Intermountain Slurry Seal - 2016 AgreementSECTION 00500
AGREEMENT
PAVEMENT IMPROVEMENT PROJECT
PROJECT No. 17 -PW -237
THIS AGREEMENT, made this 18th day. of November ,
2016, by and between the City of Gilroy, hereinafter called the "City," and Intermountain
Slurry Seal, Inc. hereinafter called the "Contractor."
WITNESSETH:
WHEREAS, the City has caused the Contract Documents to be prepared
comprised of bidding and contract requirements and technical specifications and
drawings for the construction of the PAVEMENT IMPROVEMENT PROJECT, 17 -PW-
237, as described therein, and
WHEREAS, the Contractor has offered to perform the proposed work in
accordance with the terms of the Contract Documents.
NOW, THEREFORE, in consideration of the mutual covenants and
agreements of the parties herein contained and to be performed, the City and
Contractor agree as follows:
Article 1. Work.
Contractor shall complete the Work as specified or indicated in the Contract
Documents.
Article 2. Contract Time.
The Work shall be completed by the Contractor in accordance with the Contract
Documents within the time period required by Paragraph 00810 -2.0, Time Allowed for
Completion, subject to extension as expressly provided in the Contract Documents.
Pavement Improvement Project 17 -PW -237 28
AUTHORIZATION OF APPROVED ATTESTORS
RESOLVED, that the below listed officers are authorized to attest documents, agreements and
undertakings required in connection with construction contract formation and operations of the Company.
Jason T. Klaumann President
Kathleen Schreckengost Vice President, Treasurer & Assistant Secretary
Darren S. Beevor Vice President, Controller & Secretary
Gary R. Price Vice President & Assistant Secretary
Ryan W. Brady Assistant Secretary
RESOLVED FURTHER, that the below listed individuals of Granite Construction Incorporated,
parent of the Company, are authorized to attest documents, agreements and undertakings required in
connection with construction contract formation and operations of the Company:
James H. Roberts
President & Chief Executive Officer
Christopher S. Miller
Executive Vice President, Chief Operating Officer & Assistant Secretary
Laurel J. Krzeminski
Senior Vice President, Chief Financial Officer & Assistant Secretary
Philip M. DeCocco
Senior Vice President of Human Resources & Assistant Secretary
Michael F. Donnino
Senior Vice President, Group Manager & Assistant Secretary
Patrick B. Kenny
Senior Vice President, Group Manager & Assistant Secretary
Martin P. Matheson
Senior Vice President, Group Manager & Assistant Secretary
James D. Richards
Senior Vice President, Group Manager & Assistant Secretary
Richard A. Watts
Senior Vice President, General Counsel, Corporate Compliance Officer & Secretary
Jigisha Desai
Vice President of Corporate Finance, Treasurer, Assistant Financial Officer &
. Assistant Secretary
Bradley G. Graham
Vice President, Controller, Assistant Financial Officer & Assistant Secretary
Nicholas B. Blackburn
Director of Corporate Taxation & Assistant Secretary
Kenneth M. Smith
Group Counsel & Assistant Secretary
Jason M. Jasper
Group Counsel & Assistant Secretary
Heather J. Lenhardt
Group Counsel & Assistant Secretary
'1
Dated: June 28, 2016
Kathleen Schreckengost
4
� * ' LNG `' .•'i��
O.N t.ti
Page 2 of 2
L- SHARED.000,M.L CORP C.,I—W\09d0027 Cetifi.t of s aary,AC i--c rdBwtee- UWCs\ce ft iss 12.14.Fhwl.dtx
Article 3. Liquidated Damages.
The city and the contractor recognize that the city will suffer substantial damages
and significant financial loss as a result of the contractor's delays in performance
of the work described in the contract documents. The city and the contractor
hereby acknowledge and agree that the damages and financial loss sustained as
a result of any such delays in performance will be extremely difficult and
impractical to ascertain. Therefore, the city and contractor hereby agree that in
the event of such delays in performance, the city shall be entitled to
compensation by way of liquidated damages (and not penalty) for the detriment
resulting therefrom in accordance with paragraph 00700 -6.5, liquidated damages,
of the contract documents. The city and the contractor further agree that the
amounts designated as liquidated damages are a reasonable estimate of the
city's damages and financial loss in the event of any such delays in performance
considering all of the circumstances existing as of the date of this agreement,
including the relationship of such amounts to the range of harm to the city which
reasonably could be anticipated as of the date of this agreement and the
expectation that proof of actual damages would be extremely difficult and
impractical.
