CONTRACT PW 13-30 Tennis Court Resurfacing CLOSED Bond Number: 1000801696-31
PROPOSAL GUARANTEE
BID BOND
TENNIS COURT RESURFACING
PROJECT NO.: FW I3-30
I NOW ALL VIEN BY THESE PRESENTS that,
Edward C.Kruse dba:Trueline ;131Dlh IL, and
American Contr actors Indemnity Company s as SURETY,are geld and firmly.bound unto the
City of El Segundo, in the penal sum of * 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 whiclr sum,BIDDER and SURETY agree to be bound,jointly and
severally,firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION_ARE SUCH that,whereas BIDDER is about
to submit a bid to the City of El Segundo for the above stated.project,if said bid is refected,or if
said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and
time specified;then this obligation shall be null and void.otherwise it shall remain in full force
and effect in favor of the City of El Segundo,
IN WITNESS WHEREOF the parties hereto have set their names,titles,hands, and seals this
1.9th day tIl May 20 14
BIDDER* ladward C.Kruse dba:Trueline
SURETY* American Gong t s Indemnity Cornpany.,--
Paul S.Dito,Attorney-In-Fact
Subscribed and sworn to this 12th day of May 1 20 14
NOTARY PUBLIC
*Provide BIDDER/SURETY name,title, address and telephone number and the name, title,
address and telephone number for authorized representative,
*Five Thousand Dollars and 00/100
** $5,000.00
I-C-7
State of California CALIFORNIA ALL-PURPOSE
II
County of orange _ _a_..-....—__ ,..... - ....w.. ) CERTIFICATE OF ACKNOWLEDGMENT
19, 2014 before me, M. Barreras, Notary IR14 c „r
On m. March.. .. .-� ...._ w.....-_
(here insert name and title of the officer)
personally a pp eared Pa ul S. Dito - _ mw. ..._ _.... ........ ..�._....._..m....__ . _"""
�.a., _..�. ..... _ ........ .m... ,�.....e.. A....� .._...m...._..... -- -- r
who proved to me on the basis of satisfactory evidence to be the person(V whose name(10 isMM subscribed to
the within instrument and acknowledged to me that he/lImMUy, executed the same in his/ K#
authorized capacity(}, and that by hisIMOX signatureW on the instrument the person(30, or the entity
upon behalf of which the person(Ka 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, M.BARRERAS
Commission 2048208
a Public-California
WITNESS my hand and official seal. Orange County
Comm.Ex Ires Nova 20ty
p
Signature �.,.. .�,.. .:
(Seal)
OPTIONAL INFORMATION "
Although the information in this section is not required by law,it could prevent fraudulent removal and reattachment of this
acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document.
Description of Attached Document r
The preceding Certificate of Acknowledgment is attached to a document "tits "r signer identification
titled/for the purpose of Bond No 1000801696-31
Proved to me on the basis of satisfactory evidence:
_ , _...
