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Agreement - Certa Pro Painters of the Peninsula and Silicon Valley - Annex PaintingDocusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 City of Gilroy Agreement/Contract Tracking Today’s Date: August 27, 2024 Your Name: Izabela Cirloganu Contract Type: Services over $5k - Contractor - NO ENG OR DESIGN Phone Number: 4088460255 Contract Effective Date: (Date contract goes into effect) 10/1/2024 Contract Expiration Date: 11/15/2024 Contractor / Consultant Name: (if an individual’s name, format as last name, first name) Certa Pro Painters of the Peninsula and Silicon Valley Contract Subject: (no more than 100 characters) Painting the west side of the Annex building to prepare the building for office occupancy. Contract Amount: (Total Amount of contract. If no amount, leave blank) 36817 By submitting this form, I confirm this information is complete: Date of Contract 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 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 8/27/2024LeeAnn McPhillips 8/30/2024Andy Faber Heath McMahon 9/3/2024 Beth Minor 9/3/2024 TYPE OF PROCURMENT DOLLAR THRESHOLD / SIGNING AUTHORITY STAFF LEVEL DEPARTMENT HEAD CITY ADMINISTRATOR COUNCIL APPROVAL $0-$999.99 $1,000-$49,999.99 $50,000-$99,999.99 $100,000-Above EQUIPMENT /SUPPLIES/ MATERIALS Furniture, hoses, parts, pipe manholes, office supplies, fuel, tools, PPE items, etc…  Vendor selection at discretion of staff Payment Method Purchase Card or Payment Request (if vendor does not accept credit cards)  Informal bid/quotation – 3 quotes (verbal or written)  Purchasing Summary form w/ Purchasing Approval  Purchase Requisition Payment Method Purchase Order*  Informal bid/quotation – 3 written quotes  Purchasing Summary form w/ City Administrator Approval  Purchase Requisition Payment Method Purchase Order  Formal Bid  Advertisement  Council Approval  Purchase Requisition signed by City Administrator Payment Method Purchase Order GENERAL SERVICES Janitorial, landscape maintenance, equipment repair, installation, graffiti abatement, service inspections, uniform cleaning, etc…  Vendor selection at discretion of staff  May require insurance documents depending on scope/ nature of work Payment Method Purchase Card (if incorporated) Signed Payment Request (if sole proprietor or partner)  Informal bid/quotation – 3 quotes (verbal or written)  Purchasing Summary form w/ Department Head Approval  Standard Agreement  Purchase Requisition Payment Method Purchase Order*  Informal Bid/RFP quotation – 3 written quotes  Purchasing Summary form w/ City Administrator Approval  Standard Agreement  Purchase Requisition Payment Method Purchase Order  Formal Bid/RFP/RFQ  Advertisement  Council Approval  Standard Agreement  Purchase Requisition Payment Method Purchase Order PROFESSIONAL SERVICES Consultants, architects, designers, auditors, etc...  Vendor selection at the discretion of staff  Purchase Summary Form w/ Purchasing Approval  Standard Agreement signed by Department Head  Purchase Requisition Payment Method Purchase Order  RFP/RFQ to at least 3 consultants  Purchase Summary Form w/ Department Head Approval  Standard Agreement  Purchase Requisition Payment Method Purchase Order  RFP/RFQ to a list of consultants  Evaluation Spreadsheet w/ City Administrator Approval  Standard Agreement  Purchase Requisition Payment Method Purchase Order  Formal RFP/RFQ  Advertisement  Council Approval  Standard Agreement signed by City Administrator  Purchase Requisition Payment Method Purchase Order Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: C64403BA-7D1F-45EB-B4ED-56F692382120Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 8/8/2024 Panorama Insurance Associates/Garry Grace P3 3009 Douglas Blvd, Suite 300 Roseville, CA 95661 Garry Grace (619)507-8507 760-454-0404 garry@garrygrace.com 00000363-240730190706 3 Peninsula Improvements, Inc CertaPro Painters of the Peninsula 1206 South Amphlett Blvd, Unit #2 San Mateo, CA 94402 Associated Industries Insurance Company A AES1047979 07 7/28/2024 7/28/2025X X X 1,000,000 100,000 EXCLUDED 1,000,000 2,000,000 2,000,000 California Automobile Insurance Company B BA0400000920239 8/4/2024 8/4/2025 X X X 1,000,000 Associated Industries Insurance Company A EXA1236016 01 7/28/2024 7/28/2025X X 5,000,000 5,000,000 City of Gilroy, its officers, officials and employees are named as an additional insured, per the attached endorsement City of Gilroy, its offiers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 (GHG) Printed by GHG on 08/08/2024 at 11:34AM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ACORD 25 (2016/03) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED HIRED AUTOS ONLY NON-OWNEDAUTOS ONLY AUTOS AUTOS ONLY COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Acct#:2526176 8/19/2024 USI Insurance Services, LLC 844-290-49082502 N Rocky Point Drive Tampa, FL 33607 BBSIcerts@locktonaffinity.com Ace American Insurance Company 22667 PENINSULA IMPROVEMENTS, INC. DBA: CERTAPRO PAINTERS OF THE PENINSULA & SOUTHBAY 1206 S. AMPHLETT BLVD, STE 2, SAN MATEO, CA 94402 A X C58825591 9/1/2024 9/1/2025 X 2,000,000 2,000,000 2,000,000 Policy State = CA Waiver of Subrogation in favor of certificate holder when required by written contract City Of Gilroy7351 Rosanna St.Gilroy, CA 95020 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Policy Number Symbol: WLR Number: Policy Period TO Effective Date of Endorsement Issued By (Name of the Insurance Company) Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1.( ) Specific Waiver Name of person or organization: ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2.Operations: 3. Premium: The premium charge for this endorsement shall be percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4.Minimum Premium: _______________________________________ Authorized Agent WC 90 03 75 (05/18) ALL CALIFORNIA OPERATIONS 1.0 $0 PENINSULA IMPROVEMENTS, INC. DBA: CERTAPRO PAINTERS OF THE PENINSULA & SOUTHBAY 1206 S. AMPHLETT BLVD, STE 2, SAN MATEO, CA 94402 C58825591 9/1/2024 9/1/2025 9/1/2024 Ace American Insurance Company X Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751 Docusign Envelope ID: AEB2D8DF-9E03-400D-A473-4882FF7E4751