By initialing this paragraph below, the parties hereto signify their approval and
consent to the terms of this article 3.
City's Initia
Contractors Initials
Article 4. Contract Price.
In consideration of the Contractors performance of the Work in accordance with the
Contract Documents, the City shall pay the Contract Price set forth in the Contract
Documents.
Article 5. Contract Documents.
The Contract Documents which comprise the entire agreement between City and
Contractor concerning the Work consist of this Agreement (Section 00500 of the
Contract Documents) and the following, all of which are hereby incorporated into this
Agreement by reference with the same force and effect as if set forth in full.
Invitation to Bid
Instructions to Bidders
Pavement Improvement Project 17 -PW -237 29
Bid Documents
Designation of Subcontractors
Bid Guaranty Bond
Agreement
Acknowledgements
Performance Bond
Payment Bond
General Conditions
Supplementary Conditions
General Requirements
Standard Specifications (Caltrans, 2010 edition)
Technical Specifications
Drawings
Addenda, if any
Executed Change Orders, if any
Maintenance Bond
Notice of Award
Notice to Proceed
Article 6. Miscellaneous.
Capitalized terms used in this Agreement which are defined in Section 01090,
References, of the Contract Documents will have the meanings set forth in Section
01090, References.
Contractor shall not assign any rights, obligations, duties or responsibilities under or
interest in the Contract Documents without the prior written consent of the City, which
consent may be withheld by the City in its sole discretion. No assignment by the
Contractor of any rights, obligations, duties or responsibilities under or interests in the
Contract Documents will be binding on the City without the prior written consent of the
City (which consent may be withheld in City's sole discretion); and specifically but
without limitation monies that may become due and monies that are due may not be
assigned without such consent (except to the extent that the effect of this restriction
may be limited by law), and unless specifically stated to the contrary in any written
consent to an assignment, executed by the City, no assignment will release or
discharge the assignor from any liability, duty, obligation, or responsibility under the
Contract Documents.
Subject to the foregoing, the Contract Documents shall be binding upon and shall inure
to the benefit of the parties hereto and their respective successors and assigns.
Nothing contained in the Contract Documents shall in any way constitute a personal
obligation of or impose any personal liability on any employees, officers, directors,
Pavement Improvement Project 17 -PW -237 30
agents or representatives of the City or its successor and assigns.
In accordance with California Business and Professions Code Section 7030, the
Contractor is required by law to be licensed and regulated by the Contractors' State
License Board which has jurisdiction to investigate complaints against Contractors if a
complaint regarding a latent act or omission is filed within four years of the date of the
alleged violation. A complaint regarding a latent act or omission pertaining to structural
defects must be filed within 10 years of the date of the alleged violation. Any questions
concerning the Contractor may be referred to the Registrar, Contractors' State License
Board, P.O. Box 26000, Sacramento, California 95826.
IN WITNESS WHEREOF, this agreement has been executed on this 18th
day of November , 2016
Intermountain Slurry Seal, Inc.
Name of Contractor
By. �������,
Signature f Contract �%0'
Kathleen Schreckenqost .``�p�
:� o G•
s
Vice President % S .�;
Title of Signator �'�,�.NaN..`
110
ATTEST:
By: 1 , OVA
I e Jigish Desai
Assistant Secretary of Granite Construction
Incorporated, parent of the Company
Title of Signator
Pavement Improvement Project 17 -PW -237 31
Signature of City
City Administrator
Title of Signator
Approved as to form by
ity Attorney
Title of Si nator
*"*END OF SECTION'
Pavement Improvement Project 17 -PW -237 32
INTERMOUNTAIN SLURRY SEAL, INC.
