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The Don Chapin Company - Sixth Street Improvement Project - Change Order No. 8
City of Gilroy Engineering Division 7351 Rosanna St., Gilroy, CA 95020 Phone (408) 846 -0450; Fax (408) 846 -0429 CHANGE ORDER NO. 8 To contract for : Updates to estimated material quantities and project clean up. Contractor: Don Chapin Company Contract Date: 7/13/2010 This order shall become effective when it has been signed by the City Administrator, City Engineer, Project Engineer, and Contractor. All copies forwarded to Contractor for signature shall be returned to The City of Gilroy properly filled out. Upon acceptance by the City, the Contractor's copy will be returned to him as his authority to proceed with the work. Description of Work This change order provides for the updates to estimated material quantities that were authorized during the project ( +$I 1,219.10)and deduction of change order #1 (- $98,763.00 that was outside scope of this project and part of another 6th street project that was cleaned up in the payment history but not in the change order history). The material updates, that were required for project completion, included addition of aggregate base, asphalt concrete, sidewalk drains, lighting fixture, 3/4" GLS conduit, 3" PVS SCH. 40 conduit, and #5 and #6 pull boxes and a decrease in signage. See attached for full listing of quantity and unit pricing as well as bid item list updates. All requirements of the original Contract Documents shall apply to the above work except as specifically modified by this Change Order. The contract time shall not extend unless expressly provided for in this Change Order. By signing this Change Order, Contractor acknowledges and agrees that the adjustments to cost and time contained herein are in full satisfaction and accord, and are accepted as payment in full, for any and all costs and expenses associated with this Change Order, (the "Extra Work "), including but not limited to labor, materials, overhead and profit, delay, disruption, loss of efficiency and any and all other direct and/or indirect costs or expenses associated with the Extra Work and hereby waives any right to claim any further cost and time impacts at any time during and after completion of the Contract associated with the Extra Work. Cost Percentage Initial I (We) agree to make the above change Original Contract Price $1,024,474.00 subject to the terms of this Change Order Previous Change Orders $511,996.30 49.98% for the NET INCREASE of - $87,543.90 Total to Date $1,536,470.30 This Change Order - $87,543.90 % Total Change Orders to Date $424,452.40 41.43% &tj C I_ !1C(�IN �Q .._rN , Revised Contract Price $1,448,926.40 CONTRACTOR By. \ �LV� Date: C,)-12- ) —� RECOMMENDED 135 ACCEPTED BY: 5/3/2012 Line Item # Description Change in QTY Unit Price Total $ Change _ 14 Aggregate Base (12 ") 50 $ 140.00 ' $ 7,000.00 15 iAsphalt Concrete (6 ") 12.63 F $ 170.00 $ 2,147.10 21 'Sidewalk Drain 8 $ 22.00 1 $ 176.00 37 iWay Finding Signs j -1 $ 3,000.00 $ (3,000.00) 58 lighting Fixture Fou i 1 $ 1,000.00 $ 1,000.00 59 3/4 " GLS Conduit _ I 8 — $^ 30.00 $ 240.00 63 3" PVC SCH. 4_0 CONDO 88 $ 32.00 $ 2,816.00 68 1#6 Pull Box 1 ; $ 320.OQ $ 320.00 144 — ; #� 5 Pull Box 2 $ 260.00 r$ 520.00 REVISED QTY COST - Need Change Order $ 11,219.10 G/ o �I I "V,� Please return one copy with Fstyment. All invoices are due within 30 days from date of invoice. Past due invoices are sub(ecr to a late Payment charge computed at 2A96 Per i n nth (24% annual Percentage rate) rnt the past due an)ramr. WE ACCEPT VISA / 1AASTERCARD J DISCOVER • WE ACCEPT VISA / MASTGRCARD / DISCOVER • WE ACCEPT VISA j MASTERCAILD I I)ISCOVL'I( a Invoice 21009817 Page No. -1•• 560 Crazy Horse Canyon Road Salinas, CA 93907 -8434 Pay Application Date Terms Contract Phone: 831 -449 -4273 • Pax: 831 -449 -0700 l' 17 l 31 MAR 2012 _ I NET 30 DAYS POI1110135 f Contract Location Customer 10084 VV l Job Cost Project 9 210098 l r_21'Y OF GILROY v i l CITY OF GILROY -6th ST. IMBROv, l l attn: DON DEY - l PCC,AC,SD,LIGHT- G,MASONAY l 7351 ROSANNA ST. Gilroy , CA 95020 `G(j Ar::j_ 'I II r v EIGLBERRY TO RAILROAD S'I' Gilroy CA 95020 l Estimated Previous Current To Date Unit Current To Date Bid Ite.+n Description UOM Quantity Quantity Quantity Quantity Price Amount Amount 1 MOBILIZATION LS 1.0000 1.0000 0.0000 1,0000 15000.0000 O.pO 15,000.00 2 TRAFFIC CONTROL & CO LS 110000 1.0000 0.0000 1.0000 9000.0000 0.00 9,000.00 3 REMOVE AC PAVEMENT SF 325.0000 325.0000 0.0000 325,0000 6.0000 0,00 1,950,00 4 REMOVE PCC PAVEMENT Sr 4896.0000 4896.0000 0.0000 4896.0000 3.0000 0.00 14,688.00 5 REMOVE FCC SIDE't4ALK SF 5444.0000 5444.0000 0.0000 5944.0000 2.0000 0.00 I0,B88.00 6 REMOVE PCC DRIVEWAY SF 960.0000 960.0000 0.0000 960.0000 2.0000 0100 1,920.00 7 REMOVE PCC CURB LF 29010000 290.0000 0.0000 290.0000 7.0000 0.00 2,030.00 a REMOVE PCC CURB & GU LF 237.0000 237.0000 0.0000 237.0000 15.0000 0.00 3,555.00 9 REMOVE EXISTING SD -D EA 1,0000 1.0000 0.0000 1.0000 700.0000 0.00 700.00 10 CLEARING AND GRUBBIN LS 1.D000 1.0000 0.0000 1.0000 1000.0000 0.00 11000.00 11 REMOVE TREE EA 8.0000 8.0000 0.0000 8.0000 400.0000 _ 0.00 3,200.00 1.2 NEW WM BOX MID COPPE EA 4.0000 4.0000 0.0000 4.0000 1300.0000 0.00 5,200.00 13 14 15 2" WATER SERVICE AGGREGATE BASE (1 ?. ") ASPHALT CONCRETE (6" EA CY TON 1.0000 132.0000 127.0000 1.0000 `�?i r- 182"0600 __ ].39.G300 �] 0000 ��.0000 0.0000 1.0000 182.0000 139.6300 3000.0000 140.0000 -7 J f CO 170.0000 0100 0.00 0.00 3,000.00 25,480.00 '23,737.10 16 CURB & GUTTER LF 537.0000 537.0000 0.0000 537.0000 40.0000 0.00 21,480.00 17 SIDEWALK OF 3664.0000 3664.0000 0.0000 3664,0000 8.0000 0.00 29,31.2.00 is 'DRIVEWAY SF 975.0000' 975.0000 010000 975.0000 10.0000 0.00 91750.00 1.9 PEDESTRIAN CROSSWALK SF 300.0000 300.0000 0.0000 300.0000 20.0000 0,00 61000.00 20 21 CURB RAMP SIDEWALK DRAIN EA LF 4.0000 62.0000 4.0000 % 0.0000 f,7 0.000 N 010000 4.0000 70.0000 