Filice Enterprises - 2014 AgreementAGREEMENT FOR SERVICES
(For contracts over $5,000)
This AGREEMENT made this 20th day of MAY, between:
CITY: City of Gilroy, having a principal place of business at
7351 Rosanna Street, Gilroy, California
and CONSULTANT:
R` J i ce-
ENTERPRISES, INC., having a principal place of business at 1608 W. CAMPBELL AVENUE
#344 CAMPBELL, CALIFORNIA 95008.
ARTICLE 1. TERM OF AGREEMENT
This Agreement will become effective on 5/20/14 and will continue in effect through June 13,
2015 unless terminated in accordance with the provisions of Article 7 of this Agreement.
ARTICLE 2. INDEPENDENT CONTRACTOR STATUS
It is the express intention of the parties that CONSULTANT is an independent contractor and not
an employee, agent, joint venturer or partner of CITY. Nothing in this Agreement shall be
interpreted or construed as creating or establishing the relationship of employer and employee
between CITY and CONSULTANT or any employee or agent of CONSULTANT. Both parties
acknowledge that CONSULTANT is not an employee for state or federal tax purposes.
CONSULTANT shall not be entitled to any of the rights or benefits afforded to CITY'S
employees, including, without limitation, disability or unemployment insurance, workers'
compensation, medical insurance, sick leave, retirement benefits or any other employment
benefits. CONSULTANT shall retain the right to perform services for others during the term of
this Agreement.
ARTICLE 3. SERVICES TO BE PERFORMED BY CONSULTANT
A. Specific Services
CONSULTANT agrees to: Perform the services as outlined in Exhibit "A" ( "Specific
Provisions ") and Exhibit "B" ( "Scope of Services "), within the time periods described in
Exhibit "C" ( "Milestone Schedule ").
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B. Method of Performing Services
CONSULTANT shall determine the method, details and means of performing the above -
described services. CITY shall have no right to, and shall not, control the manner or determine
the method of accomplishing CONSULTANT'S services.
C. Employment of Assistants
CONSULTANT may, at the CONSULTANT'S own expense, employ such assistants as
CONSULTANT deems necessary to perform the services required of CONSULTANT by this
Agreement, subject to the prohibition against assignment and subcontracting contained in
Article 5 below. CITY may not control, direct, or supervise CONSULTANT'S assistants in the
performance of those services. CONSULTANT assumes full and sole responsibility for the
payment of all compensation and expenses of these assistants and for all state and federal income
tax, unemployment insurance, Social Security, disability insurance and other applicable
withholding.
D. Place of Work
CONSULTANT shall perform the services required by this Agreement at any place or location
and at such times as CONSULTANT shall determine is necessary to properly and timely perform
CONSULTANT'S services.
ARTICLE 4. COMPENSATION
A. Consideration
In consideration for the services to be performed by CONSULTANT, CITY agrees to pay
CONSULTANT the amounts set forth in Exhibit "D" ( "Payment Schedule "). In no event
however shall the total compensation paid to CONSULTANT exceed $ 26,677.00.
B. Invoices
CONSULTANT shall submit invoices for all services rendered.
C. Payment
Payment shall be due according to the payment schedule set forth in Exhibit "D ". No payment
will be made unless CONSULTANT has first provided City with a written receipt of invoice
describing the work performed and any approved direct expenses (as provided for in
Exhibit "A ", Section IV) incurred during the preceding period. If CITY objects to all or any
portion of any invoice, CITY shall notify CONSULTANT of the objection within thirty (30)
days from receipt of the invoice, give reasons for the objection, and pay that portion of the
invoice not in dispute. It shall not constitute a default or breach of this Agreement for CITY not
to pay any invoiced amounts to which it has objected until the objection has been resolved by
mutual agreement of the parties.
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D. Expenses
CONSULTANT shall be responsible for all costs and expenses incident to the performance of
services for CITY, including but not limited to, all costs of equipment used or provided by
CONSULTANT, all fees, fines, licenses, bonds or taxes required of or imposed against
CONSULTANT and all other of CONSULTANT'S costs of doing business. CITY shall not be
responsible for any expenses incurred by CONSULTANT in performing services for CITY,
except for those expenses constituting "direct expenses" referenced on Exhibit "A."
ARTICLE 5. OBLIGATIONS OF CONSULTANT
A. Tools and Instrumentalities
CONSULTANT shall supply all tools and instrumentalities required to perform the services
under this Agreement at its sole cost and expense. CONSULTANT is not required to purchase
or rent any tools, equipment or services from CITY.
B. Workers' Compensation
CONSULTANT agrees to provide workers' compensation insurance for CONSULTANT'S
employees and agents and agrees to hold harmless, defend with counsel acceptable to CITY and
indemnify CITY, its officers, representatives, agents and employees from and against any and all
claims, suits, damages, costs, fees, demands, causes of action, losses, liabilities and expenses,
including without limitation reasonable attorneys' fees, arising out of any injury, disability, or
death of any of CONSULTANT'S employees.
C. Indemnification of Liability, Duty to Defend
1. As to professional liability, to the fullest extent permitted by law,
CONSULTANT shall defend, through counsel approved by CITY (which approval shall not be
unreasonably withheld), indemnify and hold harmless CITY, its officers, representatives, agents
and employees against any and all suits, damages, costs, fees, claims, demands, causes of action,
losses, liabilities and expenses, including without limitation attorneys' fees, to the extent arising
or resulting directly or indirectly from any willful or negligent acts, errors or omissions of
CONSULTANT or CONSULTANT'S assistants, employees or agents, including all claims
relating to the injury or death of any person or damage to any property.
2. As to other liability, to the fullest extent permitted by law, CONSULTANT shall
defend, through counsel approved by CITY (which approval shall not be unreasonably withheld),
indemnify and hold harmless CITY, its officers, representatives, agents and employees against
any and all suits, damages, costs, fees, claims, demands, causes of action, losses, liabilities and
expenses, including without limitation attorneys' fees, arising or resulting directly or indirectly
from any act or omission of CONSULTANT or CONSULTANT'S assistants, employees or
agents, including all claims relating to the injury or death of any person or damage to any
property.
