The URL can be used to link to this page

CONTRACT 5243 Public Works Contract CLOSED Agreement No. 5243 PUBLIC WORKS CONTRACT BETWEEN THE CITY OF EL SEGUNDO AND ROBERTSON INDUSTRIES INC. GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO. PW 14-10 This CONTRACT is entered into this 28th day of December,2016,by and between the CITY OF EL SEGUNDO, a general law city and municipal corporation ("the City") and ROBERTSON INDUSTRIES INC., a California Corporation("the Contractor"). 1. WORK. A. The Contractor will provide all work required by the Contract Documents (the "Work"). The Contractor agrees to do additional work arising from changes ordered by the City in accordance with the Contract Documents. B. The Contractor and the City agree to abide by the terms and conditions contained in the Contract Documents; C. The Contractor will furnish all of the labor; supplies and materials; equipment; printing;vehicles;transportation;office space and facilities;all tests,testing and analyses; and all matters whatsoever(except as otherwise expressly specified to be furnished by the City)needed to perform and complete the Work and provide the services required of the Contractor by the Contract Documents. D. "Contract Documents"means the Notice Inviting Bids;Instructions to Bidders; Supplementary Instructions to Bidders; Proposal; this Contract; Standard Specifications; Supplementary Conditions; Exhibits; Technical Specifications; List of Drawings;Drawings;Addenda;Notice to Proceed;Change Orders;Notice of Completion; and all other documents identified in the Contract Documents which together form the contract between the City and the Contractor for the Work. The Contract Documents constitute the complete agreement between the City and the Contractor and supersede any previous agreements or understandings. 2. CONTRACT SUM. The City agrees to pay the Contractor a sum not to exceed FORTY FOUR THOUSAND SIX HUNDRED SIXTY SIX DOLLARS AND SIXTY CENTS ($44,666.60)for the Work in the manner set forth in the Contract Documents. The City may adjust this amount as set forth in the Contract Documents. 3. TIME FOR PERFORMANCE. I-D-l Agreement No. 5243 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: i. 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. 5243 9. INDEMNIFICATION. The Contractor agrees to indemnify, defend, and hold the City harmless as set forth in the Contract Documents. The requirements as to the types and limits of insurance coverage to be maintained by the Contractor as required by the Contract Documents,and any approval of such insurance by the City,are not intended to and will not in any manner limit or qualify the liabilities and obligations otherwise assumed by the Contractor pursuant to the Contract Documents, including, without limitation, to the provisions concerning indemnification. 10. INDEPENDENT CONTRACTOR. The City and the Contractor agree that the Contractor will act as an independent contractor and will have control of all work and the manner in which is it performed. The Contractor will be free to contract for similar service to be performed for other employers while under contract with the City. The Contractor is not an agent or employee of the City and is not entitled to participate in any pension plan,insurance, bonus or similar benefits the City provides for its employees. Any provision in this Contract that may appear to give the City the right to direct the Contractor as to the details of doing the work or to exercise a measure of control over the work means that the Contractor will follow the direction of the City as to end results of the work only. 11. AUDIT OF RECORDS. The Contractor will maintain full and accurate records with respect to all services and matters covered under this Contract. The City will have free access at all reasonable times to such records, and the right to examine and audit the same and to make transcript therefrom, and to inspect all program data, documents,proceedings and activities. The Contractor will retain such financial and program service records for at least three(3)years after termination or final payment under the Contract Documents. 12.NOTICES. All communications to either parry by the other party will be deemed made when received by such party at its respective name and address as follows: The City City of El Segundo 350 Main Street, El Segundo, CA 90245 Attn:Nick Petrevski The Contractor Robertson Industries Inc. 2414 W. 12" St. Suite 5 Tempe, AZ 85281 Attn: Richard Hawley 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 I-D-3 Agreement No. 5243 time of actual delivery. Changes may be made in the names or addresses of persons to whom notices are to be given by giving notice in the manner prescribed in this paragraph. 13. NO THIRD PARTY BENEFICIARY. This Contract and every provision herein is for the exclusive benefit of the Contractor and the City and not for the benefit of any other party. There will be no incidental or other beneficiaries of any of the Contractor's or the City's obligations under this Contract. 14. INTERPRETATION. This Contract was drafted in, and will be construed in accordance with the laws of the State of California, and exclusive venue for any action involving this Contract will be in Los Angeles County. 15. EFFECT OF CONFLICT. In the event of any conflict,inconsistency,or incongruity between any provision of the Contract Documents,precedence will be as follows: A. This Contract; B. The Standard Specifications;and C. Precedence of documents as determined in the Standard Specifications. 16. SEVERABILITY. If any portion of the Contract Documents are declared by a court of competent jurisdiction to be invalid or unenforceable, then such portion will be deemed modified to the extent necessary in the opinion of the court to render such portion enforceable and, as so modified,such portion and the balance of this Contract will continue in full force and effect. 17. AUTHORITY/MODIFICATION. The Parties represent and warrant that all necessary action has been taken by the Parties to authorize the undersigned to execute this Contract and to engage in the actions described herein. This Contract may be modified by written amendment. The City's city manager,or designee,may execute any such amendment on the City's behalf. 18. ACCEPTANCE OF FACSIMILE SIGNATURES. The Parties agree that this Contract, agreements ancillary to this Contract,and related documents to be entered into in connection with this Contract will be considered signed when the signature of a party is delivered by facsimile transmission. Such facsimile signature will be treated in all respects as having the same effect as an original signature. 