CERTIFICATE OF SECRETARY
I, Kathleen Schreckengost, Assistant Secretary of INTERMOUNTAIN SLURRY SEAL, INC., a
Wyoming corporation (the "Company "), do hereby certify that the following is a true and correct copy of
resolutions duly adopted effective December 18, 2014 by unanimous written consent and without a
meeting as authorized by 17 -16 -821 of the Wyoming Business Corporation act and the Bylaws of the
Company:
AUTHORIZATION OF APPROVED CONTRACT SIGNERS
RESOLVED, that the below listed officers are authorized to execute and deliver on behalf of the
Company all documents, agreements and undertakings required in connection with construction contract
formation and operations of the Company:
Jason T. Klaumann President
Kathleen Schreckengost Vice President, Treasurer & Assistant Secretary
Darren S. Beevor Vice President, Controller & Secretary
Gary R. Price Vice President & Assistant Secretary
Ryan W. Brady Assistant Secretary
RESOLVED FURTHER, that the below listed individuals of Granite Construction Incorporated,
parent of the Company, are authorized to execute and deliver on behalf of the Company all documents,
agreements and undertakings required in connection with construction contract formation and operations of
the Company:
James H. Roberts
Christopher S. Miller
Laurel J. Krzeminski
Philip M. DeCocco
Michael F. Donnino
Patrick B. Kenny
Martin P. Matheson
James D. Richards
Richard A. Watts
Jigisha Desai
Bradley G. Graham
Nicholas B. Blackburn
President & Chief Executive Officer
Executive Vice President, Chief Operating Officer & Assistant Secretary
Senior Vice President, Chief Financial Officer & Assistant Secretary
Senior Vice President of Human Resources & Assistant Secretary
Senior Vice President, Group Manager & Assistant Secretary
Senior Vice President, Group Manager & Assistant Secretary
Senior Vice President, Group Manager & Assistant Secretary
Senior Vice President, Group Manager & Assistant Secretary
Senior Vice President, General Counsel; Corporate Compliance Officer & Secretary
Vice President of Corporate Finance, Treasurer, Assistant Financial Officer &
Assistant Secretary
Vice President, Controller, Assistant Financial Officer & Assistant Secretary
Director of Corporate Taxation & Assistant Secretary
RESOLVED FURTHER, that the authority provided for herein shall be in accordance with applicable
policies, procedures and limits of authority previously approved and the Granite Construction Incorporated
Delegation of Authority and Policy then in effect.
Page 1 of 2
L:`SHARED.COU'!ALL'CORP Corpnre1F:09-W27 Cmifim. oI'S—M y,A lions- Cmifi.t..0 WCs,Cw., fi. ISS 12.14.M.Ado
�►� CERTIFICATE OF LIABILITY INSURANCE
DATE 0/19/2016YY,
10/19 2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
THE POUCH IS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED ES
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 LIC #OC36861 1 -415--403 -1491
Alliant Insurance Services, Inc.
CONTACT NAME: Kimberly Leik_a_m
PHONE , 415- 403 -1491 IC No: 415- 874 -4818
ADDRESS: kleikam®alliant.com
100 Pine Street, 11th Floor
INSU S AFFORDING COVERAGE
NAIC ii
San Francisco, CA 94111
John Gilliland
INSURER A: VALLEY FORGE INS CO
20508
INSURED
INSURER B: TRANSPORTATION INS CO
20494
INSURER C:
MED EXP (Arty one person)
Intermountain Slurry Seal, Inc.