2200.0000 22.0000 0.00 0.00 81800.00 1,540.00 2 BRICK PAVERS SF 1563.0000 1563,0000 0.0000 1563.0000 25.0000 0.00 39,075.00 23 DECORATIVE TRASH CAN EA 1.0000 110000 010000 1.0000 1000.0000 0.00 1,000.00 24 TREE GRATE AND GUARD EA 11.0000 11,0000 0.0000 11.0000 2000.0000 0.00 22,000.00 25 BIKE RACK EA 3.0000 3.0000 0.0000 3.0000 600.0000 0.00 11000.00 26 BOLLARD EA 4.0000 4,0000 D.00DO 4.0000 600.0000 0100 2,400.00 27 12-INCH RCP LF 510000 5.0000 0.0000 5.0000 300.0000 0.00 1,500.06 28 CONSTRUCT SD -DI EA 1.0000 1.0000 0.0000 110000 6000.0000 0.00 61000.00 29 30 31 32 33 CONSTRUCT SDMH GRATE 4 -INCH WHITE TRAFFIC 12 -INCIF WHITE TRAFFI DETAIL - 22 CENPERLI PAINT CURB RD EA LF LF LF LF 1.0000 40.0000 420.0000 395.0000 15.0000 1.0000 48.0000 420.0000 395.0000 15.0000 D.D000 0.0000 D.0000 0.0000 0.0000 1.0000 48.0000 420.000D 395.0000 15.0000 1000.0000 3.0000 3.0000 3.0000 2.0000 0.00 0.00 0.00 0.D0 0.00 1,000.00 144,00 1,260.00 1,I85.00 30.00 34 35 36 BLUE REFLECTIVE MARK PAVEMENT MARKING (ST ROADSIDE" SIGNS EA OF EA 2.0000 44.0000 19.0000 2.0000 44.0000 19.0000 0.0000 010000 0,0000 210000 44.0000 19.0000 25.0000 S.00DO 175.0000 0.00 0.00 0.00 50.00 220.00 3,325.00 Please return one copy with Fstyment. All invoices are due within 30 days from date of invoice. Past due invoices are sub(ecr to a late Payment charge computed at 2A96 Per i n nth (24% annual Percentage rate) rnt the past due an)ramr. WE ACCEPT VISA / 1AASTERCARD J DISCOVER • WE ACCEPT VISA / MASTGRCARD / DISCOVER • WE ACCEPT VISA j MASTERCAILD I I)ISCOVL'I( 560 Crazy Horse Canyon Road Salinas, CA 93907 -8434 Phone: 831 -449 -4273 • Fax: 831 -449 -0700 Did Item 3 7" 3.8 39 40 41 42 43 44 45 46 47 40 49 50 51 52 53 54 55 56 57 5 S9 60 61. 62 65 66 67 68� 69 70 71 '12 Customer 10084 CITY OF GILROY attn: DON DEY 7351, ROSANNA ST. Gilroy , CA 95020 Description WAY FINDING SIGNS (A PREPARE BOLE IMPORT TOPSOIL ANNUAL COLOR (FROM I' 1 GALLON SHRUBS 5 GALLON SHRUBS TREE - 24" BOX WITH 3 YEAR PLANT ESTABLI CONTROLLER ASSEMBLY 1 -INCH REMOTE CONTRO MISC. FITTINGS AND W 1 1/2 INCH .BALL VALV 1 -INCH QUICK COUPLIN 4 -INCH SCHEDULE 40 P 2 -INCH SCHEDULE 40 P SCHEDULE 40 PVC LATE 1. -1/2" CLASS 315 PVC REDUCED PRrSSURE BAC 12" POP -UP SPRAY HEA BUBBLERS FOR TREES REMOVE, REINSTALL, -S LIGHTING FIXTURE FOU 3/4" ORS CONDUIT 1 112" CRS CONDUIT I" PVC CONDUIT 1 2" PVC CONDUIT 3" PVC SCH, 40 CONDO 3" PVC BCIi. 40 SERVT 4" PVC SCH. 40 CONDO QUAD -DUCT CONDUITS 115 PULL BOX 4{6 PULL BOX Invoice 21009817 Page No. -2- Pa y Application Date TermS Contract 17 i 31 MAR 2012 i N$T 30 DAYS i P011110135 i 0- - I,F 600.0000 600. 0000 � D 0.0000 LF '220.0000 �" 300. OO�j.O.- 0.0000 LF 20.0000 20,0000 0.0000 LF 20.0000 20.0000 0.0000 LF 500.0000 500.0000 0.0000 EA 6.0000 6.0000 , 0.0000 'A 7.0000 8 Q00 0.0000 PO & E 02. PULLBOX EA 1.0000 1.0000 0.0000 TYPE III -AF ELECTRIC LS 1.0000 1.0000 0.0000 RECEPTACLES BESIDE T EA 910000 910000 0.0000 TYPE A LIGHTING FIXT EA 6.0000 6.0000 0,0000 Contract Location j Job Cost Project 41 210098 i i CITY OF GILROY -6th ST. IMPROV i PCC, AC, SO, LIGHT'G,MASONRY i EIGLBBRRY TO RAILROAD ST i Gilroy , CA 95020 To Date Unit Current To Date Quantity ` - Price Amount Amount 0.0000 3000.0000 0.00 0.00 118.0000 22.0000 0100 2,596.00 32,0000 65.0000 0.00 2,080.00 60.0000 20.0000 0.00 1,200.00 99.0000 11.0000 0.00 1,009.00 0.0000 24.0000 0.00 192.00 11.0000 360.0000 0.00 3,960,00 1.0000 5000.0000 0.00 5,000.00 1.0000 15000.0000 0.00 15,000.00 3.0000 150.0000 0.00 450.00 1.0000 2500.0000 0,00 2,500.00 4.0000 200.0000 0.00 000.00 4.0000 165.0000 0.00 660.00 1300.0000 6,0000 0.00 71000,00 40.0000 4.0000 0.00 160.00 1.0000 1600.0000 0.00 1,600.00 800,0000 4.0000 0.00 3,200.00 1.0000 2000.0000 0.00 2,000.00 30.0000 35.0000 0.00 1,050.00 22.0000 27.0000 0.00 594.00 1..0000 5000.0000 0100 5,000.00 010000 1000.0000 0100 8,000.00 268.0000 30.0000 0.00 0,040,00 160,0000 34.0000 0.00 5,440.00 20.0000 32.0000 0.00 640.00 600.0000 32.0000 0.00 19,200.00 300,0000 32,0000 0.00 9,856.00 20.0000 44.0000 0.00 080.00 20.0000 35.0000 0.00 700,00 500.0000 20.0000 0.00 10,000.00 610000 260.0000 0.00 11560,00 8.0000 320.0000 0.00 21560.00 1.0000 825,0000 0.00 825.00 1.0000 6500.OD00 0.00 61499,90 9.0000 200.0000 0.00 1,800.00 6.0000 7000,0000 0.00 42,000.00 Please. return one COPY with lztyntcnt, All invoices are due within 30 days front dare of Invoice. Past due invoictj are suItject ton late payment charge eotnputed at 2.0% Per month (Z4 &,annual pe[rentaiM [me) on the past due amount. WE ACCBI)'r VISA J MASTGRCARD J DISCOVFit • WE ACCEPT VISA J IrtASTERCARD J DISCOVER WE ACCEPT VISA / MASTERCARD J DISCOVER Estimated" P Previous Current UOM Q Quantity Q Quantlt � �Quantity LS 1 1.0000 0 0.0000 J 0 0.0000 rA 1 110.0000 1 118.0000 0 0.0000 CY 3 32.0000 3 32.0000 0 0.0000 EA 6 6,0.0000 6 60.0000 0 0.0000 EA 9 99.0000 9 99,0000 0 0.0000 EA 8 8.0000 8 8.0000 0 0.0000 EA 1 11.0000 1 11.0000 0 0.0000 LS 1 1.0000 1 1.0000 0 0.0000 EA 1 1.0000 1 1,0000 0 0.0000 EA 3 3.0000 3 3.0000 0 0.0000 LS 1 110000 1 1.0000 0 0.0000 EA 4 4,0000 4 4.0000 0 010000 EA 4 410000 4 4.0000 0 0.0000 LF 1 1300.0000 1 1300.0000 0 010000 I.,F 4 40.0000 4 40.0000 0 010000 I's 1 1.0000 1 1,0000 0 0.0000 LF 8 800.0000 8 800,0000 0 0.0000 EA , ,1.0000 1 1.0000 0 0.0000 EA 3 30.0000 3 30.0000 0 0.0000 EA 2 22.0000 2 22.0000 0 0.0000 LS 1 1.0000 1 1.0000 , 0 0.0000 EA 7 7.0000 8 8.000X' 6 0.0000 EA 2 260.0000 6 6� 0 0.0000 LF 1 160.0000 1 160.0000 0 0,0000 .F 2 20.0000 2 20.0000 x x/0.0000 PO & E 02. PULLBOX EA 1.0000 1.0000 0.0000 TYPE III -AF ELECTRIC LS 1.0000 1.0000 0.0000 RECEPTACLES BESIDE T EA 910000 910000 0.0000 TYPE A LIGHTING FIXT EA 6.0000 6.0000 0,0000 Contract Location j Job Cost Project 41 210098 i i CITY OF GILROY -6th ST. IMPROV i PCC, AC, SO, LIGHT'G,MASONRY i EIGLBBRRY TO RAILROAD ST i Gilroy , CA 95020 To Date Unit Current To Date Quantity ` - Price Amount Amount 0.0000 3000.0000 0.00 0.00 118.0000 22.0000 0100 2,596.00 32,0000 65.0000 0.00 2,080.00 