19. COVENANTS AND CONDITIONS. The parties agree that all of the provisions hereof will be construed as both covenants and conditions,the same as if the words importing such covenants and conditions had been used in each separate paragraph. 20. CAPTIONS. The captions of the paragraphs of this Contract are for convenience of reference only and will not affect the interpretation of this Contract. I-D-4 Agreement No. 5243 21.TIME IS OF ESSENCE. Time is of the essence for each and every provision of the Contract Documents. IN WITNESS WHEREOF the parties hereto have executed this contract the day and year f st hereinabove written. CIT OJ, , l'C�:R`f D6... Greg, arpegter Richard HawleytInc. s City anager Robertson Indus ATTST: p I,, TaxpayerIDNo. u U� OS 1779 Traci Wevr, ot,y d6rk, �... Contractor ense Stag Lic No.: Contractor City Business License No.:h vLe 11[CA APPROVED AS TO FORM: MARK D. HEN'SLEY, City Attorney By: d David H.King, Assistant City Attorney -A.'- 1 Insurance Reviewed by: I-D-S Agreement No. 5243 ""'Executed in Duplicate— FAITHFUL PERFORMANCE BOND GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: PW 14-10 Bond No. 0156756 Bond Fee: $670.00 Robertson Industries Inc. as principal ("PRINCIPAL") and Berkley Insurance Company _ _ , a corporation rp Delaware and licensed by the State of California to incorporated under the laws of the State of execute bonds and undertakings as sole surety,as surety("SURETY"),are held and firmly bound unto the CITY OF EL SEGUNDO("CITY")in the sum of FORTY FOUR THOUSAND SIX 1-1UiNI)III D SIXTY SIX DOI..,LAR'S AND SIXTY CENVI' ($44,666.60),lawful money ofthe United States, which may be increased or decreased by a rider hereto executed in the same maamer as(leis bond, for(lie payment of which stma-PRINCIPAL'aa.nd SUR.E"I'Y bind themselves, their successors, and assigns,jointly and severally, by this insta°uAlent. ' 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'. GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT ,SPECIFICATIONS NO.PW 14-10,and the public works contract exeeutIO with such Specifications. In the case of any default in the per`ormmnce of the conditions as d,96pulatioaas of"this undertaking,it is agreed that PRINCIPAL or SURETY will apply the bond or aany'portion thereof, to tli' �sdtistacogp of any damages, reclamation, assessments, peaaaalties, or deficiencies arising by,reason of such default. BOND CONDITIONS 1. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS NO. PW 14-10, 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 CounciPand 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 I-E-1 Agreement No. 5243 Certificate pursuant to m ( )Code of CMI Procedum p�a �.-N 1 .A, ,. w � sate #if i t id Countr yyi�p rwebw �.�, ^� ,p�ww. na A � ',. carbc,,Ae oi-aNcwltv 1e" e ";qp4 Mired by 0 1 61a ML-6tap•..QT f ljtom v 1zj um rinsed oathe oewrt spy in Ov Wpamnent ow ,nw dutrwilly(vas neat bra sduirtwidered,wok ,canceled, In Iftibmwij wfwVll"""nto sAmy hwW and a of saw racy Wfl COUNTY o Y �� Deputy County Agreement No. 5243 completion and acceptance by CITY. 4. This bond is conditioned upon and guarantees due compliance with all applicable law including, without limitation, the El Segundo Municipal Code ("ESMC"). 5. SURETY, for value received, agrees that no changes, extensions of time, alteration or modification of SPECIFICATIONS NO. PW 14-10 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 frill force and effect. [SIGNATURES ON FOLLOWING PAGE] I-E-2 Agreement No. 5243 SIGNED AND SEALED this 4th day of January . 2017 Robertson Industries 0 C, Berkley Insurance Company ........... TY's Aiiorn4-in'-fact PRINCIPAL'S P USIDENT S(' E Sylvia M. Ogle D A A "W PRINCIPA 5s CRI,',,I"ARY SURETY'S itnes Christine Doc; PRINCIPAL'S MAILING ADDRESS: SURETY's MAILING ADDRESS: Robertson Industries, Inc. Berkley Surety Group, LLC ................................. .......... ....._.....e ... 2414 W. 12th Street, Suite 5 412 Mount Kemble Ave., Suite 310N ............................ .......... ......--......................... ............................................... Tempe,AZ 85281 Morristown, NJ 07960 ..................-1-1.1-1.1.1................. Attn: Surety Claims Department 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-E-3 No.BI-477h POWER OF ATTORNEY BERKLEY INSURANCE COMPANY Agreement No. 5243 WILMINGTON,DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware,having its principal office in Greenwich, CT,has made, constituted and appointed, and does by these presents make, constitute and appoint: Gary D. Eklund; William G. Moody;D Ann Kleidosty; Sylvia M. Ogle; Sharon J. Potts; Brooke A. Sharp; or Christine Doczy of Marsh USA, Inc. of Atlanta, GA its true and lawful Attorney-in-Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty Insurance,providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010: RESOLVED, that, with respect to the Surety business written by Berkley Surety Group, the Chairman of the Board, Chief Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such attorney-in-fact and revoke any power of attorney previously granted;and further RESOLVED,that such power of attorney limits the acts of those named therein to the bonds,undertakings,recognizances,or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated;and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and further 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, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued. • Company d these presents to be signed and attested by its appropriate officers and its IN corporate se l hercuntomYaffixed thisZ ina has wc... ...Se..... ,2016. Attest: Berkey Insurance Company (Seal) By B ,� .. Ira S. Ledc:rinari 1 ft'RKL�EY"ry President Senior Vice President&Secrets WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE" SECURITY PAPER. STATE OF CONNECTICUT) ss: COUNTY OF FAIRFIELD ) Notary � Y w .te,"Sen ior •sN.Lederman and Jeffrey . Hafter who are sworn to me to be the Senior Vice President and Secre ai I <'zN' Vice ! r� y Sworn to before me,a Nota Public in the State of Connecticut,this da of ' ' 0 I.Ci„b Ira ent, respectively, of ' Berkley Insurance Company, MARIA C. RUNDBAKEN ,,✓ NOTARY PUBLICa' MY COMMISSION EXPIRES Notary Public, State of Connecticut APRIL 30,2019 CERTIFICATE I,the undersigned,Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney;that said Power of Attorney has not been revoked or rescinded and that the authority of the Attorney-in-Fact set forth therein,who executed the bond or undertaking to wliich this Power of Attorney is attached,is in full force and effect as of this date. A pu Given under my hand and seal of the Company,this day of 1.,.. •.