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Calstate Construction - San Ysidro Park Rec. Building Remodel - Change Order No. 11Citp of O%frop Public Works Department - Engineering Division 7351 Rosanna St., Gilroy, CA 95020 Phone (408) 846 -0451; Fax (408) 846 -0429 CHANGE ORDER NO. 11 To contract for: San Ysidro Park City Project No. Contractor: Calstate Construction Inc, Contract Date: 12 -PW -194 1/6/2012 This order shall become effective when it has been signed by the City Administrator, City Engineer, Project Engineer, and Contractor. All copies forwarded to Contractor for signature shall be returned to the City of Gilroy properly filled out. Upon acceptance by the City, the Contractor's copy will be returned to him as his authority to proceed with the work. Description of Work Calstate is directed to remove and replace the FRP (48) wall panels in the outside bathrooms. Calstate to repair dryrott and termite conditions that where exposed during demolition that will hinder the structural integrity of the building. Calstate is also directed to remove the existing damaged 2x4 redwood window and door trims and replace with new. Per the COG building inspector to meet ADA requirements Calstate is directed to supply and install approximately 701f of curved handrail. The handrail is to be installed from the top of the landing pad near the restrooms to the to the perimeter access road. Calstate to provide a new Ademco wireless security system with Keypad, 4 motion detectors (for complete coverage) and door contacts on all exterior doors. Calstate to prep and prime wall surfaces and to supply two finish coats of paint to the exterior bathroom walls above the FRP wall panels and the large utility storage room with the double doors. (Time extension of 7 days will be added to the contract) All requirements of the original Contract Documents shall apply to the above work except as specifically modified by this Change Order. The contract time shall not extend unless expressly provided for in this Change Order. By signing this Change Order, Contractor acknowledges and agrees that the adjustments to cost and time contained herein are in full satisfaction and accord, and are accepted as payment in full, for any and all costs and expenses associated with this Change Order, (the "Extra Work "), including but not limited to labor, materials, overhead and profit, delay, disruption, loss of efficiency and any and all other direct and /or indirect costs or expenses associated with the Extra Work and hereby waives any right to claim any further cost and time impacts at any time during and after completion of the Contract associated with the Extra Work. ► All Extra Work authorized under this Change Order must be billed separately from the original contract. All bills for work done under this Change Order shall reference this Change Order No. 11. I (We) agree to make the above change subject to the terms of this Change Order for a NET INCREASE not to exceed $27,594.8 CONTRA TO By Calstate Construction, Inc. Original Contract Price Previous Change Orders Total to Date This Change Order Total Change Orders to Date Revised Contract Price Date: 6/12/12 Cost Percentage Initial $771,744.00 $122,098.75 15.82% $893,842.75 $27,594.86 $149,693.61 19.40% $921,437.61 RECOMMENDED BY: 1A Construction 6anager D ate ACCEPTED. BY: g ' Proj Projec ager Date fmgineer ���g I' 2 Administrator Date San Ysidro Park Recreation Bldg Remodel # 12-PW -194 Project No. 12 -001 DATE: 5126MO12 San Ysldro Park 012-PW -194 CONTRACTOR: Calstate