Loading...
CONTRACT 3782 Public Works Contract CLOSED3782.., ORIGINAL PUBLIC WORKS CONTRACT BETWEEN THE CITY OF EL SEGUNDO AND TONY PAINTING INC. This CONTRACT is entered into this 7th day of, February 2008, by and between the CITY OF EL SEGUNDO, a general law city and municipal corporation ( "the City ") and TONY PAINTING 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 FORTY NINE THOUSAND NINE HUNDRED FIFTY DOLLARS AND NO CENTS ($49,950.00) 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 SIXTY FIVE (65) working days (the "Contract Time. ") I -D -1 3782 • , 3' 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. I -D -2 3782 . 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 Ms. Maryam Jonas City of El Segundo 350 Main Street El Segundo, CA 90245 310- 524 -2361 The Contractor Mr. Ante Marijanovic Tony Painting Inc. 12812 Valley View, Suite 14 Garden Grove, CA 92845 714 - 899 -5303 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. 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 I -D -3 3782 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 Ventura County. 15. BUSINESS LICENSE. Unless waived in accordance with Santa Paula Municipal Code § 110.03(B), the Contractor and all sub - contractors must obtain a City Business License before executing this Contract. 16. 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. 17. 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. 18. 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. 19. 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. 20. 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. 21. CAPTIONS. The captions of the paragraphs of this Contract are for convenience of reference only and will not affect the interpretation of this Contract. I -D -4 3 7 8 2 • , .: 22. TIME IS OF ESSENCE. Time is of the essence for each and every provision of the Contract Documents. IN WITNESS WHEREOF the parties hereto have executed this contract the day and year first hereinabove written. CITY OF El UNDO By: /,fe ewart City Manager ATTEST: By: Cindy Wortesen City Clerk APPROVED O'F M: MARK D. H IT7 , 11 By: Karl H. Berger, Assistant City Attorn4 G I -D -5 CONTRACTOR By: - - - -- - - -- Print Name: ANTE MARIUANOVIG Title: PRZC- MINT, GAO, RMO Taxpayer ID Number: qT-0 }g6208 Contractor State License Number: 320164 Contractor City Business License Number: 14 � 2008-02- 1114.05 » 3782 , P WTI i FAITHFUL PERFORMANCE BOND PAINTING OF PUBLIC FACILITIES IN THE CITY OF EL SEGUNDO IN THE CITY OF EL SEGUNDO SPECIFICAITON NO.: PW 07 -12 EXECUTM IN TWO (2) ORIGINALS Bond No. 732979P Bond Fee: $1, 249.00 TM'S PAINTING IM ( "PRINCIPAL ") incorporated under the laws of the State of -CALIFORNIA_ and licensed by the State of Califomia 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 FORTY NINE THOUSAND NINE HUNDRED FIFTY DOLLARS AND ZERO CENTS ($48,950.00), 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 07 -12, 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 07 -12 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 ) 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. $- 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 Murliaipal Code ( "FSIVIC ") I -E -1 37 82 2008-02- 1114:05 » BOND NO. 732979P 5. SURETY, for value received, agrees that no changes, extensions of time, alteration or modification of SPECIFICATIONS NO. 07-12 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 § 995.840 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 A D SEALED this 11TH day of FEBRUARY 20 8 TIONY' S P IEJC F7 Y AND INDEZeUTY COMPANY P RI IPAII s PRESIDENT i 76ioALls SECRETARY---- PRINCIPAL's MAILING ADDRESS: 12812 VALLEY VBW ST STE 14 C ARDE 7 GR= CA 92845 SURETY's PRESIDENT SHILO LEE CRANE (ATTORNEY -IN -FACT) SURETY's SECRETARY SURETY's MAILING ADDRESS: 20350 VENTURA BLVD. STE 240 WOODLAND HILLS CA 91364 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. I -E -2 3782 CALIFORNIA ALL — PURP05E ACKNOWLEUGEMENT State of California County of Los Angeles On FEB 1 1 2008 before me, JAN - MICHELLE S. REALEZA, NOTARY PUBLIC DATE NAME, TITLE OF OFFICER Personally appeared SHILO LEE CRANE 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. 