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CONTRACT 4901 Public Works Contract CLOSEDAgreement No. 4901 PUBLIC WORKS CONTRACT BETWEEN THE CITY OF EL SEGUNDO AND AMERICAN ASPHALT SOUTH, INC. 2014 -2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15 -02 This CONTRACT is entered into this 26 day of August, 2015, by and between the CITY OF EL SEGUNDO, a general law city and municipal corporation ( "the City ") and American Asphalt South, Inc., ("the Contractor "). 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 Four Hundred Twenty Thousand, One Hundred Four Dollars and Eighty Cents ($420,104.80) 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. 1 -D -1 Agreement No. 4901 A. The Contractor will fully complete the Work within Twenty-five (25) working days (the' "Contract Time.") 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 Agreement No. 4901 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 Iimit 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, bomus 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 tinder 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 Stephanie Katsouleas Public Works Director City of El Segundo 350 Main Street, El Segundo, CA 90245 (310) 524 -2356 The Contractor Jeff Petty Vice President American Asphalt South, Inc. 14436 Santa Ana Avenue Fontana, CA 92337 (909) 427 -8276 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. 1 -D -3 Agreement No. 4901 13. NO THIRD PARTY BENEFICIARY. This Contract and every provision herein is for the exclusive benefit of the Contractor and the City and not for the benefit of any other party. There will be no incidental or other beneficiaries of any of the Contractor's or the City's obligations under this Contract. 14. INTERPRETATION. This Contract was drafted in, and will be construed in accordance with the laws of the State of California, and exclusive venue for any action involving this Contract will be in Los Angeles County. 15. EFFECT OF CONFLICT. In the event of any conflict, inconsistency, or incongruity between any provision of the Contract Documents, precedence will be as follows: A. This Contract; B. The Standard Specifications; and C. Precedence of documents as determined in the Standard Specifications. 16. SEVERABILITY. If any portion of the Contract Documents are declared by a court of competent jurisdiction to be invalid or unenforceable, then such portion will be deemed modified to the extent necessary in the opinion of the court to render such portion enforceable and, as so modified, such portion and the balance of this Contract will continue in full force and effect. 17. AUTHORITY/MODIFICATION. The Parties represent and warrant that all necessary action has been taken by the Parties to authorize the undersigned to execute this Contract and to engage in the actions described herein. This Contract may be modified by written amendment. The City's city manager, or designee, may execute any such amendment on the City's behalf. 18. ACCEPTANCE OF FACSIMILE SIGNATURES. The Parties agree that this Contract, agreements ancillary to this Contract, and related documents to be entered into in connection with this Contract will be considered signed when the signature of a party is delivered by facsimile transmission. Such facsimile signature will be treated in all respects as having the same effect as an original signature. 19. COVENANTS AND CONDITIONS. The parties agree that all of the provisions hereof will be construed as both covenants and conditions, the same as ifthe words importing such covenants and conditions had been used in each separate paragraph. 20. CAPTIONS. The captions of the paragraphs of this Contract are for convenience of reference only and will not affect the interpretation of this Contract. 21. TIME IS OF ESSENCE. Time is of the essence for each and every provision of the Contract Documents. Agreement No. 4901 IN WITNESS WHEREOF the parties hereto have executed this contract the day and year first hereinabove written. C17LE7 GUNDO Cl D A Greg 6, penter P / Jeff y City pager Vice President, American Asphalt South, Inc. ATTE�,�T: Tra Weaver,,_ Cltv Cler- /I APPROVED AS TO FORM: MARK D. H SLEY, City Attorney By: FOR Karl H'Aerger, Assistant City Attorney Insurance Reviewed by: n"\ ! v "Im Taxpayer ID No. Yll-A? W 8 / Contractor State License No.: OR& Contractor City Business License No.: June 17, 2015 Agreement No. 4901 to THE CONTRACT DOCUMENTS, SPECIFICATIONS AND PLANS for 2014-2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO. PW 15-02 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, June 30, 2015 at 11:00 am 2. Please write N/A for both Name and Title entries on page I-C-5 (see attached sample). There is no Job Walk for this project. 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 rei ectior4 Signature: of Date: ,7.5jve d.