Construction, Inc. CONTRACTOR COST PROPOSAL* 6.2 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - PRIME CONTRACTOR DESCRIPTION OF CHANGE: Curved Handralls MATERIAL + 15% LABOR + 15% EQUIPMENT+ 15% PRIME CONTRACTOR TOTAL Sub Contractor Costs from Attached Cost Proposal(s) SUBCONTRACTOR SUBTOTAL DIRECT COSTS PRIMARY 6% FEE ON SUBCONTRACTORS COST SUBCONTRACTOR TOTAL FEE PRIME TOTAL SUBTOTAL COR BOND ( not to exceed 2% of sub total) TOTAL Option $0.00 $188.60 $0.00 i1W.so $8 486.15 $424.31 $6,910.46 :188.60 $9,099.06 $ 181.98 ;9,281.64 PREPARED & SUBMITTED BY: Jim Lyons ...� COMPANY: Calstate Construction, Inc. TITLE: PM Cost Proposal San Ysidro Park Recreation Bldg Remodel 912 -PW -194 Project No. 12 -001 DATE: 5/25/2012 San Ysldro Park 012-PW -194 CONTRACTOR: Calstate Construction, Inc. CONTRACTOR COST PROPOSAL #: 5.2 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - SUBCONTRACTOR CONTRACTOR DESCRIPTION OF CHANGE: • UPOW e MATERIAL $0.00 LABOR ®� EQUIPMENT •Li:.:itJll��� SUBTOTAL DIRECT COSTS $8,486.15 FEE ON DIRECT COSTS (15 %) �� SUBCONTRACTOR SUBTOTAL a Third and Fourth Tier Sub Cantrantor Casts from Attached Cost Proposal SUBCONTRACTOR SUBTOTAL TOTAL $6,466.16 PREPARED & SUBMITTED BY: Jim Lyons - CSCI COMPANY: Universal TITLE: Proposed Cost Proposal Subcontractor UPOW e MATERIAL $0.00 LABOR $8,488.15 EQUIPMENT $0•00 SUBTOTAL DIRECT COSTS $8,486.15 FEE ON DIRECT COSTS (15 %) $0.00 SUBCONTRACTOR SUBTOTAL $8,48616 Third and Fourth Tier Sub Cantrantor Casts from Attached Cost Proposal SUBCONTRACTOR SUBTOTAL TOTAL $6,466.16 PREPARED & SUBMITTED BY: Jim Lyons - CSCI COMPANY: Universal TITLE: Proposed Cost Proposal Subcontractor 1650 GRANT 51 FAT • SANTA CLARA, CAUFOANiA 95050 14081 727 -4640 • FAX (4081727 -7739 • (9001896.4640 QUOTATION Customer: �ks W-t (&-t 4 Attention;'�"e -� Project: FOB: JA S jh! Bid Date: Phone: I — SAO -- GU — 1 100 Fax: _ 1.- sl 0 - Terms: NET 30 DAYS QTY. ITEM DES ZMPTION I COST Robert Garcia ! Chief Estimator 7. lqo �6. ti5 * Please Add Sales Tax If Am% Job Name ! Job Number SRI Dennis / Plant Manager Pu Mar Number. Jack Paravagna / President Approved By PRICES SUBJECT TO REVIEW AFTER 30 DAYS San Ysidro Park Recreation Bldg Remodel # 12 -PW -194 Project No. 12-001 DATE: 4/17=12 San Ysidro Park 912-PW 194 CONTRACTOR: Calstate Construction, Inc. CONTRACTOR COST PROPOSAL #: 19 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - PRIME CONTRACTOR DESCRIPTION OF CHANGE: Remove and replace the B' FRP panels and trims to the adedrig restrooms at San Ysidro Park Sub Contractor Costs from Attached Cost Proposal(s) Option A MATERIAL + 15% $0.00 LABOR + 15% $2,663.86 EQUIPMENT+ 15% $0.00 PRIME CONTRACTOR TOTAL 563.E Sub Contractor Costs from Attached Cost Proposal(s) SUBCONTRACTOR SUBTOTAL DIRECT COSTS PRIMARY 5% FEE ON SUBCONTRACTORS COST $0.00 SUBCONTRACTOR TOTAL FEE PRIME TOTAL SUBTOTAL COR g$2,563.86 BOND ( not to exceed 2% of sub total) $ TOTAL $6,695.14 PREPARED & SUBMITTED BY: COMPANY: TITLE: PM San Ysidro Park Recreation Bldg Remodel # 12 -PW -194 Project No. 12.001 DATE: 3/16/2012 San Ysidro Park #12-PW -194 CONTRACTOR: Calsfate Construction, Inc. CONTRACTOR COST PROPOSAL #: 19 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - SUBCONTRACTOR CONTRACTOR DESCRIPTION OF CHANGE: Remove and replace the V FRP panels and b*m to the exstinp res"onrr at San Ysidro Paris ■ - u - ���� ���iL.rli111ta .., MATERIAL LABOR EQUIPMENT SUBTOTAL DIRECT COSTS FEE ON DIRECT COSTS (15 %) SUBCONTRACTOR SUBTOTAL Third and Fourth Tier Sub Contractor Coats from Attached Coat Proposal SUBCONTRACTOR SUBTOTAL TOTAL