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Agreement -McKim CDBG.pdf
City of Gilroy Agreement/Contract Tracking Today’s Date: February 13, 2024 Your Name: Susana Ramirez Contract Type: Services over $5k - Contractor - NO ENG OR DESIGN Phone Number: 408-846-0212 Contract Effective Date: (Date contract goes into effect) Click here to enter a date. Contract Expiration Date: 12/31/2024 Contractor / Consultant Name: (if an individual’s name, format as last name, first name) McKim Coporation 8505 Church St. #1 Gilroy, CA 95020 Taxpayer ID: 45-5559224 Contractor’s License #: 976269 Signer’s Name/Title: Santino Orozco/President Contract Subject: (no more than 100 characters) FY24 CDBG Curb Ramp Project Phase 2 No. 24-PW-289 Contract Amount: (Total Amount of contract. If no amount, leave blank) $96,700.00 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: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 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 so 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: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00500-25 SECTION 00500 AGREEMENT FY24 CDBG CURB RAMP PROJECT PHASE 2 NO. 24-PW-289 THIS AGREEMENT, made this day of , 2024, by and between the City of Gilroy, hereinafter called the “City,” and hereinafter called the “Contractor.” W I T N E S S E T H: 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 FY24 CDBG Curb Ramp Project Phase 2 No. 24-PW- 289, 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. 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 20th February McKim Corporation DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00500-26 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 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 Bid Documents Agreement Acknowledgements Performance Bond Payment Bond General Conditions Supplementary Conditions General Requirements Standard Specifications (Caltrans) Technical Specifications Drawings Addenda, if any DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00500-27 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, 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 day of , . February 20 2024 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00500-28 Name of Contractor Signature of City City Administrator Signature of Contractor Title of Signator _____________________ Title of Signator Approved as to form by City Attorney ATTEST: ATTEST: Signature Signature Title of Signator Title of Signator ***END OF SECTION*** McKim Corporation President Secretary / CFO DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988 Interim City Clerk DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00630-33 SECTION 00630 CERTIFICATE OF INSURANCE 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 Bodily LIMITS Property Injury Damage POLICY NUMBER EXPIRATION DATE Workers’ Compensation (Name of Insurer) (Best’s Rating) Employers Liability $ Check policy type: COMPREHENSIVE GENERAL LIABILITY , or COMMERCIAL GENERAL LIABILITY . (Name of Insurer) (Best’s Rating) “Claims Made” Occurrence Each Each Occurrence Occurrence $ $__________ Aggregate Aggregate $ $ or Combined Single Limit $ Aggregate $ BUSINESS AUTO POLICY Liability Coverage Symbol Each Person Each Accident $ $ $ Each Accident $ or, Combined Single Limit $ UMBRELLA LIABILITY (Name of Insurer) (Best’s Rating) “Claims Made” Occurrence Occurrence/Aggregate $ Self-Insured Retention $ PLEASE SEE ATTACHED INSURANCE CERTIFICATE DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00630-34 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 the Named Insured, and (c) premises owned, leased or used by the Named Insured. Products and Completed Operations The undersigned will mail to the Agency 30 days written notice of cancellation or reduction of coverage or limits Cross Liability Clause (or equivalent wording) Personal Injury, Perils A, B and C Broad Form Property Damage X, C, U& Hazards included Contractual Liability Coverage applying to this Contract Liquor Liability 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 name of the Agency Waiver of subrogation from Workers’ Compensation Insurer 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. Agency or Brokerage Insurance Company Address Home Office Name of Person to be Contacted Authorized Signature Date 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. InterWest Insurance Services, Inc. Jordan Swanson ''As per attached Cert '' '' On Certificate '' 916-609-8323 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00630-35 GENERAL LIABILITY ENDORSEMENT City of Gilroy (“the Agency”) 7351 Rosanna Street Gilroy, CA 95020 Attn: Risk Manager A. POLICY INFORMATION Endorsement No. 1. Insurance Company Policy No. 2. Policy Term (from) (to) 3. Named Insured 4. Address of Named Insured 5. Limit of Liability Any One Incident/Aggregate $ 6. Deductible or Self-Insured Retention: (Nil unless otherwise specified): $ 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: 1. 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: '' AS PER ATTACHMENT '' DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00630-36 (1) Insurance Services Office form number GL 002 (Ed. 1/73), Comprehensive General Liability Insurance and Insurance Services Office form number GL 0404 Broad Form comprehensive General Liability endorsement: or (2) Insurance Services Office Commercial General Liability Coverage, “occurrence” form CG 0001 or “claims-made” form CG 0002; or (3) If excess, affords coverage which is at least as broad as the primary insurance forms referenced in the preceding sections (1) and (2). 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: (Title) (Department) (Company) (Address) (Telephone) D. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER I, (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. SIGNATURE OF AUTHORIZED REPRESENTATIVE (original signature required on endorsement furnished to the Agency) ORGANIZATION TITLE ADDRESS TELEPHONE Office Manager ACCOUNTING MCKIM CORPORATION 8505 Church Street #1, Gilroy, CA 95020 408-848-8700 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 FY24 CDBG Curb Ramp Project Phase 2 Project No. 24-PW-289 SECTION 00630-37 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 (“the Company”) Policy Number 2. Effective Date of This Endorsement 3. Named Insured 4. Employer’s Liability Limit (Coverage B) 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, (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. SIGNATURE OF AUTHORIZED REPRESENTATIVE (Original signature required on endorsement furnished to the Agency) ORGANIZATION TITLE ADDRESS TELEPHONE ***END OF SECTION*** DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 2/27/2024 InterWest Insurance Services,LLC P.O.Box 255188 Sacramento CA 95865-5188 Katie Snell 9166098374 9166098374 ksnell@iwins.com License#:0B01094 Travelers Property Casualty Company of America 25674 MCKICOR-01 Insurance Co.of the West 27847McKimCorporation 8505 Church Street,Unit 1 Gilroy CA 95020 944321476 A X 1,000,000 X 300,000 5,000 10,000,000 2,000,000 X CO6X188979 1/23/2024 1/23/2025 2,000,000 A 1,000,000 X X X BA6X189571 1/23/2024 1/23/2025 A X X 4,000,000CUP6X1901031/23/2024 1/23/2025 B X N WSA505422203 3/10/2023 3/10/2024 1,000,000 1,000,000 1,000,000 A CO6X188979 1/23/2024 1/23/2025 RE:FY24 CDBG CURB RAMP PROJECT PHASE 2 NO.24-PW-289 The City of Gilroy,its officers,officials,employees,and volunteers are to be covered as additional insureds. City of Gilroy Public Works Department 7351 Rosanna Street Gilroy CA 95020 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED – PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE – CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2.The following is added to Paragraph B.5.,Other Insurance of SECTION IV – BUSINESS AUTO1.The following is added to Paragraph c.in A.1.,CONDITIONS:Who Is An Insured, of SECTION Il – COVERED AUTOS LIABILITY COVERAGE:Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, thisThis includes any person or organization who you insurance is primary to and non-contributory withare required under a written contract or applicable other insurance under which anagreement, that is signed by you before the additional insured person or organization is a"bodily injury" or "property damage" occurs and named insured when a written contract orthat is in effect during the policy period, to name agreement with you, that is signed by you beforeas an additional insured for Covered Autos the "bodily injury" or "property damage" occursLiability Coverage, but only for damages to which and that is in effect during the policy period,this insurance applies and only to the extent of requires this insurance to be primary and non-that person's or organization's liability for the contributory.conduct of another "insured". CA T4 99 02 16 ú 2016 The Travelers Indemnity Company. All rights reserved.Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number: BA6X189571 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 Do not add this form to a policy. It is for informational purposes only.COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE – This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF USE – INCREASED LIMIT A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED PHYSICAL DAMAGE – TRANSPORTATIONI. EXPENSES – INCREASED LIMIT C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED PERSONAL PROPERTYJ. SUPPLEMENTARY PAYMENTS – INCREASEDE. LIMITS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSSF. HIRED AUTO – LIMITED WORLDWIDE COV- ERAGE – INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE – GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. The following is added to Paragraph A.1.,Who Is An Insured, of SECTION II – COVERED AUTOS LIABILITY COVERAGE: C. EMPLOYEE HIRED AUTOAny organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. 1.The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness.B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II – COVERED AUTOS LIABILITY COVERAGE: 2.The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV – BUSI- NESS AUTO CONDITIONS: b.For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which (1)Any covered "auto" you lease, hire, rent or borrow; and (2)Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 ú 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number: BA6X189571 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 Do not add this form to a policy. It is for informational purposes only.COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. (a)With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada:However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".(i)You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. D. EMPLOYEES AS INSURED The following is added to Paragraph A.1.,Who Is An Insured, of SECTION II – COVERED AUTOS LIABILITY COVERAGE: (ii)Neither you nor any other involved "insured" will make any settlement without our consent. Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. (iii)We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". E. SUPPLEMENTARY PAYMENTS – INCREASED LIMITS 1.The following replaces Paragraph A.2.a.(2), of SECTION II – COVERED AUTOS LIABIL- ITY COVERAGE:(iv)We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II – COVERED AUTOS LIABILITY COVERAGE. (2)Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2.The following replaces Paragraph A.2.a.