• r , (Seal) crortc Agreement No. 5243 I IIII ,I � I II � II I I II I(I' lid p l,';) ,I III I I I III L, I 6 II in III' 1 i 11:0 �,... .. ...... _____ Agreeme,n.,,t..,,No._5..2..,43 .... cow... � . I CALIFORNIA ALL- PURPOSE E � CERTIFICATE OF ACKNOWLEDGMENT 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. i State of Georgia } County of Fulton } On January 4, 2017 before me, Christine I' oczy gHWO irb$ad name and 11119 of the of fi r,li personally appeared Sylvia M. Ogle, Attorney-in-fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. certify under PENALTY OF PERJURY under the paws qt&e#$)9te of California that the foregoing paragraph is true and correct, � '0, '...Do ' 0 WITNESS my hand and official seal. OTA I •,. glop V#40 rr�, r weld t 16-20. O .. Notary 6 Signature Ch10 Idoc y (Notary Public deal) ** � ....m.................... ................................................."', ,.W.r,.,.,.........,...,........,. X N M k ST RsClONS FOR rnONTLETING THIS.... FORM ADDITIONAL OPTIONAL INFORMATION Tiform lwith regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary Performance Bond law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. 3 01/04/2017 • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect fomrs(i.e. he/she/11w)—is/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges,re-seal if a (Title) sufficient area pemrits,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. Ct Attorney-in-Fact . Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document,number of pages and date. ❑ 46 Indicate the capacity claimed by the signer. If the claimed capacity is a . corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www NotaryClasses corn 800-873-9865 Securely attach this document to the signed document with a staple. " ..mnmmr yMmmmmmmn�mmmPamwmu!ttumaammm�ti,'�mm iiwrem�mmmw�mu�mMMMM�mmimi .... �mmwwmimlmwwa�mi� vm�ai...... rar�w�..... wwwlw�wwi mrv�i u� ....... ------- ................ �Zreement No. 5243 ....................................... CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 County of On 1 - 15 — il before me, A� Vv'J'y'- ore 11 1 d6 0'hi and fitl 0,of kho o personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 8P M '9111 N 'A Notary PujWb : ature (Notary Public Seal) ......................................... INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded,should be completed and attached to the document.Acknowledgments from other states may be completedfor documents being sent to that state so long as the wording does not require the California notary to violate California notary Performance Bond law. (Title or description of attached document) a State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. -----•• • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attacheddoc'ument continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages 3 Document Date 01/04/2017 commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. he/she/d*y,-is lam)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. IN Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document,number of pages and date. ❑ 4- Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses,com 800-873-9865 • Securely attach this document to the signed document with a staple. •• m MKTM�Rn Agreement No. 5243 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE N4 070082 SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY THAT, Pursuant to the Insurance Code of the State of California, Berkley Insurance Company Of Wilmington, Delaware , organized under the laws of Delaware , 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: Fire, Marine, Surety, Disability, Plate Glass, Liability, Workers ' Compensation, Boiler and Machinery, Burglary, Credit, Automobile, Aircraft, and Miscellaneous 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 lawful requirements made under authority of the laws of the State of California as long as such laws or requirements 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 10th _ day of J u l V 2001 I have hereunto set my hand and caused my official seal to be af,flxed this 10th day of JuIY 2001 I Agreement No. 5243 ***Executed in Duplicate— LABOR AND MATERIALS BOND GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: PW 14-10 Bond No. 0156756 Bond Fee: $670.00 .._...........__- Robertson Industries Inc, as principal ("PRINCIPAL") and Berkley Insurance Company _ a corporation incorporated under the laws of the State of" Delaware 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 ("CjTY") Jn the.sum of FORTY FOUR THOSAND SIX IIUNI3IIEM SI "�TV'SIX I)OLLAR Ail"D SIXTY CENTS, ($44.666.60) decreased by ra rider'Iaea°etta executed in the same,raaxat�raer as tbas�i o 11(11,for the payment of which sum PIZ.INC."IPAL and, SUI ETYwlbind ther�asel�� ' tll i�° t ,�,.. irtid rtssiga� '„ jointly and severally, by thin instrument. This bond is conditioned upon and •guararatces payment by PRINCIPAL f6"'contractors, subcontractors,and persoris'renting eq aril ibyit;payrrlr?nt day PRINCIPAUand all PRINCIPAL'S subcontractors for alb rt t °ldl ;'(tt°c vision s,provender,Or other supplies,and equipment used in, upon, for or about tfic,o r,f9rinance of thee ofk'boritchi i)Iate in GEORGE E. GORDON C,LUBIIOUSE PLAYGROUND RESU 1"FACING PRO.IiE�C°I", SPECIFICATIONS NO. PW I4-10('*I'tablic Pi-oject''),'the p'tabli'w"Oi�lcs coratz'act execute(]Ior sLrcla l'ul)lic Ptoiect,aracl for all work or labor of any kind performed for°[lie Public Project. Ira the case ofany default in the performance o the conditions and stipulations 01'011S undertaking, it is agreed that PRINCIPAL or SURETY will apply the bond or any portion thereof`, to the satisl"action of ally dana�ages, reclamation, assessments, penalties, or deficiencies arising by reason of such default. BOND CONDITIONS 1. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS NO. PW 14-10, 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. I-F-1 Agreement No. 5243 M.640(a) 1, � N , � N m C f County of I I /b N, � e SM of California,In and W sold County DO Y'DER a I ' "THAT q has cd9 t1ii(M ,of a,W�U&'N vs,an adntt''ft x i surety Issued y t Cllr the, 4m�, a a iW ,mra, +,ri at nased onft reayrds shown in the of I,Gt craw a,r nal outrwMy nas not b rs somwoored,revoked,Mme- dOMA610, (14 In IOVAnhvy OWN, 00, t*rhy hand and~the of said Qu4inty vda , COUNTY CLERK Deputy County Clerk Agreement No. 5243 3. PRINCIPAL will pay for all materials and other supplies, for equipment used in,on,for or about the performance of the Public Project,and will pay for all work and labor thereon. 