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D. Insurance
In addition to any other obligations under this Agreement, CONSULTANT shall, at no cost to
CITY, obtain and maintain throughout the term of this Agreement: (a) Commercial Liability
Insurance, including coverage for owned and non -owned automobiles, with a minimum
combined single limit coverage of $1,000,000 per occurrence for all damages due to bodily
injury, sickness or disease, or death to any person, and damage to property, including the loss of
use thereof; and (b) Professional Liability Insurance (Errors & Omissions) with a minimum
coverage of $1,000,000 per occurrence and aggregate. As a condition precedent to CITY'S
obligations under this Agreement, CONSULTANT shall furnish evidence of such coverage
(naming CITY, its officers and employees as additional insured's on the Comprehensive
Liability insurance policy referred to in (a) immediately above) and requiring thirty (30) days
written notice of policy lapse or cancellation, or of a material change in policy terms.
E. Assignment
Notwithstanding any other provision of this Agreement, neither this Agreement nor any duties or
obligations of CONSULTANT under this Agreement may be assigned or subcontracted by
CONSULTANT without the prior written consent of CITY, which CITY may withhold in its
sole and absolute discretion.
F. State and Federal Taxes
As CONSULTANT is not CITY'S employee, CONSULTANT shall be responsible for paying
all required state and federal taxes. Without limiting the foregoing, CONSULTANT
acknowledges and agrees that:
• CITY will not withhold FICA (Social Security) from CONSULTANT'S
payments;
• CITY will not make state or federal unemployment insurance contributions on
CONSULTANT'S behalf,
• CITY will not withhold state or federal income tax from payment to
CONSULTANT;
• CITY will not make disability insurance contributions on behalf of
CONSULTANT;
• CITY will not obtain workers' compensation insurance on behalf of
CONSULTANT.
ARTICLE 6. OBLIGATIONS OF CITY
A. Cooperation of City
CITY agrees to respond to all reasonable requests of CONSULTANT and provide access, at
reasonable times following receipt by CITY of reasonable notice, to all documents reasonably
necessary to the performance of CONSULTANT'S duties under this Agreement.
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B. Assignment
CITY may assign this Agreement or any duties or obligations thereunder to a successor
governmental entity without the consent of CONSULTANT. Such assignment shall not release
CONSULTANT from any of CONSULTANT'S duties or obligations under this Agreement.
ARTICLE 7. TERMINATION OF AGREEMENT
A. Sale of Consultant's Business/ Death of Consultant.
CONSULTANT shall notify CITY of the proposed sale of CONSULTANT's business no later
than thirty (30) days prior to any such sale. CITY shall have the option of terminating this
Agreement within thirty (30) days after receiving such notice of sale. Any such CITY
termination pursuant to this Article 7.A shall be in writing and sent to the address for notices to
CONSULTANT set forth in Exhibit A, Subsection V.H., no later than thirty (30) days after
CITY' receipt of such notice of sale.
If CONSULTANT is an individual, this Agreement shall be deemed automatically terminated
upon death of CONSULTANT.
B. Termination by City for Default of Consultant
Should CONSULTANT default in the performance of this Agreement or materially breach any
of its provisions, CITY, at CITY'S option, may terminate this Agreement by giving written
notification to CONSULTANT. For the purposes of this section, material breach of this
Agreement shall include, but not be limited to the following:
1. CONSULTANT'S failure to professionally and/or timely perform any of the
services contemplated by this Agreement.
2. CONSULTANT'S breach of any of its representations, warranties or covenants
contained in this Agreement.
CONSULTANT shall be entitled to payment only for work completed in accordance with the
terms of this Agreement through the date of the termination notice, as reasonably determined by
CITY, provided that such payment shall not exceed the amounts set forth in this Agreement for
the tasks described on Exhibit C" which have been fully, competently and timely rendered by
CONSULTANT. Notwithstanding the foregoing, if CITY terminates this Agreement due to
CONSULTANT'S default in the performance of this Agreement or material breach by
CONSULTANT of any of its provisions, then in addition to any other rights and remedies CITY
may have, CONSULTANT shall reimburse CITY, within ten (10) days after demand, for any
and all costs and expenses incurred by CITY in order to complete the tasks constituting the scope
of work as described in this Agreement, to the extent such costs and expenses exceed the
amounts CITY would have been obligated to pay CONSULTANT for the performance of that
task pursuant to this Agreement.
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C. Termination for Failure to Make Agreed -Upon Payments
Should CITY fail to pay CONSULTANT all or any part of the compensation set forth in Article
4 of this Agreement on the date due, then if and only if such nonpayment constitutes a default
under this Agreement, CONSULTANT, at the CONSULTANT'S option, may terminate this
Agreement if such default is not remedied by CITY within thirty (30) days after demand for such
payment is given by CONSULTANT to CITY.
D. Transition after Termination
Upon termination, CONSULTANT shall immediately stop work, unless cessation could
potentially cause any damage or harm to person or property, in which case CONSULTANT shall
cease such work as soon as it is safe to do so. CONSULTANT shall incur no further expenses in
connection with this Agreement. CONSULTANT shall promptly deliver to CITY all work done
toward completion of the services required hereunder, and shall act in such a manner as to
facilitate any the assumption of CONSULTANT's duties by any new consultant hired by the
CITY to complete such services.
ARTICLE 8. GENERAL PROVISIONS
A. Amendment & Modification
No amendments, modifications, alterations or changes to the terms of this Agreement shall be
effective unless and until made in a writing signed by both parties hereto.
B. Americans with Disabilities Act of 1990
Throughout the term of this Agreement, the CONSULTANT shall comply fully with all
applicable provisions of the Americans with Disabilities Act of 1990 ( "the Act ") in its current
form and as it may be amended from time to time. CONSULTANT shall also require such
compliance of all subcontractors performing work under this Agreement, subject to the
prohibition against assignment and subcontracting contained in Article 5 above. The
CONSULTANT shall defend with counsel acceptable to CITY, indemnify and hold harmless the
CITY OF GILROY, its officers, employees, agents and representatives from and against all suits,
claims, demands, damages, costs, causes of action, losses, liabilities, expenses and fees,
including without limitation reasonable attorneys' fees, that may arise out of any violations of
the Act by the CONSULTANT, its subcontractors, or the officers, employees, agents or
representatives of either.