INSURER D:
-MADE OCCUR
ntractual Li ability
585 West Beach
INSURER E:
PERSONAL&ADVINJURY
INSURER F
GENERAL AGGREGATE
Watsonville, CA 95076
COVERAGES L r-mIirtw%ir- nvmia r- -------- --------
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
TYPE OF INSURANCE
DL
SUER
WVO
POLICY NUMBER
POUCY EFF
IMM /D
POLICY EXP
(MMIDDrnnM
LIMITS
A
—
GENERAL ABILITY
R COMMERCIAL GENERAL LIABILITY
X
R
GL 2074976689
10 /01 /1
10 /01 /18
EACH OCCURRENCE
$2,000,000
DAMAGE TO RENTED
P EMISES Ea rTence
$ 2, 00 0_, 000
MED EXP (Arty one person)
$Nil
-MADE OCCUR
ntractual Li ability
PERSONAL&ADVINJURY
$2,_000,000
GENERAL AGGREGATE
$10,000,000
FG9ENCLAIMS
U Hazards
PRODUCTS- COMP /OPAGG
$.2,000,_000
A
X
X
BUA2074978692
10 /O1 /1
10/01/18
'L GGREGATELMITApPUESPER
LICY X PRO X LOC
'AUTOMOBILE LIABILITY
Meacci accident) LE LIMIT
acadent
$
-2,- 000.,000
BODILY INJURY (Per person)
$
S -- ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS ED
X ,HIRED AUTOS X AUTOS
g Contractua
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
r
$
$
UMBRELLA I"
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
HCLAIMS-MADE
X WCSTATU. OTH
TORY LIMITS I EEL
$
B
A
A
B
NIA
X
X
X
WC274978661 (MT,WI,HI)
WC274978644 (ADS /Stop Ga
274978630 (CA)
10 /01 /1
)10 /Ol /1
10 /01 /1
1 0 /O1 /1
10/01/17
10/01/17
10/01/171
1001/17
DED - ..RETENTION
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTNE ❑
OFFICERMIEMBEREXCLUDED7 N
(Mandatory M NH)
desa
,,r under
f DSC 0, OPERATIONS belw
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
-
$ 2,000,000
E.L. DISEASE •pOLIYLIMIT
2.000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
-Job #:1651 Pavement Improvement Project No. 17 -PW -237
The Agency, its elected and appointed officers, officials, employees and volunteers are named
additional insureds per the attached forma.
GL Per ISO Form CG0001 10 /01, AL Per ISO Form CA0001 03/10
CERTIFIUA I r- MULUtK
---- —
1651
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Gilroy
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Risk Manager
AUTHORIZED REPRESENTATIVE
7351 Rosanna Street
Gilroy, CA 95020
Alliant Insurance Services, Ina
USA
�.,...,...,. .nra.� nnnnnowrnu All
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
jnielson
ava►
CNA71527XX
(Ed. 10/12)
ADDITIONAL INSURED - PRIMARY AND NON - CONTRIBUTORY
It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows:
SCHEDULE
Name of Additional Insured Persons Or Organizations
City of Gilroy. its officers.
7351 Rosanna Street
Gilroy. CA 95020
Service Agreement: Pavement Improvement services performed by Intermountain Slurry Seal covers City of Gilroy,
its officers. officials and employees are named as an additional insured. per the attached endorsement
1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II — LIABILITY COVERAGE, the person
or organization scheduled above is an insured under this policy.
2. The insurance afforded to the additional insured under this policy will apply on a primary and non - contributory
basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the
"accident" for which the additional insured seeks coverage under this policy.
All other terms and conditions of the Policy remain unchanged.
CNA71527XX (10/12)
Page 1 of 1
Policy No:
Endorsement No:
Effective Date:
Insured Name: Granite Construction Incorporated
Copyright CNA All Rights Reserved.
BUA2074978692
10/01/2016
- 70-
G- 140331 -D
(Ed. 01/13)
BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS —
WITH PRODUCTS - COMPLETED OPERATIONS COVERAGE
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE
PART as follows:
SCHEDULE
Name of Additional Insured Persons Or Organizations
(As required by "written contract" per Paragraph A. below.)
Locations of Covered Operations
(As per the "written contract," provided the location is within the "coverage territory" of this Coverage Part.)
A. Section II - Who Is An Insured is amended to include as an additional insured:
1. Any person or organization whom you are required by "written contract" to add as an additional insured on
. this Coverage Part; and
2. The particular person or organization, if any, scheduled above.
B. The insurance provided to the additional insured is limited as follows:
1. The person or organization is an additional insured only with respect to liability for "bodily injury," "property
damage," or "personal and advertising injury" caused in whole or in part by:
a. Your acts or omissions, or the, acts or omissions of those acting on your behalf, in the performance of
your ongoing operations specified in the "written contract "; or
b. "Your work" that is specified in the "written contract" but only for "bodily injury" or "property damage'
included in the "products - completed operations hazard," and only if:
(1) The "written contract" requires you to provide the additional insured such coverage; and
(2) This Coverage Part provides such coverage.