4. This bond is conditioned upon and guarantees due compliance with all applicable law including, without limitation, the El Segundo Municipal Code (`SSMC"). 5. SURETY, for value received, agrees that no changes, extensions of time, alteration or modification of SPECIFICATIONS NO. PW 14-10, 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. [SIGNATURES ON FOLLOWING PAGE] I-F-2 Agreement No. 5243 SIGNED AND SEALED this 4th day of January 20 17 Robertsgndusie Berkley Insurance Company .... �w PRINCD ^N`i LIRE'I Y's Attolr� yin-fa ct Sylvia M. Qgle-, PRINCGARY SURETY'S Witness Christine Doczy PRINCIPAL's MAILING ADDRESS: SURETY's MAILING ADDRESS: Robertson Industries, Inc. Berkley Surety Group, LLC 2414 W. 12th Street, Suite"5 412 Mount Kemble Ave.,, Suite 31 Tempe,AZ 85281 Morristown, NJ 07960 Attn: Surety Claims Department 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 1-F-3 No.BI-477h POWER OF ATTORNEY BERKLEY INSURANCE COMPANY Agreement No. 5243 WILMINGTON,DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware,having its principal office in Greenwich,CT,has made,constituted and appointed, and does by these presents make, constitute and appoint: Gary D. Eklund; William G. Moody;D Ann Kleidosty; Sylvia M. Ogle; Sharon J. Potts; Brooke A. Sharp; or Christine Doczy of Marsh USA, Inc. of Atlanta, GA its true and lawful Attorney-in-Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings,with the exception of Financial Guaranty Insurance,providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010: RESOLVED, that, with respect to the Surety business written by Berkley Surety Group, the Chairman of the Board, Chief Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such attorney-in-fact and revoke any power of attorney previously granted; and further RESOLVED,that such power of attorney limits the acts of those named therein to the bonds,undertakings,recognizances, or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated;and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and further 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, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued. IN W11"NESS , ��y d these presents to be signed and attested by its appropriate officers and its corporate al hereunto d Ml"flxecl�tE�riyoda:aan tyl�,l c ..Se... .2016. Attest: � Berkley Insurance Company 0, i�� Seal B li lra S. 'I.cderatian Jc l + llaller Senior Vice President&Secretary S'n 6 is President WARNING; THIS POWER INVALID IF NOT PRINTED ON BLUE"I3 .RKLEY" SECURITY PAPER. STATE OF CONNECTICUT) ) ss: Sworn t bOUNme'O'I+'I+�A'I'III+`I'h`'l.L) - {� .'.:.............ri, Notary Public in the State of Connecticut,this day of_ X016,by Ira S. Lederrnin and Jeffrey M. Hafter who are sworn to me to be the Senior Vice President and Secre ,,at lie Senior'Vice I"r psident, respectively, of Berkley Insurance Company. MARIA C. RUNDBAKEN NOTARY PUBLIC ; MY COMMISSION EXPIRES Notary Public, State of Connect_i cu.... t -- APRIL 30,2019 CERTIFICATE I, the undersigned,Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney;that said Power of Attorney has not been revoked or rescinded and that the authority of the Attomey-in-Fact set forth therein,who executed the bond or undertaking to which this Power of Attorney is attached,is in full force and effect as of this date. P" Given under my hand and seal of the Company,this day of _ . �u (Seal) ................. . ....... Vince t Fort Agreement No. 5243 ! vu III'il Ip ui' p,III p If ii li If a II oll,ll!i, oll 'I II II II 11!i i 1i'P li II a'.'ll . illpll Oi,ll';.; II Lup I i I 4;, II,II,;�li a", II :II 0.'j• IL. �I I'i� III I' '�, I��'� i� I'I"V�,II li II II,"II o.." i l! I'.,,+�..!I�' p d II.!(11�� II III,'II II! � I !II''u II II IIuIII I �lo,,;IIIII,'PIiIIIII I!ih'6'^'pII„ `'o�., uj �p'oII' !!II 1111 II III'III" II „ II I I, 1I 1i 1 II IIi I'!IIIIIp;_' ','� Illliu" II II li;;,�i,;ll;" oi�'ll V. 11;,' 'd,', t,l'IIII111"II„ Illi',I '�I' 'hu ' ;ili"6!'.' pII R i'u 'Illllil,',ullll 'I,"^II ill V!,"II, �!i'V'liiillllllilllll " "fu' III„III,,, jY� o �;?u'” Id"� "'III p 11 if Ch 11 I:l:11 d II II u6; II' P II ° d; U.II.o ill li. V p li II II a u,, 1 1101, No 5243 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT' 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 _e County of Fulton On January 4, 2017 before me, Christine Doc personally appeared Sylvia M. Ogle, Attorney-in-fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the �jqjq of California that %It I I the foregoing paragraph is true and correct. S0- \ E D :0 0 "A R WITNESS my hand and official seal. PUB\, 03-16-'T Notary blfc Signature 'GhAs6e Docz (Notary Public Sea[) r I NCOUN .............. ADDITIONAL OPTIONAL I ORMATION INSTRUCTIONS FOR COMPLETING THIS FORM DESCRIPTION OF THE ATTACHED DOCUMENT from other states nimp he ownpkted for documems be sem to Am stale so long as the svoreloig eloes nor require mwrry to violate(ahfornia wvary Payment Bond low, (Title or description of attached document) • State antl County information irkusl be the State and County where the document sigitcqs)personally appeared before the notary piAlic for acknowledgment, • oule of nolarization,inust be the ifitte that tile sig,=(s)lictsonAy appeared which �TiUe o�description ofiattached docume�ni-contlnued) must also he the same date the acknowledgment is corripieted, • ne notary public must print his or her name as it appears within his or her Number of Pages 3 Document Date 01/04/2017 commission followed by a cariuma and then,your title(notary public", • Print the narise(s) of docurneni sign ei(s) who persona-lly appear to the time of notarization CAPACITY CLAIMED BY THE SIGNER 0 Injicatc(lie Correct singuist or plural forms by crossing off incorrect forms(i.e. IV a re is Pie)air circling the correct fmms,17 flu to correctly indicate this ❑ Individual(s) information may lead to rc ection of document recording. 'i mprodkwitile, ❑ Corporate Officer • '11le riotarM, seat impression must be clear sand photographically Impression must not cover text or fines, lfscal inipmeision striudges,re-seal if a (Title) stiff icicirit area permits,otheraisecomplete a different acknowledgment form ❑ Partner(s) • Signaturc of the notary public must match the signature on file with the office of file county clerk, photographically acknowledgment t off p w c 0 I o in rr c a e r d correctly y 6 c Iy r Attorney-in-Fact Additional information is not required but could help to ensure this ❑ r, t Trustee(s) acknowledgment is not misused or attached to a different document. Indicate title or type of ate tached document,number orpages and date. Other -'o Indicate the capnity claimed by the signer. If the claimed Capacity is a 0 �j'ry) corporate officcr,indicate die title(i.c,CEO,CFO,Scorclary) CFO,S • Securel attach this document to the si ed document with st ple, ith a staple, W Rai .............. .. .... Agreerrle-nt No. 5243 ...... =Ww"Mm- "Own ..... ...... CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 County of On V�9- -k� before me, app q 'Asapi nanie arl,d 11114 01 khe aftuc0r) personally appeared who proved to me on the basis of satisfactoKryevi2dene to be fthe person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. C, 1411f,��. 