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HomeMy WebLinkAboutA8412 - VIDO SAMARZICH, IncRecording Requested By: ,�:;,27a 2( City of Palm Springs When Recorded Mail To: Name Anthony J. Mejia, City Clerk Street Address 3200 E. Tahquitz Canyon Way City & State Palm Springs, CA 92262 CITY FFPt`4LFg1SPRIPJGS OFFICE OF THE CI owl, -Y CLEF; 05/11/2020 10:09 AM Fee: $ 01.00 Page 1 of 3 Recorded in Official Records County of Riverside Peter Aldana Assessor -County Clerk -Recorder 1111RESON"KhRul SPACE ABOVE THIS LINE FOR RECORDERS USE p� NOTICE OF COMPLETION (CA Civil Code §§ 8180-8190, 8100.8118, 9200-9208) NOTICE IS HEREBY GIVEN THAT: 1. The undersigned is an owner of an interest of estate in the hereinafter described real property, the nature of which interest or estate is: Fee (e.g. fee, leasehold, joint tenancy, etc.) 2. The full name and address of the undersigned owner or reputed owner and of all co -owners or reputed co -owners are: Name Street and No. City State City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs CA 92262 3. The name and address of the direct contractor for the work of improvement as a whole is: VI DO SAMARZICH, INC. 6829 Billing Place, Rancho Cucamonga 917014923 4. This notice is given for (check one): 0 Completion of the work of improvement as a whole. ❑ Completion of a contract for a particular portion of the work of improvement (per CA Civ. Code § 8186). 5. If this notice is given only of completion of a contract for a particular portion of the work of improvement (as provided in CA Civ. Code § 8186), the name and address of the direct contractor under that contract is: Not Applicable 6. The name and address of the construction lender, if any, is: Not Applicable 7. On the 20th day of February 20 20 , there was completed upon the herein described property a work of improvement as a whole (or a particular portion of the work of improvement as provided in CA Civ. Code § 8186) a general description of the work provided: City Project 15-31, Sidewalk Gap Closure Project 8. The real property herein referred to is situated in the City of Palm Springs County of Riverside State of California, and is described as follows: City Wide Various Locations 9. The street address of said property is: See Attachment 10. If this Notice of Completion is signed by the owner's successor in interest, the name and address of the successor's transferor is: Not applicable I certify (or declare) under penalty of perjury under the laws of the a of California that regoing is true and correct. Date: I AA4 By: Signature of Owner or Owner's Authorized Agent Marcus Fuller, Assistant City Manager/City Engineer City of Palm Springs Page 1 of 2 IS VERIFICATION I, Marcus Fuller , state: I am the Assistant City Manager/City Engineer_ ("Owner", "President", "Authorized Agent", "Partner", etc.) of the Owner identified in the foregoing Notice of Completion. I have read said Notice of Completion and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on (date), at Palm Springs (city), CA (state). Signature of Owiler or Owner's Authorized Agent Marcus Fuller, Assistant City Manager/City Engineer City of Palm Springs 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. TERRI HINTZ NotaryPublic- California z Riverside County > Commission P 2202861 My Comm. Expires Jun 26, 2021 STATE OF CALIF¢R NIA COUNTY OF „2410 (date), before me, Notary Public (name and title of officer) personally appeared us <v 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 PURJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official se Page 2 of 2 Signature PROJECT LOCATIONS Project Title: Sidewalk Gap Closure Project, City Project No. 15-31 Project Location (City): City of Palm Springs Project Location (County): Riverside Project Location (Specific): Street Alejo Road Amado Road Baristo Road Baristo Road Camino Real Indian Canyon Drive Racquet Club Sunny Dunes Road Between Calle Encilia and Calle El Segundo Farrell Drive and Sunrise Way Belardo Road and Tennis Club Road Farrell Drive and Sunrise Way So. Riverside and Indian Trail Mel and Vista Chino Cardillo to North Palm Canyon S. Palm Canyon and Calle Amigo r CITY OF PALM SPRINGS CONTRACT CHANGE ORDER To: Vido Samarzich, Inc. 6829 Billings Place Rancho Cucamonga, CA 91701 Attn: Vido L. Samarzich Date: Project: Change Order No: Purchase Order Account No. March 12, 2020 15-31 Sidewalk Gap Closure Project 2 (two) 20-0809 260-4494-58702 This Contract Change Order No. 2 provides for contract quantity adjustments for bid schedules as indicated below. Base Bid Schedule A — Aleio Road: Bid Item No. Description Qty Price Total A-6 REMOVE & DISPOSE EXISTING AC +2 SF $5.00 $10.00 PAVEMENT A-10 REMOVE & DISPOSE EXISTING +1 SF $3.00 $3.00 CONCRETE SIDEWALK, DRIVEWAY, CROSS GUTTER & SPANDREL Subtotal Base Bid Schedule A $13.00 Base Bid Schedule B — Amado Road: Bid Item No. Description