HomeMy WebLinkAbout05122 - TRI STAR CONTRACTING INC INDIAN CANYON DR ASPHALT REMOVAL DOCUMENT TRACKING
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Qannrf: -Soon to Eyn ra I1nmimantc I Icting Winvamhor 1 2nnS
Condition: Expire Within 90 days,ALL Groups,ALL Services,ALL XREFs
Document# Comt)anv Grout) Service At)rvi Date Exalre Date Close Date
A5030 Muni FinancialENGINEERING G`�� In Flle 01/28/2005 12/01/2005 C I Ila(05
A5031 Dateland-Construction Co---= ` =ENGINEERINGCI�S In File 01/12/2005 01/01/2006 t7`t/aV105
A5034 Hilton,Farnkopt&Hobson LLC CITY MANAGER In File 02/02/2005 12/3112005
A5037 P S Gun Club POLICE DEPARTMENT In File 02/07/2005 12101/2005
A5039 Datetand Construction Cc ENGINEERING G 05e� In File 01/12/2005 01101/2006 rA/au)05
A5050 Stumbaugh&Associates Inc. PROCUREMENT �(�, NOC 01/05/2005 01/01/2006
A5057 Infotox Inc. _ ENGINEERING_-C�54 In File 03/25/2005 12/31/2005 07 100 I05
A5061 Richter Group FIRE DEPARTMENT In File 04/05/2005 12/30/2005
A5091 Hanson House Foundation PARKS&RECREATION In File 05/04/2005 12/31/2005
A5092 Tn Star Contracting ,ENGINEERING Closed In File 06/04/2005 12/31/2005 05 105(05
A5109 Desert Sun PIO C11 ,0 In File 12/20/2004 11/28/2005 /
A5114 JP Planning&Design G��S <R'�"' .ENGINEERING Frr°tk� None 06/08/2005 12/31/2005 �r7ld W IoS'
A5122 Tri Star ^ -_ ENGINEERING-_CVEed In File 06/20/2005 12/31/2005
A5125 Lynoo Associates COMMUNITY& In File 07/06/2005 11117/2D05
A5144 JR Planning&Design AIRPORT In File 07/21/2005 12/31/2005
A5146 Linda Tette POLICE DEPARTMENT In File 08/19/2005 12/30/2005
A5149 Infotxthe ` ENGINEERiNG ;Cn^r^C,�A In File 06/1912005 12/31/2005 C7-I�3a10�
A5169 Alms - -ENGINEERING L`Sro'�"� In File 10/0(112005 12/31/2005 It l C05
A5174 NXTCYCLE RECYCLING In File 10/14/2005 12/31/2005
*** *** END OFREPORT*** * **
1q ND
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Tri Star Contracting, Inc.
Asphalt Removal Indian Cyn
AGREEMENT #5122
Exec. Order2004-01, 12-29-04
CITY OF PALM SPRINGS
CONTRACT SERVICES AGREEMENT FOR
Tri-Star
---------------------------------
Asphalt Removal at Indian Canyon Drive
THIS CONTRACT SERVICES'AGREEMENT (herein "Agreement") is made and
entered into this'JPltday of 1�1°,1t, , by and between the CITY OF PALM SPRINGS, a
municipal corporation (herein "City") and tt".�Tri-Star (herein "Contractor").
NOW, THEREFORE, the parties hereto agree as follows:
1.0 SERVICES OF CONTRACTOR
1.1 Scope of Services. In compliance with all of the terms and conditions of this
Agreement, the Contractor shall perform the work or services set forth in the "Scope of Services"
attached hereto as Exhibit"A" and incorporated herein by reference. Contractor warrants that all
work and services set forth in the Scope of Services will be performed in a competent,
professional and satisfactory manner. Schedule of Performance to comply with Exhibit "D".
1.2 Compliance With Law. All work and services rendered hereunder shall be
provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of the City
and any Federal, State or local governmental agency of competent jurisdiction.
1.3 Licenses, Permits, Fees and Assessments. Contractor shall obtain at its
sole cost and expense such licenses, permits and approvals as may be required by law for the
performance of the services required by this Agreement.