1,� h j,,�Wo: ly Notary Pubic 4ature (Notary Public ............. .... .................. ........................ INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION Thisform complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary Payment Bond law. (Title or description of attached document) e State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her 'Number of Pages 3 Document Date commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. he/she/dw5--is JeFe)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. [N Corporate Officer o The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of ❑ Partner(s) the county clerk. ❑ Attorney-in-Fact •0• Additional information is not required but could help to ensure this Trustee(s) acknowledgment is not misused or attached to a different document. Other 4- Indicate title or type of attached document,number of pages and date. ❑ ee Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). _.m. ..mmmmmmmrt�mmmrem�wu 2a 01wm5 V�wweuwtw w..,w__.w Notary Classes.com 800-873-9865 Securely attach this document to the signed document with a staple.w .............. ............... ........... mim�imwmanmmu��rvma��V Agreement No. 5243 I " i STATE OF CALIFORNIA V' DEPARTMENT OF INSURANCE No 07382 c SAN FRANCISCO i r Amended Certificate of Authorit Y THIS IS TO CERTIFY THAT, Pursuant to the Insurance Code of the State of California, Berkley Insurance Company Of Wilmington, Delaware , organized under the laws of Delaware , 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: Fire, Marine, Surety, Disability, Plate Glass, Liability, Workers ' Compensation, Boiler and Machinery, Burglary, Credit, Automobile, Aircraft, and Miscellaneous 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 MI compliance with all,and not in violation of any,of the applicable laws and lawful requirements made under authority of the laws of the State of California as long as such laws or requirements 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 10th day of July P 2001 ,I have hereunto set my hand and caused my official seal to be affixed this 10th day of Jul 2001 Agreement No. 5243 PROPOSAL FOR THE GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT Project No.: PW 14-10 Date OCTOBER 31 2016 Company Name ROBERTSON INDUSTRIES INC. TO THE CITY OF EL SEGUNDO: In accordance with the City of El Segundo's Notice Inviting Sealed Bids, the undersigned BIDDER hereby proposes to furnish all materials, equipment, tools, labor, and incidentals required for the above stated project as set forth in the Plans, Specifications, and contract documents therefor, and to perform all work in the manner and time prescribed therein. BIDDER declares that this proposal is based upon careful examination of the work site,Plans, Specifications, Instructions to Bidders, and all other contract documents. Submittal of this bid shall be considered evidence that the BIDDER has satisfied himself regarding the contract documents,access and any other field conditions which may affect bid prices.If this proposal is accepted for award,BIDDER agrees to enter into a contract with the City of El Segundo at the unit and/or lump sum prices set forth in the following Bid Schedule.BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to the City of El Segundo of the proposal guarantee accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed.THE CITY OF EL SEGUNDO RESERVES THE RIGHT TO INCREASE OR DECREASE THE AMOUNT OF ANY QUANTITY SHOWN AND TO DELETE ANY ITEM FROM THE CONTRACT.It is agreed that the unit and/or lump sum prices bid include all apparent expenses,taxes,royalties, and fees.In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned further agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within ten working days after the date of the City of El Segundo's notice of award of contract to the BIDDER, including sending by U.S.Mail a Public Works Contract for signature by the Awardee,the proceeds of the security accompanying this bid shall become the property of the City of E1 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 Agreement No. 5243 COITAL �d A111LOY MENT 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.Furthennore, BIDDER certifies that affirmative action will be taken to meet all equal employment opportunity requirements of the contract documents. NONCOLLUSION DECLARATION 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 Agreement No. 5243 BID SCHEDULE GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: PW 14-10 Company Name: ROBERTSON INDUSTRIES INC. BASE BID ITEMS .UpL)er_Play Item ground only Unit Price Total No. Description QTY Unit ($) ....... ...... I Mobilization not to exceed 5% of the I LS 1 990.00 total base bid) I I Remove F-wide existing rubber surface INCLUDED at playground perimeter to full subgrade 0 IN BASE 2 depth and replace with Tot Turf 223 SF PRICING Aromatic Poured in Place Rubber Surfacing to 1.5" below grade. Remove isolated areas of playground 3 surface requiring patching to depth of 3" 260 SF 891 231660 and patch back up to 1.5"below grade . . per manufacturer's instructions. Install 1.5"thick Tot Turf Aromatic 4 Poured in Place Rubber Surfacing over 4,700 SF 8.80 I 41,360.00 entire playground surface. Install 3.5"thick Tot Turf Supreme Poured in Place Rubber Surfacing. INCLUDED 5 Supreme must be flush with Aromatic 10 EA 0 IN BASE surface and color must be different from PRICING Aromatic surface. Must be an organic shape and fit inside 30" x 30". TOTAL BASE BID=$ 44,666.60 TOTAL BID WRITTEN IN WORDS: FORTY-FOUR THOUSAND SIX HUNDRED AND SIXTY DOLLARS WITH SIXTY CENTS All work shall be per these specifications and attachments. Prevailing wage rates apply. The City 01"EI Segundo reserves the right to reject any or all bids,,to waive any irregularity, and to take all bids Linder advisement for as period of ninety (90) calendar days. I-C-3a Agreement No. 5243 ALTERNATIVE BID SCHEDULE GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: PW 14-10 Company Name: ROBERTSON INDUSTRIES INC. ALTERNATIVE BID ITEMS Upper Playground Item Unit Price Total No. Description QTY Unit ($) ($) Install sail shade structure per project Al specifications and plans and per 1 LS tjA manufacturer's instructions rr.................................................................................................................................................................................................................................................................................................................................................................................................................................................