- Print Company Name: Page I of I 350 Main Street, El Segundo, CA 90245-3895 (310) 524-2300 Fax (310) 640-0489 AgreemT,� ft4901 1,1, I I Wil : ILI II, Company Name: AbG ("Omparig Bidder shall list the name of the person who attended the mandatory pre-bid job walk: Name: M/A Title: I-C-5 Agreement No. 4901 PROPOSAL FOR THE 2014 -2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15 -02 Date .J( /i�,L , 20 Company Name: _!"l�� ,&&41 -1- g , , 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. 1 -C -1 Agreement No. 4901 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 BID SCHEDULE 2014 -2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15 -02 Company Name: BASE BID ITEMS Agreement No. 4901 Ite m Estimated Description Unit Price Item Total No. Quantities 1 141,679 SY Slurry Seal Type I application for Z�S s Mondays through Fridays 2 51,265 SY Slurry Seal Type 1 application for Saturdays and Sundays 3 1 LS Sandblast, restore and replace all -� cpt1 �r ta. -7 y street markings and striping 4 2,000 SF 2 -inch deep asphalt repairs jo TOTAL BID = $ - &° TOTAL BID WRITTEN IN WORDS: .f'eye,4V t%aa 7,4oyr no ,i / it +j ha4Aej f e1 `1y ;D,,& r.0 I -C -3a Company Name: 2014-2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15-02 ALTERNATIVE BID ITEMS Agreement No. 4901 Ite m Estimated Description Unit Price Item Total No. Quantities Al 141,679 SY Slurry Seal Type 11 application for Jo Mondays through Fridays A2 51,265 SY Slurry Seal Type 11 application for 2c) 67 5D . SO Saturdays and Sundays Slurry Seal Type 11 application for A3 16,097 SY Main St. between Imperial Ave. /,91/ 31, ZZ6, 18 and Mariposa Ave. I-C-3b Agreement No. 4901 Company Name: BIDDER certifies that the following information is true and correct: Form of Legal Entity (i.e., individual, partnership, corporation, etc.) If corporation, State of Incorporation (i.e., California) Business ( tl Address , a Original Date Issued 01 Expiration Date G I,400* 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 0 - AW A Ar;aelwll 0O 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: M I -C -4 Company Name: C i f • !' i 1, i W Agreement No. 4901 Bidder shall list the name of the person who attended the mandatory pre -bid job walk: Name: 1111d Title: I -C -5 Agreement No. 4901 IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, titles, hands, and seals of all a forenamed principals this d day of i , 20 BIDDER Subscribed and sworn to this � day of Gtn� , 20_6 f►tiM C I -C -6 Agreement No. 4901 PROPOSAL GUARANTEE BID BOND 2014 -201.5 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.; PW 15 -02 KNOW ALL MEN BY THESE PRESENTS that, American Asphalt South, Inc. as BIDDER, and The Guarantee Company of North America USA , as SURETY, are held and firmly bound unto the Ten Percent of City of El Segundo, in the penal sum of Amount Bid DOLLARS ($12D, which is ton (10 %) percent of the total amount bid by BIDDER to the City of F1. Segundo for the above stated project, for the payment of which sum., BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDMONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to the City of EI Segundo for the above stated project, if said bid is rejected, or if said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of the City of El Segundo. ]IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seals this day of June } 20 15 BIDDER* American Asphalt South, Inc. 14436 Santa Ana Avenue, Fontana , CA 96337 909 -42 -8276 SURETY* The Guarantee Company of North America USA Bobbie Beeny, Attorney -in -Fact Nancy Flores, C/O CT Corporation Syst m 818 West Seventh Street, Suite 930 c Angeles, CA 90017 925- 566 -6040 Subscribed and sworn to this day of _ , 20 NOTARY PUBLIC *Provide BIDDER/SUR.ETY name, title, address and telephone number and the name, title, address and telephone number for authorized representative. I -C -7 Agreement No. 4901 State of California ss. County of r0- Z I'A A X� )q S�Q 15 before me, On Tt.A o Ua6c efc,-O� 'Name and `rlle of OlIkEr (e.g. 'Jane Doe. Notary ry Pu Vt personally appeared C n L tc) y) e- Narnels) of Signeej Ep-proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Bare subscribed to the within instrument and acknowledged to me that W&he/they executed the same in h s/h-er/their authorized capacity(ies), and that by t� /he/lheir signature(s) on the instrument the person(s), or JERI MARIE GRA the entity upon behalf of which the person(s) NT co M. 0 31882 acted, executed the instrument. M * 2 Z NOTARY PUBLIC - CALIFORNIA ;Z ...... SAN BERNARDINO COUNTY WITNESS my H nd and off' I seal. My Comm. Expires June 30, 2017 Sign i.,e of Notary Alic OPTIONAL Though the information below is not required by law, it may prove valuable to per nsin�g on the document and could prevent I to fraudulent removal and reattachment of this form another document Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual ❑ Corporate