PREPARED & SUBMITTED BY: Jim Lyons - CSCI COMPANY: United RMR TITLE: option B $0.00 $0.00 $0.00 $0.00 $0.00 I� $4,000.00 Proposed Cost Proposal Subcontractor Project Name: San Ysidro Park Recreation Building Project No: 12 -PW -194 FIELD ORDER City Of Gilroy 4/4112 7387 Rosanna Street Gilroy, CA 95020 FIELD ORDER NO. Project Name: San Ysidro Park Recreation Contract Date: 01/06/2012 To Contractor: Calstate Construction Inc Address: 4165 Business Center Dr. Fremont CA 94538 DESCRIP'I'iON OF WORK: Supply pricing to remove and replace the 8' FRP panels and trims to the existing restrooms at San Ysidro Park. Estimated Adjustment of Contract Sum: Ron Barri / PM (Name of Construction Manager/Title - typed or printed) M (Signature) Date: 414/2012 Jared Perry / Project Manager (Name of Contractor Representative✓ de - typed or printed) (Signature) PITM Estimated Adjustment of Contract Time: Note: This Field Order will be superseded by an allowance adjustment or a Change Order that will include the scope of the change in the Work and any actual adjustments of the Contract Sum. Zr/4/1111rrap RMR EN'll'aRPRISES BID SHEET 1722 Junction Ave #B San Jose, CA 95112 Phone: (408)644 -1111 Fax: 408 437 -3116 L.k:# 806554 Job Name: San Ysidro Bid Date: 04117/12 Title: FRP Section: Titre: Section: We Propose to furnish and install the following: 25 sheets of class C pebbeled 4x8 FRP rotas FU $4,000.00 freight ax InClUdOd. Lead Time 5 to 0 weeks. Prices are valid for 30 days. No retention to be withhold for F.O.8 bid with net 30 days. Exclusions: Hauling packaging off site; wall bacidrng We are Signatories to the Carpenters union San Ysldro Park Recreation Bldg Remodel # 12 -PW -194 Project No. 12 -001 DATE: 5/25/2012 San Ysldro Paris 912 -PW 194 CONTRACTOR: Calstate Construction, Inc. CONTRACTOR COST PROPOSAL #: 29 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - PRIME CONTRACTOR DESCRIPTION OF CHANGE: Colstate to repair dryott and termite eondWons that have been exposed during the demoldlon that wilt hinder the interprity of the building. Repair work tD be lnspechad and authorized by Ron Berri on a T d, M basis per FO #18 ITEM DESCRIPTION MATERIAL sales tax included OR tfulibyr enwmbered QUANTITY UNIT UNIT COST EXTENSION QUANTITY HOURS RATE EXTENSION QUANTITY UNIT COST EXTENSION SurveyAzPullCoadnale mrWSubs 0 0 $ 2 $82.00 $164.00 0 50.00 Laborer 12 $W.42 71104 carp~ 52 $82.00 $ 4284.00 Lumber 3950 SUBTOTAL $ 950.00 $ 5,141.04 S MARK -Up $ 75.00 $ 771.18 S TOTALS $ 1,025.00 3 5,912.20 3 MATERIAL 415% LABOR + 15% EQUIPMENT + 15% PRIME CONTRACTOR TOTAL Sub Contractor Costs from Attached Cost Proposal(s) SUBCONTRACTOR SUBTOTAL DIRECT COSTS PRIMARY 5% FEE ON SUBCONTRACTORS COST SUBCONTRACTOR TOTAL FEE PRIME TOTAL SUBTOTAL COR BOND ( not to exceed 2% of sub total) TOTAL Option A $1,025.00 $5,912.20 $0.00 $6,937.00 $0.00 $0.00 00 $6,937.00 $6,937.00 $ 136.74 ;7,075.74 PREPARED & SUBMITTED BY: Jim Lyons COMPANY: Calstate Construction, Inc. _ TITLE: PM Cost Proposal Project Name: San Ysidro Park Recreation Building FIELD ORDER City Of Gilroy 7387 Rosanna Street Gilroy, CA 95020 FIELD ORDER NO. IS Project Name: San Ysidro Park Recreation Contract Date: 01/06/2012 To Contractor: Calstatc Construction Inc Address: 4165 Business Center Dr. Fremont CA 94538 DESCRIPTION OF WORK: Project No: 12 -PW -194 5/3/12/12 Calstate to repair dryrott and termite conditions that have been exposed during the demolition that will hinder the integrity of the building. Repair work to be inspected and authorized by Ron Barri on a T&M basis. Estimated Adjustment