�...rrrrrrrr...wwwwww......ww...rr_wwww All work shall be per these specifications and attachments. Prevailing wage rates apply. The City of El Segundo reserves the right to reject any or all bids,to waive any irregularity, and to take all bids under advisement for a period of ninety (90) calendar days. I-C-3b Agreement No. 5243 ALTERNATIVE BID ITEMS Lower Playground Item Unit Price Total No. Description QTY Unit ($) ($) Remove existing Poured in Place and Install 3.5" Tot Turf Supreme Poured in B 1 Place Rubber Surfacing. Supreme must 120 SF 2508.00 be flush with Aromatic surface and color to be different from Aromatic Surface. ...._....__....._W....._................................................._�_...__,.-----__... ................ Install rectangular hi shade structure per � B2 project specifications and plans and per 1 LS 4- NA manufacturer's instructions All work shall be per these specifications and attachments. Prevailing wage rates apply. The City of El Segundo reserves the right to reject any or all bids, to waive any irregularity, and to take all bids under advisement for a period of ninety(90) calendar days. I-C-3c Agreement No. 5243 BIDDER'S INFORMATION Company Name: ROBERTSON INDUSTRIES INC. BIDDER certifies that the following information is true and correct: Form of Legal Entity(i.e., individual, partnership, corporation, etc.) CORPORATIONw � If corporation, State of Incorporation (i.e., California) ARIZONA Business ROBERTSON INDUSTRIES INC. Address 2414 W. 12TH ST., SUITE 5 TEMPE. AZ 85281 Telephone No. (800)858-0519 Facsimile No. (6021340-0402 State Contractor's License No. and Class 667261 C61/D12 Original Date Issued 1991 Expiration Date 3/31/2017 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: PLAYCORE m The date of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this proposal is as follows: N/A All current and prior DBA's, aliases, and/or fictitious business names for any principal having an interest in this proposal are as follows: ROBERTSON RECREATIONAL SURFACES I-C-4 Agreement No. 5243 BIDDER'S INFORMATION(CONTINUED) Company Name: ROBERTSON INDUSTRIES INC. Bidder shall list the name of the person who attended the mandatory pre-bid job walk: Name: VINCE BRANTLEY ......w..w..w.._.................................. ......................... . Title: SCA SALES MANAGER I-C-5 Agreement No. 5243 IN WITNESS WHEREOF,BIDDER executes and submits this proposal with the names,titles, hands, and seals of all aforenamed principals this 31 day of OCTOBER,. 2016 . BIDDER RICHARD HAWLEY. VP OF SALES Subscribed and sworn to this 31 day of OCTOBERO 16 OFFRIAL SEAL' NOTARY PUBLIC °" „' q aird �,roFoa waa,�r�ry I-C-6 Agreement No. 5243 PROPOSAL GUARANTEE BID BOND GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: PW 14-10 KNOW ALL MEN BY THESE PRESENTS that, SEE ATTACHED , as BIDDER, and , as SURETY, are held and firmly bound unto the City of El Segundo, in the penal sum of DOLLARS ($_),which is ten (10%)percent of the total amount bid by BIDDER to the City of El Segundo for the above stated project,for the payment of which sum,BIDDER and SURETY agree to be bound,jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that,whereas BIDDER is about to submit a bid to the City of El Segundo for the above stated project,if said bid is rejected,or if said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and time specified,then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of the City of El Segundo. IN WITNESS WHEREOF the parties hereto have set their names,titles,hands,and seals this day of 20 BIDDER* SURETY* Subscribed and sworn to this day of 20 NOTARY PUBLIC *Provide BIDDER/SURETY name, title, address and telephone number and the name, title, address and telephone number for authorized representative. I-C-7 Agreement No. 5243 PROPOSAL GUARANTEE BID BOND GEORGE E.GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: P W 14-10 KNOW ALL MEN BY THESE PRESENTS that, Robertson Industries,Inc. ,as BIDDER,and Berkley Insurance Company ,as SURETY,are held and firmly bound unto the Ten Percent(10%)of City of El Segundo, in the penal sum of Total Amount Bid DOLLARS($�,which is ten (10%)percent of the total amount bid by BIDDER to the City of El Segundo for the above stated project,for the payment of which sum,BIDDER and SURETY agree to be bound,jointly and severally,firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that,whereas BIDDER is about to submit a bid to the City of El Segundo for the above stated project,if said bid is rejected,or if said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and time specified,then this obligation shall be null and void,otherwise it shall remain in full force and effect in favor of the City of El Segundo. IN WITNESS WHEREOF the parties hereto have set their names,titles,hands,and seals this 31 st October 16 day of A 20................ BIDDER* Robertson lndu tries, Inc. By: w 2414 W. 12th Street;Suite 5;Tempe, 281 Tel:602-707-6884 SURETY* Berkley Insurance Company By: jw� �, „„ , �. wN Sylvia M.Ogle,Attorney-in-fact TWO Ra is Dr.,Suite 1050;Arita, GA 30346 Tel:678-624-1818 Authorized Representative: Kari Davis; Marsh USA, Inc. 777 So. Figueroa St.;Los Angeles, CA 90017 Tel:213-346-5005 Subscribed and sworn to t' NOTARY PUBLIC Christine Dopy„Notary Publicwww° " N 4 S, 31st day f r ry.w � *Provide BIDDER/SURETY name, title, addre�and telephone number and t Aw &T c� X address and telephone number for authorized representative. .w(m OTA l 44 w w.dF w MMi tl 6twt w �w 116.2 w a 1-C-7 o3 04?COUNTY, rw”` Agreement NON5243177h POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WH vIINGTON,DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly ti organized and existing under the laws of the State of Delaware,having its principal office in Greenwich,CT,has made,constituted and appointed, and does by these presents make, constitute and appoint: Gary D. Eklund; William G.Moody;D-Ann gleidosty; Sylvia M, Ogle;Sharon J. Potts,Brooke A. Sharp;or Christine DocV of Marsh USA,Inc. of Atlanta, GA its true and lawful Attomey-in-Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings,with the exception of Financial Guaranty