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CXT - 2016 Agreement - Change Order No. 1Cftp of Ofirop Public Works Department - Engineering Division 7351 Rosanna St., Gilroy, CA 95020 Phone (408) 846 -0451; Fax (408) 846 -0429 CONTINGENCY CHANGE ORDER NO. 1 To contract for: Miller Park Restroom Replacement City Project No. Contractor: CXT Concrete Buildings Contract Date: PO No. 160722 3/15/2016 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 The additional work includes increasing the width of the concrete sidewalk around the building from 5 ft to 15 ft for better access, adding anti - grafitti coating to the walls, adding vandal resistant door louver vents, switching to vandal resistant flush mounted hand dryers, adding automatic door locks with emergency notification feature, and adding a mop sink with faucet for ease of maintenance. 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. Change in working time granted by this change order: ► 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. 1. * Working Days Contingency Amount Original Purchase Order Previous Change Orders Total to Date This Change Order Total Change Orders to Date Revised Contract Price Cost Percentage $22,900.00 151.4% used $161,326.08 $0.00 N/A $161,326.08 $34,661.65 $34,661.65 21.49% of bid $195,9 &7.73 I (We) agree to make the above change subject to the * No specific number of additional working days are granted with terms of this Change Order for a NET INCREASE not to this change order. However, working days are difficult to define exceed $34,661.65. in this contract because it involves manufacture or the building, permitting, as well as construction. Instead, the work is to be t" X7- ✓/��AT! substantially complete by June 24, 2016. :L�_ >/ .. RECOMMENDED BY: ACCEPTED 1► ✓�r' PIP, P-111,2 vi City Administrator Client #: 15056 LBFOST ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 2/23/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER HDH Pittsburgh P&C 210 Sixth Avenue, 30th Floor CONTACT Frank Pampeno PHONE 412 - 992 -2874 412 - 391 -7322 A/C, No, Ext : A/C, No E -MAIL ADDRESS: P P am frank. eno hubinternational.com Pittsburgh, PA 15222 412 391 -7300 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance C 23035 INSURED CXT, Inc. 415 Holiday Drive Pittsburgh, PA 15220 INSURER B: $ INSURER C COMMERCIAL GENERAL LIABILITY INSURER D INSURER E INSURER F: -EACH PREMISETO a occurrence $ 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 CONTRACTOR 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MWDO LIMITS GENERAL LIABILITY OCCURRENCE $ COMMERCIAL GENERAL LIABILITY -EACH PREMISETO a occurrence $ CLAIMS -MADE D OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ $ POLICY PROT- LOC A AUTOMOBILE LIABILITY AS264 MBINED INGLELIMIT aocid.nlS 1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS IX PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below A Property - Incl. YU21-41-443762026 0110112016 01/01/2017 $247,612,129 Blanket Personal Property Limit of Others $25,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ** Supplemental Name *' CXT Inc. L.B. Foster Rail Technologies, Inc. City of Gilroy, its officers, officials, and employees are named as additional insured. A waiver of subrogation applies. Coverage is primary and non- contributory. Re: Service Agreement: Miller Restroom Replacement City of Gilroy, its officers, THE ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN officials, and employees ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna Street Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S651594/M644003 FPO A` 40RO a CERTIFICATE OF LIABILITY INSURANCE DATE (MM1DD/YYYY) 05!04/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA Inc. Six PPG Place, Suite 300 CONTACT NAME: PHONE FAX No): No_ E -MAIL ADDRESS: Pittsburgh, PA 15222 Attn: pittsburgh.certrequest @marsh.com COMMERCIAL GENERAL LIABILITY INSURERS AFFORDING COVERAGE NAIC # INSURER A: Evanston Insurance Company 35378 051823-- E &C -16 -17 L.B. INSURED L.B. Foster Company and Subsidiaries INSURER B : CXT Incorporated, L. B. Foster Rail Technologies, Inc., INSURER C: INSURER D: $ Salient Systems, Inc., L. B. Foster Ball Winch, Inc. Attn: Christopher T. Kijowski MED EXP (Any one person) $ 415 Holiday Drive INSURER E: INSURER F: Pittsburgh, PA 15220 COVERAGES CERTIFICATE NUMBER: CLE -005056600 -02 REVISION NUMBER:10 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MWDDIYYYY POLICY EXP MM /DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE F7 OCCUR DAMAGE TO PREMISES Ea occuErrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEM- AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PRO- F LOC PRODUCTS - COMP /OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LUIB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAR DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liability - E &O MAX7PL0002229 05101/2016 05101/2017 Per Claim Limit 1,000,000 Aggregate Limit 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Service Agreement Miller Restroom Replacement Evidence of Insurance. Deductible for the Professional Liability policy is $1,000,000. GtK I II-IGA I t HULUtK City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee JA-CL%A.040�+ a�<t @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AC40p0® .lv AA CERTIFICATE OF LIABILITY INSURANCE DATE ( /2016 YYYY) 02/12/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA Inc. Six PPG Place, Suite 400 Pittsburgh, PA 15222 Pittsburgh.certrequest @marsh.com CONTACT NAME: PHONE FAX A/c No): E -MAIL ADDRESS: INSURER (S) AFFORDING COVERAGE NAIC q INSURER A: Liberty Surplus Insurance Corporation 10725 051823-- Cas -16 -17 L.B. INSURED L.B. Foster Company and Subsidiaries CXT Incorporated, L. B. Foster Rail Technologies, Inc., INSURER B: American Guarantee & Liability Ins Co 26247 INSURER C: Sentry Casualty Company 28460 INSURER D; Salient Systems, Inc., L. B. Foster Ball Winch, Inc. Attn: Christopher T. Kijowski - 415 Holiday Drive INSURER E : INA-MAGETO RENTED PREMISES Ea occur enc.) INSURER F: Pittsburgh, PA 15220 COVERAGES CERTIFICATE NUMBER- CLE- 005056606.01 REVISION NUMBER:5 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY MMI DYIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLHV318842 -4 01/01 12016 01/01/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR - INA-MAGETO RENTED PREMISES Ea occur enc.) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY a PRO- JECT F7 LOC PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY AGGREGATE $ 10,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE (Per accident) $ NON -OWNED HIRED AUTOS AUTOS B X UMBRELLA LIAB X OCCUR AUC- 9378203 -12 01/01/2016 01/01/2017 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 90- 14714 -01 (ADS) 90- 14714 -02 (MA, OR, WI) Incl. Stop Gap Employers Liability 01/01/2016 01/0112016 01/0112017 01/01/2017 X STATUTE ERA E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If es, describe under DESCRIPTION OF OPERATIONS below for OH, ND, WA, WY &Canadian Prov. E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Service Agreement Miller Resttoom Replacement City of Gilroy, its officers, officials and employees is /are included as an Additional Insured under the General Liability where required by written contract. This insurance is primary and non - contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract. CERTIFICATE HOLDER CANCELLATION City of Gilroy, its officers, officials SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 Rosanna Street ACCORDANCE WITH THE POLICY PROVISIONS. Gilroy, CA 95020 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi MukherjeeAU�►.: @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Liberty Surplus Insurance Railroad General Liability Cor�x>rat'° LIBERTY SURPLUS INSURANCE CORPORATION (A New Fiamp6hlce Stock Insurance Company, hecetnaftec the "Company D ENDORSEMENT NO. 38 Effective Date: 2/8/2016 Policy Number: GLHV-1188424 Issued To: L. B. Foster Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION SCHEDULE Name of Person or Organization: City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 WHO IS AN INSURED (Section II) 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. This endorsement does not change any other provision of the policy. MI-1 I CGL 1001 0103