Qty Price Total B-13 CONSTRUCT 4" THICK CONCRETE -101.5 SF $7.00 -$710.50 SIDEWALK PER CITY STD. NO, 210 B-20 CONSTRUCT RETAINING CURB PER +382 LF $14.00 $5,348.00 DETAIL AS SHOWN ON PLAN Subtotal Base Bid Schedule B $4,637.50 Base Bid Schedule C — Camino Real: Bid Item No. Description Qty Price Total C-4 SAWCUT EXISTING PAVEMENT -57 SF $3.00 -$171.00 C-5 GRIND AND OVERLAY EXISTING AC +7,384 SF $6.00 $44,304.00 PAVEMENT 1.5" MIN. C-6 REMOVE & DISPOSE EXISTING AC -10,071 SF $3.00 -$30,213.00 PAVEMENT CP 15-31 Sidewalk Gap Closure Project Contract Change Order No. 2 March 12, 2020 Page 2 C-10 REMOVE & DISPOSE EXISTING +701 SF $3.00 $2,103.00 CONCRETE SIDEWALK, DRIVEWAY, CROSS GUTTER & SPANDREL C-11 CONSTRUCT 5" AC OVER 4" CLASS II -6,427 SF $6.00 -$38,562.00 AGG.BASE C-12 CONSTRUCT 6" CURB & GUTTER PER +541 LF $45.00 $24,345.00 CITY STD. NO. 200, TYPE A3 C-13 CONSTRUCT ROLL CURB TRANSITION -2 LF $50.00 -$100.00 PER CITY STD. NO. 209 C-14 CONSTRUCT CONCRETE CROSS -216 SF $14.00 -$3,024.00 GUTTER AND SPANDREL PER CITY STD.NO. 200 TYPE D1 & STD. NO.206 C-15 CONSTRUCT 4" THICK CONCRETE -459 SF $7.00 -$3,213.00 SIDEWALK PER CITY STD. NO. 210 C-16 CONSTRUCT CURB RAMP TYPE A PER +1 EA $3,600.00 $3,600.00 CITY STD. NO. 212 C-17 CONSTRUCT CURB RAMP TYPE B PER +1 EA $3,600.00 $3,600.00 CITY STD. NO. 213 C-18 CONSTRUCT CURB RAMP TYPE C PER -1 EA $3,600.00 -$3,600.00 CITY STD. NO. 214 C-20 CONSTRUCT 6" CONCRETE DRIVEWAY +2,206 SF $8.00 $17,648.00 AS SHOWN ON PLAN C-21 CONSTRUCT 4" AC DRIVEWAY OVER -27 SF $10.00 $270.00 COMPACTED NATIVE AS SHOWN ON PLAN C-22 CONSTRUCT ROLL CURB PER CITY STD. -311 LF $40.00 -$12,440.00 202 C-23 CONSTRUCT 2" PVC SLEEVE -16 LF $20.00 -$320.00 C-24 REMOVE EXISTING WATER METER BOX -2 EA $500.00 -$1,000.00 & VALVE BOX, INSTALL NEW WATER METER BOX WITH LID AND VALVE BOX PER DETAIL ON SHEET 2 C-25 RELOCATE EXISTING SIGNS -3 EA $100.00 -$300.00 C-26 ADJUST WATER VALVE TO GRADE -1 EA $400.00 -$400.00 Subtotal Base Bid Schedule C $1,987.00 Base Bid Schedule D — Racquet Club: Bid Item No. Description Qty Price Total D-4 SAWCUT EXISTING PAVEMENT +318 LF $3.00 $954.00 D-6 REMOVE & DISPOSE EXISTING AC -194 SF $3.00 -$582.00 PAVEMENT D-16 CONSTRUCT CONCRETE DRIVEWAY -98.5 SF $8.00 -$788.00 PER CITY STD. NO. 201 D-17 CONSTRUCT RETAINING CURB PER 36 LF $25.00 $900.00 DETAIL AS SHOWN ON PLAN Subtotal Base Bid Schedule D $484.00 CP 15-31 Sidewalk Gap Closure Project Contract Change Order No. 2 March 12, 2020 Page 3 Base Bid Schedule E — N. Indian Canyon Dr: Bid Item No. Description Cft Price Total E-4 SAWCUT EXISTING PAVEMENT +115 LF $4.00 $460.00 E-6 REMOVE & DISPOSE EXISTING AC +904.5 SF $3.00 $2,713.50 PAVEMENT E-7 REMOVE & DISPOSE EXISTING -297 SF $4.00 -$1,188.00 CONCRETE SIDEWALK, DRIVEWAY, CROSS GUTTER & SPANDREL E-8 CONSTRUCT 5" AC OVER 4" CLASS II -227 SF $8.00 -$1,816.00 AGG. BASE E-9 CONSTRUCT 4" THICK CONCRETE 124.5 SF $8.00 $996.00 SIDEWALK PER CITY STD. NO. 210 E-10 CONSTRUCT 4" AC DRIVEWAY OVER -25.5 SF $12.00 -$306.00 COMPACTED NATIVE AS SHOWN ON PLAN Subtotal Base Bid Schedule E $859.50 Base Bid Schedule F — Sunny Dunes Rd: Bid Item No. Description Qty Price Total F-4 SAWCUT EXISTING PAVEMENT -8 LF $3.00 -$24.00 F-6 REMOVE & DISPOSE EXISTING AC +10 SF $3.00 $30.00 PAVEMENT F-7 REMOVE & DISPOSE EXISTING CURB OR -21.5 $10.00 -$215.00 CURB & GUTTER F-12 CONSTRUCT CONCRETE CROSS -40 SF $14.00 -$560.00 GUTTER AND SPANDREL PER CITY STD.NO. 200 TYPE D1 & STD. NO.206 F-13 CONSTRUCT 4" THICK CONCRETE -919.5 SF $6.50 -$5,976.75 SIDEWALK PER CITY STD. NO. 210 F-16 CONSTRUCT CONCRETE DRIVEWAY +8 SF $8.00 $64.00 PER CITY STD. NO. 201 F-17 CONSTRUCT 6" CONCRETE DRIVEWAY -74 SF $8.00 -$592.00 AS SHOWN ON PLAN F-18 CONSTRUCT 4" AC DRIVEWAY OVER -2 SF $12.00 -$24.00 COMPACTED NATIVE AS SHOWN ON PLAN F-29 FIELD ORDERS -0.006 EA $10,000.00 -$60.00 Subtotal Base Bid Schedule F-$7,572.75 CP 15-31 Sidewalk Gap Closure Project Contract Change Order No. 2 March 12, 2020 Page 4 Base Bid Schedule G — Baristo Rd: Bid Item No. Description Qty Price Total G-4 SAWCUT EXISTING PAVEMENT -228 LF $3.00 -$684.00 G-6 REMOVE & DISPOSE EXISTING AC -55 SF $3.00 -$165.00 PAVEMENT G-7 REMOVE & DISPOSE EXISTING CURB OR +42 LF $10.00 $420.00 CURB & GUTTER G-8 REMOVE & DISPOSE EXISTING +55.5 SF $3.00 $166.50 CONCRETE SIDEWALK, DRIVEWAY, CROSS GUTTER & SPANDREL G-9 CONSTRUCT 5" AC OVER 4" CLASS II -439 SF $8.00 -$3,512.00 AGG. BASE G-10 CONSTRUCT 6" CURB & GUTTER PER +16 LF $50.00 $800.00 CITY STD. NO. 200, TYPE A3 G-11 CONSTRUCT CONCRETE CROSS -78 SF $14.00 -$1,092.00 GUTTER AND SPANDREL PER CITY STD.NO. 200 TYPE D1 & STD. NO. 206 G-12 CONSTRUCT 4" THICK CONCRETE +614 SF $7.00 $4,298.00 SIDEWALK PER CITY STD. NO. 210 G-13 CONSTRUCT CURB RAMP TYPE A, B OR +1 EA $3,800.00 $3,800.00 C PER CITY STD. NO. 212 G-14 CONSTRUCT DETECTABLE WARNING -1 EA $500.00 -$500.00 SURFACE (TRUNCATED DOMES) PER CITY STD. 212 & 212A G-15 CONSTRUCT