Insurance,providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.S50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by,the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010: RESOLVED, that,with respect to the Surety business written by Berkley Surety Group,the Chairman of the Board, Chief cl: Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attomey-in-fact named therein to s "'P execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove an such rp P Y Po Y P Y attomey-in-fact and revoke any power of attorney previously granted;and further RESOLVED,that such power of attorney limits the acts of those named therein to the bonds,undertakings,recognizances,or other suretyship obligations specifically named therein,and they have no authority to bind the Company except in the manner and to the extent therein stated;and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attomey-in-fact named; and "p further RESOLVED, that the signature of an authorized officer and the seal of the Company may be affixed b facsimile to an >� Y P Y Y Y Y power of attorney or certification thereof authorizing the execution and delivery of any bond,undertaking,recognizance, or E other suretyship obligation of the Company;and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company,notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued. 10 :°j "„:” IN WITNESS WHEREOF, the Company has c ed these presents to be signed and attested by its appropriate officers and its N; corporate seal hereunto affixed this ay of ,2016. n, g;; Attest. "�-^� Berkley Insurance Company (Seal) By B Ira S,i edermnan J lialler u Senior Vice President&Secretary S is President WARNING:THIS POWER INVALID IF NOT PRINTED ON BLUE" RKLE'Y"SECURITY PAPER. STATE OF CONNECTICUT) µ'l'i'' COUNTY OF FAIRFIELD ss: J. C:, Sworn to before me,a Notary Public in the State of Connecticut,this day of ,2'016,.by Ira S.Lederman and Jeffrey M. Hager who are sworn to me to be the Senior Vice President and Secre' 1 zpfle Settior Vice r sident,respectivdely, of ' Berkley Insurance Company. MARIA C.RUNDBAKEN NOTARY PUBLIC � �' MY COMMISSION EXPIRES Notary Public, State of Connecticut "" APRIL 30,2019 i CERTIFICATE Z, 'f I,the undersigned,Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney;that said Power of Attorney has not been revoked or rescinded and that the authority of the ' Power Attorney attached,is in full force and effect as Attomey-in-Fact set forth therein who executed the bond or undertaking to which this Power of Attorn is attach of this date. under m hand and seal of the Company,this,", ) day of Y Y .�... ..._....`m'�. (Seal) Vll;cc .fon Agreement No. 5243 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 Georgia County of Fulton On October 31, 2016 before me, Christine Docz a, t=rtPublic ew t I, dtWeafomc" personally appeared S ylvia M. Ogle, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/the y executed the same in his/her/their authorized ca act and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the JA;plifornia that 00 o' the foregoing paragraph is true and correct. .0 T A tj p 10. WITNESS my hand and official seal. PUBII,. G war 16'10%% 6 NoNotary Pub Irc Signature ehrffline,!T oo(Notary Public Seal) Ot kC011,1141t ..........- .......... INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION 77iisform complies with current California statutes regarding nolmy wording and DESCRIPTION OF THE ATTACHED DOCUMENT ifneedrA should be completed and attached to the document.Acknowkdgments from other stales may be completed for documents being sent to dial Vale so long as the wording does not require the California notary to violate California notary Bid Bond law. (Title or descriptlon of altectied document) a State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment * Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continuer]) must also be the same date the admowledgment is completed. a The notary public must print his or her name as it appears within his or her Number of Pages Document Date 10/312016 commission followed by a comma and then your title(notary public). a Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER a Indicate the coma singular or plural forms by crossing off incorrect forms(i.e. WsheMsyr-is/an)or circling the correct forms.Failure to correctly indicate this El Individual(a) information may lead to rejection of document recording. ❑ Corporate Officer e The notary seal impression must be clear and photographically reproducible. Impression must not cover Wd or lines.If seal impression smudges,reseal if a (TRIO) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) a Signature of the notary public must match the signature on file with the office of the county clerk. 8 Attorney-in-Fact # Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document C] Other 4- Indicate tide or type of attached document number of pages and d 0 Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www NotaryClasses com 600-873-9865 Securely attach this document to the signed document with a staple. Agreement No. 5243 STAM OF CALIFORNIA DEPARTMENT OF INSURANCE NQ 07382 SAN FRANCISCO Amended Certificate of Authon'ty THIS IS To CERTIFY THAT,Pursuant to the Insurance Code of the State of California, Berkley insurance company Of Wilmington, Delaware organized under the laws of Delaware subject to 11Y Articles of Incorporation or otherfundamenfal organizational documents,is hereby authorized to transact within the State,subjectto all provisions of this Certfflcate, the following classes of inmrance. Fire, marine, Surety, Disability, Plate Glass, Liability, workers' compensation, Boiler and Machinery, Burglary, Credit, Automobile, Aircraft, and Miscellaneous as such classes are now or may he after be den ed in the Insurance Laws of the State of California. THIS CERTMCATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all,and not in violation ofany,of the applicable laws and lawfid requirements made under authority of the laws of the State of California as long as such laws or it is are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended. IN WrfNESS WHEREOF,effective as of the..--—U-th- rJay of TM July ___ 2001 ,I have hereunto set my hand and caused my official sepi to be affixed this 10th day of.—JU1y---, —2001 Agreement No. 5243 CONTRACTOR'S LICENSE DECLARATION (Business and Professions Code Section 7028.15) 1. BIDDER'S Contractor's License Number is: 667261 Class No.: C61 / D12 2. The expiration date of BIDDER'S Contractor License is: MARCH 31 20 17 . 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 10/31 20 16, at TEMPE. ARIZONA (insert City and State where Declaration signed). r Signature RICF1A'RD.H111►'IRV"t� .Y Typed Name M-P_Ot:_.6ALES................................