2.0 COMPENSATION
2.1 Contract Sum. For the services rendered pursuant to this Agreement,
Contractor shall be compensated in accordance with the "Schedule of Compensation" attached
hereto as Exhibit"C"and incorporated herein by this reference, but not exceeding the maximum
contract amount of Nine Thousand Seven Hundred Forty-Two Dollars and Fifty Cents
($9,742.50) ("Contract Sum").
2.2 Method of Payment. Provided that Contractor is not in default under the
terms of this Agreement, Contractor shall be paid as outlined in Exhibit "C" "Schedule of
Compensation".
3.0 COORDINATION OF WORK
3.1 Representative of Contractor. Larry Owens is hereby designated as being
the principal and representative of Contractor authorized to act in its behalf with respect to the
work and services specified herein and make all decisions in connection therewith.
3.2 Contract Officer. Pete Agres is hereby designated as being the
representative the City authorized to act in its behalf with respect to the work and services
specified herein and make all decisions in connection therewith ("Contract Officer"). The City
Manager of City shall have the right to designate another Contract Officer by providing written
notice to Contractor.
3.3 Prohibition Aqainst Subcontractinq or Assignment. Contractor shall not
contract with any entity to perform in whole or in part the work or services required hereunder
without the express written approval of the City. Neither this Agreement nor any interest herein
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i
may be assigned or transferred, voluntarily or by operation of law, without the prior written
approval of City. Any such prohibited assignment or transfer shall be void.
3.4 Independent Contractor. Neither the City nor any of its employees shall
have any control overthe manner, mode or means by which Contractor, its agents or employees,
perform the services required herein, except as otherwise set forth. Contractor shall perform all
services required herein as an independent contractor of City and shall remain under only such
obligations as are consistent with that role. Contractor shall not at any time or in any manner
represent that it, or any of its agents or employees, are agents or employees of City.
4.0 INSURANCE, INDEMNIFICATION AND BONDS
4.1 Insurance, The Contractor shall procure and maintain, at its sole cost
and expense, in a form and content satisfactory to City, during the entire term of this Agreement
including any extension thereof, the following policies of insurance:
(a) Commercial General Liability Insurance. A policy of commercial general
liability insurance written on a per occurrence basis with a combined single limit of at least
$1,000,000 bodily injury and property damage including coverages for contractual liability,
personal injury, independent contractors, broad form property damage, products and
completed operations.The Commercial General Liability Policy shall name the City of Palm
Springs as an additional insured in accordance with standard ISO additional insured
endorsement form CG2010(1185) or equivalent language.
(b) Worker's Compensation Insurance. A policy of worker's
compensation insurance in an amount which fully complies with the statutory requirements
of the State of California and which includes $1,000,000 employer's liability.
(c) Business Automobile Insurance. A policy of business automobile
liability insurance written on a per occurrence basis with a single limit liability in the amount
of $1,000,000 bodily injury and property damage. Said policy shall include coverage for
owned, non-owned, leased and hired cars.
(d) Additional Insurance. Additional limits and coverages, which may
include professional liability insurance, will be specified in Exhibit B.
All of the above policies of insurance shall be primary insurance. (Reference Section 4.4
regarding sufficiency.) The insurer shall waive all rights of subornation and contribution it may
have against the City, its officers, employees and agents, and their respective insurers. In the
event any of said policies of insurance are canceled, the Contractor shall, prior to the cancellation
date, submit new evidence of insurance in conformance with this Section 4.1 to the Contract
Officer. No work or services under this Agreement shall commence until the Contractor has
provided the City with Certificates of Insurance, endorsements or appropriate insurance binders
evidencing the above insurance coverages and said Certificates of Insurance, endorsements, or
binders are approved by the City.
The contractor agrees that the provisions of this Section 4.1 shall not be construed as
limiting in any way the extent to which the Contractor may be held responsible for the payment of
damages to any persons or property resulting from the Contractor's activities or the activities of
any person or persons for which the Contractor is otherwise responsible.