Officer Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Number of Pages: Signer Is Representing: 0 1999 National Nolary Association • 9350 De Solo Ave.. P.O. Box 2402 • Chalswonh. CA 91313-2402 • ve-v.nallonalnolaryotg Prod. No. 5907 Top of thumb here Reorder. Call Ton -Free 1-800-876-6827 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Butte On June 5, 2015 Agreement No. 4901 before me, Elizabeth Collodi, Notary Public (insert name and title of the officer) personally appeared Bobbie Beeny who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/�Ma subscribed to the within instrument and acknowledged to me that he/she/#W executed the same in )bWherAbeiK authorized capacity(is&), and that by i6siherfte*signature(s) on the instrument the person(s), or the entity upon behalf of which the person() acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature ELIZABETH COLLODI 15 CONK #205660? > NOTARY PUBLIC - CALIFORNIA COUNTY OF BUTTE Comm. Expires FEB. 1, 2018 1 Agreement No. 4901 Barbara Midstokke, Renee Ramsey, Richard W. Pratt, John Hopkins, Elizabeth Collodi, Bobbie Beery, Nancy Luttenbacher Phillip O. Watkins, Keith T. Schuler, Melissa D. Diaz, Shawna Johnson, Patricia M. Simas Interwest Insurance Services, Inc. its true and lawful attorneys) -in -fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31s` day of December, 2003. The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority: 1. To appoint Attorney(s) -in -fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time, any such Attomey -in -fact and revoke the authority given, except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and /or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and /or its assignee, shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner — Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011, of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. �a�A"Tco IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and F� its corporate seal to be affixed by its authorized officer, this 23rd day of February, 2012. 0 aye THE GUARANTEE COMPANY OF NORTH AMERICA USA 4NAMEWe STATE OF MICHIGAN Stephen C. Ruschak, President & Chief Operating Officer Randall Musselman, Secretary County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai „a A ti Notary Public, State of Michigan s County of Oakland My Commission Expires February 27, 2018 cr�;c Acting in Oakland County IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Company of North America USA offices the day and year above written. I, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect. r6J Tee 0, IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 5th day of ,June 2015 yoR "M`a�p Randall Musselman, Secretary Company Profile Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Action /Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer Agreement N . 4bb' 2 COMPANY PROFILE Company Information GUARANTEE COMPANY OF NORTH AMERICA USA (THE) ONE TOWNE SQUARE, SUITE 1470 SOUTHFIELD, MI 48076 Old Company Names Effective Date MID -STATE SURETY CORPORATION 12/20/2006 Agent For Service NANCY FLORES C/O CT CORPORATION SYSTEM 818 WEST SEVENTH STREET, SUITE 930 LOS ANGELES CA 90017 Reference Information back to top NAIC Group List NAIC Group #: 0000 Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AUTOMOBILE BOILER AND MACHINERY BURGLARY COMMON CARRIER LIABILITY CREDIT FIRE LEGALINSURANCE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER https:Hinteractive.web. insurance. ca. gov /companyprofile /companyprofile ?event= company... 06/05/2015 Company Profile SURETY TEAM AND VEHICLE back to top O c 2008 California Department of Insurance Agreement &-4681' https:Hinteractive.web.insurance.ca.gov/companyprofile/companyprofile?event=company... 06/05/2015 Agreement No. 4901 CONTRACTOR'S LICENSE DECLARATION (Business and Professions Code Section 7028.15) 1. BIDDER'S Contractor's License Number is: � /O / Class No.: 2. The expiration date of BIDDER'S Contractor License is: cJ0 ,11fflier ✓d IAI , 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 ���� , 20Z�f, at ��dlQ (insert City and State where Declaration signed). I -C -8 Agreement No. 4901 NON - COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ) ss. County of ) and Lle 'Afe , being first duly sworn, deposes and say that he or she is rke ?WdeW asid ✓tee �y of Aer;e4o /7�' the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Signature Name of Bidder Company Name le Typed Name Title I -C -9 Date Agreement No. 4901 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." r 1' Telephone Number:( Dated this of ¢day of ,,%A1 , 20 % I -C -10 Company Name: DESIGNATION OF SUBCONTRACTORS 2014 -2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15 -02 Agreement No. 4901 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: Name of Subcontractor 114.