C. Attorneys' Fees
If any action at law or in equity, including an action for declaratory relief, is brought to enforce
or interpret the provisions of this Agreement, the prevailing party will be entitled to reasonable
attorneys' fees, which may be set by the court in the same action or in a separate action brought
for that purpose, in addition to any other relief to which that parry may be entitled.
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D. Captions
The captions and headings of the various sections, paragraphs and subparagraphs of the
Agreement are for convenience only and shall not be considered nor referred to for resolving
questions of interpretation.
E. Compliance with Laws
The CONSULTANT shall keep itself informed of all State and National laws and all municipal
ordinances and regulations of the CITY which in any manner affect those engaged or employed
in the work, or the materials used in the work, or which in any way affect the conduct of the
work, and of all such orders and decrees of bodies or tribunals having any jurisdiction or
authority over the same. Without limiting the foregoing, CONSULTANT agrees to observe the
provisions of the Municipal Code of the CITY OF GILROY, obligating every contractor or
subcontractor under a contract or subcontract to the CITY OF GILROY for public works or for
goods or services to refrain from discriminatory employment or subcontracting practices on the
basis of the race, color, sex, religious creed, national origin, ancestry of any employee, applicant
for employment, or any potential subcontractor.
F. Conflict of Interest
CONSULTANT certifies that to the best of its knowledge, no CITY employee or office of any
public agency interested in this Agreement has any pecuniary interest in the business of
CONSULTANT and that no person associated with CONSULTANT has any interest that would
constitute a conflict of interest in any manner or degree as to the execution or performance of
this Agreement.
G. Entire Agreement
This Agreement supersedes any and all prior agreements, whether oral or written, between the
parties hereto with respect to the rendering of services by CONSULTANT for CITY and
contains all the covenants and agreements between the parties with respect to the rendering of
such services in any manner whatsoever. Each party to this Agreement acknowledges that no
representations, inducements, promises or agreements, orally or otherwise, have been made by
any party, or anyone acting on behalf of any party, which are not embodied herein, and that no
other agreement, statement or promise not contained in this Agreement shall be valid or binding.
No other agreements or conversation with any officer, agent or employee of CITY prior to
execution of this Agreement shall affect or modify any of the terms or obligations contained in
any documents comprising this Agreement. Such other agreements or conversations shall be
considered as unofficial information and in no way binding upon CITY.
H. Governing Law and Venue
This Agreement shall be governed by and construed in accordance with the laws of the State of
California without regard to the conflict of laws provisions of any jurisdiction. The exclusive
jurisdiction and venue with respect to any and all disputes arising hereunder shall be in state and
federal courts located in Santa Clara County, California.
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I. Notices
Any notice to be given hereunder by either party to the other may be effected either by personal
delivery in writing or by mail, registered or certified, postage prepaid with return receipt
requested. Mailed notices shall be addressed to the parties at the addresses appearing in
Exhibit "A ", Section V.H. but each party may change the address by written notice in
accordance with this paragraph. Notices delivered personally will be deemed delivered as of
actual receipt; mailed notices will be deemed delivered as of three (3) days after mailing.
J. Partial Invalidity
If any provision in this Agreement is held by a court of competent jurisdiction to be invalid, void
or unenforceable, the remaining provisions will nevertheless continue in full force without being
impaired or invalidated in any way.
K. Time of the Essence
All dates and times referred to in this Agreement are of the essence.
L. Waiver
CONSULTANT agrees that waiver by CITY of any one or more of the conditions of
performance under this Agreement shall not be construed as waiver(s) of any other condition of
performance under this Agreement.
Executed at Gilroy, California, on the date and year first above written.
CONSULTANT:
FILICE ENTERPRISES, INC.
By:,--/ )M // t7�1
Name: MICHELLE FILICE
Title: VICE PRESIDENT
Social Security or Taxpayer
Identification Number 20- 0804580
Approved as to Form
City Attorney
CITY:
GILROY
By-1 y ) /
Title: �+V�
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EXHIBIT "A"
SPECIFIC PROVISIONS
I. PROJECT MANAGER
CONSULTANT shall provide the services indicated on the attached Exhibit "B ", Scope of
Services ( "Services "). (All exhibits referenced are incorporated herein by reference.) To
accomplish that end, CONSULTANT agrees to assign_FILICE ENTERPRISES, INC., who will
act in the capacity of Project Manager, and who will personally direct such Services.
Except as may be specified elsewhere in this Agreement, CONSULTANT shall furnish all
technical and professional services including labor, material, equipment, transportation,
supervision and expertise to perform all operations necessary and required to complete the
Services in accordance with the terms of this Agreement.
II. NOTICE TO PROCEED /COMPLETION OF SERVICE
A. NOTICE TO PROCEED
CONSULTANT shall commence the Services upon delivery to CONSULTANT of a written
"Notice to Proceed ", which Notice to Proceed shall be in the form of a written communication
from designated City contact person(s). Notice to Proceed may be in the form of e -mail, fax or
letter authorizing commencement of the Services. For purposes of this Agreement, FILICE
ENTERPRISES, INC. shall be the designated City contact person(s). Notice to Proceed shall be
deemed to have been delivered upon actual receipt by CONSULTANT or if otherwise delivered
as provided in the Section V.H. ( "Notices ") of this Exhibit "A ".
B. COMPLETION OF SERVICES
When CITY determines that CONSULTANT has completed all of the Services in accordance
with the terms of this Agreement, CITY shall give CONSULTANT written Notice of Final
Acceptance, and CONSULTANT shall not incur any further costs hereunder. CONSULTANT
may request this determination of completion when, in its opinion, it has completed all of the
Services as required by the terms of this Agreement and, if so requested, CITY shall make this
determination within two (2) weeks of such request, or if CITY determines that CONSULTANT
has not completed all of such Services as required by this Agreement, CITY shall so inform
CONSULTANT within this two (2) week period.
III. PROGRESS SCHEDULE
The schedule for performance and completion of the Services will be as set forth in the attached
Exhibit "C ".
IV. PAYMENT OF FEES AND DIRECT EXPENSES
Payments shall be made to CONSULTANT as provided for in Article 4 of this Agreement.
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Direct expenses are charges and fees not included in Exhibit "B ". CITY shall be obligated to
pay only for those direct expenses which have been previously approved in writing by CITY.
CONSULTANT shall obtain written approval from CITY prior to incurring or billing of direct
expenses.