In the event the Contractor subcontracts any portion of the work in compliance with Section
3.3 of this Agreement the contract between the Contractor and such subcontractor shall require
the subcontractor to maintain the same polices of insurance that the Contractor is required to
maintain pursuant to this Section.
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4.2 Indemnification. Contractor agrees to indemnify the City,its officers, agents
and employees against, and will hold and save them and each of them harmless from, any and
all actions, suits, claims, damages to persons or property, losses, costs, penalties, obligations,
errors, omissions or liabilities, (herein"claims or liabilities")that may be asserted orclaimed by any
person, firm or entity arising out of or in connection with the negligent performance of the work,
operations or activities of Contractor, its agents, employees, subcontractors, or invitees, provided
for herein, or arising from the negligent acts or omissions of Contractor hereunder, or arising from
Contractor's negligent performance of or failure to perform any term, provision, covenant or
condition of this Agreement, whether or not there is concurrent passive or active negligence on
the part of the City, its officers, agents or employees but excluding such claims or liabilities arising
from the sole negligence or willful misconduct of the City, its officers, agents or employees, who
are directly responsible to the City, and in connection therewith:
(a) Contractor will defend any action or actions filed in connection with
any of said claims or liabilities and will pay all costs and expenses, including legal costs and
attorneys' fees incurred in connection therewith;
(b) Contractorwill promptly pay anyjudgment rendered againstthe City,
its officers, agents or employees for any such claims or liabilities arising out of or in connection
with the negligent performance of or failure to perform such work, operations or activities of
Contractor hereunder; and Contractor agrees to save and hold the City, its officers, agents, and
employees harmless therefrom;
(c) In the event the City, its officers, agents or employees is made a
party to any action or proceeding filed or prosecuted against Contractor for such damages orother
claims arising out of or in connection with the negligent performance of or failure to perform the
work, operation or activities of Contractor hereunder, Contractor agrees to pay to the City, its
officers, agents or employees, any and all costs and expenses incurred by the City, its officers,
agents or employees in such action or proceeding, including but not limited to, legal costs and
attorneys' fees.
4.3 Performance Bond. Concurrently with execution of this Agreement,
Contractor shall deliver to City a performance bond in the sum of the amount of this Agreement,
in the form provided by the City,which secures the faithful performance of this Agreement, unless
such requirement is waived by the Contract Officer. The bond shall contain the original notarized
signature of an authorized officer of the surety and affixed thereto shall be a certified and current
copy of his power of attorney. The bond shall be unconditional and remain in force during the
entire term of the Agreement and shall be null and void only if the Contractor promptly and
faithfully performs all terms and conditions of this Agreement.
4.4 Sufficiencv of Insurer or Suretv. Insurance or bonds required by this
Agreement shall be satisfactory only if issued by companies qualified to do business in California,
rated "A" or better in the most recent edition of Best's Key Rating Guide or in the Federal
Register, unless such requirements are waived by the City Manager or designee of the City
Manager due to unique circumstances. In the event the City Manager determines that the work
or services to be performed under this Agreement creates an increased or decreased risk of loss
to the City, the Contractor agrees that the minimum limits of the insurance policies and the
performance bond required by this Section 4 may be changed accordingly upon receipt of written
notice from the City Manager or designee; provided that the Contractor shall have the right to
appeal a determination of increased coverage by the City Manager to the City Council of City
within ten (10) days of receipt of notice from the City Manager.
5.0 TERM 5.1 Term. Unless earlier terminated in accordance with Section
5.2 below, this Agreement shall continue in full force until December 30, 2005
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5.2 Termination Prior to Expiration of Term. Either party may terminate this
Agreement at any time, with or without cause, upon thirty (30) days written notice to the other
party. Upon receipt of the notice of termination, the Contractor shall immediately cease all work
or services hereunder except as may be specifically approved by the Contract Officer. In the
event of termination by the City, Contractor shall be entitled to compensation for all services
rendered prior to the effectiveness of the notice of termination and for such additional services
specifically authorized by the Contract Officer and City shall be entitled to reimbursement for any
compensation paid in excess of the services rendered.