L-0 form(s)of identification 0 credible witness(es)
Notarial event is detailed in notary journal on:
containing pages,and dated Page# Entry#
The signer(s)capacity or authority is/are as. Notary contact:
❑ Individual(s) other
m Attorney-in-Fact ❑ AdditionalSigner(s) ❑ Signer(s)Thumbprint(s)
❑ Corporate Officer(s)
Title(s) ❑
❑ Guardian/Conservator
❑ Partner-Limited/General
❑Trustee(s)
❑ Other:
representing- American Contractors Indemnity Company
Varnwr(s'J ofPets0a 0 a tnir ype0 5urtuas0 Is,Rep resenIIn
®Copyright 2007 Notary Rotary,Inc,925 29th St,Des Moines,IA 50312-3612 Form ACK03. 10/07 To re-order,call toll-free 1-877-349-6580 or visit us on the Internet at http:%/wwW,notaryrotary cam
POWER OF ATTORNEY
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
UNITED STATES SURETY COMPANY U.S.SPECIAI'TY lNSVRANCIt COMPANY
1«NOW A:LL, Mt,,N 13Y THESE PRESENTS: That American Contractors Indemnity Company, ar Californian ctirprarkt�On, "l° Sit
l tlnelitrg
Company,v an assumed name of American Contractors Indemnity ,Coitlpart , United States Surety Co nitaat , a°'Mi ryland
corporation and U.S. Specialty Insurance Company, a Texas corporation(collectively,the"Companies"), do by these presents make,
constitute and appoint:
Paul S.Dito,Ariel T.Heredia,Khoi Tra n,Maricela'Lares,for Angola Min of Orange,California
;Mme&d4awTo1 oiney(s)-in-1"act,each"in their,,separate capacity if more than one is narned above„with fiwil power and atnh lity
ere anferred in its name,place a nt#stead,to exoiciltd,acknowledge and deliver any and all bonds, revogni ances,undertaking's
or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond
penalty does not exceed *****Three Million***** Dollars ($, **3,000,000.00**
This Power of Attorney shall expire without further action on December 08,2016.This Power of Attorney is graved under and by
a+ithortofhe_following resolutions adopted by the Boards of Directors of the Compannies -
t es e h ePresident,any Vice-President,any Assistant Vice-President,any Secre arrygT any Assistant Secretary shall be and is lereby-vesCed With=
w�utl point any one or more suitable persons as Attorney(s)-in-Fact to represmiMr�'and on behalf of the Company s - -et-to�Ahe few-stg
�rov�srertsc -
Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and deliver,any and all bonds,
recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained
percentages and/or final estimates on engineering and construction contracts,and any and all notices and documents canceling or terminating the Company's liability
thereunder,and any ue *truments so executed byany_such A rneF- act shall be binding upon the Company as if signed by the President and sealed and effeictedl
he�e€porat�See�etae -
-1te?iMeso-Ne a�Ignature of any authorize afficer-and�061 company heretofore or hereafter affixed to any power of attorney oniftAwMatexalaft
6eref acsitrfile any power of attome�o-t--certMeatAeaungTaEs�imile signature or facsimile seal shall be valid and binding upon the ComAdO WI#E tec -
any bond or undertaking to which it is attached.
IN WITNESS WHEREOF,The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this
10th day of December,2012.
AMERICAN CONTRACTORS INDEMNITY COMPANY 177 AS BON PING COMPANY'
UNITED STATES SURETY COMPANY U.S.SPfT,C],,ALA". VI.NSURANCE'C'C'I?'M I ANY'
Corporote'Seals
'� " „'TM�NaYu4VY 48 A3 'rte ,
Aoe ul
ok
svr as n®so ids
�4z � � ilarii
= ~�„ ,�, � ;�„ � •,��� � 4, � f�t Daniel P.Aguilar,Vice President
Stait;�of Catlil`oa`iiitt ;,
'Cottrtty°ol`LOS An„el S SS,
On 10th day of December,2012,before me,Vanessa Wright,a notary public,personally appeared Daniel P.Aguilar,Vice President of
American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance
Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument
and acknowledged to me that he executed the same in his authorized capacity, and piaaat by bas sug l'ffltffe on the iansQrruarrnml the
person(s),aarr the entity upon behalf of which the person(s)acted,executed tlic instrument
I certify under`PENALTY OF PERJURY under the laws of the State of Cad`atorniaa that Ific forq;cing paragraph is true and coircct.
WITNESS my hand and official seal. ii M
Canuniabn 1 1919819
Signature (Seal) taaarrtaak-® ®r.w
Los AR9019 0"01Y
Comm t a. t9
1, .)CjnIIiC'L e,�ss►stant Secretary olf American Cdntracto Indemnity Company, Texas Bonding Company, United States suret I y
Company and U.S. Specialty Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power
of Attorney,executed by said Companies,which is still in full force and effect;furthermore,the resolutions of the Boards of Directors,
set out in the Power of Attorney are in full force and effect.