60.0000 20.0000 0.00 1,200.00 99.0000 11.0000 0.00 1,009.00 0.0000 24.0000 0.00 192.00 11.0000 360.0000 0.00 3,960,00 1.0000 5000.0000 0.00 5,000.00 1.0000 15000.0000 0.00 15,000.00 3.0000 150.0000 0.00 450.00 1.0000 2500.0000 0,00 2,500.00 4.0000 200.0000 0.00 000.00 4.0000 165.0000 0.00 660.00 1300.0000 6,0000 0.00 71000,00 40.0000 4.0000 0.00 160.00 1.0000 1600.0000 0.00 1,600.00 800,0000 4.0000 0.00 3,200.00 1.0000 2000.0000 0.00 2,000.00 30.0000 35.0000 0.00 1,050.00 22.0000 27.0000 0.00 594.00 1..0000 5000.0000 0100 5,000.00 010000 1000.0000 0100 8,000.00 268.0000 30.0000 0.00 0,040,00 160,0000 34.0000 0.00 5,440.00 20.0000 32.0000 0.00 640.00 600.0000 32.0000 0.00 19,200.00 300,0000 32,0000 0.00 9,856.00 20.0000 44.0000 0.00 080.00 20.0000 35.0000 0.00 700,00 500.0000 20.0000 0.00 10,000.00 610000 260.0000 0.00 11560,00 8.0000 320.0000 0.00 21560.00 1.0000 825,0000 0.00 825.00 1.0000 6500.OD00 0.00 61499,90 9.0000 200.0000 0.00 1,800.00 6.0000 7000,0000 0.00 42,000.00 Please. return one COPY with lztyntcnt, All invoices are due within 30 days front dare of Invoice. Past due invoictj are suItject ton late payment charge eotnputed at 2.0% Per month (Z4 &,annual pe[rentaiM [me) on the past due amount. WE ACCBI)'r VISA J MASTGRCARD J DISCOVFit • WE ACCEPT VISA J IrtASTERCARD J DISCOVER WE ACCEPT VISA / MASTERCARD J DISCOVER Contract Location j Job Cost Project 41 210098 i i CITY OF GILROY -6th ST. IMPROV i PCC, AC, SO, LIGHT'G,MASONRY i EIGLBBRRY TO RAILROAD ST i Gilroy , CA 95020 To Date Unit Current To Date Quantity ` - Price Amount Amount 0.0000 3000.0000 0.00 0.00 118.0000 22.0000 0100 2,596.00 32,0000 65.0000 0.00 2,080.00 60.0000 20.0000 0.00 1,200.00 99.0000 11.0000 0.00 1,009.00 0.0000 24.0000 0.00 192.00 11.0000 360.0000 0.00 3,960,00 1.0000 5000.0000 0.00 5,000.00 1.0000 15000.0000 0.00 15,000.00 3.0000 150.0000 0.00 450.00 1.0000 2500.0000 0,00 2,500.00 4.0000 200.0000 0.00 000.00 4.0000 165.0000 0.00 660.00 1300.0000 6,0000 0.00 71000,00 40.0000 4.0000 0.00 160.00 1.0000 1600.0000 0.00 1,600.00 800,0000 4.0000 0.00 3,200.00 1.0000 2000.0000 0.00 2,000.00 30.0000 35.0000 0.00 1,050.00 22.0000 27.0000 0.00 594.00 1..0000 5000.0000 0100 5,000.00 010000 1000.0000 0100 8,000.00 268.0000 30.0000 0.00 0,040,00 160,0000 34.0000 0.00 5,440.00 20.0000 32.0000 0.00 640.00 600.0000 32.0000 0.00 19,200.00 300,0000 32,0000 0.00 9,856.00 20.0000 44.0000 0.00 080.00 20.0000 35.0000 0.00 700,00 500.0000 20.0000 0.00 10,000.00 610000 260.0000 0.00 11560,00 8.0000 320.0000 0.00 21560.00 1.0000 825,0000 0.00 825.00 1.0000 6500.OD00 0.00 61499,90 9.0000 200.0000 0.00 1,800.00 6.0000 7000,0000 0.00 42,000.00 Please. return one COPY with lztyntcnt, All invoices are due within 30 days front dare of Invoice. Past due invoictj are suItject ton late payment charge eotnputed at 2.0% Per month (Z4 &,annual pe[rentaiM [me) on the past due amount. WE ACCBI)'r VISA J MASTGRCARD J DISCOVFit • WE ACCEPT VISA J IrtASTERCARD J DISCOVER WE ACCEPT VISA / MASTERCARD J DISCOVER Please. return one COPY with lztyntcnt, All invoices are due within 30 days front dare of Invoice. Past due invoictj are suItject ton late payment charge eotnputed at 2.0% Per month (Z4 &,annual pe[rentaiM [me) on the past due amount. WE ACCBI)'r VISA J MASTGRCARD J DISCOVFit • WE ACCEPT VISA J IrtASTERCARD J DISCOVER WE ACCEPT VISA / MASTERCARD J DISCOVER _invoice 21009817 - - Page No. -3- Pay 580 Crazy Horse Canyon Road 7tlplication Date Ternts Contract Salinas, CA 93907 -8434 Phone: 831 -449 -4273 • Fax: 831 -449 -0700 I 17 1 31 MAR 2012 I NET 30 DAYS I P04110135 i (Contract Location Customer 10084 Job Cost Project 8 210098 CITY OF GILROY I CITY OF GILROY -6th ST. 1M?ROV. attn: DON BEY PCC, AC, SD, LI GHT I G, MASONRY I 7351 ROWR•TA ST, I EIGLBLRRY TO RAILROAD ST Gilroy , CA 9502'0 Gilroy CA 95020 To Date Estimated Previous Current To Date unit Current Sid Item Description I)OM Quantity Quantity Quantity Quantity Price Amount Amount 73 TYPE 8 & 01 BANNER P EA 210000 2.0000 0.0000 2,0000 22000.0000 44,000.00 74 MOBILIZATION LS 1.0000 1.0000 0.0000 1.0000 15000.0000 0.00 15,000.00 75 TRAFFIC CONTROL & CO LS 1.0000 1.0000 0.0000 1.0000 9500.0000 0.00 9,501).00 76 REMOVE AC PAVEMENT SF 3795.0000 3795.0000 0.0000 3795.0000 2.0000 0.00 7159(1.00 77 REMOVR PCC PAVEMENT SF 3100.0000 3100.0000 0.0000 3100.0000 3.0000 0,00 9,300.00 78 REMOVE PCC SIDEWALK SF 37GD.000D 3760.0000 010000 3760.0000 2.0000 0.00 7,520.00 79 REMOVE PCC DRIVP1AY' SF 119010000 1190.0000 0.0000 1190.0000 2.0000 0.00 2,380.00 80 REMOVE PCC CURB & GU LF 630.0000 630.0000 0.0000 630.0000 7.0000 0100 4,410.00 81 REMOVE EXISTING SO -D EA 1.10000 1.0000 0.0000 110000 1400.0000 0.00 11400.00 82 CLEARING & GURSBING LS 1.0000 1.0000 0.0000 1.0000 1000.0000 0.00 11000.00 83 REMOVE TREE EA 5.0000 5.0000 0.0000 510000 400.0000 0.00 2,000.00 84 REMOVE EXIST 3/4 INC EA 1.0000 1.0000 0.0000 1.0000 1000.0000 0.00 1,000.00 85 INSTALL REMOVRD 3/4 EA 1.0000 1.0000 0.0000 110000 1000.0000 0.00 11000.00 86 ABANDON EXIST 1 INCH EA 1.0000 1.0000 0.0000 1.0000 4500.0000 0.00 4,500.00 87 ABANDON EXIST 2 INCH EA 1.0000 1.0000 0.0000 1.0000 2000.0000 0100 2.,000.00 88 NEW WM BOX AND COPPE EA 2.0000 2.0000 0.0000 2.0000 1000.0000 0.00 2,000.00 89 2" WATER SERVICE EA 1.0000 1.0000 0.0000 1.0000 4000.0000 0.00 4,000.00 90 91 92 93 94 95 96 97 95 99 100 101 102 103 104 105 106 107 108 AGGREGATE BASE 12" AC (611 } CURB & GUTTER SIDEWALK DRIVEWAY PEDESTRIAN CROSSWALK CURB RAMP SIDEWALK DRAIN BRICK PAVERS 'DECORATIVE TRASH CAN TREE GRATE AND GUARD NIKE RACK BOLLARD 15 -IIICH RCP CONSTRUCT SD -DI CONSTRUCT SD -DI GRAT 4 -INCH WRITE TRAFFIC 12 -INCH WHITE TRAFFI DETAIL - 22 CENT ERLI - - CY TON LF SF SF SF EA LF S° EA EA EA EA LF EA EA LF LF LF 160.0000 160.0000 6 28.0000 4800.0000 730.0000 315.0000 4,0000 105.0000 2200.0000 1.0000 9.0000 2.0000 4.0000 3S.0000 1.0000 510000 37.0000 275.0000 305.0000 16010000 160.0000 628.0000 4800.0000 730.0000 315.0000 4.0000 105.0000 2200.0000 1.0000 9.0000 2.0000 1 4.0000 35.0000 1.0000 510000 37,0000 275.0000. 