CONCRETE DRIVEWAY -398.5 SF $8.00 -$3,188.00 PER CITY STD. NO. 201 G-16 CONSTRUCT 6" CONCRETE DRIVEWAY -600 SF $8.00 -$4,800.00 AS SHOWN ON PLAN G-17 CONSTRUCT RETAINING CURB PER +142.5 LF $30.00 $4,275.00 DETAIL AS SHOWN ON PLAN G-18 REMOVE EXISTING WATER METER BOX -3 EA $400.00 -$1,200.00 & VALVE BOX, INSTALL NEW WATER METER BOX WITH LID AND VALVE BOX PER DETAIL ON SHEET 2 G-19 RELOCATE EXISTING SIGNS -2 EA $100.00 -$200.00 Subtotal Base Bid Schedule G-$1,581.50 Total Change Order Amount: $-958.25 Reasons for Changes: CP 15-31 Sidewalk Gap Closure Project Contract Change Order No. 2 March 12, 2020 Page 5 This is a deductive change order in the amount of-$1,173.25, and represents a final balancing of construction quantities and costs. Changes to Contract Time: 10 days for additional work. Deemed Substantially Complete on 2/21/2020. Source of Funds: The approved contingencies for this project in account 260-4494-58702, covers the cost of this change order. Summary of Costs: Original Contract Amount: $1,251,556.00 Start Date: 11-12-19 Previous Change Order Amount: $16,795.00 Previous Days Added: 0 This Change Order Amount:-$958.25 Days Added: 10 Revised Contract Amount: $1,267,392.75 Revised Completion: 02-21-20 I have received a copy of this Change Order /nde above AGREED PRICES are acceptable to Contractor Vido Samarzichs Inc. 3 �G SAnature Date Vido L. Samarzich, Vice President City of Palm Springs Recommended By: Marcus L. ruller, Assistant City Manager/City Engineer -5(31 129 Date Recommended By: N David H. Rfiady, City Manager Date Attest By: �r Affithony Mejia, Ci y Clerk Date P",Qs- , o�,C�:- Distribution Original Conformed Copy: Conformed - File Copy. - Contractor (1) Engineering Pay File (1) CitV Clerk (1) City Protect File (1) APPROVED BYCITY COUNCIL Purchasing (1)� Finance (1) C� pALM SAP 4A V fA A CITY OF PALM SPRINGS CONTRACT CHANGE ORDER To: Vido Samarzich, Inc. 6829 Billings Place Rancho Cucamonga, CA 91701 Attn: Vido L. Samarzich Date: Project: Change Order No Purchase Order Account No. January15, 2020 15-31 Sidewalk Gap Closure Project 1 (one) 20-0809 260-4494-58700 S 2 a. This Contract Change Order No. 1 adds rebuilding the driveway to Fire Station #2. Change Order 1: Bid Item No. Description Qty Price Total REMOVE & REPLACE CONCRETE CURB 61 LF $75.00 $4,575.00 & GUTTER REMOVE & REPLACE 8" CONCRETE 3660 SF $17.00 $62,220.00 DRIVEWAY W/ #4 REBAR @ 12" O.C. Subtotal New Driveway Approach $66,795.00 FIELD ORDERS Bid Item No. Description Qty Price Total A-16 FIELD ORDERS BID SCHEDULE A -1 EA $5,000.00 -$5,000.00 B-31 FIELD ORDERS BID SCHEDULE B -1 EA $10,000.00 -$10,000.00 C-35 FIELD ORDERS BID SCHEDULE C -1 EA $15,000.00 -$15,000.00 D-21 FIELD ORDERS BID SCHEDULE D -1 EA $5,000.00 -$5,000.00 E-13 FIELD ORDERS BID SCHEDULE E -1 EA $5,000.00 -$5,000.00 G-25 FIELD ORDERS BID SCHEDULE G -1 EA $10,000.00 -$10,000.00 Subtotal Field Orders-$50,000.00 Total Change Order Amount: $16,795.00 Reasons for Changes: The existing driveway to Fire Station #2 is severely cracked and further deteriorating each time it rains. The driveway constructed many decades ago, does not seem to be thick enough to carry the weight of the fire apparatus trucks currently used today. The City considered adding the repairs to other projects however, the cost was prohibitive. The current sidewalk project had several streets where the field order allowance for each street was not used. When those field orders are totaled up, this change order is now feasible. CP 15-31 Sidewalk Gap Closure Project Contract Change Order No. 1 January 15, 2020 Page 1 Changes to Contract Time: None. Source of Funds: The approved contingencies for this project in account 260-4494-587-80, covers the cost of this change order. 5,31Oa 1� Summary of Costs: Original Contract Amount: $1,251,556.00 Start Date: 11-12-19 Previous Change Order Amount: $0.00 Previous Days Added: 0 This Change Order Amount: $16,795.00 Days Added: 0 Revised Contract Amount: $1,268,351.00 Revised Completion: 02-10-20 I have received a copy of this Change Order and tl a above AGREED PRICES are acceptable to Contractor JVido Samarzich, Inc. / 7 Za gnature Date Vido L. Samarzich, Vice President City of Palm Springs Recommended By: Recommended By: Marcus L. Fuller, Assistant City Manager/City gineer avid . eady, City Manager Date O z- II I hczg) Date Attest By: 07 i I Anth Clerk Date Distribution: Original Conformed Cooy: Contractor (1) City Clerk (1) Conformed - File CODT Engineering Pay File City Proiect File Purchasinq Finance (1) (1)APPROVED BY CITY COUNCIL AGREEMENT (CONSTRUCTION CONTRACT) THIS AGREEMENT made this 3rd day of October, 2019, by and between the City of Palm Springs, a charter city, organized and existing in the County of Riverside, under and by virtue of the laws of the State of California, hereinafter designated as the City, and Vido Samarzich, Inc., a California