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 OF NOTARY JA t E No°mmtssion S' REALE7�q loary Pubilc . Calllo186 COmm Deles Court nlp sT NOTARY SEAL 3782.., POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263 -3300 KNOW ALL MEN BY THESE PRESENTS, that as except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each, hereby make, constitute and appoint: ** *Stephanie Hope Shear, Shilo Lee Crane, jointly or severally * ** as their true and lawful Attomey(s) -in -Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts of surety- ship giving and granting unto said Attomey(s) -in -Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attorney(s) -in -Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Board of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st, 2008. RESOLVED, that the chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is, authorized to execute Powers of Attorney, qualifying the attomey(s) named In the Powers of Attorney to execute, on behalf of the corporations, bonds, undertakings and contrails of suretyship; and that the Secretary or any Assistant Secretary of the corporations be, and each of them hereby is, authorized to attest the execution of any such Power of Attorney; RESOLVED, FURTHER, that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective Vice President and attested by their respective Assistant Secretary this January 1st, 2008. By:ANb ^* Stephen T. Pate, Senior Vice President $J4orAt >O/tt W OCT. By: 0 1936 Charles L. Day, Assistant Secretary State of California County of Orange On January 1st 2008 before me, Christopher J. Roach Notary Public Date Here Insert Name and Title of the Officer personally appeared Stephen T. Pate and Charles L. Da Name(s) of Signer(s) Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islare 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 offi 'al seal. Signature Ch ' er J. Roach CERTIFICATE The undersigned, as Assistant Secretary, of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney, are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California, the day of FEB 1 1 2008 By: Albert Hillebrand, Assistant ecretary ID- 11 380(Wet)(Rev.07/07) 2008 -02- 1114:06 3782• - •a.1 P 10/11 LABOR AND MATERIALS BOND PAINTING OF PUBLIC FACILITIES IN THE CITY OF EL SEGUNDO IN THE CITY OF EL SEGUNDO SPECIFICAITON NO.: PW 07.12 EX cum IN TWO (2) ORIGINAIS Bond No. 732979P Bond Fee: INCLUDED TONY'S PAINTING INC , as principal incorporated under the laws of the State of CALIFORNIA 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 FORTY NINE THOUSAND NINE HUNDRED FIFTY DOLLARS AND ZERO CENTS ($49,960.00), 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 replacement of playground equipment at Recreation Park and Candy Cane Park, SPECIFICATIONS NO.PW 07 -12 ( "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 07 -12, 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" ), I -F -1 3 7 8 2 LUUt1-02-1114:Ub >> N 11x11 ' BOND NO. 732979P 5. SURETY, for value received, agrees that no changes, extensions of time, alteration or modification of SPECIFICATIONS NO. PW 07-12, 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; 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 11TH day of FEt'ARY 1� L120; 8 TONY S PAINTING INC. P Cl AL's PRES ENT PRI CI AL's S TARY PRINCIPAL's MAILING ADDRESS: 12812 VALLEY VIEfni' SP STE 14 GAIMM ( tQZE- CA 92845 LEE CRANE (ATTORNEY-IN-FACT-) SURETY's SECRETARY SURETY's MAILING ADDRESS: 20250 VENTURA BLVD STE 240 WOODLAND HIUS CA 91364 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. I -F -2 CALIFORNIA ALL — PURPOSE ACKNOWLEUGEMCN I State of California County of Los Angeles On FEB 1 1 2008 before me, JAN - MICHELLE S. REALEZA, NOTARY PUBLIC DATE NAME, TITLE OF OFFICER Personally appeared SHILO LEE CRANE , 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 th of the State of California that the foregoing paragraph is true and correct. Commission # 1 >'a ZLEZ WITNESS my hand and official seal. y No1pry Public - Cairomb Los An Ojos County I Can. JU3 2011 SIQ ATl1RF nF NOTARY SEAL NOTARY 37 8 2 • .' POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263 -3300 KNOW ALL MEN BY THESE PRESENTS, that as except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each, hereby make, constitute and appoint: ** *Stephanie Hope Shear, Shilo Lee Crane, jointly or severally * ** as their true and lawful Attomey(s) -in -Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts of surety- ship giving and granting unto said Attomey(s) -in -Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attorney(s) -in -Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Board of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st, 2008. RESOLVED, that the chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is, authorized to execute Powers of Attorney, qualifying the attomey(s) named in the Powers of Attorney to execute, on behalf of the corporations, bonds, undertakings and contracts of suretyship; and that the Secretary or any Assistant Secretary of the corporations be, and each of them hereby