Copies of pertinent financial records, including invoices, will be included with the submission of
billing(s) for all direct expenses.
V. OTHER PROVISIONS
A. STANDARD OF WORKMANSHIP
CONSULTANT represents and warrants that it has the qualifications, skills and licenses
necessary to perform the Services, and its duties and obligations, expressed and implied,
contained herein, and CITY expressly relies upon CONSULTANT'S representations and
warranties regarding its skills, qualifications and licenses. CONSULTANT shall perform such
Services and duties in conformance to and consistent with the standards generally recognized as
being employed by professionals in the same discipline in the State of California.
Any plans, designs, specifications, estimates, calculations, reports and other documents furnished
under this Agreement shall be of a quality acceptable to CITY. The minimum criteria for
acceptance shall be a product of neat appearance, well - organized, technically and grammatically
correct, checked and having the maker and checker identified. The minimum standard of
appearance, organization and content of the drawings shall be that used by CITY for similar
purposes.
B. RESPONSIBILITY OF CONSULTANT
CONSULTANT shall be responsible for the professional quality, technical accuracy, and the
coordination of the Services furnished by it under this Agreement. CONSULTANT shall not be
responsible for the accuracy of any project or technical information provided by the CITY. The
CITY'S review, acceptance or payment for any of the Services shall not be construed to operate
as a waiver of any rights under this Agreement or of any cause of action arising out of the
performance of this Agreement, and CONSULTANT shall be and remain liable to CITY in
accordance with applicable law for all damages to CITY caused by CONSULTANT'S negligent
performance of any of the services furnished under this Agreement.
C. RIGHT OF CITY TO INSPECT RECORDS OF CONSULTANT
CITY, through its authorized employees, representatives or agents, shall have the right, at any
and all reasonable times, to audit the books and records (including, but not limited to, invoices,
vouchers, canceled checks, time cards, etc.) of CONSULTANT for the purpose of verifying any
and all charges made by CONSULTANT in connection with this Agreement. CONSULTANT
shall maintain for a minimum period of three (3) years (from the date of final payment to
CONSULTANT), or for any longer period required by law, sufficient books and records in
accordance with standard California accounting practices to establish the correctness of all
charges submitted to CITY by CONSULTANT, all of which shall be made available to CITY at
the CITY's offices within five (5) business days after CITY's request.
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D. CONFIDENTIALITY OF MATERIAL
All ideas, memoranda, specifications, plans, manufacturing procedures, data (including, but not
limited to, computer data and source code), drawings, descriptions, documents, discussions or
other information developed or received by or for CONSULTANT and all other written and oral
information developed or received by or for CONSULTANT and all other written and oral
information submitted to CONSULTANT in connection with the performance of this Agreement
shall be held confidential by CONSULTANT and shall not, without the prior written consent of
CITY, be used for any purposes other than the performance of the Services, nor be disclosed to
an entity not connected with the performance of the such Services. Nothing furnished to
CONSULTANT which is otherwise known to CONSULTANT or is or becomes generally
known to the related industry (other than that which becomes generally known as the result of
CONSULTANT'S disclosure thereof) shall be deemed confidential. CONSULTANT shall not
use CITY'S name or insignia, or distribute publicity pertaining to the services rendered under
this Agreement in any magazine, trade paper, newspaper or other medium without the express
written consent of CITY.
E. NO PLEDGING OF CITY'S CREDIT.
Under no circumstances shall CONSULTANT have the authority or power to pledge the credit
of CITY or incur any obligation in the name of CITY.
F. OWNERSHIP OF MATERIAL.
All material including, but not limited to, computer information, data and source code, sketches,
tracings, drawings, plans, diagrams, quantities, estimates, specifications, proposals, tests, maps,
calculations, photographs, reports and other material developed, collected, prepared (or caused to
be prepared) under this Agreement shall be the property of CITY, but CONSULTANT may
retain and use copies thereof subject to Section V.D of this Exhibit "A ".
CITY shall not be limited in any way in its use of said material at any time for any work,
whether or not associated with the City project for which the Services are performed. However,
CONSULTANT shall not be responsible for, and City shall indemnify CONSULTANT from,
damages resulting from the use of said material for work other than PROJECT, including, but
not limited to, the release of this material to third parties for work other than on PROJECT.
G. NO THIRD PARTY BENEFICIARY.
This Agreement shall not be construed or deemed to be an agreement for the benefit of any third
party or parties, and no third party or parties shall have any claim or right of action hereunder for
any cause whatsoever.
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H. NOTICES.
Notices are to be sent as follows:
CITY:
CONSULTANT:
City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
FILICE ENTERPRISES, INC.
1608 W. CAMPBELL AVENUE #344
CAMPBELL, CALIFORNIA 95008
I. FEDERAL FUNDING REQUIREMENTS.
❑ If the box to the left of this sentence is checked, this Agreement involves federal
funding and the requirements of this Section V.I. apply.
If the box to the left of this sentence is checked, this Agreement does not involve
federal funding and the requirements of this Section V.I. do not apply.
1. DBE Program
CONSULTANT shall comply with the requirements of Title 49, Part 26, Code of Federal
Regulations (49 CFR 26) and the City- adopted Disadvantaged Business Enterprise programs.
2. Cost Principles
Federal Acquisition Regulations in Title 48, CFR 31, shall be used to determine the allowable
cost for individual items.
3. Covenant against Contingent Fees
The CONSULTANT warrants that he /she has not employed or retained any company or person,
other than a bona fide employee working for the CONSULTANT, to solicit or secure this
Agreement, and that he /she has not paid or agreed to pay any company or person, other than a
bona fide employee, any fee, commission, percentage, brokerage fee, gift or any other
consideration, contingent upon or resulting from the award or formation of this Agreement. For
breach or violation of this warranty, the Local Agency shall have the right to annul this
Agreement without liability or, at its discretion, to deduct from the agreement price or
consideration, or otherwise recover, the full amount of such fee, commission, percentage,
brokerage fee, gift or contingent fee.