Corporation hereinafter designated as the Contractor. The City and the Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: ARTICLE 1 -- THE WORK For and in consideration of the payments and agreements to be made and performed by City, Contractor agrees to furnish all materials and perform all work required to complete the Work as specified in the Contract Documents, and as generally indicated under the Bid Schedule(s) for the Project entitled: SIDEWALK GAP CLOSURE PROJECT CITY PROJECT NO. 15-31 The Work comprises of the installation of missing sidewalks and other items of work on various roads in the City of Palm Springs. Work includes surveying and monument control (corner records), removal of existing asphalt concrete pavement, unclassified excavation, preparation of subgrade, asphalt concrete paving, removal and replacement or installation of concrete curbs, gutter, sidewalks, driveways, cross gutters, spandrels, curb ramps with truncated domes, adjustment of manholes and water valves to grade, traffic striping, landscaping, irrigation and tree removal. ARTICLE 2 -- COMMENCEMENT AND COMPLETION The Work to be performed under this Contract shall commence on the date specified in the Notice to Proceed by the City, and the Work shall be fully completed within the time specified in the Notice to Proceed. The City and the Contractor recognize that time is of the essence of this Agreement, and that the City will suffer financial loss if the Work is not completed within the time specified in Article 2, herein, plus any extensions thereof allowed in accordance with applicable provisions of the Standard Specifications, as modified herein. They also recognize the delays, expense, and difficulties involved in proving in a legal proceeding the actual loss suffered by the City if the Work is not completed on time. Accordingly, instead of requiring any such proof, the City and the Contractor agree that as liquidated damages or delay (but not as a penalty), the Contractor shall pay the City the sum specified in Section 6-9 of the Special Provisions for each calendar day that expires after the time specified in Article 2, herein. In executing the Agreement, the Contractor acknowledges it has reviewed the provisions of the Standard Specifications, as modified herein, related to liquidated damages, and has made itself aware of the actual loss incurred by the City due to the inability to complete the Work within the time specified in the Notice to Proceed. SIDWALK GAP CLOSURE PROJECT CITY PROJECT NO. 15-31 AGREEMENT FORM AUGUST 2019 AGREEMENT AND BONDS - PAGE 1 Termination Prior to Expiration of Term. City may terminate this Agreement for its convenience at any time, without cause, in whole or in part, upon giving Contractor written notice, pursuant to Section 6-8 of the Special Provisions. Where termination is due to the fault of Contractor and constitutes an immediate danger to health, safety, and general welfare, the period of notice shall be such shorter time as may be determined by the City. Upon such notice, City shall pay Contractor for Services performed through the date of termination in accordance with the Contract Documents. Upon receipt of such notice, Contractor shall immediately cease all work under this Agreement, unless stated otherwise in the notice or by written authorization of the Contract Officer. After such notice, Contractor shall have no further claims against the City under this Agreement. Upon termination of the Agreement under this section, Contractor shall submit to the City an invoice for work and services performed prior to the date of termination. ARTICLE 3 -- CONTRACT PRICE BID SCHEDULE A, B, C, D, E, F, G The City shall pay the Contractor for the completion of the Work, in accordance with the Contract Documents, in current funds the Contract Price(s) named in the Contractor's Bid Proposal and Bid Schedule(s), and any duly authorized Construction Contract Change Orders approved by the City. The amount of the initial contract award in accordance with the Contractor's Bid Proposal is One Million Two -Hundred Fifty -One Thousand Five Hundred Fifty Six Dollars ($1,251,556). Contractor agrees to receive and accept the prices set forth herein, as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Said compensation shall cover all expenses, losses, damages, and consequences arising out of the nature of the Work during its progress or prior to its acceptance including those for well and faithfully completing the Work and the whole thereof in the manner and time specified in the Contract Documents; and, also including those arising from actions of the elements, unforeseen difficulties or obstructions encountered in the prosecution of the Work, suspension of discontinuance of the Work, and all other unknowns or risks of any description connected with the Work. ARTICLE 4 -- THE CONTRACT DOCUMENTS