is, authorized to attest the execution of any such Power of Attorney; RESOLVED, FURTHER, that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF their respective Vice President and attested by their respective Assistant Secretary this January 1st, 2008. AN Br•, INOF Stephen T Pate, Senior Vice President J gFOJ� tu f4� OCT. r� By o 1836 Charles L. Day, Assistant Secretary b State of California County of Orange CALIFORNIA have severally caused these presents to be signed by ANYO PO�9 r OCT.5 O W 1987 On January 1st, 2008 before me, Christopher J. Roach, Notary Public Date Here Insert Name and Title of the Officer personally appeared Stephen T Pate and Charles L. Da Name(s) of Signer(s) Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islare subscribed to the within instrument and acknowledged to me that helshelthey 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 taws of the State of California that the foregoing paragraph Is true and correct. WITNESS my hand and offi 'al seal. Signature Ch ' er J. Roach CERTIFICATE The undersigned, as Assistant Secretary, of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney, are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California, the day of FEB 1 12008 By: V Wc_�d_r�� Albert Hillebrand, Assistant Secretary ID- 1380(Wet)(Rev.07 /07) 3782. 0-"GI PROPOSAL PAINTING OF PUBLIC FACILITIES IN THE CITY OF EL SEGUNDO IN THE CITY OF EL SEGUNDO SPECIFICATIONS NO.: PW 07 -12 TO THE CITY OF EL SEGUNDO: In accordance with the City of El Segundo's Notice Inviting Sealed Bids, the undersigned BIDDER hereby proposes to furnish all materials, equipment, tools, labor, and incidentals required for the above stated project as set forth in the Plans, Specifications, and contract documents therefor, and to perform all work in the manner and time prescribed therein. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders, and all other contract documents. Submittal of this bid shall be considered evidence that the BIDDER has satisfied himself regarding the contract documents, access and any other field conditions which may affect bid prices. If this proposal is accepted for award, BIDDER agrees to enter into a contract with the City of El Segundo at the unit and /or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to the City of El Segundo of the proposal guarantee accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE CITY OF EL SEGUNDO RESERVES THE RIGHT TO INCREASE OR DECREASE THE AMOUNT OF ANY QUANTITY SHOWN AND TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and /or lump sum prices bid include all apparent expenses, taxes, royalties, and fees. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned further agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within ten working days after the date of the City of El Segundo's notice of award of contract to the BIDDER, including sending by U.S. Mail a Public Works Contract for signature by the Awardee, the proceeds of the security accompanying this bid shall become the property of the City of El Segundo and this bid and the acceptance hereof may, at the City of El Segundo's option, be considered null and void. I -C -1 NASPECS.MST I -C -1 (02- 28 -02) 3 7 8 2 - ." ;' ;, EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE BIDDER certifies that in all previous contracts or subcontracts, all reports which may have been due under the requirements of any agency, State, or Federal equal employment opportunity orders have been satisfactorily filed, and that no such reports are currently outstanding. AFFIRMATIVE ACTION CERTIFICATION BIDDER certifies that affirmative action has been taken to seek out and consider minority business enterprises for those portions of the work to be subcontracted, and that such affirmative actions have been fully documented, that said documentation is open to inspection, and that said affirmative action will remain in effect for the life of any contract awarded hereunder. Furthermore, BIDDER certifies that affirmative action will be taken to meet all equal employment opportunity requirements of the contract documents. NONCOLLUSION AFFIDAVIT BIDDER declares that the only persons or parties interested in this proposal as principals are those named herein; that no officer, agent, or employee of the City of El Segundo is personally interested, directly or indirectly, in this proposal; that this proposal is made without connection to any other individual, firm, or corporation making a bid for the same work and that this proposal is in all respects fair and without collusion or fraud. I -C -2 37 82 ..:: CITY OF ELSEGUNDO — BID SHEET PAINTING OF PUBLIC FACILITIES IN THE CITY OF EL SEGUNDO PROJECT NO. PW 07 -12 ITEM ESTIMATED UNIT PRICE AMOUNT NO. QUANTITIES WRITTEN IN WORDS 1 LS Painting of the Park Vista Senior Apartments complete in place. $ 2 LS Painting of the Lakes Golf Course complete in place. $ 3 LS Painting f the Police Department Jail complete in place. $ TOTAL BID = $ tiq q50 " TOTAL BID WRITTEN IN WORDS FOR" 14NE '(M%WD NINE 040M � P N D01,t,1 AS AN b No GENTS. I -C -3 (page 1 of 1) 3782.,,.= BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder's Name TON`! PAINTING INC. Form of Legal Entity (i.e., individual, partnership, corporation, etc.) 6VIW0 RATI 0IJ If corporation, State of Incorporation (i.e., California) 0AWFORMA Business Address 12$12- VAtXy VIEW 5TRe6T Address SUYF 114 GARDEN GROVE , CA, 82845 Telephone No. -+d4. 8 i `1 • 6-30S FAX No. 114. 8101. 5305 State Contractor's License No. and Class # 32016 y C- 33 Original Date Issued 06120 Expiration Date 113012col The following are the names, titles, addresses, and phone numbers of all individuals, firm members, partners, joint venturers, and /or corporate officers having principal interest in this proposal: PrNIF MAR I JANOVIG PW510EW I- CEv , RM 0 I2512 yAu y view 5T svItE 14 &AROEN C R0V E GA 012-W45 The date of any voluntary or involuntary bankruptcy judgements against any principal having an interest in this proposal are as follows: NIA All current and prior DBA's, alias, and /or fictitious business names for any principal having an interest in this proposal are as follows: ANtI: MARIJANoV10- p8A'9 TVNY PAWTING INC. TONY PAINTING I -C -4 37 82 IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, titles, hands, and seals of all aforenamed principals this 15 day of JANVAPY , 2008 . BIDDER T-ONY PAW7 -W6 INC. TE AR i 7ANOV I G Subscribed and sworn to this i g day of (I�V\ 20 i NOTARY PUBLIC A AA w w a SAM BEIK t� FQ- COMM. #1510806 00 NOTARY PUBLIC - CALIFORNIA I ORANOECOUNTY O My Comm, Expires Sept. 29. 2008 I -C -5 PROPOSAL GUARANTEE BID BOND PAINTING OF PUBLIC FACILITIES IN THE CITY OF EL SEGUNDO IN THE CITY OF EL SEGUNDO SPECIFICATIONS NO.: IOW 07 -12 KNOW ALL MEN BY THESE PRESENTS that, 3782• :1 N �F'Y TONY PAINTING, INC. , as BIDDER, and DEVELOPERS SURETY AND INDEMNITY COMPANY as S'�2ETY, are held and firmly bound unto the City of El Segundo, in the penal sum ofTEN PERCENT D DOLLARS ($ * ), 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. *TMR GREATEST AMOUNT BID ($10% G.A.B.) 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 E1 Segundo. IN WITNESS WHEREOF the parties hereto have set their names, 14TH day of JANUARY 20 08 BIDDER* TONY SURETY* I AND INDEMNITY ✓�� P Cr0 LEE CRANE (ATT'ORNE'Y -1N -FACT) Subscribed -and sworn to this 14TH day of JANUARY 20 08 NOTARY PUBLIC * . provide BIDDER /SURETY name, address and telephone number and the name, title, address and telephone number for authorized representative. I -C -E N:%PECS.PRJTW JC6 102.11.02) IFORNIA ALL — PURPOSE ACKNOWLEDGEMENT State of California County of Los Angeles On ,SAN 14 7nna before me, JAN-MICHELLE S. REALEZA, NOTARY PUBLIC DATE NAME, TITLE OF OFFICER Personally appeared SHILO LEE CRANE , 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. JAN- MICHELLE S. REALEZA Commission # 1755186 z : �� �j, Notary Public - California Los Angeles County �ExpIves 3. JUI 20 11 NOTARY SEAL I POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263 -3300 KNOW ALL MEN BY THESE PRESENTS, that as except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each, hereby make, constitute and appoint. ** *Stephanie Hope Shear, Shilo Lee Crane, jointly or severally * ** as their true and lawful Attomey(s) -In -Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts of surety- ship giving and granting unto said Attorney(s) -in -Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attomey(s) -in -Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Board of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st, 2008. RESOLVED, that the chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is, authorized to execute Powers of Attorney, qualifying the attomey(s) named in the Powers of Attorney to execute, on behalf of the corporations, bonds, undertakings and contracts of suretyship; and that the Secretary or any Assistant Secretary of the corporations be, and each of them hereby is, authorized to attest the execution of any such Power of Attorney; RESOLVED, FURTHER, that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective Vice President and attested by their respective Assistant Secretary this January 1st, 2008. By, �•{AAND j�,O,42 Stephen T, Pate, Senior Vice President s �J +��POaq a+d>sZ a� OCT. F��Q fUA 10 qty: By'o� 1836_ Charles L. Day, Assistant State of California County of Orange �OMpANY�.