2. If the "written contract" specifically requires you to provide additional insurance coverage via the 10/01 edition
of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 37 10 01), or via the 11185
edition of CG2010 (aka CG 20 10 11 85), then in paragraph B.I. above, the words 'caused in who_ le or in part
by' are replaced by the words 'arising out of.
3. We will not provide the additional insured any broader coverage or any higher limit of insurance than:
a. The maximum permitted by law,
b. That required by the "written contract ";
c. That described in B.1. above; or
d. That afforded to you under this policy,
whichever is less.
4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is
excess of all other insurance available to the additional insured whether on a primary, excess, contingent or
G- 140331 -D (Ed. 01/1.3) POLICY #: GL2074978689
Page 1 of 2 EFFECTIVE: 10/01/2016
Copyright, CNA All Rights Reserved.
G- 140331 -D
(Ed. 01/13)
any other basis. But if required by the "written contract" to be primary and non - contributory, this insurance
will be primary and non - contributory relative to insurance on which the additional insured is a Named Insured.
5. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or
"personal and advertising injury" arising out of:
a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying
services, including:
(1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports,
surveys, field orders, change orders or drawings and specifications; and
(2) Supervisory, inspection, architectural or engineering activities; or
b. Any premises or work for which the additional insured is specifically listed as an additional insured on
another endorsement attached to this Coverage Part.
C. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows:
1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following
additional conditions applicable to the additional insured:
An additional insured under this endorsement will as soon as practicable:
(1) Give us written notice of an "occurrence" or an offense which may result in a claim or "suit" under this
insurance, and of any claim or "suit" that does result;
" - (2) Except as provided in Paragraph B.4. of this endorsement, agree to make available any other insurance
the additional insured has for a loss we cover under this Coverage Part;
(3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation,
defense, or settlement of the claim or "suit and
(4) Tender the defense and indemnity of any claim or "suit" to any other insurer or self insurer whose policy
or program applies to a loss we cover under this Coverage Part. But if the "written contract" requires this
insurance to be primary. and non - contributory, this provision (4) does not apply to insurance on which the
additional insured is a Named Insured.
We have no duty to defend or indemnify an additional insured under this endorsement until we receive from
the additional insured written notice of a claim or "suit."
D. Only for the purpose of the insurance provided by this endorsement, SECTION V — DEFINITIONS is amended to
add the following definition:
"Written contract" means a written contract or written agreement that requires you to make a person or
organization an additional insured on this Coverage Part, provided the contract or agreement:
1. Is currently in effect or becomes effective during the term of this policy; and
2. Was executed prior to:
a. The "bodily injury" or "property damage "; or
b. The offense that caused the "personal and advertising injury,"
for which the additional insured seeks coverage under this Coverage Part.
All other terms and conditions of the Policy remain unchanged.
Material used with permission of ISO Properties, Inc.
G- 140331 -D (Ed. 01/13) POLICY #: GL2074978689
Page 2 of 2 EFFECTIVE: 10/01/2016
Copyright, CNA All Rights Reserved.
THIS ENDORSEMENT. CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Waiver of Transfer of Rights of Recovery Against Others to Us
This endorsement modifies insurance provided under the following:
Commercial General Liability Coverage Form
Under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, The Transfer Of Rights Of
Recovery Against Others To Us Condition is amended by the addition of the following:
We waive any right of recovery we may have against any person or organization because of payments we
make for injury or damage arising out of:
1. Your ongoing operations; or
2. "Your work" included in the "products completed operations hazard."
However, this waiver applies only when you have agreed in writing to waive such rights of recovery in a
contract or agreement, and only if the contract or agreement:
1. Is in effect or becomes effective during the term of this policy; and
2. Was executed prior to loss.
This endorsement is part of your policy and takes effect on the effective date of your policy, unless another effective
date is shown below. .
Must Be Completed
ENDT. NO.
POLICY NO.