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EXHIBIT "B"
SCOPE OF SERVICES
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EXHIBIT "C"
MILESTONE SCHEDULE
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EXHIBIT "D"
PAYMENT SCHEDULE
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City of Gilroy
PUBLIC WORKS DEPARTMENT
7351 Rosanna Street, Gilroy, CA 95020
Engineering Division
Parks and Landscape Division
Streets, Sewer, Forestry Division
Water Division
(408) 846 -0450; fax (408) 846 -0429
(408) 846 -0283; fax (408) 846 -0306
(408) 846 -0281; fax (408) 846 -0306
(408) 846 -0271; fax (408) 846 -0288
DATE: Thursday May 15, 2014
TO: Vendors of Playground Engineered Wood Fiber Safety Product
FROM: Bill Headley
City of Gilroy Park Supervisor
SUBJECT: Seeking Quote for Installation of Park Playground Engineered Wood Fiber for
Various City Parks by Tuesday May 20, 2014
The City of Gilroy is seeking quotes by Tuesday May 20, 2014 for installation of park playground
wood safety fiber at various City parks at the earliest date possible. Installation and invoicing must be
completed by Friday, June 13th. The vendor must meet all listed proposal requirements. The City
may award all, part, or none of the playground wood fiber installation work.
PARK SITE
Miller Park
Sunrise Park
Forest Street Park
Large area
Small area
7851 Carmel Drive
9525 Saddler Drive
7325 Forest Street
Las Animas Veterans Park 400 Mantelli Drive
Los Arroyos Park
Large area
Small area
801 Moro Drive
San Ysidro Park 7700 Murray Ave.
Carriage Hills Park 1701 Crest Hill Way
Large area
Small area
Christmas Hill Park 4950 Miller Ave.
Grand Total
YARDAGE UNIT PRICE Ext. Price
(tax + Shipping)
50 $ 38.11 $ 1905.50
100
$ 38.11
$ 3811.00
30
$ 38.11
$ 1143.30
20
$ 38.11
$ 762.20
100
$ 38.11
$ 3811.00
100
$ 38.11
$ 3811.00
50
$ 38.11
$ 1905.50
50
$ 38.11
$ 1905.50
100
$ 38.11
$ 3811.00
50
$ 38.11
$ 1905.50
50
$ 38.11
$ 1905.50
650 $ 26,677.00 $ 26,677.00
Earliest Date for Estimated Completion: JUNE 13, 2014 Lab Reports Status: SEE ATTACHED
REQUIREMENTS / SPECIFICATIONS
• Submittal of quote DEADLINE is this Tuesday May 20, 2014 or sooner.
• Installation deadline for playground wood fiber is Friday June 13, 2014 or sooner. Enter your
estimated completion date on quote for all listed playgrounds.
• Billing invoice deadline by Friday 13, 2014, or sooner
•
All playground engineered wood fiber must meet ASTM Standards F1292 Impact Attenuation
and F1951 ADA accessibility requirements.
• Wood fiber shall be 100% wood fiber, free of chemicals or additives and void of bark, leaves,
dirt twigs, or other foreign matter. All fiber is produced from new wood. The final product shall
exceed the recommendations of the U.S. Consumer Product Safety Commissions Technical
guidelines for playground surfacing
• Provide wood fiber laboratory testing reports with proposal regarding proof that wood fiber
meets and exceeds ASTM standards.
• Vendor /contractor shall provide for all necessary on -site delivery vehicle and pedestrian safety
measures including barricades, signage, and flagman to insure safety of park users, motorists,
and pedestrians.
• Vendor /contractor shall possess a Gilroy business license at time on -site park work is
performed (semi - annual $121.00 If 408 846 -0420)
• Successful Vendor /contractor shall provide the City with Contractors License # and Taxpayer
ID or Social Security #
• Successful Vendor /contractor shall provide the City with a 1 million dollar certificate of
insurance naming the City as additionally insured with the required endorsement. See
attached sample document.
• Vendor /contractor shall provide 2 signed copies of the City's standard contract. See attached
sample contract. (it may be sent in as two faxes or emails)
• Digital copy of all proposal documents can be provide upon request if you provide email
address (City contract and insurance)
• UPDATED ADDITIONAL SERVICES PROVISION 6/2/2014:
Filice Enterprises, Inc. agrees to provide additional services during the agreement period
based on the original unit quote /bid price. Filice Enterprises, Inc. will be allowed to pass on
increased direct product cost based on a written quote for additional services with the supplier
documentation of product increase.
Thank you,
VENDOR SUBMITTAL NAME & SIGNATURE
Bill Headley MICE ENTERPRISES, INC.
Parks & Landscape Supervisor Printed Vendor Name
City of Gilroy
7351 Rosanna Street UICULII rFILICE yirc pa��m�►urin�yNER
Gilroy, CA 95020 Print Signature Name Title
(408) 846 -0283 Office `
(408) 710 -5876 Cell l MAY 20, 2014
(408) 846 -0306 Fax Signature Date
mailto : bill. head ley(cDci.gilrov.ca.us
® TESTING SERVICES, INC.
817 SHOWALTER AVE. • P.O. BOX 2041
DALTON, GEORGIA 30722 -2041
PHONE: (706) 226 -1400 • FAX: (706) 226.6118 TEST REPORT
CLIENT:
The Fiber Group LLC
REPORT NUMBER:
59162.02
80 Business Park Drive, Suite 300
LAB TEST NUMBER:
2563 -7601
Armonk, NY 10504
DATE:
October 11, 2013
TEST MATERIAL:
Death
INTRODUCTION: Testing Services Inc was instructed by the client, to perform ADA wheelchair accessibility
for the above Engineered Wood Fiber being used under and around playground equipment.
TEST METHOD: ASTM F1951 -09: Standard Specification for Determination of Accessibility of
Surface Systems Under and Around Playground Equipment
REQUIREMENT: A surface in place shall have average work per foot (work per meter) values for
straight propulsion and for turning less than the average work per foot (work per meter)
values for straight propulsion and for turning, respectively, on a hard, smooth, surface
with a grade of 1:14 (7.1 %).
PROCEDURE: Test Surface Preparation: Tests were conducted on 10/8113 indoors at TSi Laboratories in an
environment of 74 °F and 50 % R.H. The engineered wood fiber was installed in a wooden box
(4411W x 1171). The material was installed in increments of 2" and compacted using a water -
filled lawn roller until it reached a compacted depth of 12.011,
Wheelchair /Operator: The wheelchair used in these tests was manufactured by Invcare,
Model Action Xtra, serial Number 98,184142. This wheelchair is totally adjustable, a
necessity for these tests. The pneumatic tires were inflated to 60 psi on the rear and 32
psi on the front. The weight of the wheelchair was 24.25 pounds and the operator's
weight was 165 pounds for a total of 189 pounds.. The operator's distribution was
adjusted to 60% on the rear wheels and 40 % on the front.