6.0 MISCELLANEOUS
6.1 Covenant Aqainst Discrimination. Contractor covenants that, by and for
itself, its heirs, executors, assigns and all persons claiming underorthrough them, that there shall
be no discrimination against or segregation of, any person or group of persons on account of race,
color, creed, religion, sex, marital status, national origin, or ancestry in the performance of this
Agreement. Contractor shall take affirmative action to ensure that applicants are employed and
that employees are treated during employment without regard to their race, color, creed, religion,
sex, marital status, national origin or ancestry.
6.2 Non-liability of City Officers and Employees. No officer or employee of the
City shall be personally liable to the Contractor, or any successor in interest, in the event of any
default or breach by the City or for any amount which may become due to the Contractor or to its
successor, or for breach of any obligation of the terms of this Agreement.
6.3 Conflict of Interest. No officer or employee of the City shall have any
financial interest, direct or indirect, in this Agreement nor shall any such officer or employee
participate in any decision relating to the Agreement which effects his financial interest or the
financial interest of any corporation, partnership or association in which he is, directly or indirectly
interested, in violation of any State statute or regulation. The Contractor warrants that it has not
paid or given and will not pay or give any third party any money or other consideration for
obtaining this Agreement.
6.4 Notice. Any notice, demand, request, document, consent, approval, or
communication either party desires or is required to give to the other party or any other person
shall be in writing and either served personally or sent by prepaid, first-class mail, in the case of
the City, to the City Manager and to the attention of the Contract Officer, CITY OF PALM
SPRINGS, P.O. Box 2743, Palm Springs, California 92263, and in the case of the Contractor, to
the person at the address designated on the execution page of this Agreement.
6.5 Interpretation. The terms of this Agreement shall be construed in
accordance with the meaning of the language used and shall not be construed for or against
either party by reason of the authorship of this Agreement or any other rule of construction which
might otherwise apply.
6.6 Integration;Amendment. It is understood that there are no oral agreements
between the parties hereto affecting this Agreement and this Agreement supersedes and cancels
any and all previous negotiations,arrangements,agreements and understandings,if any,between
the parties, and none shall be used to interpret this Agreement. This Agreement may be amended
at any time by the mutual consent of the parties by an instrument in writing.
6.7 Severability. In the event that part of this Agreement shall be declared
invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such
invalidity or unenforceability shall not affect any of the remaining portions of this Agreement which
are hereby declared as severable and shall be interpreted to carry out the intent of the parties
hereunder unless the invalid provision is so material that its invalidity deprives either party of the
basic benefit of their bargain or renders this Agreement meaningless.
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6.8 Waiver. No delay or omission in the exercise of any right or remedy by a
non-defaulting party on any default shall impair such right or remedy or be construed as a waiver.
A party's consent to or approval of any act by the other party requiring the party's consent or
approval shall not be deemed to waive or render unnecessary the other party's consent to or
approval of any subsequent act. Any waiver by either party of any default must be in writing and
shall not be a waiver of any other default concerning the same or any other provision of this
Agreement.
6.9 Attorneys' Fees. If either party to this Agreement is required to initiate or
defend or made a party to any action or proceeding in any way connected with this Agreement,
the prevailing party in such action or proceeding, in addition to any other relief which may be
granted,whether legal or equitable, shall be entitled to reasonable attorney's fees,whether or not
the matter proceeds to judgment.
6.10 Corporate Authority. The persons executing this Agreement on behalf of the
parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly
authorized to execute and deliver this Agreement on behalf of said party, (iii) by so executing this
Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the entering
into this Agreement does not violate any provision of any other Agreement to which said party is
bound.
SIGNATURES ON NEXT PAGE
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IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the
date first written above
CITY OF PALM SPRINGS
'ATTE 'T: a municipal corporation
- City Clerk,; APPROVED BY CITY MANAGER City Nl-artager
_ Agreement ov�/V,?It $25,OOC
P eviewed and approved by
may`- '' 71 �` Frocurement & Contracting
City*rney ;.,�. . �
77 kan e }
Corporations require two notarized signatures:One signature must be from the Cairman of Ojai d,Fl"StDot�2rgy ant.