of Contract Sum: Ron Bann / PM (Name of Construction Manager/Title - typed or printed) By: (Signature) Date: 5/3/2012 Jared P=Y / Project Manses (Name of Contractor Representative/ritle - typed or printed) (Signature) Date: Estimated Adjustment of Contract Time: Note: 77jis Field Order will be superseded by an allowance adjustment or a Change Order that will include the scope of the change in the Work and any actual adfustments of the Contract Sum. San Ysldro Park Recreation Bldg Remodel # 12 -PW -194 Project No. 12 -001 DATE: 5/3012012 San Ysidro Park 912-PW 194 CONTRACTOR: Calstate Construcdon, Inc. CONTRACTOR COST PROPOSAL #: 30 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - PRIME CONTRACTOR DESCRIPTION OF CHANGE: CohoW to supply 2x4 wderbr redwood bim b exisdn0 windows In 4 bca0ws per F0017. MATERIAL + 15% LABOR + 15% EQUIPMENT + 15% PRIME CONTRACTOR TOTAL Sub Contractor Costs from Attached Cost Proposals) SUBCONTRACTOR SUBTOTAL DIRECT COSTS PRIMARY 5% FEE ON SUBCONTRACTORS COST SUBCONTRACTOR TOTAL FEE PRIME TOTAL SUBTOTAL COR BOND ( not to exceed 2% of sub total) TOTAL OP§w A $801.22 $188.80 $0.00 $0.00 $0.00 $0.00 .82 $989.82 $ 19.80 0611-� . 1 :1,009.62 PREPARED & SUBMITTED BY. Jim Lvons COMPANY: Calstate Construction. Inc. TITLE: PM Cost Proposal Elm MATERIAL + 15% LABOR + 15% EQUIPMENT + 15% PRIME CONTRACTOR TOTAL Sub Contractor Costs from Attached Cost Proposals) SUBCONTRACTOR SUBTOTAL DIRECT COSTS PRIMARY 5% FEE ON SUBCONTRACTORS COST SUBCONTRACTOR TOTAL FEE PRIME TOTAL SUBTOTAL COR BOND ( not to exceed 2% of sub total) TOTAL OP§w A $801.22 $188.80 $0.00 $0.00 $0.00 $0.00 .82 $989.82 $ 19.80 0611-� . 1 :1,009.62 PREPARED & SUBMITTED BY. Jim Lvons COMPANY: Calstate Construction. Inc. TITLE: PM Cost Proposal G O L D E N S T ►T E 3880, Cherry Street Quote No L U All B t R Newark, Califomis 94560 Quote bats 4. 1 510-816 -1000 Del To: 7700 MURRAY AVE XST ADAMS CT GILROY, CA, 95020 Bill To: Calstate Const Inc 4165 Business Center Dr Fremont, CA, 94538 Quotation 36770 06/2812012 Customer 17383 Cust Reference Job Code 112- 4CALSOD4 Delivery By 05/29/2012 Contact Jared Perry 4 -21 -11 Contact Phone Taken By Bob Whelan Sales Rep Bob Whelan I Dill 111111 VIII 111111111111 III 11111111111 Page 1 of 1 Signature Purchaser agrees to be bound by all the tens and conditions located at lhttp: / /wm.goldenstatelumber .cam /gsterms.aspx' or ask your local branch for a copy, which may be modified from time to time. �h ti '= .,«-". 1: T1� i#' _,..�i:+ .o+.w�...s�'aH �. �&p+"� +�e.,.w .....aG;o-�. .E.. . w. 1 zz 5026 0463 2X6 rwd cir hrt so 48 If 6,763.13 mbf 324.63 81B 2 zZL.SO24_0306 2X4 rwd dr hrt s4s 80 If 6,434.22 mbf 343.16 10/8 Total Ship Units: 101 BDFT y 0 LF $667.79 0 SOFT' 556.49 0 EA Q ;726.22 Signature Purchaser agrees to be bound by all the tens and conditions located at lhttp: / /wm.goldenstatelumber .cam /gsterms.aspx' or ask your local branch for a copy, which may be modified from time to time. Project Name: San Ysidro Park Recreation Building Project No: 12-PW -194 DESCRIPTION OF WORK: Calstate to supply 2x4 exterior redwood trims to existing windows in 4 locations. Estimated Adjustment of Contract Sum: Estimated Adjustment of Contract Time: Ron Barri / PM _ (Name of Construction Manager/Title - typed or printed) By: (Signature) Date: 5/3/2012 Jared Perry / Project Manager (Name of Contractor Representative/Title - typed or printed) (Signature) Date: Note: This Field Order will be superseded by an allowance adjustment or a Change Order that will include the scope of the change in the Work and any