Torque Measuring System: A certified Dillion Electronic Force Gauge, Model. BFG .
500N, S/N 98- 2277 -07 was used as an interface between a Dell Laptop and a certified
Dillon Smart Torque Wrench, S/N 97- 0085 -01. Software, also from Dillon, logged the
load vs. time and integrated the area under the resulting curves. The adapters and
accessories needed to attach the instrumentation were fabricated locally. This total
package added 10 pounds to the total weight bringing the total to 199 pounds.
TEST RESULTS:
--
Baseline Straight
(Avers a Work/ft.Force)
Engineered Wood Fiberr at compacted depth of 12.07'-----,., .
- (Average Work/ft ForC6) ,
14.26 lbs
11.31 Ibs
13asebne Turning _
(Average a Wofklft Force)
Engmeered Wood Fiber: at compacted depth of 12.0
(Avers e= Workift= Force)
10,04 Ibs
7.98 Ibs
CONCLUSION: The above Engineered Wood Fiber meetslexceeds both the straight line and turning propulsion
requirements set forth in this test method and therefore, passes the standard.
Approved By: ft m4deW s,JNV A0 Tol.VF
'�'I]�/!/�' O,5 p,=Erle Mlles.Jl.VP, e- hfllnq
C�'�Z +6� %�iI/T%i- mMtei ln[.o4
/f/ A- IYOfllceswlnANea,ula4
o-U5
Da1r 3017.10.1414]E31 -04'00'
Erle Miles, Jr VP
Testing Services Inc
OUR LETTERS AND REPORTS APPLY ONLY TO THE SAMPLE TESTED AND ARE NOT NECESSARILY INDICATIVE OF THE QUALITIES OF APPARENTLY IDENTICAL
OR SIMILAR PRODUCTS, THESE LETTERS AND REPORTS ARE FOR THE USE ONLY OF THE CLIENT TO WHOM THEY ARE ADDRESSED AND THEIR
COMMUNICATION TO ANY OTHERS OR THE USE OF THE NAME TESTING SERVICES, Inc. MUST RECEIVE OUR PRIOR WRITTEN APPROVAL. THE REPORTS AND
LETTERS, AND OUR NAME, OUR SEALS, OR OUR INSIGNIA ARE NOT UNDER ANY CIRCUMSTANCES TO BE USED IN ADVERTISING TO THE GENERAL PUBLIC.
VISIT OUR WEBSITE AT www.tsiofdaiton.com
TESTING SERVICES, INC.
817 SHOWALTER AVE. • P.O. BOX 2041
DALTON, GEORGIA 30722 -2041
PHONE: (706) 226 -1400 • FAX: (706) 226 -6118 TEST REPORT
CLIENT:
TFG Installations, Inc.
REPORT NUMBER:
59162 -03
12.0" Compacted
80 Business Park Drive, Suite 300
LABTEST NUMBER:
2563 -7601
REQUIREMENT:
Armonk, NY 10504
DATE:
October 11, 2013
TEST MATERIAL:
:;'Material Identification: =:
:..:: -:: :: Ae th ;!:
14.26 Ibs
GreenSoft® Engineered Wood Fiber (Supplier 03
12.0" Compacted
ASTM F1951 -09: Standard Specification for Determination of Accessibility of
INTRODUCTION:
Testing Services Inc was instructed by the client, to perform ADA wheelchair accessibility
14.26 Ibs
for the above Engineered Wood Fiber being used under and around playground equipment.
TEST METHOD:
ASTM F1951 -09: Standard Specification for Determination of Accessibility of
Surface Systems Under and Around Playground Equipment
REQUIREMENT:
A surface in place shall have average work per foot (work per meter) values for
straight propulsion and for turning less than the average work per foot (work per meter)
values for straight propulsion and for turning, respectively, on a hard, smooth, surface
with a grade of 1:14 (7.1
PROCEDURE:
Test Surface Preparation: Tests were conducted on 10/8113 indoors at TSi Laboratories in an
environment of 747 and 50% R.H. The engineered wood fiber was installed in a wooden box
(44 "W x 1171). The material was installed in increments of 2" and compacted using a water -
filled lawn roller until it reached a compacted depth of 12.0 ".
Wheelchair /Operator: The wheelchair used in these tests was manufactured by lnvcare,
Model Action Xtra, serial Number 98,184142. This wheelchair is totally adjustable, a
necessity for these tests. The pneumatic fires were inflated to 60 psi on the rear and 32
psi on the front. The weight of the wheelchair was 24.25 pounds and the operator's
weight was165 pounds for a total of 189 pounds. The operator's distribution was
adjusted to 60% on the rear wheels and 40 % on the front.
Torque Measuring System: A certified Dilllon Electronic Force Gauge, Model BFG
500N, S/N 98- 2277 -07 was used as an interface between a Dell Laptop and a certified
Dillon Smart Torque Wrench, S/N 97- 0085 -01. Software, also from Dillon, logged the
load vs. time and integrated the area under the resulting curves. The adapters and
accessories needed to attach the instrumentation were fabricated locally. This total
package added 10 pounds to the total weight bringing the total to 199 pounds.
TEST RESULTS:
Baseline Strai ht . , : ;
9
Worko e
` �En Ineered Wood Fiber _at com acted de th of 12 0'
9 P. o
(Aver(Average a orklft Force) _
14.26 Ibs
11.31 Ibs
Baseline Turning
(Avers `e Work/ft- Force) =
Engineered Wood Fiber compacted de th of 12.0'
p
(Avers a Wtirk/ft- Force)
10.04 Ibs
7.98 Ibs
CONCLUSION: The above Engineered Wood Fiber meets /exceeds both the straight line and turning propulsion
requirements set forth in this test method and therefore, passes the standard.