The second signature must be from the Secretary,Assistant Secretary,Treasur]F,(%sNglb7bgol;urer,or Chief Financial Officer.
CONTRACTOR: Check one: Individual—Partnership_Corporation
Tri-Starii
15-501 Little Morongo Road
Desert Hot Springs, CA 92240
G / Signature (notarized) Signature (notarized)
Name: Name -ad ', -�
Title: r Lay Title C -tom,r
(This Agreement must be signed in the above space by (This Agreement must be signed to the above space by
one of the following: Chairman of the Board, President one of the following. Secretary, Assistant Secretary,
or any Vice President) Treasurer, Assistant Treasurer or Chief Financial
C Q. Officer.)
State of Q�. U f YVh( I r
State of %1I`K 1I n t(.' I
County of I i\focSIr'� Iss
t County of ( Q Iss
On �� n 2 I L� t��J f-�S before me, On ��,.�'IQ 60,aOS15 before me,
I eA r ) e L Ui -Cn S tkrr1e.C2odnny X\ .Jry �'ublm
personally,appeared ( Oct,( J Ui_J�Yl( personally appeared �I erg ,re hbi eI
personally known to me (or prdved to me on the basis of .-personally-known-t@-me (or proved to me on the basis of
satisfactory evidence) to be the person(s)whose name(s) is/are satisfactory evidence)to be the persona)whose name(s) is/arc
subscribed to the within instrument and acknowledged to me that subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized he/sheRhey executed the same in hisfheMhmr authorized
capacity(ies), and that by his/her/their signature(s) on the eapacity0es), and that by hisAaeNtheir signature(s) on the
instrument the person(s), or the entity upon behalf of which the instrument the person(s} or the entity upon behalf of which the
person(s)acted,executed the instrument person(s•acted,executed the instrument
WITNESS my hand and official seal. WITNESS my hand and official seal.
Notary ` , /J t- Notary � � Z
Signature: �(,UZ>..1� C� UC'/!'L/J_ Signature:
Notary Seal' Notary Seal:
♦M�MaaaW NNaaalaaY�aa\a\Nxa
TERRIE L OWENS CARRIE ROVNEY i
COMM.#1652595 x Comrrllsslon� 7348g57 r
NOTARY PUBLIC•CALIFORNIA i Notary Public-CaUfomia
RIVERSIDE COUNTY Commission E fires MAR 6,2009 Rhrorillde CountV
+ MYCorrlm.EfgWes Mar 6,=4
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'�� � Y5'F 1 CAI ,J.'.:v"..h'JY�F'_!. _
�lq lt�.tYy.. 11.� � B � .. ., � � � _
EXHIBIT "A"
SCOPE OF WORK
Indian Canyon Drive
Remove and haul out asphalt debris from the road reconstruction of Indian Canyon Drive from
both sides of the roadway to an approved dump site including dump fees. Removal of the asphalt
debris will be done in conjunction with the remove and haul-out blow sand dirt from the City right-
of-way, including the paved shoulders.
Work includes Mobilization, PM-10 Control*, Call USA Alert, designate location where the asphalt
debris is to be disposed and rough grade areas of asphalt removal.
City forces to close Indian Canyon Drive between Garnet Avenue and Tramview Road during the
work to remove and haul-out blow sand dirt from the City right-of-way, including the paved
shoulders.
*PM-10 Requirements:
1. On-site water truck to control dust and track-out as needed per City Municipal Code
8.50.021
2. No dust control plan is required
3. No AQMD sign is required
4. Soil or other potential dust generating materials transported onto or from the site using
public streets, shall first be watered sufficiently to prevent generation of dust and then
covered so as to prevent any spillage during transport. If deemed necessary, the Public
Works and Engineering Division may specify additional measures.
City of Palm Springs will arrange with Desert Water Agency to provide a construction water meter
for the contractor.
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EXHIBIT "B"
SPECIAL REQUIREMENTS
Business License Requirement:
Contractor shall possess a valid City of Palm Springs Business License throughout the term of
this agreement.