1.9 th -
In Witncv, hereof,I hawnC2l c into set my hand and affixed the seals of said t orripanies les,California-this = day
of
In fl
Corporate_Seals
. ��w a��h s A ti9 r snaR m n��G u" "^r 4x '�' w 6 a" '•'e"Y rymr.r�
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gencp N i
PROPOSAL
FOR THE
TENNIS COURT RESURFACING
PROJECT NO.: PW 13-30
Date ". 20 0
Company Name:
TO THE CITY OF EL SEGUNDO:
In accordance with the City of El Segundo's Notice Inviting Sealed Bids, the undersigned
BIDDER hereby proposes to furnish all materials, equipment, tools, labor, and incidentals
required for the above stated project as set forth in the Plans, Specifications, and contract
documents therefor, and to perform all work in the manner and time prescribed therein.
BIDDER declares that this proposal is based upon careful examination of the work site,Plans,
Specifications, Instructions to Bidders, and all other contract documents. Submittal of this bid
shall be considered evidence that the BIDDER has satisfied himself regarding the contract
documents, access and any other field conditions which may effect bid prices.If this proposal is
accepted for award,BIDDER agrees to enter into a contract with the City of El Segundo at the
unit and/or lump sum prices set forth in the following Bid Schedule.BIDDER understands that
failure to enter into a contract in the manner and time prescribed will result in forfeiture to the
City of El Segundo of the proposal guarantee accompanying this proposal.
BIDDER understands that a bid is required for the entire work,that the estimated quantities 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
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
GOO up I/W• c'q/
May 19, 2014
ADDENDUM NO. 1
to
THE CONTRACT DOCUMENTS, SPECIFICATIONS AND PLANS
for
TENNIS COURT RESURFACING
PROJECT NO. PW 13-30
ATTENTION BIDDERS:
The following additions, modifications, and clarifications to the specifications shall be
included in, and become a part of, any contract which may be executed for the above
project in the City of El Segundo:
1. The bid due date and time is still Tuesday,May 20, 2014, at 11:00 am
2. Replace pages II-B-7 and II-B-8 with the attached pages H-B-7R and H-B-8R.
As evidence that the BIDDER has read this Addendum, the BIDDER must acknowledge
same in the space provided below and submit this Addendum with the Bid Proposal.
Failure to provide such acknowledgement shall render the bid as non-responsive and
subject to rejection.
Signature: �",�.' �- .:-� . _� e Date: J—/"�A/
Print Company Name:
Page 1 of 1
350 Main Street,El Segundo,CA 90245-3895 (310)524-2300 Fax(310)640-0489
BID SCHEDULE
TENNIS COURT RESURFACING
PROJECT NO.: PW 13-30
Company Name: I-
Bid Schedule
ITEM DESCRIPTION QTY UNIT UNIT PRICE($) AMOUNT($)
NO.
1 Mobilization 1 LUMP
.. .....
Install new pair of post sleeves
2 for tennis court in existing 3 EACH
location. (Courts 1, 2, 5)
Completely relocate center
3 posts for tennis court,including 4 EACH
relocation of post sleeves.
(Courts 3, 4, 6, and 7)
......._......_. _._ .._...._. .. .......
Tennis Court 1 —perform full LUMP CO
4 court preparation and complete 1 sum
resurfacing _
......__._.__ ...... _.._..._.__.-
Tennis Court 2—perform full LUMP
5 court preparation and complete 1
SUM Fm
resurfacing _ ..............._.._.......... .........
Tennis Court 3—perform full LUMP
6 court preparation and complete 1 SUM
resurfacing
......._. _._ ....�...—._........ _....
Tennis Court 4—perform full LUMP
7 court preparation and complete 1 m
resurfacing SUM 35-0
Tennis Court 5—perform full LUMP
5 court preparation and complete 1 0`''
resurfacing SUM
.�
Tennis Court 6—perform full
6 court preparation and complete 1 s 1 0
resurfacing _.....— _. ...—......