GL 2074978689
Complete Only When This Endorsement Is Not Prepared
with the Policv Or Is Not to be Effective with the Policy
TO:
Granite Construction Incorporated
Countersigned by
Authorized Representative
DATE OF THIS
ENDORSEMENT
I�
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS CALIFORNIA
G- 19160 -B
(Ed. 11/97)
This endorsement changes the policy to which it is attached.
It is agreed that Part One — Workers' Compensation Insurance G. Recovery From Others and Part Two — Employers' Liability
Insurance H. Recovery From Others are amended by adding the following:
We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform
work under a written contract that requires you to obtain this agreement from us.)
PREMIUM CHARGE —n /a
The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure.
The amount is n/a %.
UTAH WAIVER OF SUBROGATION ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A of the Information
Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right
against the .person or organization named in the Schedule. (This agreement applies only to the extent that you perform work
under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Our waiver of rights does not
release your employees' rights against third parties and does not release our authority as trustee of claims against third
parties.Schedule : Any person or organization for whom the named Insured has agreed by written contract to furnish
this waiver.
WC43 03 05 (Ed 7 -00)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
All Other States where allowed (except CA, T), UT)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against
the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written
contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Any person or organization for whom the named insured has agreed by written contract to furnish this waiver
WC00 0313 (Ed 4-84)
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below Is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 10/01/2016
WC2749786"
Valley Forge Insurance Company
WC274978658
Transportation Insurance Company
WC274978661
Transportation Insurance Company
WC 274978630
Valley Forge Insurance Company
G- 19160 -B Page 1 of 1
(Ed. 11/97)
DATE
SUPPLEMENT TO CERTIFICATE OF INSURANCE 10/19/2016
Intermountain Slurry Seal, Inc.
SUPP
CIi�.JB�
CHUBB GROUP OF INSURANCE COMPANIES
Surety Department, 15 Mountain View Road, P.O. Box 1615, Warren, NJ 07061 -1 61 5
Phone: (908) 903 -3485 • Facsimile: (908) 903 -3656
PERFORMANCE BOND
FEDERAL INSURANCE COMPANY
Bond No. 82448711 Premium Amount $ 2,878.00
Know All Men By These Presents,
That we, Intermountain Slurry Seal, Inc.
(hereinafter called the Principal),
as Principal, and the FEDERAL INSURANCE COMPANY, Warren, New Jersey, a corporation duly organized under
the laws of the State of Indiana; (hereinafter called the Surety), as Surety, are held and firmly bound unto
City of Gilroy
in the sum of (hereinafter called the Obligee),
One Million Three Hundred Eight Thousand Eighty-Eight Dollars
($1;308;088.00 ), for the payment of which we, the said Principal and said Surety, bind ourselves,
our heirs, executors, administrators, successors. and, assigns; jointly and severally, firmly by these presents.
Sealed with our seals and dated this October 19, 2016
WHEREAS, the Principal entered into a certain Contract with the Obligee,
for
Pavement Improvement Project
in accordance with the terms and conditions of said Contract, which is hereby referred to and made a part hereof as
if fully set forth herein.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the above bounden Principal shall
well and truly keep, do and perform each and every, all and singular, the matters and things in said Contract set forth
and specified to be by said Principal kept, done and performed, at the times and in the manner in said Contract
specked, or shall pay over, make good and reimburse to the above named Obligee, all loss and damage which said
Obligee may sustain by reason of failure or default on the part of said Principal so to do, then this obligation shall be
null and void; otherwise shall remain in full force and effect, subject however, to the following conditions:
Forth 1502-0001 (Rev. 114X9 (Over)
Any suit under this bond must be instituted before the expiration of two (2) years from the date on which final
payment under the Contract falls due.
No right of action shall accrue on this bond to or for the use of any person or corporation other than the Obligee
named herein or the heirs, executors, administrators or successors of the Obligee.
,,,1111111#111.0
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Intermountain Slurry Seal, Inc.
Prin ' al
By:
Kathleen S hreckenZNCE , Vice President
FEDERAL INS U COMPANY
Ashley Stinson, Attorney in
A notary public or other officer completing this
certificate verifies only the identity ofthe individual ACKNOWLEDGMENT
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or validity
of that document.