�� 41J Address (Number and Street) l3/ 2- F_ W0r00r� 41,e Subcontractor's Contractor License No. 2- S 2 Description of Portion of Work Subcontracted `� Estimated $ Amount (City, Zip Code) 64 %21)0,5 Spec) a 145 E r�rr�,�`'�s, % �,, $ 2S.o I -C- I I Agreement No. 4901 Location: Name and address of owner Name 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? 2. 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Q f9 ry (14 F- Z a >- Gl Z O Z < J w w S Z < Q ZJ Z U)< ° �' U Q0 ) o (D cr 0- j P ry 0 y. W r, w ups ° W0 >- CO p i J O U 6S Ei C) < U r 0- 5; C) F_ 5 IL � 5 S. (D 5 0 0) Agreement No. 4901 Agreement No. 4901 3. Project Title: 3 Location: Name and address of owner Name 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? Project Title: Location: Name and address of owner Name 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? 5. Project Title: Location: Name and address of owner I -C -13 Agreement No. 4901 Name and current telephone number of person familiar with project: Type of Work: Contract amount: $ Date completed: Amount of work done by my /our finn under contract $ Did your firm have any financial interest in Project? 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: Add I -C -14 Agreement No. 4901 BONDING AGENT: INTERWEST INSURANCE SERVICES, INC. 1357 E. LASSEN AVENUE CHICO, CA 95973 (530)897 -3154 SURETY COMPANY: GUARANTEE COMPANY OF NORTH AMERIC, USA ONE TIME SQUARE, SUITE 1470 SOUTHFIELD, MI 48076 (248)281 -0281 INSURANCE AGENT: INTERWEST INSURANCE SERVICES, INC. 368 E. YOSEMITE AVENUE, SUITE 100 MERCED, CA 95340 (209)724 -2324 BIDDER'S STATEMENT OF PAST CONTRACT DISQUALIFICATIONS 2014 -2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15 -02 Company Name: i✓yer;a(w h ,G��e- Agreement No. 4901 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. Have you ever been disqualified from any government contract? Yes ❑ No X 2. If yes, explain the circumstances: 3. Are you registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject your bid as nonresponsive]? Yes X No ❑ idder's Signature X944 line Name (Please Print) -e 1w;W v1 S&rel4 y I -C -15 Agreement No. 4901 INSURANCE REQUIREMENTS [MUST BE SUBMITTED WITH PROJECT PROPOSAL] 2014 -2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS, PROJECT NO.: PW 15 -02 Company Name: mn?j% 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: Type 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 11 85 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 0106 92, including symbol I (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 render the bidder's proposal "nonresponsive." 1741)4—e W.-w a Date Bidder's Signature Z� ✓, /�� I -C -16« /�'�� Agreement No. 4901 END PROPOSAL SECTION I -C- 17 Agreement No. 4901 2014-2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15-02 Premium for Contract Term Bond No. 12123772 Subject to Adjustments Bond Fee: $ 2,941.00 Based on Final Contract Price American Asphalt South. Inc. ("PRINCIPAL') and The Guarantee Company of North America USA . a corporation incorporated under the laws of the State of Michigan 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 ' Four Hundred Twenty Thousand, One Hundred Four Dollars and Eighty Cents ($420,104.80), lawful money of the United States, which may be increased or decreased by a rider hereto executed in the same manner as this bond, far 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 15-02, 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. 1. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS NO. PW 15-02, 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 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. CITY has estimated the required amount of the bond as shown above. 2. PRINCIPAL's work on the Public Project will be done in accordance with CITY's plans and specifications and with any permit issued by CITY. Should PRINCIPAL fail to complete all required work within the time allowed, CITY may, at its sole discretion, cause all required work to be done and the parties executing the bond will be firmly bound for the payment of all necessary costs therefor. 3. PRINCIPAL will guarantee its work against any defective work, labor, or materials on the Public Project for a period of one (1) year following the Public Project's completion and acceptance by CITY. IM Agreement No. 4901 4. This bond is conditioned upon and guarantees due compliance with all applicable law including, without limitation, the El Segundo Municipal Code ("ESIVIC"). 5. SURETY, for value received, agrees that no changes, extensions of time, alteration or modification of SPECIFICATIONS NO. PW 15-02 or of the obligation to be performed will in any way affect its obligation on this bond, and it waives notice of any such change, extension of time, alteration or modification of the contract documents or of the obligation to be performed. 