Construction Permit Requirement:
A "NO FEE" permit will be issued to the contractor prior to the start of the work.
Section 4.3: "Performance Bond" is waived
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EXHIBIT "C"
SCHEDULE OF COMPENSATION
Indian Canyon Drive at Whitewater River Wash - Hourly Rate
Remove and haul out asphalt debris from the road reconstruction of Indian Canyon Drive from
both sides of the roadway to an approved dump site, including dump fees. Removal of the
asphalt debris will be done in conjunction with the remove and haul-out blow sand dirt from the
City right-of-way, including the paved shoulders.
Water Truck (2,000 Gal)/Operator 8 hrs @ $70.00 $ 560.00
Cat 966 G Loader/ Operator 8 hrs @ $140.00 $ 1,120.00
Dump Truck (End Dump) /Operator 86 hrs @ $93.75 $ 8,062.50
Total $ 9,742.50
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EXHIBIT "D"
SCHEDULE OF PERFORMANCE
Contract Time: 2 working days to complete work from day specified in Notice to Proceed..
This contract will be under the "Greenbook" Specifications, 2003 Edition
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ACORD. CERTIFICATE OF LIABILITY INSURANCE PATC(MMODYYTJ
06/07/2005
fROIX10ER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
JOHNSTON INS AGCY LIC#DB71065 ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND DR
69035 Dinah Shore Dr. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Cathedral city, CA 92234
760 328-3106 FAX 760 328-4057 INSURERS AFFORDING COVERAGE NAICY
INlT1IIED TRI STAR CONTRACTING, INC. INSIMAA: CENTURY SURETY COMPANY
TELAR, INC INSURER CLARENDON INS[7RANCE CO.
15-501 LITTLE MORONGO ROAD wslwPNv STATE FUND
DESERT HOT SPRINGS, CA 92240 INswlEsl°: ,,,, -_ .•..___.._._.
1760-251-5454 FAX 760 251-5458 NsuRl E.
_COVERAGES
THE POLICIES OF INSURANCE LISTED 6ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR YHP POI ICY N-RIOD 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 SUMOT TO ALI, I He TERMS, EXCLTI$ONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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CITY OF PALM SPRINGS IS NAMED AS APPITIONAL INSURED
CERTIFICATE HOLDER CANCELLATION _
CITY OF PALM SPRINGS �°N•n ANr aR TseAwVE Pelaaeeo RaLlales Mt wMCELLEO MErokEtH{rsrlTaAnaN
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ACORD25(2001/0A( ®ACORD CORPORATION 19Y8
GERTHOLDER COPY
STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807
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FUND CERTIFICATE OF vi�ORKERS'COMPENSATION INSURANCE
2005 JUH ! 3 P,Ei 8: 54
ISSUE DATE: 06-07-2005 i 1C i GROUP: 000044
�:a POLICYNUMBER: 19798-2004
CI T CLFR'A' CERTIFICATE ID: 472
CERTIFICATE EXPIRES: 10-01-2005
10-01-2004/10-01-2005
CITY OF PALM SPRINGS k
3200 EAST TAHQUITZ CANYON WAYS
PALM SPRINGS CA 92262
This is to certify that we have Issued a valld Worker's Compensation insurance policy in a form approved by iile California
Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend,extend or alter the coverage afforded by the
policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with
respect to which this certificate of insurance may be issued or to which it may pertain,the insurance afforded by the policy
described herein is subject to all the terms,exclusions, and conditions,of such policy.
AUTHORIZED REPRESENTATIVE PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #1600 - LARRY J OWENS PRES - EXCLUDED.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2001 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
EMPLOYER
TRI-STAR CONTRACTING INC TRI-STAR
GRADING,INC. COACHELLA VALLEY SEWER
MATERIAL INC
15501 LITTLE MORONGO RD PC1,SC]
DESERT HOT SPRINGS CA 92240
PRINTED:06-07-2005
SCIF 10262E Accept this certificate only if you see a faint walerrnark that reads"OFFICIAL STATE FUND DOCUMENT" PAGE 1 OF 1