The Contract Documents consist of the Notice Inviting Bids, Instructions to Bidders, the prevailing rate of per diem wages as determined by the Director of the California Department of Industrial Relations, the accepted Bid and Bid Schedule(s), List of Subcontractors, Local Business Preference Program — Good Faith Efforts, Non - Discrimination Certification, Non -Collusion Declaration, Bidder's General Information, Bid Security or Bid Bond, this Agreement, Worker's Compensation Certificate, Performance Bond, Payment Bond, Standard Specifications, Special Provisions, the Drawings, Addenda issued during bidding (if any), and all Construction Contract Change Orders and Work Change Directives which may be delivered or issued after the Effective Date of the Agreement and are not attached hereto. SIDWALK GAP CLOSURE PROJECT CITY PROJECT NO. 15-31 AGREEMENT FORM AUGUST 2019 AGREEMENT AND BONDS - PAGE 2 ARTICLE 5 -- MUTUAL OBLIGATIONS For and in consideration of the payments and agreements to be made and performed by the City, the Contractor agrees to furnish all materials and perform all work required for the above stated project, and to fulfill all other obligations as set forth in the aforesaid Contract Documents. City hereby agrees to employ, and does hereby employ, Contractor to provide the materials, complete the Work, and fulfill the obligations according to the terms and conditions herein contained and referred to, for the Contract Price herein identified, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the Contract Documents. Contractor specifically acknowledges and agrees to be bound by the Wage Rates and Labor Code requirements specified in the Contract Documents, including the requirement to furnish electronic certified payroll records directly to the Labor Commissioner (via the Division of Labor Standards Enforcement), and shall pay the general prevailing rate of per diem wages as determined by the Director of the Department of Industrial Relations of the State of California. ARTICLE 6 -- PAYMENT PROCEDURES The Contractor shall submit Applications for Payment in accordance with the Standard Specifications as amended by the Special Provisions. Applications for Payment will be processed by the City Engineer as provided in the Contract Documents. ARTICLE 7 e NOTICES Whenever any provision of the Contract Documents requires the giving of a written Notice between the parties, it shall be deemed to have been validly given if delivered in person to the individual or to a member of the firm or to an officer of the corporation for whom it is intended, or if delivered at or sent by registered or certified mail, postage prepaid, to the last business address known to the giver of the Notice. ARTICLE 8 -- INDEMNIFICATION The Contractor agrees to indemnify and hold harmless the City, and all of its officers and agents from any claims, demands, or causes of action, including related expenses, attorney's fees, and costs, based on, arising out of, or in any way related to the Work undertaken by the Contractor hereunder. This Article 8 incorporates the provisions of Section 7-15 "Indemnification," of the Special Provisions, which are hereby referenced and made a part hereof. Prevailing Wages. Contractor agrees to fully comply with all applicable federal and state labor laws including, without limitation California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq. ("Prevailing Wage Laws"). Contractor shall bear all risks of payment or non-payment of prevailing wages under California law, and Contractor hereby agrees to defend, indemnify, and hold the City, its officials, officers, employees, agents and volunteers, free SIDWALK GAP CLOSURE PROJECT AGREEMENT FORM CITY PROJECT NO. 15-31 AUGUST 2019 AGREEMENT AND BONDS - PAGE 3 and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. ARTICLE 9 -- NON-DISCRIMINATION In connection with its performance under this Agreement, Contractor shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin (i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition (each a "prohibited basis"). Contractor shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City's lawful capacity to enter this Agreement, and in executing this Agreement, Contractor certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Contractor activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Contractor is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. ARTICLE 10 -- MISCELLANEOUS Terms used in this Agreement which are defined in the Standard Specifications and the Special Provisions will have the meanings indicated in said Standard Specifications and the Special Provisions. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically, but without limitation, monies that may become due and monies that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment, no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. The City and the Contractor each binds itself, its partners, successors, assigns, and legal representatives, to the other party hereto, its partners, successors, assigns, and legal representatives, in respect of all covenants, agreements, and obligations contained in the Contract Documents. SIGNATURES ON NEXT PAGE SIDWALK GAP CLOSURE PROJECT CITY PROJECT NO. 15-31 AGREEMENT FORM AUGUST 2019 AGREEMENT AND BONDS - PAGE 4 IN WITNESS WHEREOF, the City and the Contractor have caused this Agreement to be executed the day and year first above written. CITY OF PALM SPRINGS, CALIFORNIA B;1�;= David H. Ready City Manager ATTEST: m Anthony 1. Mejia, C&Qork- APPROVED AS TO FORM: By Jdftr6y S.IWIlinger, City Attorney RE MMENDE y Marcus L. Fuller, P.E., P.L.S. Assistant City Manager/City Engineer APPROVED BY THE CITY COUNCIL: Date Jb—Z-lq Agreement No. 2— APPROVED BY CnY COUNCIL M 12 1,L d~Z l f SIDWALK GAP CLOSURE PROJECT CITY PROJECT NO. 15-31 AGREEMENT FORM AUGUST 2019 AGREEMENT AND BONDS - PAGE 5 CONTRACTOR By. Vido Samarzich, Inc. Firm/Company Name By: t U ig ture (notarized) Name: Vido L. Samarzich By: Signature (no rized) Name: Vido Samarzich Title: Vice President Title: President 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. (This Agreement must be signed in the above space by one having authority to bind the Contractor to the terms of the Agreement.) State of California County of Los Angeles )ss October 8. 2019 before me, Desmond G. Warren, Notary Public personally appeared Vido L. Samarzich who proved to me on the basis of satisfactory (This Agreement must be signed in the above space by one having authority to bind the Contractor to the terms of the Agreement.) State of California County of Los Angeles )ss October 8, 2019 before me, Desmond G. Warren, Notary Public personally appeared Vido Samarzich who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and 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 signatures(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. Notary Signature. a� Notary Seal: Won eaQu�armurananunawuuwwrmr� ` DESMOND G. WARREN COMM. #2190534 Notary Public - California Riverside COunty 3 My Comm. Expires Apr. 9, 2021 �rmma unumammmmraunmmmmnnnnnuuun SIDWALK GAP CLOSURE PROJECT CITY PROJECT NO. 15-31 AUGUST 2019 acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures(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. Notary Signature. Notary Seal: uonuum aaaunummummmmammuuurmrraaaa DESMOND G. WARREN = COMM. #2190534 = Notary Public - Caiifomia 'o _ Riverside County — My Comm. Expires Apr. 9, 2021 — i ri mmu nunummunnmmnnnunnnnmmuuunuw� PAYMENT BOND AGREEMENT AND BONDS - PAGE 6 CONTRACT ABSTRACT 2 Oriainals: Aareement: 1 Oriainal: Insurance: Pavment and Performance Bonds Contract Company Name Company Contact Summary of Services Contract Price Funding Source: Contract Term Vido Samarzich, Inc. Vido Samarzich, Present City Project No. 15-31, Sidewalk Gap Closure $1,251,556 Measure J ($1,105,056) 1 SB 821 ($146,500) 60 Working Days from the Notice to Proceed Contract Administration Lead Department: Engineering Services Contract Administrator: Joel Montalvo /Donn Uyeno Contract Approvals Council Approval Date: Oct ber 2, 2019, Item 1.E. Agreement Number: s By: Tabitha Richards VIDOSAM-01 LBURRILL ,4�oRv CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 10/8/2/8/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Southern California Insurance Brokerage 3110 E. Guasti Road Suite 500 Ontario, CA 91761 CONAM :NTACT Lisa Burrill PHONE o, Ext): (909 484-2456 FAX ( ) (AC, No): Eo A'L . lisa@socalinsurance.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Financial Pacific Insurance Company 31453 _ INSURED INSURER B: Everest Premier Insurance Company 16045 INSURERC: Vido Samarzich, Inc. 6829 Billings Place Rancho Cucamonga, CA 91701 INSURERD: INSURER E: INSURER F : COVERAGES CERTIFICATE NLIMBER 0EVlcln1d ml IMaGo• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR TYPE OF INSURANCE IN ADD SUER POLICY NUMBER POLICY EFF POLICY EXP D LIMITS EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY DAMAGE TORENTED oNTED ccurrence $ 100,_CEa000 CLAIMS -MADE X OCCUR 60455974 12/23/2018 12/23/2019 MED EXP (Any oneperson) $ 5,000 -_ PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GENT X PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY YPa LOG OTHER: AUTOMOBILE LIABILITY EOMaBINdED SINGLE LIMIT $ BODILY INJURY Perperson) $ ANY AUTO OWNED SCHEDULED BODILY BODILY INJURY Per accident $ AUTOS ONLY AUTOS p AUTOS ONLY AUTO ONLY PeoracEcRd ntDAMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS -MADE 60455974 12/23/2018 12/23/2019 AGGREGATE $ DED I I RETENTION$ $ 1,000,000 B WORKERS COMPENSATION X PER OE H- STATUTE AND EMPLOYERS' LIABILITY N YIN R E.L. EACH ACCIDENT 1,000,000 $ ANY PROPRIETOR/PARTNER/EXECUTIVE 7600020438191 5/22/2019 5/22/2020 %F.10ER/MEMBER EXCLUDED? ❑ (Mandatory In NH) N/A E.L. DISEASE - EA EMPLOYE $ 1,000,000 If es, describe under E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS below A rented/leased equip. 