(4), of SECTION II – COVERED AUTOS LIABIL- ITY COVERAGE: (v)We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II – COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (4)All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO – LIMITED WORLDWIDE COV- ERAGE – INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7.,Policy Period, Coverage Territory, of SECTION IV – BUSINESS AUTO CONDI- TIONS: (5)Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. (b)This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c)This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. Page 2 of 4 ú 2015 The Travelers Indemnity Company. All rights reserved.CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 Do not add this form to a policy. It is for informational purposes only.COMMERCIAL AUTO (2)In or on your covered "auto".You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3.,Exclu- sions, of SECTION III – PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: (d)It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. a.If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b.The airbags are not covered under any war- ranty; andG. WAIVER OF DEDUCTIBLE – GLASS c.The airbags were not intentionally inflated.The following is added to Paragraph D.,Deducti- ble, of SECTION III – PHYSICAL DAMAGE COVERAGE: We will pay up to a maximum of $1,000 for any one "loss". No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV – BUSINESS AUTO CONDITIONS:H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF USE – INCREASED LIMIT Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: The following replaces the last sentence of Para- graph A.4.b.,Loss Of Use Expenses, of SEC- TION III – PHYSICAL DAMAGE COVERAGE: (a)You (if you are an individual);However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". (b)A partner (if you are a partnership); (c)A member (if you are a limited liability com- pany);I. PHYSICAL DAMAGE – TRANSPORTATION EXPENSES – INCREASED LIMIT (d)An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or The following replaces the first sentence in Para- graph A.4.a.,Transportation Expenses, of SECTION III – PHYSICAL DAMAGE COVER- AGE: (e)Any "employee" authorized by you to give no- tice of the "accident" or "loss". We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5.,Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV – BUSINESS AUTO CONDI- TIONS:J. PERSONAL PROPERTY 5. Transfer Of Rights Of Recovery Against Others To Us The following is added to Paragraph A.4.,Cover- age Extensions, of SECTION III – PHYSICAL DAMAGE COVERAGE:We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1)Owned by an "insured"; and CA T3 53 02 15 ú 2015 The Travelers Indemnity Company. All rights reserved.Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 Do not add this form to a policy. It is for informational purposes only.COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non-renewal. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2.,Con- cealment, Misrepresentation, Or Fraud, of SECTION IV – BUSINESS AUTO CONDITIONS: Page 4 of 4 ú 2015 The Travelers Indemnity Company. All rights reserved.CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products-Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II -WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured,but only: a.With respect to liability for "bodily injury"or "property damage"that occurs,or for "personal injury"caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect;and b.If,and only to the extent that,such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work"to which the written contract or agreement applies.Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a.If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement,the insurance provided to the additional insured will be limited to such minimum required limits.For the purposes of determining whether this limitation applies,the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III -Limits Of Insurance. b.The insurance provided to such additional insured does not apply to: (1)Any "bodily injury","property damage"or "personal injury"arising out of the providing, or failure to provide,any professional architectural,engineering or surveying services,including: (a)The preparing,approving,or failing to prepare or approve,maps,shop drawings,opinions,reports,surveys, field orders or change orders,or the preparing,approving,or failing to prepare or approve,drawings and specifications;and (b)Supervisory,inspection,architectural or engineering activities. (2)Any "bodily injury"or "property damage" caused by "your work"and included in the "products-completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c.The additional insured must comply with the following duties: (1)Give us written notice as soon as practicable of an "occurrence"or an offense which may result in a claim.To the extent possible,such notice should include: (a)How,when and where the "occurrence" or offense took place; (b)The names and addresses of any injured persons and witnesses;and (c)The nature and location of any injury or damage arising out of the "occurrence" or offense. (2)If a claim is made or "suit"is brought against the additional insured: CG D2 46 0419 ©2018 The Travelers Indemnity Company.All rights reserved.Page 1 of 2 Policy Number: CO6X188979 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage.Read the entire policy carefully to determine rights,duties and what is and is not covered. Throughout this policy the words "you"and "your"refer to the Named Insured shown in the Declarations,and any other person or organization qualifying as a Named Insured under this policy.The words "we","us"and "our"refer to the company providing this insurance. The word "insured"means any person or organization qualifying as such under Section II -Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning.Refer to Section V - Definitions. SECTION I -COVERAGES COVERAGE A -BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1.Insuring Agreement a.We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury"or "property damage" to which this insurance applies.We will have the right and duty to defend the insured against any "suit"seeking those damages.However, we will have no duty to defend the insured against any "suit"seeking damages for "bodily injury"or "property damage"to which this insurance does not apply.We may,at our discretion,investigate any "occurrence"and