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Teichert Construction - FY 21 Citywide Pavement Maintenance, 21-PW-260DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 Citv of Gilroy Agreement/Contract Tracking Today's Date: October 15, 2020 Your Name: Nirorn Than Contract Services over $5k - Contractor - Phone Number: 408-846-0293 Type: NO ENG OR DESIGN Contract Effective Date: 10/19/2020 (Date contract goes into effect) Contract Expiration Date: 12/31/2021 Contractor / Consultant Name: Teichert & Son, Inc. (if an individual's name, format as last name, first name) Contract Subject: FY 21 Citywide Pavement Maintenance Project, Project no. 21-PW-260 (no more than 100 characters) Contract Amount: $2,997,955.00 (Total Amount of contract. If no amount, leave blank) By submitting this form, I confirm ➢ Date of Contract this information is complete: ➢ Contractor/Consultant name and complete address ➢ Terms of the agreement (start date, completion date or "until project completion", cap of compensation to be paid) ➢ Scope of Services, Terms of Payment, Milestone Schedule and exhibit(s) attached ➢ Taxpayer ID or Social Security # and Contractors License # if applicable ➢ Contractor/Consultant signer's name and title ➢ City Administrator or Department Head Name, City Clerk (Attest), City Attorney (Approved as to Form) Routing Steps for Electronic Signature Risk Manager City Attorney Approval As to Form City Administrator or Department Head City Clerk Attestation 84���9�ME5... 7A,mv Ml� OV%C C6456EF98054DC... E D++��ocuSigned by: hator,ec T7� 14C536FCOE76461_.. DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 TYPE OF PROCURMENT EQUIPMENT /SUPPLIES/ MATERIALS Furniture, hoses, parts, pipe manholes, office supplies, fuel, tools, PPE items, etc... GENERAL SERVICES Janitorial, landscape maintenance, equipment repair, installation, graffiti abatement, service inspections, uniform cleaning, etc... PROFESSIONAL SERVICES Consultants, architects, designers, auditors, etc... STAFF LEVEL $0-$999.99 • Vendor selection at discretion of staff Pavment Method Purchase Card or Payment Request (if vendor does not accept credit cards) DOLLAR THRESHOLD / SIGNING AUTHORITY DEPARTMENT HEAD CITY ADMINISTRATOR COUNCIL APPROVAL $1,000-$49,999.99 $50,000-$99,999.99 $100,000-Above • Informal • Informal • Formal Bid bid/quotation — bid/quotation — • Advertisement 3 quotes (verbal 3 written quotes • Council Approval or written) • Purchasing . Purchase • Purchasing Summary form w/ Requisition signed Summary form City Administrator by City w/ Purchasing Approval Administrator Approval • Purchase • Purchase Requisition Requisition Payment Method Purchase Order* • Vendor selection at • Informal discretion of staff bid/quotation — • May require insurance 3 quotes (verbal documents depending or written) on scope/ nature of • Purchasing work Summary form w/ Department Head Approval Pavment Method • Standard Purchase Card (if Agreement incorporated) • Purchase Signed Payment Request (if sc Requisition proprietor or partner) • Vendor selection at the discretion of staff • Purchase Summary Form w/ Purchasing Approval • Standard Agreement signed by Department Head • Purchase Requisition Pavment Method Purchase Order Payment Method Purchase Order* RFP/RFQ to at least 3 consultants Purchase Summary Form w/ Department Head Approval Standard Agreement Purchase Requisition Pavment Method Purchase Order Pavment Method Purchase Order • Informal Bid/RFP quotation — 3 written quotes • Purchasing Summary form w/ City Administrator Approval • Standard Agreement • Purchase Requisition Pavment Method Purchase Order • RFP/RFQ to a list of consultants • Evaluation Spreadsheet w/ City Administrator Approval • Standard Agreement • Purchase Requisition Pavment Method Purchase Order Pavment Method Purchase Order • Formal Bid/RFP/RFQ • Advertisement • Council Approval • Standard Agreement • Purchase Requisition Pavment Method Purchase Order • Formal RFP/RFQ • Advertisement • Council Approval • Standard Agreement signed by City Administrator • Purchase Requisition Pavment Method Purchase Order DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 DATE (MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 1 10/14/2020 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 have ADDITIONAL INSURED provisions or 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 CONTACT Kayla Fritzberg Edgewood Partners Insurance Center I PHONE FAx PO BOX 2110 (A/C. No. Ext): 925.822.9044 (A/C, Not: 916-583-7613 Rancho Cordova CA 95670 I ADDRESS: kayla.fritzberg@epicbrokers.com INSURER(S) AFFORDING COVERAGE NAIC # License* OB29370 INSURERA: Liberty Mutual Fire Insurance Company 23035 INSURED TEICCONS INSURERB: Allied World Assurance Company (U.S.) 19489 A. Te&Son, Inc. DBA I INSURERC: Liberty Insurance Corporation 42404 Teichichert Construction PO Box 15002 I INSURER D : Sacramento CA 95851 I INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:445316890 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y Y EB2661067002030 3/31/2020 3/31/2021 EACH OCCURRENCE $ 2 000 000 CLAIMS -MADE � OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑X PRO- LOC JECT OTHER: A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY B UMBRELLA LIAB I X I OCCUR X EXCESS LIAB CLAIMS -MADE Y Y EU2661067002040 Y Y 03082614 DED I I RETENTION $ C WORKERS COMPENSATION Y EW766NO67002010 