60455974 12/23/2018 12/23/2019 Limit 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) vonda.teed@palmspringsca.gov RE: ANY AND ALL WORK PERFORMED WITH THE CITY OF PALM SPRINGS. THE CITY OF PALM SPRINGS, ITS OFFICIALS, EMPLOYEES, AND AGENTS ARE NAMED AS ADDITIONAL INSURED FOR ANY AND ALL WORK PERFORMED WITH THE CITY. THIS INSURANCE IS PRMARY AND NON-CONTRIBUTORY OVER ANY INSURANCE OR SELF-INSURANCE THE CITY MAY HAVE FOR ANY AND ALL WORK PERFORMED WITH THE CITY. -A/I (ON -GOING 8: COMP. OPS), PRIMARY, PER PROJECT AND W.C. WAIVER ATTACHED. 30-DAY NOC TO FOLLOW. CITY OF PALM SPRINGS 3200 E. TAHQUITZ CANYON WAY Palm Springs, CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED �REPRESENTATIVE U 19BB-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10P 11 85 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that person or organization is held liable for "your work" for that person or organization by or for you. When this endorsement applies and when required by written contract, such insurance as is afforded by the general liability policy is primary insurance and other insurance shall be excess and shall not contribute to the insurance afforded by this endorsement. This endorsement applies to the following worts: Description of Job: Location of Job: At only effective from: Effective Date: Expiration Date: CG 20 10P 11 85 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: CG 20 1OR 12 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (WITH LIMITED COMPLETED OPERATIONS COVERAGE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART BUSINESSOWNERS COVERAGE FORM SCHEDULE NAME OF PERSON OR ORGANIZATION Any person or organization to whom or to which the named insured is obligated by a virtue of a written contract to provide insurance that is afforded by this policy. Where required by contract, the officers, officials, employees, directors, subsidiaries, partners, successors, parents, divisions, architects, surveyors and engineers are included as additional insureds. All other entities, including but not limited to agents, volunteers, servants, members and partnerships are included as additional insureds, if required by contract, only when acting within the course and scope of their duties controlled and supervised by the primary (first) additional insured. If an Owner Controlled Insurance Program is involved, the coverage applies to off - site operations only. If the purpose of this endorsement is for bid purposes only, then no coverage applies. WHO IS AN INSURED: (Section II) This section is amended to include as an insured the person or organization within the scope of the qualifying language above, but only to the extent that the person or organization is held liable for your acts or omissions in the course of "your work" for that person or organization by or for you. The "products - completed operations hazard" portion of the policy coverage as respects the additional insured does not apply to any work involving or related to properties intended for residential or habitational occupancy (other than apartments). This clause does not affect the "products - completed operations" coverage provided to the named insured(s). WAIVER OF SUBROGATION: We waive any right of recovery, when required by written contract, that we may have against the person or organization within the scope of the qualifying language above because of payments we make for injury. LOCATION OF JOB: The job location must be within the State of domicile of the named insured, or within any contiguous State thereto. DESCRIPTION OF WORK: The type of work performed must be that as described under classifications in the CGL Coverage Part Declarations. PRIMARY CLAUSE: When this endorsement applies and when required by written contract, such insurance as is afforded by the general liability policy is primary insurance and other insurance shall be excess and shall not contribute to the insurance afforded by this endorsement. EXCLUSION This insurance provided to the additional insured does not apply to "bodily injury", "property damage' or "personal and advertising injury" arising out of an architect's, engineer's or surveyor's rendering or failure to render any professional services, including: 1. The preparing, approving, or failing to prepare or approve, maps, designs, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. Endorsement EFFECTIVE DATE: SEE DEC Endorsement EXPIRATION DATE: SEE DEC CG 20 1OR 1211 Page 1 of 1 Includes copyrighted material of Insurance Services Office. Inc., with its permission POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I — Coverage A, and for expenses shall reduce the Designated all medical expenses caused by accidents under Construction Project General Aggregate Limit Section I — Coverage C, which can be attributed for that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General construction project shown in the Schedule above: Aggregate Limit shown in the Declarations nor 1. A separate Designated Construction Project shall they reduce any other Designated General Aggregate Limit applies to each Construction Project General Aggregate Limit designated construction project, and that limit is for any other designated construction project equal to the amount of the General Aggregate shown in the Schedule above. Limit shown in the Declarations. 