385.0000 0.0000 0.0000 0.0000 0,0000 0.0000 0.0000 0.0000 010000 0.0000 0.0000 0.0000 0.0000 _ 0.0000 0.0000 0.0000 010000 0.0000 0.0000 0.0000 16(1.000(} 160.0000 620.0000 4800.0000 730.0000 315.0000 4,0000 105.0000 2200.0000 1.0000 9.0000 2.0000 4.0000 35.0000 1.0000 5.0000 37.0000 275.0000 .385.0000 140.0000 170.0000 40.0000 8.0000 10.0000 20.0000 2200.0000 22.0000 25.0000 1000.0000 200.0000 600.0000 6D0.0000 300.0000 6000.0000 2000.0000 3.0000 3.0000 3,0000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0100 0.00 0.00 0.00 22,400.00 27,200.00 25,120.00 38,400.00 7,300.00 6,300.00 8,800.00 2,310.00 55,000.00 1,000.00 1,80D.00 11200.00 2,400.00 10,500.00 6,000.00 10,000.00 111.00 825.00 1,155,00 All invokes are due within 30 days from (late sf invoice. Past %lue invoices Please return site copy with Ixtyment. - are ati ject to a (nre payntent Charge Computed ;it 2.0'X0 Per munlh (2•I % annual prrunutgc rate) on the past Juc ttmnuut. WE ACCEPT VISA / MASTERCARD / DISCOVER • WE ACCEPT VISA / ?AASTERCARD / DISCOVER • WE ACCUi, -r VISA / NIAS'rERCARl) / LIISCOVLil 560 Crazy Horse Canyon Road Salinas, CA 93907 -6434 Phone: 831- 449 -4273 • Fax: 831- 449 -0700 CItStwer 10064 CITY OF GILROY attn.: DON DEY 7351 ROSANNA ST. Gilroy , CA 95020 Did Item Description UGM Estimated Quantity 109 PAINT CURS RED LF 15.0000 110 BLUE REFLECTIVE MARK CA 1.0000 111 PAVEMENT MARKING (RA Sr 140.0000 112 PAVEMENT MARKING (ST SF 49.0000 113 PAVEMENT MARKING (HA SF 70.0000 114 ROADSIDE SIGNS EA 18.0000 115 WAY FINDING SIGNS (A LS 1.0000 116 PREPARC HOLE EA 62.0000 117 IMPORT TOPSOIL CY 29.0000 118 AtMAL COLOR (FROM F EA 50.0000 119 1 GALLON SHRUBS CA 674000 120 5 GAILON SHRUBS CA 6.0000 121 TREE - 24" BOX WITH EA 9.0000 122 3.YEAR PLANT ESTABLI LS 1.0000 123 CONTROLLER ASSEMBLY EA 1.0000 124 1 -INCH REMOTE CONTRO EA 2.0000 125 MISC. FITTINGS AND W LS 1.0000 126 1 1/2 INCH HALL VALV EA 2.0000 127 1 -INCH QUICK COUPLIN EA 4.0000 128 4 -INCH SCHEDULE 40 P LF 950.0000 129 2 -- INCH SSCHEDULE. 40 P Lt- 40.0000 130 SCEDULE 40 PVC LATER LS 1.0000 131 1 1/2 INCH CLASS 315 LF 525.0000 132 REDUCED PRESSURE BAC EA 1,0000 133 12" POP -UP SPRAY HEA EA 14.0000 134 BUBBLERS FOR TREES EA 18.0000 135 REMOVE, INSTALL, SAL LS 1,0000 136 .LIGHTING I'IXTURE FOU EA 10.0000 137 3/4" GRS CONDUIT LF 140.0000 138 1 3./2" ORS CONDUIT LF 60.0000 139 1" PVC CONDUIT LF 30.0000 140 1 112" PVC CONDUIT LF I00.0000 141 21' PVC CONDUIT LP 580.0000 142 3" PVC SCR 40 CONDUI LP 270,0000 143 QUAD -DUCT CONDUITS LF 420.0000 T14 tS PULL BOX EA 7.0000 Pay Application Date Terms Invoice 21009817 . Page No. -I- Contract i 17 1 31 MAR 2012 i NET 30 DAYS I P011110135 I Contract Location i Job Cost Project 0 210096 I I I CITY OF GI.LROY -6th ST. IMPROV. i PCC, AC, SD, LIGHT I G, MASONRY l FIGLBFRRY TO RAILROAD ST Gilroy , CA 95020 Previous Current To Date Quantity Quantity Quantity 15.0000 1.0000 140.0000 44.0000 70.0000 18.0000 1.0000 02.0000 29.0000 50.0000 67.0000 6.0000 9.0000 1.0000 1.0000 2.0000 1.0000 2.0000 4.0000 950.0000 40.0000 1.000D 525.0000 1.0000 14.0000 ?.0.0000 1.0000 10.0000 140.0000 60.0000 30.0000 100.0000 580.0000 7.70.0000 420,0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0,0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 15.0000 1.0000 140.0000 44.0000 70.0000 18.0000 1.0000 87..0000 29.0000 50.0000 67.0000 6.0000 9.0000 1.0000 1.0000 2.0000 1.0000 2.0000 4.0000 950.0000 40.0000 1.0000 525.0000 1.0000 14.0000 18.0000 1.0000 10.0000 140.0000 60.0000 30.0000 100.000D 580.0000 270.0000 420.0000 9.0000 Unit Current To Date Price Amount Amount 2.0000 0.00 30.00 25.0000 0.00 25.00 5.0000 0.00 700.00 5.0000 0.00 220.00 5.0000 0.00 350.00 175.0000 0.00 31150.00 3000.0000 0.00 3,000.00 22.0000 D.00 1,804.00 65.0000 0.00 1,805.00 20.0000 0.00 1,000.00 11.0000 0.00 737.00 24.0000 0.00 144.00 360.0000 0.00 1,240,00 5000.0000 0.00 5,000.00 17000.0000 0.00 17,000.00 150.0000 0.00 300.00 2000.0000 0.100 21000.00 200.0000 0.00 400.00 165.0000 0.00 660.00 6.0000 0,00 5,'700.00 4.0000 0.00 160.00 1300.0000 0100 1,300.00 4.0000 0.00 2,100.00 2000.0000 0.00 2,000.00 35.0000 0.00 490.00 27.0000 0.00 486.00 3000.0000 0.00 3,000.00 1000.0000 0.00 10,000.00 30.0000 0.00 4,200.00 34,0000 0.00 21040.00 32.0000 0.00 960.00 32.0000 0100 3,20D.00 32.0000 0.00 18,560,00 50.0000 O.OD 13,500.00 20.0000 _ 0.00 6,400.00 260.0000 0100 2,340,00 Please return one copy with pnyanent. All invoices are due within 30 &ays from date of invoice. Post due invoices are subject to n Irate payment charge computed at 2.0'Y per month (24% annual perccotage rate) on the past doe amount. WE ACCEPT VISA / N4ASTERCARD / DISCOVER " WE ACCEPT VISA / N4ASTERCARD j DISCOVER " WE' ACCEPT VISA / N(ASTERCARU J DISCOVER !Q R r 560 Crazy Norse Canyon Road Salinas. CA 93907 -8434 Phone; 831 - 449 -4273 • Fax: 831- 449 -0700 Customer 10024 CITY OF GILROY attn: DON DRY '7351 ROSAIMA, ST. Gilroy , CA 95020 Invoice 21009817 Page NO. -5- Pay Application Date Terms Contract i 17 l 31 MAR 2012 1 NET 30 DAYS POMI10135 k Contract Location ( Job Cost Project N 210098 i i CITY OF GiLROY -6t11 ST. IMPROV. i PCC,AC,SD,LIGHT'G,MASONRY i EIGLBERRY TO RAILROAD ST i f Gilroy , CA 95020 l Bid Item Description UOM Estimated Quantity Previous Quantity Current Quantity To Date Quantity unit Price Current Amount To Date Amount 145 1i6 PULL BOX FA 7.0000 7.0000 0.0000 7.0000 320.0000 0.00 2,240.00 146 TYPE III -Ar CLCCTRIC LS 1.0000 110000 0.0000 1,0000 5000.0000 0.00 5,000.00 147 RECEPTACLES BESIDE T EA 9.0000 9.0000 0.0000 9.0000 200.0000 0.00 1,eD0.00 146 TYPE A LIGHTING FIXT CA 10.0000 .10. Goo 0 0.0000 10.0000 7000.0000 0.00 70,000.00 149 TYPE B & 31 BANNER P EA 2.0000 2.0000 0.0000 2,0000 10000.0000 0.00 36,000.00 * *Total Base Contract** 0.00 1,035,693.00 Change Order 1 Ccolll- parking Lot 001 ACCTII 220 2600 3759 LS Total Change order 1 Change Order 2 CC082 A ADD% BRICK PAVER LS B BIKE RACK CHANGE TO L6 C BIKE RACK CHANGE TO LS D ADD'L CONCRETE SAWCU LS E ADD'L STRIPING L8 F CATCH BASIN /NEW SVC/ LS To'.