_m Title Company Name I-C-8 Agreement No. 5243 NON-COLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID (pursuant to Cal. Pub. Contract Code § 7106) The undersigned declares: I am the VP OF SALES of ROBERTSON INDUSTRIES,IWparty making the foregoing bid. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company,association,organization,or corporation.The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid.The bidder has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. 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. All statements contained in the bid are true. 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, to any corporation,partnership,company,association,organization,bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose. Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership,or any other entity,hereby represents that he or she has full power to execute,and does execute,this declaration on behalf of the bidder. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 10/31/16 [date], at TEMPE [city], AZ [state]." Dated this 31ST day of OCTOBER 20 16. RICHARD HAWLEY Name VP OF SALES .W................ Title W-o.A�d Signature I-C-9 Agreement No. 5243 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: VP OF SALES Business Name: ROBERTSON INDUSTRIES INC. Business Address: 2414 W. 12TH ST., SUITE 5 TEMPE, AZ 85281 Telephone Number: 800 858.0519 Dated this 31 day of OCTOBER 12016 I-C-10 Agreement No. 5243 DESIGNATION OF SUBCONTRACTORS GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: PW 14-10 Company Name: ROBERTSON INDUSTRIES INC. 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 Subcontractor's Portion of Name of Contractor Work Estimated$ Subcontractor Address License No. Subcontracted Amount (Number and Street) i ............................................... (City,Zip Code) . .............................. ............ .._._.................. . I I I I i ._........................ w ............................................ ....... I ....................................._._._._. ....... _. .... __m .__................................_...... I I-C-11 Agreement No. 5243 REFERENCES Company Name: PLEASE SEE ATTACHED 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: 1. 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? 2. 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?_ I-C-12 Agreement No. 5243 3. 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? ...... 4. 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. 5243 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? 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: MARSH USA INC. - TWO ALLIANCE CENTER, 3560 LENOX RD. #2401 0, ATLANTA GA 303 .................. I-C-14 Agreement No. 5243 BIDDER'S STATEMENT OF PAST CONTRACT DISQUALIFICATIONS GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT NO.: PW 14-10 Company Name: ROBERTSON INDUSTRIES INC. 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. I. Have you ever been disqualified from any government contract? Yes ❑ No 2. If yes, explain the circumstances: .................................................................................................W............_ ........... .................... 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 IR No ❑ Bidder's Signature ww_wr RICHARD HAWLEY _................ � Name (Please Print) I-C-15 Agreement No. 5243 olu III ° �11u 1 1 II p I ,µAll! 1100 I !; u p Robertson i Recreational Surfaces 1354 14th Street . Oakland, California . 94612 PROJECT REFERENCE LIST Recentiv Com leted Public Works Proiects: 1. Boyd,Ricks,Hidden Valley (Martinez) Contract#13-10105 -$92,817 ■ 55,830 Sq ft-Aliphatic pour-in-place surfacing Emilio Bustos,General Contractor,Suarez&Munoz Construction,Inc, 510.782.6065 Don Salts,Project Manager,Public Works,City of Martinez 925.372.3596 Boyd-Start 10-24-2013 End 11-12-2013,Hidden Valley Start 11-20-2013-End 12-3- 2013,Ricks -Start 10-29-2013-Done Same Day Nancy Boyd Park Hidden Valley Park Pleasant Hill Rd E Martinez 94553 Center Ave Martinez 94553 Cappy Ricks Park Brown Street Martinez 94553 2. Yerba Buena Gardens (San Francisco) Contract#13-10244-$218,000 9946 Sq ft-Supreme pour-in-place surfacing 745 Mission St,San Francisco 94103 +� Stacy West,Assist.General Manager,Yerba Buena Gardens Office.415.820.3550 / Cell.415.601.3366 Jan Drees,Project Manager,Yerba Buena Gardens 415.820.3500 Start Date 10-18-2013-Completion 10/26/2013 Agreement No. 5243 3. Palega Playground (San Francisco) w Contract# 12-9256-$54,166 Y 9900 Sq ft-Aliphatic pour-in-place surfacing • 500 Felton Street,San Francisco 94134 w David Sedeno,Project Manager,Arntz Builders,415.382.1188 a Toks Ajike,Project Manager,City Parks of San Francisco, 415.581.2543 a Start Date 9/4/2013-Completion 9/13/2013 4. Rocketship Renovation Summer(San Jose) F Contract# 13-10722-$44,852 a 9900 Sq ft -Aliphatic pour-in-place surfacing 0 788 Locust Street,San Jose,CA 95122 0 Greg Kubo,Project Manager,Robert Bothman,408.279.2277,ext 245 e Harrison Tucker,Facilities Project Manager,Rocketship Education,704.995.2254 a Start Date 10/22/2013-Completion 10/24/2013 5. McLaren Park (San Francisco) 0 Contract# 12-8500-$49,652 a 3241 Sq ft-Supreme pour-in-place surfacing MI Mansell Street&John F.Shelley Drive,San Francisco,94134 Lauren Cardinalli,Azul Works,415.558.1507 Dii Luis,Project Manager,Azul Works 415.225.6525 + Matt Jasmin,Project Works,Rec&Parks(415) 831-2700 Start Date 9/18/2013-Completion 9/19/2013 6. Fiesta Gardens International (San Mateo) Contract# 11-4686-$69,030 ■ 5900 Sq ft-Supreme pour-in-place surfacing 4 1001 Bermuda Drive,San Mateo 94403 W Ali Mostoflan,Project Manager,Zolman Construction&Development,650.642.4884 i George Kaufer,Project Manager,San Mateo USD, 0 Start Date 10/17/2013-Completion 11/14/2013 7. Calabazas Park(San Jose) Y Contract#11-4843-$78,545 ® 7795 Sq ft-pour-in-place surfacing a 1201 S.Blaney Avenue,San Jose,95129 a Blossom Valley Construction,Robert Jimenez,Project Manager 408.993.0766 ext#124 Planning&Development, City of San Jose, 408.535.3555 Start Date- 5/03/2012 Completed-5/14/2013 Agreement No. 5243 INSURANCE REQUIREMENTS [MUST BE SUBMITTED WITH PROJECT PROPOSAL] GEORGE E. GORDON CLUBHOUSE PLAYGROUND RESURFACING PROJECT PROJECT N,O_.: PW 14-10, Company Name: 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: Tvpe 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 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 render the bidder's proposal"nonresponsive." Date Bidder's Signature I-C-16 Agreement No. 5243 END PROPOSAL SECTION I-C-17