4. The limits shown in the Declarations for Each 2. The Designated Construction Project General Occurrence, Damage To Premises Rented To Aggregate Limit is the most we will pay for the You and Medical Expense continue to apply. sum of all damages under Coverage A, except However, instead of being subject to the damages because of "bodily injury " or "property General Aggregate Limit shown in the damage" included in the "products -completed Declarations, such limits will be subject to the operations hazard", and for medical expenses applicable Designated Construction Project under Coverage C regardless of the number of: General Aggregate Limit. a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. CG 25 03 05 09 C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. CG 25 03 05 09 OO Insurance Services Office, Inc., 2008 Page 2 of 2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR BLANKET WAIVER OF SUBROGATION WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 05-22-19 Insured VIDO SAMARZICH INC Policy No. 7600020438191 Endorsement No. 001 Premium $ INCL. Insurance Company EVEREST PREMIER INSURANCE COMPANY Countersigned By -1998 by the Workers' Compensation Insurance Rating Bureau of Califomia. Al rights reserved. From the WCIRWs California Wbrkers' Compensation Insurance Forms Manual - 1999. MSURED COPY ACCOR H CERTIFICATE OF LIABILITY INSURANCE DATE(MWD01YYYY) 10/O812019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsement(s). PRODUCER C NTACT RICHARD H. VOSSMEYER, AGENT NAME: RICHARD H. VOSSMEYER LICENSE #: 0532861 PHONE FAX-44 81 49 3 rAwc Not: 818 942-4427 5t t� a+rn 2722 FOOTHILL BLVD AmAIess: RICHARDMOSSMEYER.88RZ STATEFARM.COM LA CRESCENTA CA 91214 INSURER(S)AFFORDING COVERAGE I NAIt0 INSURER VIDO SAMARZICH, INC. INSURER B 4972 CRESTVIEW PLACE jNjSURERC RANCHO CUCAMONGA, CA 91701-1260 INSURERD. INSURER E; INSURER F : �T--- OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTVOTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR I TYPE Of INSURANCE uu�wnn POLICY NUMBER GENERAL LIABILITY ■ ■ COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE - OCCUR I GEN'L AGGREGATE LIMI r APPLIES PER POLICY Pipr,RO- I� LCC A AUTOMOBILE LIABILITY Y Y 546 9268-AO5-75 --i ANY AUTO j X SCHEDULED 276 2485-A09-75 ALLOWNED „ AUTOS iX — NON-O MIED HIRED AUTOS }( 049 2620-F27-75 .-- i AUTOS AUTOS 535 7448-D06-75 UMBRELLA LIAR OCCUR EXCESS LIA6 �, WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROFRIETO"ARTNERIEXECUTVE YIN OFF'CE1MEM6ER EXCLUDED? ❑ N I A jMandatory in NH) If yes, describe unce. 01/05/2019 01/05/2020 01/0912019 0110912020 12117/2018 1212712019 04/0612019 04/0612020 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES )Attach ACORD 101, Additional Remarks Schedule, if more space fs requfred) Scheduled Autos: 2016 Chevrolet 3GCPCREC3GG338740 / 2011 Ford F450, 1993 INTL 4900, 2007 CHEVROLET 1GCEC19017Z644151 / Non owned Project City Of Palm Springs CERTIFICATE HOLDER LIMITS EACH OCCURRENCE I $ I MED EY,P (Ary Or,* person) E _ I PERSONAL & ADV INJURY _ S GENERAL AGGREGATE _ E PRODUCTS-COMPIOP AGG ! E ;S BODILY INJURY (Per person) E BODILY INJURY (Per accident) E ?ROPE YDAMAGE (Peraccider.l) E S EACH OCCURRENCE E AGGREGATE lE E E.L EACH ACCIDENT E E.L DISEASE EA EMPLOYE - E E L DISEASE - POLICY LIMIT E ',000 000 City of Palm Springs SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE , 3200 E. Tahquitz Canyon Way ACCORDANCE WITH THE POLICEY REOFPROVISIONS.E WILL BE DELIVERED IN Palm Springs, CA 92262 AUTHORIZED ENTATIVE .r--�"• ACORD 25 (2010/05) The ACORD Hama and Logo are r©gisteret! marksof 010 ACORD CORPORA Tf.6N. Affrights resefved. 1001486 132849.8 01.23-2013 WORKER'S COMPENSATION CERTIFICATE (AS REQUIRED BY SECTION 1861 OF THE CALIFORNIA LABOR CODE) I am aware of the provisions of Section 3700 of the California Labor Code, which require every employer to be insured against liability for worker's compensation, or to undertake self-insurance in accordance with the provisions of said Code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Contractor G, By /T. J�/ Title U4 V !&ERm6ir SIDWALK GAP CLOSURE PROJECT CITY PROJECT NO. 15-31 WORKER'S COMPENSATION CERTIFICATE AUGUST 2019 AGREEMENT AND BONDS - PAGE 7