� v�'PON�i(��"�•. =OC7.5 �o U t9f37 cq < /Foe���P fi On January 1 st, 2008 before me, Christopher J. Roach, Notary Public Date Here Insert Name and Title of the Officer personally appeared Stephen T. Pate and Charles L. Day 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 CHRISTO>'H J: 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. COMM # 174500 NOTARY PUBLIC CALIFRO 11A I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is ORANdE COUNTY true and correct. 4b.My0MM!2tftMay;19; 2D11 WITNESS my hand and offi al seal. Place Notary Seal Above Signature Ch' erJ.Roach CERTIFICATE The undersigned, as Assistant Secretary, of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked, and furthermore, that ths provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney, are In force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California, the day of JAN 1, 4 2008 By. 44?9��� Albert Hillebrand, Assistant eoretary ID-1 380 (Wet)(Rev.07 /07) CONTRACTOR'S LICENSE DECLARATION (Business and Professions Code Section 7028.15) BIDDER'S Contractor's License Number is: 32016y Class No.: x-33 2. The expiration date of BIDDER'S Contractor License is: SEPTUM OUR 30 , 2009. 3. BIDDER ACKNOWLEDGES THAT section 7028.15(e) of the Business and Professions Code provides as follows: "A licensed contractor shall not submit a bid to a public agency unless his or her contractor's license number appears clearly on the bid, the license expiration date is stated, and the bid contains a statement that representations herein are made under penalty of perjury. Any bid not containing this information, or a bid containing information which is subsequently proven false, shall be considered non - responsive and shall be rejected by the public agency." The undersigned declares, under penalty of perjury, that the representations made by the undersigned in this bid proposal are true and correct. Executed on 15 J,41WA" , 2000 , at GARDW4&V6 GARDEN GROVE CALIFOAN /A (insert City and State where Declaration is signed). Sig at re ANA WRIIANOVlG Typed Name aU- PRE100"f.ctor Fmo Title TONY PAINTlNC� INC. Steteot;Qajlginia, countyo. -.1- - Name of Bidder Sp6st gibed ali¢ $worn to (oi atbrrned }, be lof M on this (cloy of by AN Tr- i"( iP, Q_9"-PV Y� porsQnal y known to or p Y @cl to -me'an 1�i basis of satisfy evidence tri.l.itie pBni9llrx) who appe efor signat lAi A t> _ a :...::. SAM BEIK ��. COMM. #1510806 n NOTARY PUBLIC - CALIFORNIA -4 I -C -7 m ORANGE COUNTY O My Comm. Expires Sept. 29.2008 3782 -;�� NON - COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ) ) ss. County of ) ANTE MARi7AtIOV/t✓ , being first duly sworn, deposes and say that he or she is fWclKNTI fkb� 9-MO of 7_010 PAINRM5 /NC. 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 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. ANM MAR17RA10V1Ci Typed Name PRCStDWT, (%70. RMO Title State,of;Cafiforrna, County.01C Subur,bod adt.sworn to (oc affirmed) betor-e on this l._ dart of 26 a '3, ppf:rsarra}iy'0own to me or proved to me on the ' I_C_$ ba6is- gf::aali0ac deuce to be the er"nfs). W40 ore Sighature:- TON y PA11V77 (3 /Aic . Name of Bidder /5. JANVAP -y. 2005 Date o SAM B 1 comm. #1510806 W m 2 NOTARY PUBLIC • CALIFORNIA Q ORANGE COUNTY My Comm. Expires Sept, 2% �QOd 3782. , -;;I CERTIFICATION Section 1861 OF THE LABOR CODE (Workers' Compensation) Pursuant to Section 1861 of the Labor Code, the BIDDER, in submitting his PROPOSAL, shall sign the following certification: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation 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: Title: 4 pRU122'r Crr i RMO Business Name: %-ONY PAINTING NO . Business Address: 12812 VAUCY MW MEET r SvliF M GARDN GROVE , CA . g28N5 - Telephone Number: -+ly. f3gq. 5303 Dated this 15 day of JAWAPLY , 2008 . I -C -9 DESIGNATION OF SUBCONTRACTORS BIDDER proposes to subcontract certain portions of the work which are in excess of one -half of one percent (1/2 of 1 %) of the bid and to procure materials and equipment from suppliers and vendors as follows: NAME, ADDRESS AND PHONE NUMBER OF SUBCONTRACTORS, SUPPLIERS, AND VENDORS PORTION OF WORK, MATERIALS, OR EQUIPMENT I -C -10 NASPECS.MST (02/25/02) ` e 1 3? 6 2 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: Neal 6615- MMMeP POEM 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? 2. 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? 3. 