__.
Tennis Court 7—perform full 00 000
7 court preparation and complete 1 sum
resurfacing
HEM
NO. DESCRIPTION QTY UNIT UNIT PRICE M AMOUNT
6 Re-stripe court per USTA 7 EACH
standards
...........................................__..........
Replace center strap anchor on
7 one court 7 EACH
........ ....... ...........
Adjust all applicable utility 3iJ8 conduits, covers, boxes, etc. to I de m
TOTAL BASE B11D(In Figures)
TOTAL BASE B1111D(In Words)
Alternate Bid Schedule (Revised 5/15/14)
ITEM
NO. DESCRIPTION QTY UNIT UNIT PRICE AMOUNT
Al Provide new tennis court net, 7 EACH
42-feet wide 2L eO
...............................................................................................................................................................................
A2 Provide new net center strap for 7 EACH
one court 17 6-
A3 Provide centerline caulking, all 405 L.F.
courts �Z
................... ...........................................
A4 Provide perimeter caulking, all 2,458 L.F.
courts
...................................
.......... .......
BIDDER'S INFORMATION
Company Name:
BIDDER certifies that the following information is true and correct:
Form of Legal, Entity (i.e., individual, partnership, corporation, etc.)
�,° " ," 4s/J,
If corporation, State of Incorporation (i.e., California)
Business Ive
Address x -1 . '"
Telephone No.
Facsimile No. rl 7 e9 77
State Contractor's License No. and Class e "f
Original Date Issued / o Expiration Date
The following are the names,titles, addresses, and phone numbers of all individuals,firm
members,partners,joint venturers, and/or corporate officers having principal interest in this
proposal: �, � a..���� .. '"��'".�"" ...• �
. ..........
_. WWW
The date of any voluntary or involuntary bankruptcy judgments against any principal having an
interest in this proposal is as follows:
All current and prior DBA's, aliases, and/or fictitious business names for any principal having
an interest in this proposal are as follows:
I-C-4
BIDDER'S INFORMATION(CONTINUED)
Company Natne:
Bidder sha1l, list the name of the person who attended the mandatory pre-bid job walk:
Na,me:
I-C-5
IN WITNESS WREIR �Q. 'BIDDER exMne,S and submits this proposal with the names,titles,
bands,
and seals of all a forenamed principals this day of 20Z Y.
BIDDER
......................
...........
......................-...... ............
...............
.............
Subscribed and sworn to this Z& day of 20 2�
NOTARY PUBLIC
I- -6
California Jurat 2008 Code Section 8202 Compliant
State of California
County of
Subscribed and sworn to (or affirmed) before me on this day of . 20 IV
by - proved to me on the basis of satisfactory
evidence to be the person(s)who appeared before me.
SHEILA J.CLANK
. Comm. #2019254
NoUq Publk•CAllmnis
Riversii do County
Comm.Expires Apr 12,2017
Seal
Signature
OPTIONAL INFORMATION
Law does not require the information below.This information could be of great value to any person(s)relying on this document
and could prevent fraudulent and/or the reattachment of this document to an unauthorized document(s)
DESCRIPTION OF ATTACHED DOCUMENT
Title or Type of Document: 1 b R 0 j
Document Date: - / 14, Number of Pages.
Signer(s) if Different Than Above;;
Other Information:
CAPACITY(IES)CLAIMED BY SIGNER(S)
Signer's Name(s), C K/ -
❑ Individual
-6rporate Officer
(Title(s))
❑ Partner
❑Attorney-in-Fact
❑Trustee
❑ Guardian/Conservator
❑ Other:
SIGNER IS REPRESENTING:
Name of Person(s)or Entity(ies):
,0 2008 Notary Public Seminars www.notarypubIicseminars.com
CONTRACTOR'S LICENSE DECLARATION
(Business and Professions Code Section 7028.15)
1. BIDDER'S Contractor's License Number is:
. � Class No. �y J1
2. The expiration date of BIDDER'S Contractor License is:
20�.