actual adjustments of the Contract Sum. FIELD ORDER City Of Gilroy 513112/12 7387 Rosanna Street Gilroy, CA 95020 FIELD ORDER NO. 17 Project Name: San Ysidro Park Recreation Contract Date: 01/06/2012 To Contractor: Calstate Construction Inc Address: 4165 Business Center Dr. Fremont CA 94538 DESCRIPTION OF WORK: Calstate to supply 2x4 exterior redwood trims to existing windows in 4 locations. Estimated Adjustment of Contract Sum: Estimated Adjustment of Contract Time: Ron Barri / PM _ (Name of Construction Manager/Title - typed or printed) By: (Signature) Date: 5/3/2012 Jared Perry / Project Manager (Name of Contractor Representative/Title - typed or printed) (Signature) Date: Note: This Field Order will be superseded by an allowance adjustment or a Change Order that will include the scope of the change in the Work and any actual adjustments of the Contract Sum. San Ysidro Park Recreation Bldg Remodel # 12 -PW -194 Project No. 12 -001 DATE: 8/11/2012 San Ysidro Paris 012 -PW -194 CONTRACTOR: Calstate Constructlon, Inc. CONTRACTOR COST PROPOSAL It 33 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - PRIME CONTRACTOR DESCRIPTION OF CHANGE: Additional Painting per F0#26 OPUon A MATERIAL + 15% $0,00 LABOR + 15% $188.80 EQUIPMENT + 15% $0.00 PRIME CONTRACTOR TOTAL 1 $188.80 Sub Contractor Costs from Attached Cost Proposal(s) SUBCONTRACTOR SUBTOTAL DIRECT COSTS 1 $2,660.001 PRIMARY 5% FEE ON SUBCONTRACTORS COST $127.50 SUBCONTRACTOR TOTAL FEE ,877.50 PRIME TOTAL $188.80 SUBTOTAL COR $2,888.10 BOND ( not to exceed 2% of sub total) $ 57.32 TOTAL 1 $2,923.42 PREPARED 81 SUBMITTED BY: Jim Lyons COMPANY: CalstateConstruction, Inc. TITLE: PM Cost Proposal i OPUon A MATERIAL + 15% $0,00 LABOR + 15% $188.80 EQUIPMENT + 15% $0.00 PRIME CONTRACTOR TOTAL 1 $188.80 Sub Contractor Costs from Attached Cost Proposal(s) SUBCONTRACTOR SUBTOTAL DIRECT COSTS 1 $2,660.001 PRIMARY 5% FEE ON SUBCONTRACTORS COST $127.50 SUBCONTRACTOR TOTAL FEE ,877.50 PRIME TOTAL $188.80 SUBTOTAL COR $2,888.10 BOND ( not to exceed 2% of sub total) $ 57.32 TOTAL 1 $2,923.42 PREPARED 81 SUBMITTED BY: Jim Lyons COMPANY: CalstateConstruction, Inc. TITLE: PM Cost Proposal San Ysidro Park Recreation Bldg Remodel # 12 -PW -194 Project No. 12 -001 DATE: 6/192012 Son Ysidro Park 012-PW -194 CONTRACTOR: Caletste Constriction, Inc. CONTRACTOR COST PROPOSAL #: 33 POTENTIAL CHANGE ORDER (PCO) - COST PROPOSAL - SUBCONTRACTOR CONTRACTOR DESCRIPTION OF CHANGE: Awborel Pe*ft per FMa MATERIAL LABOR EQUIPMENT SUBTOTAL DIRECT COSTS FEE ON DIRECT COSTS (15%) SUBCONTRACTOR SUBTOTAL Third and Fourth Tier Sub Contractor Casts from Attached Cast Proposal SUBCONTRACTOR SUBTOTAL TOTAL PREPARED & SUBMITTED BY: Jim Lyons - CSCI COMPANY: Universal TITLE: Upbon 8 $490.00 $2,060.00 $0.00 $2,550.00 $0.00 Iss0.o0 52,550.00 Proposed Cost Proposal Subcontractor DE MARTINEZ PAINTING, INC. PROPOSAL & CONTRACT #9183 SSE Corp DlWct Council 16 To: General Contractor Attn: Estimator! Project Manager Project SAN YSIDRO REC CENTER BATHROOM WALLS PER FIELD ORDER #26 AS PER YOUR REQUEST, WE ARE SUBMITTING A PRICE FOR PAINT WORK TO BE DONE AT THE ABOVE MENTIONED PROJECT. SCOPE: • TO PREP, PATCH, AND PAINT 2 FINISH COATS TO EXTERIOR BATHROOM WALLS ABOVE FRP PANELS, AND TO CEILINGS AND UTILITY ROOM TO INCLUDE DOORS & FRAMES. LABOR....................................................................... ............................... $ 1,760.00 ` Z060 DOORS & MATERIALS ................................................................ ............................... $ 490.00 DOORS 8 FRAMES. . = 300.00 TOTAL LABOR & MATERIAL FOR PREP & APPLICATION TIME .......................... $ 2,550.00 ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED. ALL WORK IS TO BE COMPLETED IN ACCORDANCE WITH THE DRAWINGS AND SPECIFICATIONS SUBMITTED AND IS TO BE COMPLETED IN A SUBSTANTIAL WORKMANLIKE MANNER. ANY ALTERATIONS OR DEVIATIONS INVOLVING EXTRA COSTS WILL BE EXECUTED ONLY UPON WRITTEN ORDERS, AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE. IF ACCEPTED, THIS PROPOSAL & CONTRACT IS TO BE MADE A PART OF SUBCONTRACT AGREEMENT. WE CARRY COMPLETE COMPREHENSIVE AND GENERAL LIABILITY INSURANCE AND ARE FULLY COVERED BY WORKMAN'S COMPENSATION. THE ABOVE PRICES, SPECIFICATIONS, AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED. JUNE 11, 2012 DE MARTINEZ PAINTING, INC. GENERAL CONTRACTOR CHRISTOPHER MARTINEZ. ESTIMATOR estimatina Cdldemartinezoaintina.com 407 Reynolds Circle, San Jose, CA 95112 • Tel 408/392 -9886 • Fax 4081392 -9915 • CSL# 746579 Project Name: San Ysidro Park Recreation Building Project No: 12 -PW -194 FIELD ORDER City Of Gilroy 6/7112 7387 Rosanna Street Gilroy, CA 95020 FIELD ORDER NO. 76 Project Name: San Ysidro Park Recreation Contract Date: 01/06/2012 To Contractor: Calstate Construction Inc Address: 4165 Business Center Dr. Fremont CA 94538 DESCRIPTION OF WORK: This directive is for Calstate to prep wall surfaces and to supply two finish coats of paint to the exterior bathroom walls above the FRP wall panels. Also to prep wall surfaces in the utility storage room and paint two coats of finish. Estimated Adjustment of Contract Sum: $600.00 Ron Barri / PM (Name of Construction Manager/Title - typed or printed) By: (Signature) Date: 6n12012 Jared Pem / Project Manager (Name of Contractor Representativa7itle - typed or printed) (Signature) Date: Estimated Adjustment of Contract Time: Note: This Field Order will be superseded by an allowance adjustment or a Change Order that will include the scope of the change in the Work and any actual adjustments of the Contract Sum. H OP ID: YV ACORO" �. CERTIFICATE OF LIABILITY INSURANCE DATE (MMroD1YYYY) 05129/12 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 terns 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 408 -288 -6262 BadockerIns.Svs. -San Jose 408 - 298 -7635 LIc. $$ 0580438 1330 S. Bascom Ave. San Jose, CA 95128 Nicholas Weintraub SECT PHONE FAX C No Ext : (A)C, No): E-MAIL ADDRESS: PRODUCER CALST01 CUSTOMERIDa« INSURER(S) AFFORDING COVERAGE NAIL 0 INSURED CalState Construction, Inc. 4165 Business Center Drive Fremont, CA 94538 -6182 INSURERA: Kinsale Insurance Company 38920 INSURER B: Allied Insurance Co. 42579 INSURER c: Everest National Insurance Co. 10120 INSURER D EACH OCCURRENCE INSURER E : A INSURER F: X COVERAGES 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. 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. LSI IN SR TYPE OF INSURANCE The City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. POLICY NUMBER POLICY EFF MMIDD/YYW POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X X 01000052620 04/01/12 04!01113 PREMISES Ea occurrence $ 100,00 MEDEXP (Anyone person) $ 5,00 CLAIMS -MADE OCCUR PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS- COMPIOP AGG $ 2,000,00 $ POLICY X PRO LOC B AUTOMOBILE X LIABILITY ANY AUTO ACP7833765065 11121/11 11121112 COMBINED SINGLE LIMIT (Ea acodent) $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNEDAUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIREDAUTOS PROPERTY DAMAGE (Peraccident) $ $ NON -OWNED AUTOS $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 