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? I -C -11 (Page 1 of 2) °< 2 . - s 0 • 12812 Valley View St. Suite 14 License # 320164 Garden Grove, Ca. 92845 Phone: (714) 899 -5303 e -mail: tonyspaintingsb @yahoo.com Fax: (714) 899 -5305 website: www.tonypaintinginc.com Contractor References • County of Riverside Educational Center 3939 Thirteenth Street Riverside, CA 92502 Interior/Exterior Painting 2003 -2007 Contract Price: $150, 000.00 ( +) Contact: Tim Lopez (951) 453 -1869 • City of Beverly Hills 345 N. Foothill Road Beverly Hills, Ca 90210 Interior Painting of 2 Parking Structures, 2007 Contract Price: $216,890. 00 Contact: Norman Berezowsky (310) 285 -5202 • Alvord Unified School District 10365 Keller Avenue Riverside, Ca 92505 Exterior Painting at 13 School Sites, 2007 Contract Price: $595, 000.00 Contact :Dennis Hadaway (951) 509 -5049 • Lona Beach City College 4901 E. Carson Street Long Beach Ca, 90808 Interior Painting of Gymnasium, 2006 -2007 Contract Price: $129,483.00 Contact :Nicholas Shambra ((562) 938 -4207 • Temecula Vallev Unified School District 31350 Rancho Vista Road Temecula, Ca 92592 Exterior Painting at 4 Schools Sites, 2007 Contract Price: $ 81,950. 00 Contact: Jim Miller (951) 695 -7115 • Juruna Unified School District 4850 Pedley Road Riverside, Ca 92509 Exterior Painting at 6 School Sites, 2007 Contract Price: $218,500. 00 Contact:Bill Elzig (951) 360 -2704 • San Bernardino Unified School District 777 North " F" Street San Bernardino, CA. 92410 Exterior Painting 2006 -2007 Contract Price 1654,720. 00 Contact: Armando Tamayo ( 909) 213 -3882 Thank You for Your Business 37 8 2 . 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: PWA-6 E sEr A7rA aPCD rOo?" 1 -C -11 (Page 2 of 2) 3 7 8 2 . ,4' 12812 Valley View St. Suite 14 License # 320164 Garden Grove, Ca. 92845 Phone: (714) 899 -5303 e -mail: tonyspaintingsb@yahoo.com Fax: (714) 899 -5305 website: www.tonypaintinginc.com Surety Firm Surety Firm: Contractors Best Insurance Services 20350 Ventura Blvd., Suite 205 Woodland Hills, Ca. 91364 Contact: Shilo Crane (888) 960 -1361 Insurance Carriers General Liability: Powers and Company. P.O. Box 619043 Roseville, Ca. 95661 -9043 Contact: Marc Gilbreath (916) 630 -8659 Auto Insurance: Allstate Insurance 16168 Beach Blvd. Suite # 115 Huntington B each, Ca. 92647 Contact: John Murphy (714) 843 -0501 Worker's Compensation: State Fund 1750 E. Fourth Street Santa Ana, Ca. 92705 (877) 405 -4545 Thank You for Your Business 3782 . , w-9 Request for Taxpayer Give form to the Form (Rev. November 2005) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service cy Name (as shown on your income tax return) rn Tony Painting Inc. CL Business name, if different from above c 0 N 0 p Individual/ ❑ © Corporation ❑ Partnership ❑ Other ► _ _ _ _ _ _ _ _ _ _ Exempt from backup ❑ withholding 4' 00 Check appropriate box: Sole proprietor 0 � 2 Address (number, street, and apt. or suite no.) Requester's name and address (optional) 4817 Elder Avenue City, state, and ZIP code Sc v Seal Beach, California 90740 N �i List account numbers) here (optional) U) MM Taxpayer Identification Number IN Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid social security number backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or Employer Identification number 1817+01719161210181 Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. WMM Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that 1 am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. person (including a U.S. resident alien). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. (See the in+ctions on page 4.) Sign I Signature of Here U.S. person ► Purpose of Form A person who is requir to file an information return with the IRS, must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. U.S. person. Use Form W -9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. In 3 above, if applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. Note. If a requester gives you a form other than Form W -9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W -9. For federal tax purposes, you are considered a person if you Date ► 11 TED .Z00b • An individual who is a citizen or resident of the United States, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, or • Any estate (other than a foreign estate) or trust. See Regulations sections 301.7701 -6(a) and 7(a) for additional information. Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W -9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W -9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W -9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: * The U.S. owner of a disregarded entity and not the entity, are: Cat. No. 10231X Form W-9 (Rev. 11 -2005) • , CERTIFICATE OF LIABILITY INSURANCE PRODUCER Powers and Company Insurance Agents and Srokexs P. o. Box 619043 Lie #0802564 Roseville CA 9566!. -9043 phone1916- 630 -8643 rax:800 -783 -0083 �� 17 yg Inc. ElcaEaK A p 40 Seal DATE BY THE INSURERS AFFORDING COVERAGE NAIC S INSURER A' Navigators Insurance Cc - T 42307 INSURER B: _ INSURFR C. Y INSURER D: _ (:UVCKAUCS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH pOMIEs. AoWEGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, _ .... -PO OT LTR NSR I ANCE POLICY NUMBER pip EFF OIYY PAN EXPIRATION LIMITS A X 6EN ERAL X COMM6RCIALGENERALUABILMY CLAIM8 MADE X] OCCUR 0410017716 06/17/07 06/17/08 EACH OCCURRENCE 1111,000,000 y $ 50,000 MED EXP (Arty om mnwn) 55,000 PERSONAL & AM INJURY S 1,.000 , 000 $2,000,000 X Owner /Coat Prot. 06 FERAL AGGREGATE OEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO _ $1,000,000 POLICY X JEST .. koc AUTOMOBILE LIAI % TY CCOMMMEEDD )SINGLE LIMIT S ANY AUTO ALL OWNED A1008 BODILY INJURY Per pown) 3 SCHEDULED AUTOS HIRED AUTO-- NON -OWNED AUTOS F L—Y dit INJURY y ... - --- PROPERTY OnMnaE S GARAGE LIABILITY ALTO ONLY - EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY, AGG S ANY AUTO S EXCEESWMBRELLA LIA811.I7Y EACH OCCURRENCE f AGGREGATE S OCCUR ` CLAIMS MADE S ...I DEDUCTIBLE ---- .... - - -• __ _ ! . f RETENTION i WORKERS COMPENSATION AND TORY LIMB& UP E.L. EACH ACCIDENT S EMPLOYERS 'LELIIABILITY FFIG�ERO/M�Mwe X �� ECUTIVE S E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT S By� orb" and"r SPECIAL PROVISIONS bnbw TH DESCRIPTION OF OPERATIONS 1 LOCATIONS! ICL - 1 OLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *10 day NOC applies for non - payment of premium. The City of El Segundo, its officers, agents and employees is included as Additional Insured under CoBEBercial General Liability policy per endorsement ANr-zs 160 (5/2006), subject to a written contract between Named Insured and Additional Insured. * *Endorsement to follow from company, (see attached notepad) CIyon SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION C:L ty of El Segundo DATE THEREOF, THE ISSUING INSURER Wft*MMWWM TO MAIL. 30* DAYS WRITTEN public Works Dept. NOTICE To THE CERTIFICATE MOLDER NAMED TO THE LEFT, El Segundo City Hall I- 350 Main Street E1 Segundo CA 90245 AUTHOR _ DTATIVt_rrJ Ak n n nn dAr1/lw 4 ACORD Z5 (ZOUIR M) 2008 -02- 2010:20 POWERS AND CO Page 11 37 82 . , , IMPORTANT If the certificate holder is On ADDITIONAL INSURED, the policy(ies) 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. 2008 -02- 2010:20 POWERS AND CO Page 2 , Ub I i . 00 . t A. to - -.1 ap . p . I r I a I va . 1 . -.- Re I Various . . . . . Public FACilitiC3 throughout the City of El Segundo 37 82 2008 -02- 2010:21 POWERS AND CO Page 3 03/03/2008 10:09 8667013102 KIM WENCESLAO PAGE 01 782• � • s THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT (EXCLUDING RESIDENTIAL) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL. LIABILITY COVERAGE PART ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) CG 20 10 11 85 i Policy Number. 04- 10017716 Endorsement Effective: 02/20/0"6/17/08 12:01 �m Narned Insured Countersigned By'. TONY PAINTING, INC. • SCHEDULE Name of Person or Organization: PUBLIC WORKS DEPT.; EL SEGUNDO CITY HALL; THE CITY OF EL SEGUNDO, IT'S OFFICERS, AGENTS, AND EMPLOYEES 350 MAIN STREET EL SEGUNDO, CA 90245 INTERIOR /EXTERIOR PAINTING NOT TO EXCEED 3 STORIES IN HEIGHT OF PUBLIC FACILITIES, A COMMERCIAL BUILDING, LOCATED THROUGHOUT EL SEGUNDO CA _ WHO IS AN INSURED (Section ll) 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. The following additional provisions apply to any entity that is an Insured by the terms of this endorsement 1, Primarv_Wc)rdino If required by written contract or agreement" Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self- insurance maintained by the above additional insured(s) shall be excess of the insurance afforded to the named insured and shall not contribute to it. 2. Waiver of Subrogation If required by written contract or agreement: We waive any right of recovery we may have against an entity that is an additional insured per the terms of this endorsement because of payments we make for injury or damage arising out of "your work" done under a contract with that person or organization. 