AND EMPLOYERS' LIABILITY Y / N ANYPROPRI ETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI N/A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 SIR $ 750,000 3/31/2020 3/31/2021 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) SIR $ 500,000 3/31/2020 3/31/2021 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 3/31/2020 3/31/2021 X I STATUTE EERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 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: FY21 Citywide Pavement Maintenance Project; 21-PW-260 (Teichert Job #11499). Additional Insured: The City of Gilroy, its officers, employees and volunteers. When required by written contract, additional insured status with primary coverage applies to General & Auto Liability and waiver of subrogation applies to General Liability, Automobile Liability and Excess Workers' Compensation, all per the attached endorsements. XCU, Contractual Liability, and "Broad Form Property Damage" are included per General Liability coverage form CG0001 04 13. See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Gilroy 7351 Rosanna St. Gilroy CA 95020 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 AGENCY CUSTOMER ID: TEICCONS LOC #: ACOR" AGENCY Edgewood Partners Insurance Center POLICY NUMBER CARRIER ADDITIONAL REMARKS SCHEDULE NAMED INSURED A. Teichert & Son, Inc. DBA Teichert Construction PO Box 15002 Sacramento CA 95851 NAIC CODE I EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Excess liability is follow form. Named Insured is a California qualified self -insurer registered under #1867. The Workers' Compensation Policy provides Excess Workers' Compensation / Employer's Liability coverage excess of a $750,000 SIR. Page 1 of 1 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 POLICY NUMBER: EB2661067002030 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations City of Gilroy, its officers, officials, and employees. All locations as required by a written contract or, agreement entered into prior to an 'occurrence" or offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on be- half of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 POLICY NUMBER: EB2661067002030 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Gilroy, its officers, officials, and employees. Location And Description Of Completed Operations All locations as required by a written contract or agreement entered into prior to an 'occurrence" or offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 Policy Number EB2661067002030 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE AMENDMENT — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Person(s) or Organization(s): All persons or organizations as required by written contract prior to a loss occurring. If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person(s) or organization(s) shown in the Schedule of this endorsement that qualifies as an additional insured on this Policy, this Policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV — Conditions will not apply. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV — Conditions will apply. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured for the same 'occurrence", claim or "suit". LC 24 20 11 18 © 2018 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 POLICY NUMBER: EB2661067002030 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As required by written contract or agreement entered into prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 Policy Number EU2661067002040 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - NONCONTRIBUTING This endorsement modifies insurance provided under the following: EXCESS AUTOMOBILE LIABILITY INDEMNITY POLICY With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are insureds under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s) or Organizations(s): Any person(s) or organization(s) to whom you are obligated by a written agreement to procure Additional Insured coverage under your policy Regarding Designated Contract or Project: All contracts or projects Each person or organization shown in the Schedule of this endorsement is an insured for Liability Coverage, but only to the extent that person or organization qualifies as an insured under the Who Is An Insured Provision contained in Section II of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations and the agreement was executed prior to the bodily injury or property damage, then this insurance will apply before that other insurance, and we will not seek contribution from such insurance. However, insurance provided to the Additional Insured will subject to the self -insured amount and all other terms and conditions of the policy. AM 76 52 04 17 © 2017 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 Policy Number: EU2661067002040 Issued by: LIBERTY MUTUAL FIRE INSURANCE COMPANY 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: EXCESS AUTOMOBILE LIABILITY INDEMNITY POLICY SELF -INSURED TRUCKER EXCESS LIABILITY POLICY With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. 