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 /z,r , 20 „ at
(insert City and State where Declaration signed)..
Signature
Typed Name
J �
Title
Company Name
I-C-8
NON-COLLUSION AFFIDAVIT
TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID
State of California )
) ss.
County of q11V )
t '12,4 .. , being first duly sworn, deposes and say that he or she is
p' of °"
the party making the foregoing bid that the bid is not made in the interest of,or on behalf of,any
undisclosed person,partnership,company,association,organization,or corporation;that the bid
is genuine and not collusive or sham;that the BIDDER has not directly or indirectly induced or
solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly
colluded,conspired,connived,or agreed with any BIDDER or anyone else to put in a sham bid,
or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or
indirectly, sought by agreement,communication,or conference with anyone to fix the bid price
of the BIDDER or any other BIDDER,or to fix any overhead,profit,or cost element of the bid
price, or of that of any other BIDDER, or to secure any advantage against the public body
awarding the contract of anyone interested in the proposed contract;that all statements contained
in the bid are true;and further,that the bidder has not,directly or indirectly, submitted his or her
bid price or any breakdown thereof, or the contents thereof, or divulged information or data
relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company
association, organization, bid depository, or to any member or agent thereof to effectuate a
collusive or sham bid.
µ
Signature Name of Bidder/Company Name
�,
Typed Name Date
Title
I-C-9
WORKER'S COMPENSATION CERTIFICATION
Section 1861 OF THE LABOR CODE
(Workers' Compensation)
Pursuant to Section 1861 of the Labor Code, the BIDDER,in submitting his/her
PROPOSAL, shall sign the following certification:
"I am aware of the provisions of Section 3700 of the Labor Code which require every
employer to be insured against liability for workers' compensation or to undertake self-
insurance in accordance with the provisions of that code, and I will comply with such
provisions before commencing the performance of the work of this contract."
Signature of Bidder:
Title:
Business Name:
Business Address: f^.�
Telephone Number: (;�) �� 7
Dated this . day of 1'71,4`1 , M
I-C-10
DESIGNATION OF SUBCONTRACTORS
TENNIS COURT RESURFACING
PROJECT NO.: PW 13-30
Company Name:
BIDDER will perform the majority of the work and 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:
Description of
Name of portion of Work Estimated
Subcontractor Address Subcontracted $Amount
(Number and Street)
(City, Zip Code)
................................_.__.. .
.................. .............. _ ......._..........._
I-C-1 I
REFERENCES
Company Name: _ M '
The following are the names, addresses, and telephone numbers for public agencies for which
BIDDER has performed similar work as the prime contractor or major subcontractor within the
past five (5) years:
L Project Title: IQ�OZ,� 1&c
fi r ° ✓ ;
Location: r ✓
� ✓ ..w
Name and address of owner
Narhe and current telephone number of person familiar with project
Type of Work:
Contract amount: � Date completed:® /
Amount of work done by my/our firm under contract
Did your firm have any financial interest in Project? Ala
2. Project Title: f � 1 1 I '
Location: r C l ... �..
,�..
Name and address of owner
Name and current telephone number of person familiar with project
Type of Work: ' �' ' J � � � ,..
Contract amount: Date completed:
Amount of work done by my/our firm under contract$ � '
Did your firm have any financial interest in Project?
I-C-12
3. Project Title: ', � a
Location: 6 7�..
Name and a'ddre s of owner
.M
Name and current telephone number of person familiar with project
Type of Work: e �„
Contract amount: $ ffi "" Date completed: '
Amount of work done by my/our firm under contract$
Did your firm have any financial interest in Project?
Company Name:
4. Project Title: 6'�l Z .'
Location:
Name and address of owner
Name and current telephone number of person familiar with project:
Type of Work: k; " � �.