-.al Change Order 2 Change Order 3 CC0113 003 CCO43 LS Total Change Order 3 l.DOOD 0.0000 0.0000 0.00 0 96753.0000 0.00 0.00 0,00 0.00 1.0000 1.0000 0.0000 1.0000 31960.0000 0.00 31,960,00 1.0000 1.0000 010000 1,0000 431.2500 0.00 431.25 1.0000 1.0000 0.0000 110000 2100.0000 0.00 2,100.00 1.ODOO 1.0000 0.0000 1.0000 6576.4300 0.00 6,576.43 1.0000 1.00.00 010000 1.0000 1055.0000 0.00 1,055.00 1.0000 1.0000 0.0000 1.0000 46114.0000 0.00 46,114.00 0.00 88,236.68 1.0000 1.0000 0.0000 1.0000 112734.1700 0.00 112,734.17 0.00 112,734.17 Change Order 4 CCO114 Please return one Copy with payment. All invoices are due within 30 days front dine of invoice. PM due invoices arc. subject to a late tvnyment charge coutpuce.l at 2.0% per month (21`1G annual pucenrage ante) on the past clue unnxmt. WE ACCEPT VISA / MASTERCARD / DISCOVER • Wr, ACCEPT VISA I MASTERCARD J DISCOVER 4 WE ACCEP'i VISA / MASTERCARD / DISCOVL'It 6; 560 Crazy Horse Canyon Road Salinas, CA 93907 -8434 Phone: 831- 449 -4273 • Fax: 831 -449 -0700 Customer 10084 CITY OF GILROY attn: DON DEY 7351 ROSAgNA ST. Gilroy , CA 95020 Invoice 21009817 Page No. -6- Pay Application Date Terms Contract 17 i 31 MAR 2012 I NET 30 DAYS PO #110135 contract Location J Job Coot Project It 210098 I CITY OP GILROY -6th ST. IMPROV. PCC,AC,SD,L:GF1T'C,MASONRY EIGLBERRY TO RAILROAD ST Gilroy , CA 95020 Estimated Previous Current To Date Unit Current To Date Aid Item Description VOM Quantity Quantity Quantity Quantity Price Amount Amount 004 CCO #A LS 1,0000 110000 0.0000 1 .OD00 148665.7200 0.00 14B,GG5.72 Total Change Order 4 0.00 148,665.72 Change Order 5 CCO45 G ADD'L H2O SERVICE 4t0 LS R ELFCTRICAL REPAIR LS- i R l R PATCH oN SIXTH LS Total Change Order 5 Change Order 6 CCOIIG :F CC0116 Total Charge Order 6 1.0000 1.0G00 010000 1.0000 17320.0000 1.0000 1,0000 0.0000 1.00011 9281.8100 1.0000 1.0000 0.0000 1.0000 1694.2500 LS 1.0000 1.0000 0.0000 1.0000 28942.3200 Change order 7 CCO117 K ADD'L DUE CCO #6 LS L REMOVE SOIL VET BLD' LS N1 PRK'G LOT EIGLESERRY LS Total Change Order 7 Total Contract And Change Orders 1.0000 1.0000 0.0000 1.0000 4743.7500 1.0000 1.0000 0.000D 1.0000 1614.6000 1.0000 1.0000 010000 1.0000 3BG7.3100 0.00 17,320.00 0.00 9,281.B1 0.00 1,694.25 0.00 28,296.06 0100 28,942.32 0.00 28,942.32 0.00 4,743.75 0.00 1,614,60 0.00 3,867.31 0.00 10,225.66 0.00 1,452,793.61 Billing Sununary For Contract 210098 . - - -- PkIsc relur[1 cite COPY with llaynlell. -^ . All invoices arc due aithiti 30 clays from date of invoke. Pust due inwicea are st111JLct tit m late Paymetlt elctrre compured at 2.0`Yn Per month (24% annual i-ercent.ige rte) ell the 1:i15r dlle .11u Mint. WE ACCEPT VISA I MASTERCARD I DISCOVER • WE ACCEPT VISA I NIASTERCARU I DISCOVER • WE ACCEPT VISA I MASTF11CARD I DISCOVER 560 Crazy Horse Canyon Road Salinas, CA 93907 -8434 Phone: 831 -449 -4273 9 Fax: 831- 449 -0700 Customer 10084 CITY OF GILROY attn: DON DRY 7351 ROSA_VNA ST. Gilroy , CA 95020 Invoice 21009817 Page No. -7- Pay Application Date Terms Contract 1 17 1 31 MAR 2012 1 NET 30 DAYS ( 1`011110135 1 Estimated Previous Current Bid Item Description UOM Quantity Quantity Quantity Current Complete To Date 0.00 Materials On HOnd 0.00 Sales Tax 0.00 Less Retainage 0 10.0000 % - 145,279.37 Balance 145,279.37 Less Previous payments Total Amount Due 145,279.37 Contract Location job Cost Project 0 210098 CITY OF G.TLROY -6th ST. 'IMPROV. PCC,AC,SD,LIGHT'O,MASONRY EIGLBERRY TO RAILROAD ST Gilroy , CA 95020 To Date Untt Quantity Price To Date 1,452,793.61 0.00 0.00 0.00 1,452,793.61 1,279,220.80 173,572.81 Current To Date Amount Amount ^lam V r Please return one copy with Payment. All invoices are due within X days from date of invoice. Past due invoices are subject to a late palgient charge computed at 2.0^X, per rnunth ( 24 %annual mcentaw rate} on the past due nmount. WE ACUL"I'• VISA I htAs,rERCARD / DISCOVER • WE ACCEPT VISA / MASTERCARD J DISCOVER • WE ACCEPT VISA / hIASTERCARD I DISCOVER CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from CITY OF GILROY (Maker or Check) in the sum of $145,279.37 payable to THE DON CHAPIN COMPANY, INC. (Amount of Cheek) (Payee or Payees of Check) and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanic's lien, stop notice, or bond right the undersigned has on the job of CITY OF GILROY located at PO#110135 _ _ to the following extent. flub Pcseripann) This release covers a progress payment for labor, services, equipment or material. furnished to CITY OF GILROY through MARCH 31, 2012 only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which�paynlent has not been received; extras or items fur)ush.ed after the release elate. Rights based upon work performed or items furnished under a written change order, which has been fii.11y executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release -of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services equipment, or material covered by this release if that furnished labor, services, equipment or material was not compensated by the progress payment. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned.. Date MARCH 20, 2012 THE DON CHAPIN COMPANY, INC, (Company Name) _ By � �- -TERRY NELSON Title CONTROLLER NOTE; This document has important legal consequences; consultation with an attorney is encouraged with respect to its use or modification. This form is intended to meet the requirements of California Civil Code Section 3 262(d)(1) as of .August 1, 1997. (c) Associated General Contractors of California, Inc. 1998 Form AGCC- 10 Revised 8197 �A\5 co To contract for : .