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 the person or organization listed in the Schedule of this endorsement because of payments we make for injury or damage arising out of your operations of a covered auto. This waiver applies only to the person or organization listed in the Schedule of this endorsement. Premium: Name of Person or Organization Schedule $ INCL Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring AM 76 19 07 13 © 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 EXCESS INSURANCE POLICY FOR SELF INSURER OF WORKERS COMPENSATION AND EMPLOYERS LIABILITY WAIVER OF SUBROGATION — RECOVERY FROM OTHERS We have the right to recover any payments which we have made to you from anyone liable for such loss. We will not enforce our right against the person or organization named in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by contract or written agreement prior to loss and allowed by law. Issued by Liberty Insurance Corporation For attachment to Policy No. EW766NO67002010 Effective Date: 03/31/2020 Premium $ Issued to J"Jw:�\p GPO 4249 Ei . Page 1 of 1 Ed.01/01/1992 Ythorized Rep DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 SECTION 00450 A�REE11�/IEA�T FY21 Citywide Pavement Maintenance Project PROJECT NUMBER 21-PW-260 THIS AGREEMENT, made this 19'h day of October, 2020 by and between the Citv of Gilrov, hereinafter called the "City," and A. Teichert & Son. Inc. dba Teichert Construction 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 F Y 2 1 CiT Y WIDE PAVEMENT MAINTENANCE PROJECT, PROJECT NO. 21-PW-260, 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. Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00450-30 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 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 heret signify their approval and co @Vt to the terms of this article 3. City's Initials 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 Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00450-31 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 Bid Documents Designation of Subcontractors Bid Guaranty_ Bond Agreement Acknowledgements Performance Bond Payment Bond General Conditions Supplementary Conditions General Requirements Standard Specifications (Caltrans) 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, Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00450-32 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 agents or representatives of the City or its successor and assigns. In accordance with California Business and Professions Code Section 1080, 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 day of October 19 , 2020 A. TEICHERT & SON, INC. dba TEICHERT CONSTRUCTION Name of Contractor 16 Signature of Contractor FRANCIS JOHNSON VP/REGIONAL MANGER, BAY AREA Title of Signator OFFICE MANAGER Title of Signator ***END OF SECTION*** �tDocuSigned by: MVKK Fb6ts '—CC645 F9B054 (C Ignaure of City City Administrator Title of Signator El DocuSigned by: w), F�, (.APgnA 0R7QPAFS Approved as to form by City Attorney ATTEST: DocuSigned by: oo )i�RW�La '�'LP�PL4' I � 4L 53BF,C9.E 76461... City Clerk Title of Signator Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00450-33 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 SECTION 00670 NOTICE OF NONDISCRIMINATION IN EMPLO WENT The undersigned contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, age, marital status or national origin. The Contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, age, marital status or national origin. Such action shall include, but not be limited to, the following: Employment, upgrading, demotion, or transfer, recruitment advertising; layoff or termination; rates of pay, or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment notice to be provided by the municipality setting forth the provisions of this nondiscrimination clause. October 13, 2020 Date Francis Johnson - VP/Reg. Mgr, Bay Area A. TEICHERT & SON, INC. dba TEICHERT CONSTRUCTION Company 8 License # ***POST IN CONSPICUOUS PLACE OF EMPLOYMENT*** ***END OF SECTION*** Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00670-44 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 Bond No. 070212846 Premium: $8,176.00 SECTION 00610 FAITHFLOIL PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS, THAT, WHEREAS, City of Gilrov, hereinafter designated the "City," has, on October 19 , 2020, awarded to, A Teichert & Son Inc. dha Teichert Construction hereinafter designated as the "Principal," a Contract for the construction of the FY21 Citywide Pavement Maintenance Project, and WHEREAS, said Principal is required under the terms of said Contract to furnish a bond for the faithful performance of said Contract: NOW, THEREFORE, WE, the Principal, and , as Surety, are held and firmly bound unto the City the penal sum of two million seven hundred twenty-five thousand four hundred fourteen and 00/100 dollars ($ 2,725,414.00 ) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the above bounden Principal, it or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and abide by, and well and truly keep and faithfully perform the covenants, conditions, and agreements in the said contract and any alterations made as therein provided, on it or their part to be kept and performed, at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless, the City, its officers and agents as therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and virtue. It is acknowledged that the Contract provides for a one-year warranty period, during which time this bond remains in full force and effect. And the said Surety, for value received, hereby stipulates and agrees that no change; extension of time, alteration, or addition to the terms of the Contract or to the work to be performed thereunder or the specifications accompanying the same shall, in any way, affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration, or addition to the terms of the Contract or to the work or to the specifications. Said Surety hereby waives the provisions of Sections 2819 and 2845 of the Civil Code of the State of California. Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00610-34 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 IN WITNESS WHEREOF, the above bounden parties have executed this instrument under their seals this 8th day of nVtnher 2020 the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. A. Teichert & Son Inc. dba Teichert Construction Principal (Seal) i�s Signature for principal FRANCIS JOHNSON VP/REG. MGR, BAY AREA Title of Signator Liberty Mutual Insurance Company Surety (Seal) Signature for Surety Donna M. Planeta, Attorney -in -Fact Title of Signator ***END OF SECTION'' Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00610-35 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 NOTARY ACKNOWLEDGMENT OF SURETY: State of Connecticut County of Hartford ss. On this the 8th day of October 1 20 20, before me, Aimee Perondine, the undersigned officer, personally appeared Donna M. Planeta I known to me (or satisfactorily proven) to be the person whose name is subscribed as Attorney-ln- Fact for Libertv Mutual Insurance Companv , and acknowledged that s/he executed the same as the act of his/her principal for the purposes therein contained. In witness whereof I hereunto set my hand. Signature of Notary Public Date Commission Expires: May 31, 2022 Aimee Perondine Primed Name of Notary AIMEE PERONDINE NOTARYPUDLIC - CT 174145 My COMMISSION EXPIRES MAY 31, 2022 DocuSign Envelope ID: 36AB8lC4-269F-4904-8B62-5748847F8A94 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company Certificate No: 8202409-985949 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Aiza Anderson, Samuel E. Begun, Bryan M. Caneschi, Saylcham Chanthasone, Lorina Monique Garcia, Danielle D. Johnson, Michelle Anne McMahon, Tanya Nguyen, Aimee R. Perondine, Mercedes Phothirath, Jenny Rose Belen Phothirath, Noah William Pierce, Kristopher Pisano, Donna M. Planeta, Joshua Sanford, Bethany Stevenson, Rebecca M. Stevenson, Eric Strba, Jynell Marie Whitehead all of the city of Hartford state of Connecticut each individually if there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 23rd day of October , 2019 Liberty Mutual Insurance Company JP ORNSu OR R9y JP,11 INS& N 1Ns uR4 The Ohio Casualty Insurance Company 4rF n y �° �rF 9y �GPc°aP0R4JF�� West American Insurance Company $>, � 3 o f VQ 3 o m W 3 o Rr y 1912 y O c 1919 1991 y rd�9ssACHU`� .aa3 yO Zt�,NA MPS��•aaO010" da By: David M. Carey, Assistant Secretary State of PENNSYLVANIA+ a) n County of MONTGOMERY ss N L Q% o On this 23rd day of October 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance O o Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes - > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. W CU IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and yearfrst above written. pQ rn so, PAS,' bR � �It" ;.,o'r , T � COMMONWEALTH OF PENNSYLVANIA Q O o {S ir Notarial Seat t -a Op Teresa Pastels, Notary Public L p Upper Marion Twp., Montgomery County By: N My Commission Expires March 28, 2021 E Ire,,Patlla, Notary Public tp y� Member. Pennsylvania Association of Notaries CU 1- y This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance o .S Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: o a3 ARTICLE IV— OFFICERS: Section 12. Power of Attorney. n Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President a may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all O > undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attomey, shall have full t o ; power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall — N Z be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this C article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE All — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, 09 shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in- fact as nnay be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not Deer revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 8th day of October , 2020 . P� 1NSU� P'1V INS& %1i POST yt� 5J 4°pPO�T�2 .VP c°RP0 tq yP J3 Fom Q3 FOC+ r Focn Aula-&4- 1912 0 1919 : 1991 �, o a o HAMP5aa INOIANP a By• dej� * ��,a ,+y1 * ��a s�M * �aa Renee C. Llewellyn, Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi CO 062018 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual 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 Alameda On October 131, 2020 before me, S. Foss, Notary Public (insert name and title of the officer) personally appeared Francis Johnson who proved to me on the basis of satisfactory evidence to be the person(X) whose name(s) is/" subscribed to the within instrument and acknowledged to me that h0MMexecuted the same in his/Mr (authorized capacityM), and that by his/XOMXXsignatureO) on the instrument the persono o, or the entity upon behalf of which the person( 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. k f Signature lJ (Seal) S. FOSS Notary Public - California " Alameda County > j Commission # 2309723 [ My Comm. Expires Nov 17, 2023 r ,i DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 Bond No. 070212846 Premium: Included in Performance Bond KNOW ALL PERSONS BY THESE PRESENTS, THAT, WHEREAS, City of Gilrov , hereinafter designated as the "City," has, on October 19 , 2020 , awarded to A. Teichert& Son Inc. dba Teichert Construction , hereinafter designated as the "Principal," a Contract for the construction of the FY21 Citywide Pavement Maintenance Project and WHEREAS, said Principal is required to furnish a bond in connection and with said Contract, providing that if said Principal, or any of it or its subcontractors shall fail to pay for any materials, provisions, or other supplies used in, upon, for, or about the performance of the work contracted to be done, or for any work or labor done thereon of any kind, the Surety of this bond will pay the same to the extent hereinafter set forth: NOW, THEREFORE, we, the Principal, and , as Surety, are held and firmly bound unto the City the penal sum of two million seven hundred twentv-five thousand four hundred fourteen and 00/100 Dollars ($ 2,725.414,00 ) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors jointly and severally, firmly by these presents. The Payment Bond for which this Section provides shall secure the payment Of those persons Or entities to whom the Principal, its Subcontractors or its heirs, executors, administrators, successors, or assigns, shall be become legally indebted for labor, materials, tools, equipment or services of any kind used or employed by the bidder in performing the work, or taxes or amounts to be withheld thereon. The Surety or Sureties will pay the following amounts should the Principal or a Subcontractor fail to pay the same, plus reasonable attorneys' fees to be fixed by the court if suit is brought upon the bond: (1) amounts due to any of the persons named in California Civil Code Section 3181; (2) amounts due under the Unemployment Insurance Code with respect to work contracted to be done or any work or labor thereon of any kind; and (3) any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work and labor. This Payment Bond shall inure to the benefit of any of the persons named in Civil Code Section 3181 so as to give a right of action to those persons or their assigns in any suit brought upon this bond. Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00620-36 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or addition of the terms of the Contract or to the work to be performer) thereunder or the specifications accompanying the same shall, in any way, affect its obligations of this bond, and it does hereby waive notice of any change, extension of time, alteration, or addition to the terms of the contract or to the work or to the specifications. Said Surety hereby waives the provisions of Sections 2819 and 2845 of the Civil Code of the State of California. IN WITNESS WHEREOF, the above bounded parties have executed this instrument under their seals this 8th day of October , 2020 the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. A. Teichert & Son Inc. dba Teichert Construction Principal (Sdal) Signature for Principal FRANCIS JOHNSON VP/REG. MGR., BAY AREA Title Liberty Mutual Insurance Company Surety (Seal) C;? re for Suret Title Y Donna M. Pianeta, Attorney -in -Fact ***END OF SECTION*** Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00620-37 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 NOTARY ACKNOWLEDGMENT OF SURETY: State of Connecticut County of artford ss. On this the 8th day of October 1 20 20 , before me, Aimee Perondine, the undersigned officer, personally appeared Donna M. Planeta I known to me (or satisfactorily proven) to be the person whose name is subscribed as Attorney-ln- Fact for Liberty Mutual Insurance Companv , and acknowledged that s/he executed the same as the act of his/her principal for the purposes therein contained. In witness whereof I hereunto set my hand. Signature of Notary Public Date Commission Expires: Mav 31, 2022 Aimee Perondine Printed Name of Notary PFRONDINE PUBLIC - CT 174145 EXPIRES MAY 31, 2022 DocuSign Envelope ID: 36AB8lC4-269F-4904-8B62-5748847F8A94 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company Certificate No:8202409-985949 West American Insurance Company J.,. ., . POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the 'Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Aiza Anderson, Samuel E. Begun, Bryan M. Caneschi, Saylcham Chanthasone, Lorina Monique Garcia, Danielle D. Johnson, Michelle Anne McMahon, Tanya Nguyen, Aimee R. Perondine, Mercedes Phothirath, Jenny Rose Belen Phothirath, Noah William Pierce, Kristopher Pisano, Donna M. Planeta, Joshua Sanford,_ Bethany Stevenson, Rebecca M. Stevenson, Eric Strba, Jynell Marie Whitehead all of the city of Hartford state of Connecticut each individually if there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 23rd day of October 2019 . tNsu tv INS 1NSU Liberty Mutual Insurance Company R Rq The Ohio Casualty Insurance Company �JP40RPOR,Ql�y� �JP°°Rvo�gy \�P oRPor�r�, y� West American Insurance Company O fh U? O m W O 1T43 1912 0 o Z 1919 u 1991 � HAMP/J U) rd�9s-4r, Oda 6 * By: David M. Carey, Assistant Secretary State of PENNSYLVANIA >+ County of MONTGOMERY ss M L a) On this 23rd day of October 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o o Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes — > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. W IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. c Q Intl � c� o N�. N°nw�. COMMONWEALTH OF PENNSYLVANIA p�f�I Q 8Notarial Seale/� ate.. 0 OF Teresa Pastella, Notary Public p � Upper MerionTwp., Montgomery County By: L C tc p , �°r My Commission Expires March 28, 2021 C Teresa Pastella, Notary Public N ca% +u� Member, Pennsylvania Association of Notaries rTy es a Q iy This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance o .S; Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: 0-1E a? ARTICLE IV— OFFICERS: Section 12. Power of Attorney. 