6. This bond consists of this instrument; the plans and specifications identified above; and the following two (2) attached exhibits all of which are incorporated herein by reference: A. A certified copy of the appointment, power of attorney, bylaws or other instrument entitling or authorizing the persons executing this bond to do so; B. A certificate issued by the county clerk for the county in which SURETY's representative is located conforming with California Code of Civil Procedure § 995.640 and stating that SURETY's certificate of authority has not been surrendered, revoked, cancelled, annulled, or suspended, or in the event that it has, that renewed authority has been granted; and 7. Should PRINCIPAL perform its obligations within the time allowed, PRINCIPAL's obligation will be void upon the acceptance of the performance by CITY; otherwise this obligation will remain in full force and effect. 1:3riiii M1111111111"I 11; 1:1111 Mill I-E-2 Agreement No. 4901 SIGNED AND SEALED this 26 day of August , 2015 . American Asph t So Inc. The Guarantee Company of North America USA r ;✓ PRIN(IfA s�PRESIDENT SURE Elizabeth Coliodi Vf C iG Title: Attorney-in-Fact �. PR IPA L's SECRETARY -- PRINGIPAL's MAILING ADDRESS: SURETY's MAILING ADDRESS: P.O. Box 310036 One Towne Square, Ste. #1470 F nt na CA 92331 Southfield, Michigan 48076 NOTE: (1) ALL signatures must be acknowledged by a notary public. Return one (1) original to City Clerk's Office. (2) Bond shall be effective for one (1) year after acceptance of the jab. I.E -3 Agreement No. 4901 COrt-175cate PUM-Ont to'995.6401s) Co&n: o Cjvjj yore 're t 'T C""'unty C the Cr c', 'Untv of In ai-ld Ior said County DO HERED"t" fie, mca in A un"er"e of e r, zillf, a of said CourRy Of I i4m amra" 'L�3 seal of v- COUNTY CUERK Deputy County Clerk TODD TRAM Agreement No. 4901 State of California County of 1-? 13,., r r ,, �� d ss. / On a. Sr before me, 1-5 It',] aj A4 h, Name and Title of Officer (e.g.. 'Jane Doe, Notary Public"f personally appeared ,7 RICHARD ENTRIKIN COMM. # 2029943 ZZ NOTARY PUBLIC - CALIFORNIA r. SAN BERNARDINO COUNTY MY Comm. Expires July 13, 2017 Name(s) of Signer(s) X proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) W re subscribed to the within instrument and acknowledged to me that executed the same in I;f.!iEVh,5r`1their authorized capacity(il and that by hj�g/h-,sr/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer Signer's Name: ❑ Individual Top of thumb here ❑ Corporate Officer Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney-in-Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 1999 t,;ational Notary Association ^ 9350 De Solo Ave_ P.O. Box 2402 - Chalsv+orffi. CA 913132402 • ­vv.nationalnotary.ong Prod. No. 5907 Reorder: Call Toll-Free 1800-876-6827 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not'the truthfulness, accuracy, or validity of that document. State of California County of Butte On August 26, 2015 Agreement No. 4901 before me, Sara Walliser, Notary Public (insert name and title of the officer) personally appeared Elizabeth Collodi t who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/am subscribed to the within instrument and acknowledged to me that he/she/kw executed the same in )bis/her/thaiy, authorized capacity(), and that by JaWher/ffm* signature(s) on the instrument the person(s), or the entity upon behalf of which the person(2) 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 sea[. Signature (0 cg-� Agreement No. 4901 Barbara Midstokke, Renee Ramsey, Richard W. Pratt, John Hopkins, Elizabeth Collodi, Bobbie Beeny, Nancy Luttenbacher Phillip O. Watkins, Keith T. Schuler, Melissa D. Diaz, Shawna Johnson, Patricia M. Simas Interwest Insurance Services, Inc. its true and lawful attorney(s) -in -fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31s` day of December, 2003. The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority: 1. To appoint Attorneys) -in -fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time, any such Attorney -in -fact and revoke the authority given, except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and /or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and /or its assignee, shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner — Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011, of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. �Jypw�+TEZC IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 23rd day of February, 2012. T ay: THE GUARANTEE COMPANY OF NORTH AMERICA USA 'p, aMea`6a STATE OF MICHIGAN Stephen C. Ruschak, President & Chief Operating Officer Randall Musselman, Secretary County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai Notary Public, State of Michigan r County of Oakland My Commission Expires February 27, 2018 z Acting in Oakland County IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Company of North America USA offices the day and year above written. I, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect. OJ TEE C�4 IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 26 day of August 2015 TZ yea %h AMba`'p Randall Musselman, Secretary Agreement No. 4901 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE N4 08305 SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY THAT pursuant to the Insurance Code of the State of California, The Guarantee Company of North America USA Of Michigan , organized under the laws of Michigan subject to its Articles of Incorporation or otherfundamental organizational documents, is hereby authorized to transact within the State, subject to all provisions of this Certificate, the following classes of insurance: Surety as such classes are now or tray hereafter be defined in the Insurance Laws of the State of California. THIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all, and not in violation of any, of the applicable laws and latiful requirements inade under authority of the laws of the State of California as long as such laws or requiretnents are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended. IN WITNESS WHEREOF, effective as of the 20th day of December 2006 , 1 have hereunto set my hand and caused my official seal to be affixed this 20th day of December 2006 John Garamendi Insurance Commissioner Patricia K. taS ggs for Richard D. Baum By Chief Deputy NOTICE: Qualification with the Secretary of State must be accomplished as required by the California Corporations Code promptly after issuance of this Certificate of Authority. Failure to do so will he a violation of Insurance Code Section 701 and will be grounds for revoking this Certificate of Authority pursuant to the convenants made in die application therefor and the conditions contained herein. FORM 0113 OSP W 59391 Agreement No. 4901 2014-2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS PROJECT NO.: PW 15-02 Bond No. 12123772 Bond Fee: Included in Performance Bond American Asphalt South. Inc. as principal ("PRINCIPAL") and The Guarantee Company of Nth America USA a corporation incorporated under the laws of the State of Michigan 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 Four Hundred Twenty Thousand. One Hundred Four Dollars and Eighty Cents ($420,104.80), 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 PRINCIPALS subcontractors for all materials, provisions, provender, or other supplies, and equipment used in, upon, for or about the performance of the work contemplated in 2014-2015 FURNISHING AND APPLICATION OF SLURRY SEAL ON VARIOUS STREETS, SPECIFICATIONS NO. PW 15-02 ("Public Project "), the public works contract executed for such Public Project, and for all work or labor of any kind performed for the Public Project. In the case of any default in the performance of the conditions and stipulations of this undertaking, it is agreed that PRINCIPAL or SURETY will apply the bond or any portion thereof, to the satisfaction of any damages, reclamation, assessments, penalties, or deficiencies arising by reason of such default. I. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS NO. PW 15-02, 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, 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, forequipment used in, I-F-I Agreement No. 4901 on, for or about the performance of the Public Project, and will pay for all work and labor thereon. 4. This bond is conditioned upon and guarantees due compliance with all applicable law including, without limitation, the El Segundo Municipal Code ("ESMC"). 5. SURETY, for value received, agrees that no changes, extensions of time, alteration or modification of SPECIFICATIONS NO. PW 15-02, 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. ]-F-2 Agreement No. 4901 SIGNED AND SEALED this 26 day of August 2015 can Asphalt South Inc. The Guarantee Company of North INCIPAL' RESIDENT SUR Elizabeth Collodi Title: Attorne -in -Fact Pl? " IPAL's SECRETARY PRINCIPAL's MAILING ADDRESS: P.O. Box 310036 Fontana CA 92331 SURETY's MAILING ADDRESS: One Towne Square, Ste. #1470 Southfield, Michigan 48076 NOTE: (1) ALL signatures must be acknowledged by a notary public. Return one (1) original to City Clerk's Office. (2) Bond shall be effective for one (1) year after acceptance of the job. I-F-3 rica USA Agreement No. 4901 Cerfificate pursuant to 995.64.0(a) Code of Civil Procedure fj C 77,;'k 0 - L 0 G A N jrtv 01IM", 01, the County GOL of 01 i'affc!fMa, M aj— for said Countv Y T "N DO H E R E BY C E RT , 15 li ills f1da —as of the sia(,' c-I Cafforsila, arw �hereca- "i Insurance zbafvithonty i?as.