3. Neither the coverages provided by this insurance policy nor the provlsione of this endorsement shall apply to any claim arising out of the sole negligence of any additional insured or any of their agents/employees, 4. This endorsement does not apply to any work Involving or related to properties intended for permanent residential or habitational occupancy (other than apartments). . The words "you" and "your" refer to the Named Insured shown in the Declarations. "Your work" mcans work or operations performed by you or on your behalf; and materials, parts or equipment furnished in connection with such work or operations. ANF -E: 160 (5/2006) MAR -03 -2008 10:02 8667013102 96% P.01 reo 1a euuu u:tuvm HV LHStKJtI rHA P.2 3 7 J 2 . X CERTIFICATE OF INSURANCE ® ALLSTATE INSURANCE COMPANY ❑ ALLSTATE INDEMNITY COMPANY E THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS N HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY T�Lffy'FIXWROFATE CERTIFICATE HOLDER NAMED INSURED Name and Address of Party to Whom this Certificate Is Issued Name and Address of Insured Public Works Department Ante Marijanovic DBA Tony's Painting El Segudo City Hall 4817 Elder Ave 350 Main St El Segundo, Ca 90245 Seal Beach, CA 90740 p Certificate Holder is named Additional Insured 0 rc-)) f This is to certffy that policies of Insurance listed below have been issued to the insured named above subject to The eAWF'st6A date icated below. notwithstanding ^ standing any requiiremtent. term o` ' condition of any contract or other document with respect to which this certificate may be issued or may pertain. The TYPE OF INSURANCE AND LIMITS COMMERCIAL GENERAL LIABILITY Policy Effective Expiration Number Date Date Um it Amount GENERAL AGGREGATE LIMIT (Other than Products - Completed Operations) PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT EACH OCCURRENCE LIMIT PHYSICAL DAMAGE LIMIT ANY ONE LOSS MEDICAL EXPENSE LIMIT ANYONE PERSON WORKERS' COMPENSATION & Policy Effective Expiration EMPLOYERS' LIABILITY Number Date Date Coverage Limits WORKERS' COMPENSATION STATUTORY - applies only In the foll Ing states: BODILY INJURY BY ACCIDENT EACH ACCIDENT EMPLOYERS' BODILY INJURY BE DISEASE EACH EMPLOYEE LIABILITY BODILY INJURY BY DISEASE POLICY LIMIT AUTOMOBILE LIABILITY Policy 048728943 Effective 06/04/2007 Expiration 06/04/2008 Number Date Date Coverage Basis Limits ANY AUTO 13 OWNED AUTOS C1 HIRED AUTOS Combined Single Umit of Liability BODILY INJURY S PROPERTY DAMAGE 1,000.000 EACH ACCIDENT SPECIFIEDAUTO 0 NON -OWNED AUTOS Split Liability Limits Bodily Injury Property Damage Each El OWNED PRIVATE PASSENGER AUTOS ,.. _ PERSON OWNED AUTOS OTHER THAN PRIVATE PASSENGER ACCIDENT UMBRELLA UABILITY Policy Effective Expiration Number Date Date EACH OCCURRENCE GENERAL AGGREGATE PRODUCTS - COMPLETED OPERATIONS AGGREGATE OTHER (Show Policy Effective Expiration type of Poll Number Date Date DESCRIPTION OF OPERATIONSI LOCATIONSIVEHICLESIRESTRICTIONS /SPECIAL ITEMS CANCELLATION Number of days notice 30 JOHN MURPHY February 19, 2008 Authorized Repr~tetive owa Should any of the above described policies be cancelled before the expiration date; the issuing company will endeavor to mail within the ntrrntwr of riays entered above, written notice to the certificate holder named above. But failure to mail such notice shall impose no obligation or liability of any kind upon the com any, its agents or representatives M23 -2 200 8-02 - 1912:57 ALLSTATE INSURA Page 2 7 8 2 CERTHOLDER COPY SP STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142- -0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 02 -11 -2008 GROUP: POLICY NUMBER: 0616634 -2007 CERTIFICATE ID: 123 CERTIFICATE EXPIRES: 06 -28 -2008 06-28- 2007/06-28-2008 CITY OF EL SEGUNDO SP JOB:PW 07 -12 PUBLIC WORKS DEPARTMENT, CITY HALL 350 MAIN ST EL SEGUNDO CA 90245 -3813 Copy 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. THORIZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07 -17 -2007 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER TONY PAINTING INC SP 4817 ELDER AVE SEAL BEACH CA 90740 [RDG,CNj IREV.2 -05I PRINTED : 02 -11 -2008 3782 POLICYHOLDER COPY SP STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142 -0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 02 -11 -2008 GROUP: POLICY NUMBER: 0616634 -2007 CERTIFICATE ID: 123 CERTIFICATE EXPIRES: 08 -28 -2008 06-28- 2007/06 -28 -2008 CITY OF EL SEGUNDO SP JOB:PM 07-12 PUBLIC WORKS DEPARTMENT, CITY HALL 380 MAIN ST EL SEGUNDO CA 80248 -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 mend, 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. Ck�rr r�.t.i✓ `��� HORIZED REPRESENTATIVO PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2086 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07 -17 -2007 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER TONY PAINTING INC SP 4817 ELDER AVE SEAL BEACH CA 90740 (RDG,CNj (REV.2.05) PRINTED : 02 -11 -2008