0 CU Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President a L) may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all o co > C: undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full o power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall N Z be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this ,F article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE All — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretaryof the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 8th day of October , 2020 . P,V 1NSUR9 P01f INS& tNSU.0 J 3°oRvoRyToy�cN �J 2GORPOR,q", ORPOR,9TOym :1( 912 y10 0 1919 1991 : o a o Yd� ssgcHus` as y0eAnvs aa3 �s 'NDIANP da By: Renee C. Llewellyn, Assistant Secrets ry LMS-12873 LMIC OCIC WAIC Multi Co 062018 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual 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 Alameda On October 13, 2020 before me, S. Foss, Notary Public (insert name and title of the officer) personally appeared Francis Johnson who proved to me on the basis of satisfactory evidence to be the person(X) whose name(s) is/M subscribed to the within instrument and acknowledged to me that he/ Wexecuted the same in his/)(&A XY\authorized capacity(yA), and that by his/XXMXt?Csignature(;-) on the instrument the person(, or the entity upon behalf of which the person(t) 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. Signature (Seal) *my 5. FOSS Notary Public - California Alameda CountyCommission ft 2309723 Comm. Expires Nov 17, 2023 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 SECTION 00630 CERT!F!CATE OF!iN.S!�P NCE Return Completed Certificate to City of Gilroy (Agency) This certifies to the Agency that the following described policies have been issued to the Insured named below and are in force at this time. Insured Address Description of operations/locations/products insured (show contract name and/or number, if any): POLICIES AND INSURERS Workers' Compensation (Name of Insurer) Liberty Insurance Corporation (Best's Rating) A XV Check policy type: COMPREHENSIVE GENERAL LIABILITY or COMMERCIAL GENERAL LIABILITY X (Name of Insurer) Liberty Mutual Fire Insurance Co (Best's Rating) A XV BUSINESS AUTO POLICY Liability Coverage Symbol 01 UMBRELLA LIABILITY (Name of Insurer) Allied World Assurance Company U.S (Best's Rating) A XV Bodily LIMITS Property Injury Damage Employers Liability $1,000,000 "Claims Made" Occurrence X Each Each Occurrence Occurrence $ 2,000,000 $ Aggregate Aggregate $ 4,000,000 $ or Combined Single Limit Aggregate $ Each Person Each Accident POLICY EXPIRATION NUMBER DATE EW766NO 03/31/2021 67002010 EB26610670 02030 03/31/2021 $ $ $ EU2661067 03/31/2021 Each Accident 002040 or, Combined Single Limit $ 2,000,000 "Claims Made" Occurrence X Occurrence/Aggregate $10,000,000 Self -Insured Retention $ 10,000 03082614 03/31/2021 Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00630-38 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 The following coverage or conditions are in effect: Yes No The Agency, its officials, and employees are named on all liability policies described above as insureds as respects: (a) activities performed for the Agency by or on behalf of the Named Insured, (b) products and completed operations of X the Named Insured, and (c) premises owned, leased or used by the Named Insured. Products and Completed Operations X The undersigned will mail to the Agency 30 days written notice of cancellation or reduction of coverage or limits X Cross Liability Clause (or equivalent wording) X Personal Injury, Perils A, B and C X Broad Form Property Damage X X, C, U& Hazards included X Contractual Liability Coverage applying to this Contract X Liquor Liability X Coverage afforded the Agency, its officials, employees and volunteers as Insureds applies as primary and not excess or contributing to any insurance issued in the X name of the Agency Waiver of subrogation from Workers' Compensation Insurer X This certificate is issued as a matter of information. This certificate is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. Edgewood Partners Insurance Center Liberty Mutual Fire Insurance Companyl Agency or Brokerage Insurance Company 10877 white rock road, suite 300, rancho cordova, ca 95670 157 Berkeley St., Boston, MA 02116 Address Home Office Samantha Wimmer Jd1�t,Q.IZ wi�i 10/va/2G20 Name of Person to be Contacted Authorized Signature Date 805 450-8900 Telephone No. Note: Authorized signatures may be the agent's if the agent has placed insurance through an agency agreement with the insurer. If insurance is brokered, authorized signature must be that of official of insurer. Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00630-39 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 City of Gilroy ("the Agency") GENERAL LIABILITY ENDORSEMENT 7351 Rosanna Street Gilroy, CA 95020 Attn: Risk Manager A. POLICY INFORMATION Endorsement No. 1. Insurance Company Liberty Mutual Fire Insurance Company Policy No. EB2661067002030 2. Policy Term (from) 03/31/2020 (to) 03/31/2021 3. Named Insured_ A. Tiechert & Son, Inc. DBA Teichert Construction 4. Address of Named Insured PO BOX 15002 Sacramento, CA 95851 5. Limit of Liability Any One Incident/Aggregate $ 4,000,000 6. Deductible or Self -Insured Retention: (Nil unless otherwise specified): $ 750,000 7. Coverage is equivalent: Comprehensive General Liability form GL0002 (Ed 1/73) Comprehensive General Liability "occurrence" form CG0001 Comprehensive General Liability "claims -made" form CG0002....................................................... 8. Bodily Injury and Property Damage Coverage is: "claims -made" - "occurrence" if claims -made, the retroactive date is NOTE: The Agency's standard insurance requirements specify "occurrence" coverage. "Claims -made" coverage requires special approval. B. POLICY AMENDMENTS This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or any other endorsement attached thereto, it is agreed as follows: INSURED. The Agency, its elected and appointed officers, officials, employees and volunteers are included as insureds with regards to damages and defense of claims arising from: (a) activities performed by or on behalf of the Named Insured, (b) products and completed operations of the Named Insured, or (c) premises owned, leased or used by the Named Insured. 2. CONTRIBUTION NOT REQUIRED. As respects: (a) work performed by the Named Insured for or on behalf of the Agency; or (b) products sold by the Named Insured to the Agency; or (c) premises leased by the Named Insured from the Agency, the insurance afforded by this policy shall be primary insurance as respects the Agency, its elected or appointed officers, officials, employees or volunteers; or stand in an unbroken chain of coverage excess of the Named Insured's scheduled underlying primary coverage. In either event, any other insurance maintained by the Agency, its elected or appointed officers, officials, employees and volunteers shall be in excess of this insurance and shall not contribute with it. 3. SCOPE OF COVERAGE. This coverage, if primary, affords coverage at least as broad as: (1) Insurance Services Office form number GI 002 (Ed. 1/73), Comprehensive General Liability Insurance and Insurance Services Office form number GL 0404 Broad Form Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00630-40 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 comprehensive General Liability endorsement: (2) Insurance Services Office Commercial Genera CG 0001 or "claims -made" form CG 0002; or (3) If excess, affords coverage which is at least a: referenced in the preceding sections (1) and (2), or Liability Coverage, "occurrence" form broad as the primary insurance forms 3. SEVERABILITY OF INTEREST. The insurance afforded by this policy applies separately to each insured who is seeking coverage or against whom a claim is made or a suit is brought, except with respects to the Company's limit of liability. 4. PROVISIONS REGARDING THE INSURED'S DUTIES AFTER ACCIDENT OR LOSS. Any failure to comply with reporting provisions of the policy shall not affect coverage provided to the Agency, its elected or appointed officers, officials, employees or volunteers. 5. CANCELLATION NOTICE. The insurance afforded by this policy shall not be suspended, voided, cancelled, reduced in coverage or in limits except after thirty (30) days prior written notice by certified mail return receipt requested has been given to the Agency. Such notice shall be addressed as shown in the heading of this endorsement. C. INCIDENT AND CLAIM REPORTING PROCEDURE Incidents and claims are to be reported to the insurer at: ATTN: Eileen Spaonoli, VP Property & Casualty (Title) (Department) Edgewood Partners Insurance Center (Company) (Address) 10877 white rock rd, suite 300, rancho cordova, ca 95670 916 576-1547 (Telephone) D. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER I, Samantha Wimmer (print/type name), warrant that I have authority to bind the below listed insurance company and by my signature hereon do so bind this company. IS I a)z� 7LhLP✓L SIGNATURE OF AUTHORIZED REPRESENTATIVE (original signature required on endorsement furnished to the Agency) ORGANIZATION edoewood partners insurance center TITLE Sr. Account Manaqer ADDRESS 10877 white rock rd, suite 300, rancho cordova, ca 95670 TELEPHONE 805 450-8900 Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00630-41 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 WORKER'S COMPENSATION/EMPLOYERS LIABILITY ENDORSEMENT The City of Gilroy ("the Agency") 7351 Rosanna Street Gilroy, CA 95020 Attn: Risk Manager A. POLICY INFORMATION Endorsement # 1. Insurance Company Liberty Insurance Corporation ("the Company") Policy Number EW766NO67002010 2. Effective Date of This Endorsement 03/31/2020 3. Named Insured A. Teichert & Son, Inc. DBA Teichert Construction 4. Employer's Liability Limit (Coverage B) $1,000,000 B. POLICY AMENDMENTS In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this endorsement is attached or any other endorsement attached thereto, it is agreed as follows: 1. Cancellation Notice. The insurance afforded by this policy shall not be suspended, voided, cancelled, reduced in coverage or in limits except after thirty (30) days prior written notice by certified mail return receipt requested has been given to the Agency. Such notice shall be addressed as shown in the heading of this endorsement. 