Approved By: D100a0 „Igntd by Ede Mht N.VP
DMm.FAe MIIa+. N. VP,o-Tntliy
6e"MCes M4 w,
P•tdoDkepwlndsNeamnet.
o-u6
Dale 2013.10.14140:46 04'W
Erle Miles, Jr VP
Testing Services Inc
OUR LETTERS AND REPORTS APPLY ONLY TO THE SAMPLE TESTED AND ARE NOT NECESSARILY INDICATIVE OF THE QUALITIES OF APPARENTLY IDENTICAL
OR SIMILAR PRODUCTS, THESE LETTERS AND REPORTS ARE FOR THE USE ONLY OF THE CLIENT TO WHOM THEY ARE ADDRESSED AND THEIR
COMMUNICATION TO ANY OTHERS OR THE USE OF THE NAME TESTING SERVICES, Inc, MUST RECEIVE OUR PRIOR WRITTEN APPROVAL. THE REPORTS AND
LETTERS, AND OUR NAME, OUR SEALS, OR OUR INSIGNIA ARE NOT UNDER ANY CIRCUMSTANCES TO BE USED IN ADVERTISING TO THE GENERAL - PUBLIC.
VISIT OUR WEBSITE AT www.tslofdalton.com
Client: Tho Fibar Group LLC
Manufacturer: The Fibar Group LLC
TUV Report No.
Test Date:
411 31 17 2 9 -3
1!7/2014
Specified
Reference Temperature ,-6°C,(21.2°F)
Ref erenaQ Tempera lure23 °C,(73.4
°F)
Reference 7cmperiahim4.9 °C,(120,2°F)
Drop
Impact Height
(Ft.)
G -Mae .
HIC
Ve slty
( )
Theoretical
Drop Height
(f•)
G -Max
HIC
voNs
( )
Theoretical
Drop Height
(ft.)
G-Max
HIC
Vcloci
(Ns)0
Theoretical
Drop Height
(ft.)
1
12
80
$55
27.7
11.928
66
274
27.7
11.928
64
272
27.8
12.014
2
12
o0
432
27,8
12,014
,64
267
27.8
12.014
94
664
27.9
92101 '
3
12
104
683
27.9
12.101
423
27.9
'12.101
191
656_
28.1
12.276
Average
97
..497:6
Mac Change from reference +5 °C,
(5'r)
74
346
102.5
680
Measumd Surface Temperiduic
-6 °C
21.6 °C
Max. Change from reference± 3 °C,
(5 °F)
49'C
Mae. Change from reference
411.. (-S °F)
Sample Condition:
DRY
DRY
DRY
Diop
One foot over
R't•)
Rcfcrcncc Tempcature -6 °C, (21.2 °F)
Reference Ternperature23 °C, (73:4 °F)
Retcrencc Temperature 49°C, (1.20,27)
G -Mae
HIC
Velocity
(Ns)
Theoretical
Droplleighl
(R•)
G -Max
HTC
Velocity
(Ns)
Theoretical
Drop Height
(ft.)
G-Mae
HIC
Velocity
y
(IVs)
Tlicorclieal
llropAeiglit
ft...
1
0.000
0.000
0.000
2
0.000
0.000
0.000
3
0.000
0.000 .
0.606
Average
0
0
Max. Chap a from reference +S °C,
(5�F)
0
0
Mae. Change 0oin reference 3-C.
(5 °�
0
0
Measured Surface Temperature
°C
°C
° C
Mai. Change from reference
-3 °C. (-5 °F) -
Sample Condition:
Drop
One foot undor
il'l•)
Reference Temperature -6 °C, (21.2 °F)
Rcfcrcnco Temperature 23 °C, (73A °F)
Refi•rence Temperature 49 °C, (120.2 °i7)
G -Max
HIC
Velocity
(Ns)
Theoretical
Drop Height
(ft)
G -Mae
HIC
Velocity
(4/s)
Theoretical
llrop Ilelghl
(ft.
G•Mae
H[C
Velocity
(file)
Theoretical
Drop Height
(ft,
1
0.000
0.000
0.000
2
0.000
0.000
0.000
3
0.000
.0.000
0,060
Average
0
0
0
0
e
0•
0
Measured Surface Temperature
°C
Max. Change froi» Yeference +'5°C,
rom r
° C
Mac Clwitge from refereiee ± 3 °C,
(5 °F)
° C
Mae. Change from reference
-3 °C, (-S °F)
Sample Condition:
UDx.
A ern
Revision 6 12/6/2013 Page 2 of 2
Sieve Analysis
1
ASTM F2075 -10a Section 4.4 per 7A
A
SIID
Amerfda
ticipant The Fiber Group, LLC
xti0n: Mill.
duct Brand Name: Fiber EWF
Initial Sample Pry Weight (g)= 605.8
remaining 0.0 g + Initial sample weight (g)= 605.8 x 100 = 0.0 % not passing ° sieve
100 % - 0.0. %.not passing' /." Slave = 100.0 % Passing Sieve
maining 16.1 g + Initial sample weight (g)= 605.8 x100,= 2.7 % rat passing 3/8' sieve
100 % - 2.7. % not passing 3/8° Sieve + 0.0 % not passing'/.' Sieve 97.3 � % Passing Sieve
Job# 611311729 -2
Test Performed By. li /�/�'L {1 Date: /Zo/1-
Reviewed By. Date:
The results reported herein reflect the performance of the above described samples at the,time of testing and at the temperature(s) reported. The.results are
specific to the described samples. Samples of surfacing materials that do not closely match the described samples will perform differently. The following data
sheet provides an accurate representation of the test results.
Ce-'ication Form- ASTM F2075 -10a Sieve Only • Revision'"- 5/22/2012
Material. remaining
585.7
g + initial sample weight (g)=
605.8
x100= 96.7 %=pawing a16.sleve
100.0
100%-
96.7
% not pawing #16 Sieve+
' 0.0
+:/, not passing 3/.' Sieve + 2.7 + % hot passing 31W Sieve = 0.7 %,Passing sieve
Test Performed By. li /�/�'L {1 Date: /Zo/1-
Reviewed By. Date:
The results reported herein reflect the performance of the above described samples at the,time of testing and at the temperature(s) reported. The.results are
specific to the described samples. Samples of surfacing materials that do not closely match the described samples will perform differently. The following data
sheet provides an accurate representation of the test results.