-;G-i .gee ii sumarttieiBu, aniluiied, of wixay i have heraunao set imfy irldwi arla seat of said Courilty oo CCP n 1 Ln2�`°– - - -- COUNTYGLERIK U 8 Y. Oeputy Gooniy Gfed( TODD TRAN A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Butte On August 26, 2015 Agreement No. 4901 before me, Sara Walliser, Notary Public (insert name and title of the officer) personally appeared Elizabeth Collodi who proved to me on the basis of satisfactory evidence to be the person(a) whose name(s) is/me subscribed to the within instrument and acknowledged to me that ke/she/kw executed the same in )s/her/;authorized capacity(), and that by bWher/9m* 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. Agreement No. 4901 CALIFORNIA ALL-PURPOSEACKNOWLEDGMENT State ofCalifornia ss. On A IV beforeme, Date Name and Title of Officer (e.g. "Jane Doe. Notary Public"f personally appeared RICHARD ENTRIKIN NOTARY PUBLIC - CALIFORNIA C SAN BERNARDINO COUNTY MY COMM. Expires Jtjlv III 7ni Name(s) of Signer(s) k proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) W�ra subscribed to the within instrument and acknowledged to me that he/Ah6/th*y executed the same in I;t�/beMtheir authorized oapaoity(ioo). and that by _ttisYhl5r/their signature(s) on the instrument the pemon(e), or the entity upon behalf cd which the person(s) aoted, executed the instrument. WITNESS my hand and official seal. signature of Notary Public OPTIONAL Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Descripifon of Attached Docurnent Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer Signer's Narne: Top of thumb here 0 Individual 0 Corporate Off icer Title(s): D Partner —E] Limited El General 0 Attorney-in-Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer Is Representing: �,9qe;,;atimalwmay^ssc°atiori'9350 De Bola Ave_ poBox 2,102 'o°u"orl`c^91313-2402 '"=°=mnalnolary=v Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 Agreement No. 4901 Barbara Midstokke, Renee Ramsey, Richard W. Pratt, John Hopkins, Elizabeth Collodi, Bobbie Beeny, Nancy Luttenbacher Phillip O. Watkins, Keith T. Schuler, Melissa D. Diaz, Shawna Johnson, Patricia M. Simas Interwest Insurance Services, Inc. its true and lawful attomey(s) -in -fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31s` day of December, 2003. The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority: 1. To appoint Attorney(s) -in -fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time, any such Attorney -in -fact and revoke the authority given, except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and /or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and /or its assignee, shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner — Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011, of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. JN- *EE0� IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 23rd day of February, 2012. % Jye THE GUARANTEE COMPANY OF NORTH AMERICA USA STATE OF MICHIGAN Stephen C. Ruschak, President & Chief Operating Officer Randall Musselman, Secretary County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai ,' Notary Public, State of Michigan ' County of Oakland u c,G My Commission Expires February 27, 2018 4� Acting in Oakland County IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Company of North America USA offices the day and year above written. I, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect. h�G, a+ *EE�a -0Z IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 26 day of August 2015 +0'" ""'r' "�P Randall Musselman, Secretary Agreement No. 4901 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE N4 08305 SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY THAT Pursuant to the Insurance Code of the State of California, The Guarantee Company of North America USA Of Michigan , organized under the laws of Michigan , subject to its Articles of Incorporation or otherf ndanerntal organizational documents, is hereby authorized to transact within the State, subject to all provisions of this Certificate, the following classes of insurance: Surety as such classes are now or may hereafter be defined in the Insurance Laws of the State of California. THIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all, and not in violation of any; of the applicable laws and latiful requirements made under authority of the laws of the State of California as long as such laws or requirements are in effect mud applicable, and as such lases and requirements now are, or may hereafter be changed or anended. IN WITNESS WHEREOF, effective as of the December 2006 7 have hereunto rl 1) n�w ay of ,set my hand and caused my official seat to be affixed this 20th December 2006 of ,Illy John Garamendi Insurance Commissioner Patricia K. St g s for Richard D. Baum Chief Deputy NOTICE: Qualification with the Secretary of State must be accomplished as required by the California Corporations Code promptly after issuance of this Certificate of Authority. Failure to do so will be a violation of Insurance Code Section 701 and will be grounds for revoking this Certificate of Authority pursuant to the convenants made in the application therefor and the conditions contained herein. BORNI C➢ 3 `& OSP 00 3939,