2. Waiver of Subrogation. The Insurance Company agrees to waive all rights of subrogation against the Agency, its elected or appointed officers, officials, agents and employees for losses paid under the terms of this policy which arise from work performed by the Named Insured for the Agency. C. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER I, Samantha Wimmer (print/type name), warrant that I have authority to bind the below listed insurance company and by my signature hereon do so bind this company. 1l.Loul4 Ltlai�iL�iLQi1. SIGNATURE OF AUTHORIZED REPRESENTATIVE (original signature required on endorsement furnished to the Agency) ORGANIZATION Edgewood Partners Insurance Center TITLE Sr. Account Manager ADDRESS 10877 white rock rd. suite 300. rancho cordova. ca 95670 TELEPHONE 805 450-8900 Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00630-42 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 SECTION 00650 WORKERS' COMPENSATION INSURANCE CERTIFICATE In accordance with California Labor Code Section 1861, prior to commencement of work on the Contract, the Contractor shall sign and file with the City the following certification: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract." Signature Teichert, Inc. Name of Contractor Sr. Account Manager Title 10/08/2020 Date ***END OF SECTION*** Project No. 21-PW-260 FY21 Citywide Pavement Maintenance Project SECTION 00650-43 DocuSign Envelope ID: 36AB81C4-269F-4904-8B62-5748847F8A94 A. TEICHERT & SON, INC., 3500 Americans River Drive, Sacramori California 95864 I, PAULA D. JAMES, Secretary of A. TEICHERT & SON, INC., a California Corporation, which does business under the fictitious names of TEICHERT CONSTRUCTION, TEICHERT MATERIALS, TEICHERT AGGREGATES, TEICHERT ROCK PRODUCTS, and TEICHERT WATERWORK SERVICES, as well as under its own name, certify that the following is a true and correct copy of a resolution unanimously passed and adopted by the Board of Directors of this corporation at a meeting held on May 13, 2020: RESOLVED, That MARY T. TEICHERT President and RONALD L. GATTO Executive Vice President, Chief Financial Officer & Assistant Secretary and PAULA D. JAMES Secretary any two of whom acting in combination, are authorized on behalf of this corporation .and in its name or in any of the fictitious names under which this corporation does business, to sign, seal, acknowledge, verify and deliver deeds, deeds of trust, mortgages, pledges, transfers, promissory notes, and any other documents and instruments relating to the business and properties, real and personal, of this corporation; RESOLVED FURTHER, That the following officers of this corporation Mary T. Teichert President Ronald L. Gatto Executive Vice President, Chief Financial Officer & Assistant Secretary David A. Swartz Executive Vice President Dana M. Davis Senior Vice President A. Ed Hermberger Senior Vice President & General Manager Christopher C. Barkley Vice President, Director Field Operations Clark J. Hulbert Vice President Organizational Development Francis C. Johnson Vice President & Regional Manager, Bay Area Scott R. Lewis Vice President & Regional Manager, Greater Sacramento Timothy B. Murphy Vice President, Manager Mobile Equipment Mark A. Nilsen Vice President & Regional Manager, Central Valley Eric D. Stannard Vice President Public Works Paula D. James Secretary Christopher M. McCaffrse Treasurer Kathy Radiey-Timberlake Controller are authorized, acting alone or in any combination, on behalf of this corporation and in its name or in any of the fictitious names underwhich this corporation does business, to execute and deliver proposals, bids, bonds, contracts, and agreements for construction work; and to do all other acts of a business nature that this corporation is empowered to do by law; RESOLVED FURTHER, That the following employees of this corporation: Wee Chu Senior Estimator, North Region Rick Czuleger Chief Estimator, North Region Jeff Feusi Chief Estimator, North Region Jim Gallagher Area Manager, Bay Area Region Darryl Hansen Senior Estimator, North Region Stephen Muck Area Manager, North Region Tom Musson Chief Estimator, Central Valley Region Raul Ortiz Area Manager, Central Valley Region Bryan Ramirez Area Manager, North Region Nathan Rinaldi Senior Estimator, Central Valley Region Alexander Salcedo Area Manager, South Valley Region Janez Seliskar Chief Estimator, Central Valley Region Mike Stephenson Senior Estimator, Bay Area Region Jason Theriault Chief Estimator, Bay Area Region are designated as attorneys in fact of this corporation with full authority to execute proposals, bids, honds, contracts, and agreements for construction work; RESOLVED FURTHER, That the following employee of this corporation: Sean Collins Credit & Contracts Manager is designated as attorney in fact of this corporation with full authority to execute credit agreements, credit settlement agreements, lien rights, contracts and otherdocuments relating to the credit and contracts for this corporation. —2Z DATED; \0' 13I f�. Paula D J mes Secreta of A. Teic & Son, Inc.