Ce-'ication Form- ASTM F2075 -10a Sieve Only • Revision'"- 5/22/2012
Sieve Size Min / Max Requirements % Loss by Sieve
(Percent Passing)
Sample in compliance with.ASTM F2075 -10 for Sieve
Analysis Section 4.4 per 7.4
Yes No
3/4" (19.05 mm)
99-100%
100.0
3I8" (9.53 mm)
75-100%
97.3
No.16 (0.0469in.)
0-15%
0.7
Test Performed By. li /�/�'L {1 Date: /Zo/1-
Reviewed By. Date:
The results reported herein reflect the performance of the above described samples at the,time of testing and at the temperature(s) reported. The.results are
specific to the described samples. Samples of surfacing materials that do not closely match the described samples will perform differently. The following data
sheet provides an accurate representation of the test results.
Ce-'ication Form- ASTM F2075 -10a Sieve Only • Revision'"- 5/22/2012
TOV America Inc. Phone: (734) 455 -4841 i
47523 Clipper St. Fax 734 455 -6590 TLN
PP ( ) .. 800
Plymouth, MI 48170 E.-Mall: Info @tuvam.com
ww,TUVamerlca.com
Amei(ca
ASTM F2076 -10a, Section 4.5.2 per 8.0 Hazardous Metals Test,
Manufacturer The Fibar Group, LLC
Address 80 Business Park Dr., Armonk, NY 10504
Manufacturing Location
Product Brand Name Engineered Wood Fiber
PURCHASE ORDER: # 2000007661
The following ISO 17025 - accredited Laboratory, performed testing:
St. Louis Testing Laboratories, Incorporated
2810 Clark Avenue
St, Louis, MO 63103
St. Louis Testing Laboratory report attached (1 page).
Test Result:
Prepared By:
Pass X
Timothy Fqjfchla, Project Coordinator
Reviewed and Approved By:
ne, Certificailon Proor
Revised 02/13/2013
ager
Fail
its h -/ --
Date
i to
TOV JOB# 0113'11729 -4
4� SCANNED
FILIC•2 OP ID: MP
CERTIFICATE OF LIABILITY INSURANCE DATB(N4MONYYY'
05/2012014
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 AL'. ER 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 CERTIF'CATE HOLDER.
IMPORTANT: If the Cert'rficate holder is an ADOrTiONAL INSURED. the p00cy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require ar endorsement A statement on this conffk:ate does not confer rights to the
certificate holder In lieu of such andorsamantlxl.
PRCOUCER NTACT
Sagaclous Insurance Services. IIANE_Mlaura L Perkins
LLC ^I NE 888-
SCO S. Broadway #1C1 N -� 6 654 -8854
Walnut Creek, CA 94596 mperkins@sagaclo
i Maura L. Perkins wsuREatS) Aid¢
I4 _ IHSUAZRA unt Vernon Fire
INSURED Filiee Enterprises. Inc. -- Mo —
MikeFilice IINSuaega _
1704 Palo Santo Drive I INSURERc
Campbell, CA 95008 1 aNr,ePa n
rnvcaerxee -
THIS IS TO CERTIFY THAT THE POUCHES OF INSURANCE LIST® BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABCNE FOR THE POLICY PERlO
INDICATED.
NOT'NITHS-ANCING ANY REQUIREMENT, TERM OR COND T ON OF ANY CONTRACT OR OTHER DOCLNiEN7 WrTH RESPECT TO THIS
WHICH
CERTIFICATE MAY BE ISSUED OR MAY PERTA4\. THE INSURANCE AF:OROEC By THE POLICIES DESCRI9EC HEREIN IS SUBJECT TO A.L THE TERMS.
EXCLUSIONS
AND CONDITIONS OF SUCH POUG =S. LIMITS SHOWN MAY iHAVE BEEN REOUCED BY PAID CLAIMS.
--
TTM QNWftANCE R� — —� -
NL'NBER
/YYt'Y5 UNITS
X I Comkmmctu4w4pt4LLLWWTY
�" DC IN LE 1,000,00
T�
CLAMS—MADE OCCUR X 2660025 aF
. 0511214 OM* e • 100,00
IEDEOP (Apeaft a s,00
i
PERSONAL a AOV SLBRIr Excludeca
obit AGGREGATEVURNT APPLIES PER
GM4ERALAGGRErATE $ 2,006,00
X PO1.C'Y C EI LOC
NROOUCTS•DDAPR7PA00 B Exctu
OTHER:
� '
AUrOMOEMl
LIABILITY
nT
B
ANT AUTO
„1.�,�,
eoDxY nuuRV (PrPeism)
S
MOON +LURY (PS s-WN li
a
A�I°
II WIfL
'
mmmAUrce
_
IiRLA I" I
OCCUR
dCaSaL W CNiVfa -M,VE
EACH OCCLOUtENCE
i
' AGGIEt3ATa
i
VA)W U CONPaNBATK*
AM EIMLOyaw LIAOWTr V/N
AN" �4uP _.SE4 MCLL RrEXGCIJrryE
OF= :CERA!EYBE4 !%CLL'DEO? ��NIA El. EACH ACCIDENT
(rrd�YUI N1Il
B
e leETb!NMIR! j EL DISEASE -EA SAM O.
SCRIP7101. C'OPEM Steal EL. MSEASC- POLICV'_MaT
SON OF OPERATIONS I LOCATIONS t VEHICLES (ACORD 101, AOWbui R._k. Sd, Wc. m.y b• —t ml A mwa
+Pwro 4 rupwrorry
ty of Gilroy, its Off.cara, officials and employees as naaed Additional
'ZtNared
per form CG2026 attached.
i
CERTI°ICATE Hni OFR
GILROYC
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISCNS.
Gilroy. CA 95020
AUTHORIZEDD REPRESENTATIVE
(C 1986-2014 ACORD CORPORATION. All rights reserved.
ACCRA 25 (2014101) The ACORD name and logo are registered marks of ACORD
• t
POLICY NU
THIS
This
Name of
CL 2660025 COMMERCIAL. GENERAL UABUJW
ORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
'ZONAL INSURED - DESIGNATED PERSON OR
ORGANIZATION
modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART.
SCHEDULE
or Organization:
City of Gilroy, its officers, officials and employees
(If no entry appears above, Information required to Complete this endorsement will be shown in the Deciarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section li) is amended to Include as an Insured the person or organization shown In the
Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or
rented to you.:
1
'CG 20 2611 B
Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 ❑