROUP 8, Contract No. 3545
G2010 (11/85) Additional Insured - Owners, Lessees or Contractors (Form B) (attached)
*See attached for cancellation clause **
City of E1 Segundo
City Hall
350 Main Street
El Segundo, CA 90245
ACORD 25 (2001/08)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL *)WX00M MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
lll�l0( Yid( �1k�IlEaU( A6df d�iX�4�61EY1 (�(lfi6XcYrJfK�U6)fX�(1(I�XJ(XX
AUTHORD:ED REPRESENTATIVE
QdAGVKU L;UKrVNA 11VPl 1WOO
o► ,, -4Q)_
City of E1 Segundo
Certificate issued to City of E1 Segundo 11/14/2005
C&H Agency,Inc
08/26/2005
* *Should any of the above - described policies be cancelled before the expiration dates thereof, the
issuing company will mail within 30 days written notice to the certificate holder. **
m m�
-POLICY NUMBER: QL7047177
3545• , . to
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
ADDITIONAL INSURE6 — OWNERS, LESSEES OR
'CONTRACTORS — (FORM B)
This gttdorser+wnt modltiss Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person arOranbation:
As xqukad by controor, provided oonftCt executed prior to loss
The City of E1 Segundo, its officers, officials, employees, agents and volunteers
(If no entry appears above, Inkrroatim required to ooMplete Ihls endorsement will be shown in the Dedarstions as
apptkebte to this endorsement)
WM IS AN INSURED (Section It) is amended to include as an Insured the peravn or organization shown in the
Schad^ but only with respeot to liabiltgr &rising out ol''your work,, far that insured by or for you.
co 20loll 26 Copyright, Insurance Services 0lhce, Inc,, 1984 Page 1 of 1 ❑
0K._4g�
3545•,..
Reproduction of Insurance Services Office, Inc. Form
INSURER: ISO FORM CG 20 10 1185: (MODIFIED)
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
ENDORSEMENT NUMBER: EXHIBIT 1 -A
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — OWNERS, LESSEES OR
CONTRACTORS (FORM B)
insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
The City, its officers, officials, employees, agents, and volunteers
(If no entry appears above, the information required to complete this endorsement
will be shown in the Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization
shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or
for you.
ModifiC$tiOns to ISO form CG 20 10 1185:
1. The insured scheduled above includes the Insured's officers, officials, employees and
volunteers.
2. This insurance shall be primary as respects the insured shown in the schedule above,
or if excess, shall stand in an unbroken chain of coverage excess of the Named
Insured's scheduled underlying primary coverage. In either event, any other insurance
maintained by the Insured scheduled above shall be in excess of this insurance and
shall not be called upon to contribute with it.
3. The insurance afforded by this policy shall not be canceled except after thirty days
prior written notice by certified mail return receipt requested has been given to the
Entity.
4. Coverage shall not extend to any indemnity coverage for the active negligence of the
additional insured in any case where an agreement to indemnify the additional insured
would be invalid under Subdivision (b) of section 2782 of the Civil Code.
Signature - Authorized Representative
Address
CG 20 10 1185 Insurance Services Office, Inc. Form (Modified)
14*0A M064 4