% City of Gilroy s— Engineering Division 7351 Rosanna St., Gilroy, CA 96020 Phone (408) 846 -0451; Fax (408) 846 -0429 CHANGE ORDER NO. 1 the Contractor: Don Chapin Company Contract Date: This order shall become effective when it has been signed by the City Administrator, Ciyy'rCilt," Weer, Project Engineer, and Contractor. All copies forwarded to Contractor for signature shalurned to The City of Oilroy properly filled nut. Upon acceptance by the City, the Contractor's eg be returned to him as his authority to proceed with the work. Description of Work This Change Order provides for the following: Parking lot improvements of land at the south -west corner o 6th Street and Railroad Ave. This Change Order is being issued directly to Don Chapin as part of th original contract as Don Chapin is performing the work immediately adjacent to this parking lot imprpg ement. This Change Order work is funded separately from the Sixth Street Streetscape ProjFiti, lid must be tracked and billed separately from the Sixth Street Streetscape Project. Because this ws immediately adjacent and can be coordinated with said work it can be done on an expedited timelirr an be don e more efficiently and as part of the other work and work can be coordinated and utilizgd as part of both projects. All requirements of the original Contract E Change Order. The contract time shall not By signing this Change Order, Contractor are in full satisfaction and accord, and are Change Order, (the "Extra Work "), includ of efficiency and any and all other d any right to claim any further cost the Extra Work. I (We) agree to make the a subject to the terms of this for the NET INCREASSE De7'L CGu�pi� , By: v /change ange Order $98,763.00 I apply to the above work except as specifically modified by this expressly provided for in this Change Order, 'ki 6wledges and agrees that the adjustments to cost and time contained herein pted as payment in full, for any and all costs and expenses associated with this g but not limited to labor, materials, overhead and profit, delay, disruption, loss 1/or indirect costs or expenses associated with the Extra Work and hereby waives impacts at any time during and after completion of the Contract associated with Date: n $ // 0 Original Contract Price Previous Change Orders Total to Date This Change Order Total Change Orders to Date Revised Contract Price cost Percent a a Initial $1,024,474,00 $0.00 0.00% d-�-A $1,024,474.00 $98,763.00 $98,763.00 9.64% d4 $1,123,237.00 RECOMMENDED BY: V /4 10-4,1-14 ACCEPTED BY: C' i Prr Date City En gineer Datj �d' 2t �a /8 Project Engineer Date October 21, 2010 C 0 M P A N Y TO: Daniel Hughes City of Gilroy - Cilroy, CA RE: Asphalt Paving — SW corner of E. Sixth and Railr94td ST Gilroy, CA Our ptoposal includes the following items based on attached plan sheet :t�I"CF'sal '4ihsite investigation. No soils report or engineering documentation was provided at the (ime of this proposal. there we cannot warrant against settlement, heavim,. cracking_ or adverse drainage characteristics. 'The following pr. is to construct a paved area at tiS location referenced above. Base laid • Strip and remove approximately 4" to subgrade c ovation 12.823 SF. Off -haul spoils. • Excavate 1.575 SF approximately 8" to subgrtt for sidewalk and gutter • Furnish and install I EA small inlet and curb �ain. • Construct 168 LF of 1.5' wide valley guticr '' thick on 4" aggrcuate base, • Construct 1,020 SF sidewalk 4" thick an 4' tLgregate base. • AC (1/2" medium grade) paving 3" over ,7823 SF Bale Sid: $66,000.00 Perimeter Fence • 2" steel square tubing posts 8" on cent r embedded in concrete 3'. • 1 IA steel square tubing top and botto i railing. • '/4" steel square tubing pickets at no "eater than 4" on center. • Welded construction black powder cl>at finish (add alt) Stri6ing per plan: $1,790.00 (add alt) As Built Drawings:_ _ S2,200.00 (add aft) Staking: $2,645.00 560 Crazy Horse Canyon Road . Salinas, CA 93907 -x434 Phone - 631.449.4273 • Fax; 831.440.0700 QUALIr1CATIQN; All above work to he performed in coniunction xvith 6th r9 rect contract work * *no separate move in is included" / Pricing Subject to conditions per Attacment -13- Fees frailroad flagging, encroachment or nth ), or Permits are excluded. Any Compaction testing. or Engineering is e • •ludcd. Any additional signage is excluded. Any Posts. Gates or Bollards are exclude . Any items of work not expressly inclu �d shall be excluded. - 'Any additional work performed shall / c done via CHAWW' ORDER. Sincerely. Justin (lodges v Estimator 560 Crazy Horse Canyon Road • Salinas, CA 93907 -8434 Phone - 831.44 9,4273 • Fax: 831.449.0700 �A� U CERTIFICATE OF LIABILITY INSURANCE 0DATE 9/30/20111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LIC #0056172 1- 831 - 724 -3841 CONTACT NAME: PHONE FAX AIC No): McSherry & Hudson E-MAIL ADDRESS: 575 Auto Center Drive PRODUCER P. O. Box 2690 Watsonville, CA 95076 PERSONAL B ADV INJURY $ 1,000,000 INSURERS AFFORDING COVERAGE NAIC A INSURED INSURER A: ZURICH AMERICAN INS CO 16535 INSURER B: 1 THE DON CHAPIN COMPANY INC. INSURERC: AUTOMOBILE 560 CRAZY HORSE CANYON ROAD INSURERD: X SALINAS, CA 93907 10 /01 /1 10/01/12 COMBINED SINGLE LIMIT (Ea accident) INSURER E: X INSURER F: $ COVERAGES CERTIFICATE NUMBER: 23389788 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 LTR TYPE OF INSURANCE L POLICY EFF POLICY EXP POLICY NUMBER MMIDD MM /DDIYYYY LIMITS • GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X Contractual Liability X X GLO 9674277 -01 10 /01 /1 10/01/12 EACH OCCURRENCE $ 1,000,000 TO RENTE15— AIS Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS- COMP/OP AGG $ 2,000,000 1 $ • AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Contractual Liab. X X BAP 9674279 -01 10 /01 /1 10/01/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ X $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ • WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA X WC 9674280 -03 10 /O1 /1 10/01/12 X STATU OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) AS RESPECTS EXTRA LEGAL LOADS - ANNUAL TRANSPORTATION PERMIT CITY OF GILROY IS NAMED ADDITIONAL INSURED PER ENDORSEMENT ATTACHED GL PER ISO FORM CG0001 12/07; AL PER ISO FORM CA0001 03/06 CERTIFICATE HOLDER CANCELLATION yrivera ©1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 23389788 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF GILROY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ENGINEERING DIVISION 7351 ROSANA STREET AUTHORIZED REPRESENTATIVE GILROY, CA 95020<�� USA yrivera ©1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 23389788 DATE SUPPLEMENT TO CERTIFICATE OF INSURANCE 09/30/2011 THE DON CHAPIN COMPANY INC. SUPP (10/00) POLICY NUMBER: GLO 9674277 -01 ZURICH AMERICAN INS. CO. COMMERCIAL GENERAL LIABILITY CG 24 04 10/93 / Modified THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name of Person or Organization: Any person or organization that requires you to waive your rights of recovery, in a written contract or agreement with the named insured that is executed prior to the accident or loss. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) THE TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: 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 0410 93 Copyright, Insurance Services Office, Inc., Page 1 of 1 a Notification to Others of Cancellation, Nonrenewal ZURICH' or Reduction of Insurance Policy No. I Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. AddT Prem Return Prem. GL09674277 -01 1 10 -1 -2011 10 -1 -2012 10 -1 -2011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part Liquor Liability Coverage Part Products /Completed Operations Liability Coverage Part A. If we cancel or non -renew this Coverage Part(s) by written notice to the first Named Insured for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation or non - renewal: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the cancellation or non - renewal, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule below. B. If we cancel this Coverage Part(s) by written notice to the first Named Insured for nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. C. If coverage afforded by this Coverage Part(s) is reduced or restricted, except for any reduction of Limits of Insurance due to payment of claims, we will mail or deliver notice of such reduction or restriction: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the reduction or restriction, or the longer number of days notice if indicated in the Schedule below. D. If notice as described in Paragraphs A., B. or C. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice. SCHEDULE Name and Address of Other Person(s) / Organization s : Number of Days Notice: Any person or organization to whom you are 30 required by written contract or agreement to mail prior written notice of cancellation, non - renewal, and /or reduction in coverage All other terms and conditions of this policy remain unchanged. U -GL- 1447 -A CW (05/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Additional Insured — Automatic — Owners, Lessees Or Contractors 0 ZURICH Policy No. Eff. Date of Pol. Exp. Date of Pol. Agency Addl. Prem. Return Prem. GLO 9674277 -01 10/01/2011 10/01 /2012 1 McSherry & Hudson THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II — Who Is An Insured is amended to include as an insured any person or organization who you are required to add as an additional insured on this policy under a written contract or written agree- ment. B. The insurance provided to the additional insured person or organization applies only to "bodily injury", "property damage" or "personal and advertising injury" covered under SECTION I - Coverage A - Bodily Injury And Property Damage Liability and Section I - Coverage B - Personal And Advertising Injury Liability, but only with respect to liability for "bodily injury", "property damage" or "personal and advertis- ing 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; and resulting directly from: a. Your ongoing operations performed for the additional insured, which is the subject of the written contract or written agreement; or b. "Your work" completed as included in the "products- completed operations hazard ", performed for the additional insured, which is the subject of the written contract or written agreement. C. However, regardless of the provisions of paragraphs A. and B. above: 1. We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contractor written agreement. D. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or fail- ure to render any professional architectural, engineering or surveying services including: Includes copyrighted material of Insurance Services Office, Inc., with Its permission U- GL- 1175 -B CW (312007) Pagel of 2 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. E. The additional insured must see to it that: 1. We are notified as soon as practicable of an 'occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the writ- ten contract or written agreement requires that this coverage be primary and non - contributory. F. For the coverage provided by this endorsement: The following paragraph is added to Paragraph 4.a. of the Other Insurance Condition of Section IV — Commercial General Liability Conditions: This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and non - contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the ad- ditional insured person or organization is a Named Insured. 1. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV — Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional in- sured by attachment of an endorsement to another policy providing coverage for the same 'occur- rence", claim or "suit'. This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non - contributory basis. G. This endorsement does not apply to an additional insured which has been added to this policy by an en- dorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. Any provisions in this Coverage Part not changed by the terms and conditions of this endorsement continue to apply as written. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U -GL -1175 B CW (312007) Page 2 of 2 9 ZURIC WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Policy No. Eff . Date of Pol. Exp. Date of Pol. Eff. Date of End BAP 9674279 -01 10/1/2011 10/l/2012 10/1/2011 This endorsement modifies insurance provided by the following: Business Auto Coverage Part Truckers Coverage Part Garage Coverage Part SCHEDULE Name of Person or Organization: ALL PERSONS AND /OR ORGANIZATIONS THAT REQUIRE BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY. We waive any right of recovery we may have against the designated person or organization shown in the schedule because of payment we make for injury or damage caused by an "accident" or "loss" resulting from the ownership, maintenance, or use of a covered "auto" for which a Waivelr of Subrogation is required in conjunction with work performed by you for the designated person or organization. The waiver applies only to the designated person or organization shown in the schedule. U -CA -320 -A (CW) (4/92) POLICY NO.: BAP 9674279 -01 ZURICH AMERICAN INS. CO. COMMERCIAL AUTO CA 2048 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM 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. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 10/01/11 1 Countersigned By: Authorized Representative SCHEDULE Name of Person(s) or Organization(s): Any person or organization to whom or to which you are required to provide additional insured status or additional insured status on a primary, non - contributory basis, in awritten contract or written agreement executed prior to loss, except where such contract or agreement is prohibited by law. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule 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. CA 20 48 02 99 Copyright, Insurance Services Office, Inc. 1998 Page 1 of 1 a Notification to Others of Cancellation, Nonrenewal ZURICW or Reduction of Insurance Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. AddT Prem Return Prem. BAP 9674279 -01 10 -1 -2011 10 -1 -2012 10 -1 -2011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial Automobile Coverage Part A. If we cancel or non -renew this Coverage Part by written notice to the first Named Insured for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation or non - renewal: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the cancellation or non - renewal, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule below. B. If we cancel this Coverage Part by written notice to the first Named Insured for nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. C. If coverage afforded by this Coverage Part is reduced or restricted, except for any reduction of Limits of Insurance due to payment of claims, we will mail or deliver notice of such reduction or restriction: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the reduction or restriction, or the longer number of days notice if indicated in the Schedule below. D. If notice as described in Paragraphs A., B. or C. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice. SCHEDULE Name and Address of Other Person(s) / Organ! ation s : Number of Days Notice: Any person or organization to whom you are 30 required by written contract or agreement to mail prior written notice of cancellation, non - renewal, and/or reduction in coverage All other terms and conditions of this policy remain unchanged. U -CA -811 -A CW (05/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This Endorsement is effective on 10/112011 Policy No. WC 9674280 -03 Premium (if any) $ at 12:01 A.M. standard time, forms a part Endorsement No. of the ZURICH AMERICAN INSURANCE COMPANY Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0.0% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ALL PERSONS AND /OR ORGANIZATIONS THAT REQUIRE BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND / OR ORGANIZATION. WC 252 (4 -84) WC 04 03 06 (Ed. 484) Job Description ALL CALIFORNIA OPERATIONS Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 NOTIFICATION TO OTHERS OF CANCELLATION, NONRENEWAL OR REDUCTION OF INSURANCE ENDORSEMENT This endorsement is used to add the following to Part Six of the policy. PART SIX CONDITIONS A. If we cancel or non -renew this policy by written notice to you for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation or non - renewal to the name and address corresponding to each person or organization shown in the Schedule below. Notification to such person or organization will be provided at least 10 days prior to the effective date of the cancellation or non - renewal, as advised in our notice to you, or the longer number of days notice if indicated in the Schedule below. B. If we cancel this policy by written notice to you for nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. C. If coverage afforded by this policy is reduced or restricted, except for any reduction of Limits of Liability due to payment of claims, we will mail or deliver notice of such reduction or restriction to the name and address corresponding to each person or organization shown in the Schedule below. Notification to such person or organization will be provided at least 10 days prior to the effective date of the reduction or restriction, or the longer number of days notice if indicated in the Schedule below. D. If notice as described in Paragraphs A., B. or C. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice. SCHEDULE Name and Address of Other Person(s) / Organ ization s : Number of Days Notice: Any person or organization to whom you are 30 required by written contract or agreement to mail prior written notice of cancellation, non - renewal, and /or reduction in coverage All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 10/1/2011 Policy No. WC 9674280 -03 Endorsement No. Insured Premium $ Insurance Company: Zurich American Ins. Co. WC 99 06 34 (Ed. 05 -10) Includes copyrighted material of National Council on Compensation Insurance, Inc. with its permission. Page 1 of 1