State of California
County of Santa Cruz )
On October 19, 2016
before me,
V.J. Fox, Notary Public
(insert name and title of the officer)
personally appeared Ashley Stinson
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are
subscribed to the within instrument and acknowledged to me that he /she /they executed the same in
his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
V. J. FOX
Commissim # 2121012
z Notary Pubft - cdow Na
Z Sena Wit Counter
I MY
Conan. Sep 15 2018
Sign
V.J. Fox, Notary Public
sue;,:
CHUBB GROUP OF INSURANCE COMPANIES
Surety Department, 15 Mountain View Road, P.O. Box 16!5, Waaen, NJ 07061 -16-i5
Phone: (908) 903 -3485 o Facsimile: (908) 903 -3656
PAYMENT BOND
FEDERAL INSURANCE COMPANY
Bond No. 82448711 Premium included in Performance Bond
Know All Men By These Presents,
That we, Intermountain Slurry Seal, Inc.
(hereinafter called the Principal),
as Principal, and the FEDERAL. INSURANCE COMPANY, Warren, New Jersey, a corporation duly organized under
the laws of the State of Indiana, (hereinafter called the Surety), as Surety, are held and firmly bound unto
City of Gilroy
(hereinafter called the Obligee),
in the penal sum of One Million Three Hundred Eight Thousand Eighty -Eight Dollars
($1,3013,088.00 ), for the payment of which we, the said Principal and the said Surety, bind ourselves,
our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal entered into a certain Contract with the Obligee, dated
for
Pavement Improvement Project
in accordance with the terms and conditions of said Contract, which is hereby referred to and made a part hereof as
if fully set forth herein.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal shall pay all lawful
claims of sub- contractors, materialmen, or laborers for labor performed or materials fumished directly to the Princi-
pal, in the performance of said Contract, we agreeing that this bond shall be for the benefit of any sub - contractor,
materialmen or laborer having a just claim, then this obligation shall be void; otherwise to remain in full force and
effect, subject, however to the following condition:.
No suit or action shall be commenced hereunder by any claimant:
a) After the expiration of one (1) year following the date on which Principal ceased work on said Contract, it
being understood, however, that if any limitation embodied in this bond is prohibited by any law controlling the
construction hereof such limition shall be deemed to be amended so as to be equal to the minimum period of
limitation permitted by such law.
Form 1542-0008 (Rev. 11-99) (off,)
b) Other than in a state court of competent jurisdiction in and for the county or other political subdivision of the
state in which the Project, or any part thereof, is situated, or in the United States District Court for the district in
which the Project, or any part thereof, is situated, and not elsewhere.
Sealed with our seals and dated this October 19, 2016
,'J1111111'rJ
iiGG -a �
Intermountain Slurry Seal, Inc.
Pri i al
By:
Kathleen Sc reckengostt ce President
FEDERAL INSURANCE COMPANY
By:
Ashley Stinson, Attorney in Fact
A notary public or other officer completing this
certificate verifies only the identity of the individual ACKNOWLEDGMENT
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or validity
of that document.
State of California
County of Santa Cruz
On October 19, 2016
before me,
V.J. Fox, Notary Public
(insert name and title of the officer)
personally appeared Ashley Stinson
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are
subscribed to the within instrument and acknowledged to me that he /she /they executed the same in
his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
V.J. Fox, Notary Public
V. J. FOX
Commission #t 2124012
Z Notary Public - California Z
Santa Cruz County
My Comm ggres Sep 15 2019+
CHUBB'
Power of Attorney
Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company
Atm: Surety Department 115 Mountain View Road I Warren, NJ 07059
Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York
corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Jigisha Desa i, John D. Gilliland,
Kathleen Schreckengost, Ashley Stinson and Lillian Tse of Watsonville, California
each as their true and lawful Anomey- in- Fats to execute under such designation In their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obl%atcry in the nature thereof (other than ball bonds) given or executed In the course of business on behalf
GRANITE CONSTRUCTION INCORPORATED and allStftdiaries alone or in Jotat venture as principal. In connection with bids, proposals or contacts to or with the United States of
America. any State or poadcal subdivision thereof or any person, firm or corporation. And the eltecutton of stair bond or oblgatlon by such Attorney - In- Fad In the Companys
name and on its behalf as surety thereon or otherwise, under its corporate seal, in pursuance of the authority hereby conferred shall, upon delivery thereo( be valid and binding
upon the Company.