settle any claim or "suit"that may result.But: (1)The amount we will pay for damages is limited as described in Section III -Limits Of Insurance;and (2)Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments. b.This insurance applies to "bodily injury"and "property damage"only if: (1)The "bodily injury"or "property damage"is caused by an "occurrence"that takes place in the "coverage territory"; (2)The "bodily injury"or "property damage" occurs during the policy period;and (3)Prior to the policy period,no insured listed under Paragraph 1.of Section II -Who Is An Insured and no "employee"authorized by you to give or receive notice of an "occurrence"or claim knew that the "bodily injury"or "property damage"had occurred, in whole or in part.If such a listed insured or authorized "employee"knew,prior to the policy period,that the "bodily injury"or "property damage"occurred,then any continuation,change or resumption of such "bodily injury"or "property damage"during or after the policy period will be deemed to have been known prior to the policy period. c."Bodily injury"or "property damage"which occurs during the policy period and was not, prior to the policy period,known to have occurred by any insured listed under Paragraph 1.of Section II -Who Is An Insured or any "employee"authorized by you to give or receive notice of an "occurrence"or claim,includes any continuation,change or resumption of that "bodily injury"or "property damage"after the end of the policy period. d."Bodily injury"or "property damage"will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1.of Section II -Who Is An Insured or any "employee"authorized by you to give or receive notice of an "occurrence"or claim: (1)Reports all,or any part,of the "bodily injury"or "property damage"to us or any other insurer; (2)Receives a written or verbal demand or claim for damages because of the "bodily injury"or "property damage";or (3)Becomes aware by any other means that "bodily injury"or "property damage"has occurred or has begun to occur. CG T1 00 02 19 ©2017 The Travelers Indemnity Company .All rights reserved. Includes copyrighted material of Insurance Services Office,Inc.with its permission. Page 1 of 21 Policy Number: CO6X188979 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage.However,coverage for any injury,damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part,and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement.The following listing is a general coverage description only.Read all the provisions of this endorsement and the rest of your policy carefully to determine rights,duties,and what is and is not covered. A.Who Is An Insured -Unnamed Subsidiaries B.Blanket Additional Insured -Governmental Entities -Permits Or Authorizations Relating To Operations PROVISIONS A.WHO IS AN INSURED -UNNAMED SUBSIDIARIES The following is added to SECTION II -WHO IS AN INSURED: Any of your subsidiaries,other than a partnership, joint venture or limited liability company,that is not shown as a Named Insured in the Declarations is a Named Insured if: a.You are the sole owner of,or maintain an ownership interest of more than 50%in,such subsidiary on the first day of the policy period; and b.Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage"that occurred,or "personal and advertising injury"caused by an offense committed: a.Before you maintained an ownership interest of more than 50%in such subsidiary;or b.After the date,if any,during the policy period that you no longer maintain an ownership interest of more than 50%in such subsidiary. For purposes of Paragraph 1.of Section II -Who Is An Insured,each such subsidiary will be deemed to be designated in the Declarations as: C.Incidental Medical Malpractice D.Blanket Waiver Of Subrogation E.Contractual Liability -Railroads F.Damage To Premises Rented To You a.An organization other than a partnership,joint venture or limited liability company;or b.A trust; as indicated in its name or the documents that govern its structure. B.BLANKET ADDITIONAL INSURED GOVERNMENTAL ENTITIES -PERMITS OR AUTHORIZATIONS RELATING TO OPERATIONS The following is added to SECTION II -WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance,law,building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured,but only with respect to liability for "bodily injury","property damage"or "personal and advertising injury"arising out of such operations. The insurance provided to such governmental entity does not apply to: a.Any "bodily injury","property damage"or "personal and advertising injury"arising out of operations performed for the governmental entity;or b.Any "bodily injury"or "property damage" included in the "products-completed operations hazard". CG D3 16 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 3 Policy Number: CO6X188979 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification ▶ Go to www.irs.gov/FormW9 for instructions and the latest information. Give Form to the requester. Do not send to the IRS.Print or type. See Specific Instructions on page 3.1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ▶ Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) ▶ 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 6 City, state, and ZIP code Requester’s name and address (optional) 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Social security number –– or Employer identification number – Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later. Sign Here Signature of U.S. person ▶Date ▶ General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) 2/20/2024 McKim Corporation 8505 Church Street #1, Gilroy, CA 95020 City of Gilroy, DPW 4 5 5 5 5 9 2 2 4 4 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 PRESIDENT DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 PRESIDENT DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7 DocuSign Envelope ID: FD2C9264-5E6A-49C6-BEB2-6439C6403988DocuSign Envelope ID: E526D223-2F12-4128-850D-70CDD503D5A7