Contract aIIIOUJIt: $ ;� ,
d �„�� <�t�.completed: , � � °
Amount of work done by my/our firm under contract$ 6
Did your firm have any financial interest in Project?
5. Project Title: "w '" �
Location:
Name and address of owner
I-C-13
778,u-('r1 1-U Z716,
Name and current telephone number of person familiar with project:
Type of Work:
Co nt.rpct amoutit:$
Date completed:
Amount of work done by my/our firm under contract$
Did your firm have any financial interest in Project? 10............................
Bidder may attach additional reference pages if necessary.
The following are the names, addresses,and telephone numbers for all brokers and sureties from
whom BIDDER intends to procure insurance bonds:
c j 7 LO 1�
................
Y
I-C-14
BIDDER'S STATEMENT OF
PAST CONTRACT DISQUALIFICATIONS
TENNIS COURT RESURFACING
PROJECT NO.: PW 13-30
Company Name:
Please state all instances of being disqualified,removed, or otherwise prevented from bidding
on, or completing, a federal, state, or local government project due to a violation of a law or
safety regulation.
1. Have you ever been disqualified from any government contract?
Yes ❑ No
2. If yes, explain the circumstances:
......................................................................................................................................................................................................................................................................................................._.
........................................................................................................................................................................................................................................................................................................................................................................................................
.......................................
Bidder's Signature
Name (Please Print)
I-C-15
INSURANCE REQUIREMENTS
[MUST BE SUBMITTED WITH PROJECT PROPOSAL]
TENNIS COURT RESURFACING, PROJECT NO.: PW 13-30
Company Name: ...... ,m � .... _ _. _..
To be awarded this contract, the successful bidder must procure and maintain the following types of
insurance with coverage limits complying, at a minimum, with the limits set forth below:
Tyne of Insurance Limits
Commercial general liability: $2,000,000
Business automobile liability: $1,000,000
Workers compensation: Statutory requirement
Commercial general liability insurance must meet or exceed the requirements of ISO-CGL Form No.CG
00 01 11 85 or 88. The amount of insurance set forth above must be a combined single limit per
occurrence for bodily injury, personal injury, and property damage for the policy coverage. Liability
policies must be endorsed to name the City,its officials,and employees as"additional insureds"under said
insurance coverage and to state that such insurance will be deemed "primary" such that any other
insurance that may be carried by the City will be excess thereto. Such endorsement must be reflected on
ISO Form No. CG 20 10 1185 or 88,or equivalent. Such insurance must be on an"occurrence,"not a
"claims made,"basis and will not be cancelable or subject to reduction except upon thirty(30)days prior
written notice to the City.
Insurer will agree in writing to waive all rights of subrogation against the City, its officers, officials,
employees and volunteers for losses arising from work performed by Contractor for the City.
Automobile coverage must be written on ISO Business Auto Coverage Form CA 00 01 06 92,including
symbol 1 (Any Auto).
The Consultant must furnish to the City duly authenticated Certificates of Insurance evidencing
maintenance of the insurance required under this Agreement,endorsements as required herein,and such
other evidence of insurance or copies of policies as may be reasonably required by the City from time to
time. Insurance must be placed with admitted insurers with a current A.M. Best Company Rating
equivalent to at least a Rating of"A:VII." Certificate(s)must reflect that the insurer will provide thirty
(30) day notice of any cancellation of coverage. The Consultant will require its insurer to modify such
certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of
cancellation imposes no obligation, and to delete the word "endeavor" with regard to any notice
provisions.
The City requires California Worker's Compensation Coverage with the associated Waiver. Out-of-state
coverage will not be accepted in lieu of the California coverage,because the work is being performed in
the State of California.
By signing this form, the bidder certifies that it has read, understands, and will comply with these
insurance requirements if it is selected as the City's consultant. Failure to provide this insurance will
e bidder's p oposal "nonresponsive."
render the r p
Date Bidder's Signature
I-C-16