A X EXCESS LIAB CLAIMS -MADE 01000052560 04101!12 04/01/13 DEDUCTIBLE $ $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED' ❑ (Mandatory In NH) N/A 7600003953111 11101/11 11/01/12 X I WC STATU- 0TH - TCRY LIMITS ER E . EACH ACCIDENT $ 1,000,00 E . DISEASE - EA EMPLOYEE $ 1,000,00 E . DISEASE - POLICY LIMIT $ 1,000,00 If ves, describe under DESCRIPTION OF OPERATIONS below I I I DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) The City of Gilroy, its officials, and employees are named as additional & CG20 7 RE: San Ysidro Park Insured per GL forms CG2010 attached. Recreation Building Projectl2 -PW -194 7700 Murray Ave Gilroy Ca 95020 GL Waiver of Subrogation applies 8r attached. CERTIFICATE HOLDER CANCELLATION CITYGIL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street AUTHORIZED REPRESENTATIVE Gilroy, CA95070 O 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION Attached To and Forming Part of Policy Effective Date of Endorsement I Named insured 0100005262 -0 0„01,12 CalState Construction Inc 12:01AM at the Named Insured ad- dress shown on the Declarations Additional Premium: Return Premium: $0.00 $0.00 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered Operations Blanket, as required by written contract. The City of Gilroy, its officials, and employees Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tions) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "per- sonal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your be- half; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the Insurance afforded to these addi- tional insureds, the following additional exclusions ap- ply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or re- pairs) to be performed by or on behalf of the addi- tional insured(s) at the location of the covered op- erations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 2010 07 D4 © ISO Properties, Inc., 2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS Attached To and Forming Part of Poficy Effective Date of Endorsement Named Insured 0100005262 -0 04/01/12 12:03.AM at the Named Insured CalState Construction Inc address shown on the Declarations Additional Premium: Return Premium: $0.00 $0.00 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s): Location And Description of Completed Operations As Required By Written Contract. Excludes All New Residential Construction. The City of Gilroy, its officials, and employees "Your work" does not include "New Residential Construc- tion", which means any building or structure not previously occupied and designed or intended for occupancy in whole are in part as a residence by any person or persons. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location desig- nated and described In the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Attached To and Forming Port of Polley Effective Date of Endorsement Named Insured 0100005262 -0 ovom2 12:01AM at the Named Insured CalState Construction Inc address shown on the Declarations Additional Premium: Return Premium: $0.00 $0.00 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE SECTION IV — CONDITIONS, 8. Transfer of Rights of Recovery against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against persons or organizations because of payments we make for injury or damage arising out of "your work" done under a written contract with that person or organization wherein you have agreed to provide this waiver. The City of Gilroy, its officials, and employees ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, CAS4002 0110 Page 1 of i