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VICIIANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and
presents and affixed their corporate seals on this 29", day of August, 2016.
1� { I
STATE OF NEWJERSEY
Countyorsometset SS.
On this 2911 day of August. 2016 before me, a Notary Public of New jersey, personally came Dawn IVL Chloros. to me known to be Assistant Secretary of FEDERAL INSURANCE
COMPANY. VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY; the companies which executed the foregoing Power of Attorney, and the said Dawn M.
Ctdotos, being by me duly sworn, did depose and say that she Is Assfsta»r Secretary of FEDERAL INSURANCE COMPANY. VIGILANT INSURANCE COMPANY, and PACIFIC
INDEMNI' Y COMPANY and knows the corporate seals thereo4 that the. seals affixed -to the foregoing Power of Attorney are such corporate seals and were thereto attired by
authority of the apl aws of Said Companies. and that she signed said Power of Attorney as Assistant Secretary, of said Companies by like authority-, and that she Is acquainted with
David B. Norrtts, Jr, and knows Mm to be Vice President of said Companies; .and that the signature of David B. Norris, Jr. subscrffied to said Power of Attorney Is In the genuine
handwriting of David B. Norris,Jr., and was thereto subscribed by authority ofsaidBy-Lam and In deponelrs presence.
Notarial Seal KATHERINE J. ADIeLAAR
NpTAR y NOTARY PUBLIC OF NEW JERSEY
110-e+09 No. 2318885
PUBL1 Commiselon Expires July is, 2019 Notary Public
yrEa� CERTIFICATION
Extract from the By -Laws o FEDERAL. INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:
'Except as otherwise provided In these By -Laws or by law or as otherwise directed by the Board of Dlredom the President or any Vice President shall be authorized to execute
and deliver, in the name and on behalf of the Corporation, all agreements,.bonds, contracts, deeds, mortgages, and other instruments, either for the Corporation's own
account or in a fiduciary or other capacity, and the seat of the corporation. if appropriate, shall be affixed thereto by any of such officers or the Secretary or an Assistant
Secretary. The Board of Directors, the President or any Vice President designated by the Board of Directors may authorize any other officer. employee or agent to execute and
deliver, in the name and on behalf of the Corporation, agreements, bonds, contracts, deeds, mongagm and other instruments, either for the Corporation's own account or Ina
fidodary or other capacity, and If appropriate, to affix the Seal of the Corporation thereto. The grant of such authority by the Board or any suchatBcer'may be general or
confined to specific Instances."
I, Dawn M. Chklros. Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the' companies,) do hereby
certify that
(I) the foregoing extract of the By -laws of the Companies is true and correct, =
(tt) the signature
nay be affixed to such authorized
Power of Attorney or tce�rtificate by f simile and such Power certificate orney relating theme as behalf be value and nifl upon Lh6 C of-the 'Cotnnd an .
such Power of Attorney so executed and Certified by such facsimile the C with respect and any
signature and facsimile seal shall be valid and bin _ Companies with respect to any
bond or undertaking to which iris attached
(00 the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are
authorized by the US: Treatlt>ry Department further, Federal and VlgBatft are licensed In the U.S. Virgin Islands, and Federal is licensed in Guam Puertoalco,
and each of the Provinces of Canada except Prince Edward Island and
(iv) the foregoing Power of Atiomey is true, correct and in full force and effect
Given under my hand and seals of said companies at warren. NJ this October 19, 2016
-4 1 ffl'al%
IN TIM EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIF"HEAUTHENTIC TY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT xIS AT THE ADDRESS LISTED
ABOVE..ORBY: Tote ne(906 .
)903.3493 Fax 0 903- 3a% e-mall: sumty@ftbb=m
Form 1510 -01846 - U CORP CONSENT (rev. 08.19)