Loading...
HomeMy WebLinkAboutGraniterock/Pavex - Project No. 11-CDD-183SECTION 00500 AGREEMENT GILROY CROSSING OFFSITE IMPROVEMENTS PROJECT NUMBER 11 -CDD -183 THIS AGREEMENT, made this '-7-7 day of February , 2011, by and between the City of Gilroy, hereinafter called the "City," and Graniterock , hereinafter called the "Contractor." WITNESSETH: WHEREAS, the City has caused the Contract Documents to be prepared comprised of bidding and contract requirements and technical specifications and drawings for the construction of the Gilroy Crossing Offsite Improvements, Project No. 11 -CDD -183, 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 Gilroy Crossing Offsite Improvements 11 -CDD -183 SECTION 00500 -25 THE CONTRACTOR'S DELAYS IN PERFORMANCE OF THE WORK DESCRIBED IN THE CONTRACT DOCUMENTS. THE CITY AND THE CONTRACTOR HEREBY ACKNOWLEDGE AND AGREE THAT THE DAMAGES AND FINANCIAL LOSS SUSTAINED AS A RESULT OF ANY SUCH DELAYS IN PERFORMANCE WILL BE EXTREMELY DIFFICULT AND IMPRACTICAL TO ASCERTAIN. THEREFORE, THE CITY AND CONTRACTOR HEREBY AGREE THAT IN THE EVENT OF SUCH DELAYS IN PERFORMANCE, THE CITY SHALL BE ENTITLED TO COMPENSATION BY WAY OF LIQUIDATED DAMAGES (AND NOT PENALTY) FOR THE DETRIMENT RESULTING THEREFROM IN ACCORDANCE WITH PARAGRAPH 00700 -6.5, LIQUIDATED DAMAGES, OF THE CONTRACT DOCUMENTS. THE CITY AND THE CONTRACTOR FURTHER AGREE THAT THE AMOUNTS DESIGNATED AS LIQUIDATED DAMAGES ARE A REASONABLE ESTIMATE OF THE CITY'S DAMAGES AND FINANCIAL LOSS IN THE EVENT OF ANY SUCH DELAYS IN PERFORMANCE CONSIDERING ALL OF THE CIRCUMSTANCES EXISTING AS OF THE DATE OF THIS AGREEMENT, INCLUDING THE RELATIONSHIP OF SUCH AMOUNTS TO THE RANGE OF HARM TO THE CITY WHICH REASONABLY COULD BE ANTICIPATED AS OF THE DATE OF THIS AGREEMENT AND THE EXPECTATION THAT PROOF OF ACTUAL DAMAGES WOULD BE EXTREMELY DIFFICULT AND IMPRACTICAL. BY INITIALING THIS PARAGRAPH BELOW, THEIR APPROVAL AND CONSENT TO THE TER — —4— N City's Initials Contra THE PARTIES HERETO SIGNIFY M OF THIS ARTICLE 3. itials 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 Designation of Subcontractors Bid Guaranty Bond Gilroy Crossing Offsite Improvements 11 -CDD -183 SECTION 00500 -26 Agreement Acknowledgements Performance Bond Payment Bond General Conditions Supplementary Conditions General Requirements Standard Specifications (Caltrans) Technical Specifications Drawings Addenda, if any Executed Change Orders, if any Maintenance Bond Notice of Award Notice to Proceed Article 6. Miscellaneous. Capitalized terms used in this Agreement which are defined in Section 01090, References, of the Contract Documents will have the meetings 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 Gilroy Crossing Offsite Improvements 11 -CDD -183 SECTION 00500 -27 complaint regarding a patent 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 �z day of February, 2011. Granite Rock Company DBA Pavex Construction Division Name of Contractor RODNEY JENNY, VICE PRESIDENT Title of Signator ATTEST: Signature Qo-4-P-cr- F- n1 Title of Signator Signature of City City Administrator Title of Signator ap�rm-j ** *END OF SECTION * ** Title of gnator Gilroy Crossing Offsite Improvements 11 -CDD -183 SECTION 00500 -28 SECTION 00650 WORKERS' COMPENSATION INSURANCE CERTIFICATE In accordance with California Labor Code Section 1861, prior to commencement of work on the Contract, the Contractor shall sign and file with the City the following certification: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of -the work of this contract." Name of Contractor RODNEY JENNY, VICE PRESIDENT Title a1Aa /1a) Date ** *END OF SECTION * ** Gilroy Crossing Offsite Improvements 11 -CDD -183 SECTION 00670 -38 SECTION 00670 NOTICE OF NONDISCRIMINATION IN EMPLOYMENT The undersigned contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, age, marital status or national origin. The Contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, age, marital status or national origin. Such action shall include, but not be limited to, the following: Employment, upgrading, demotion, or transfer, recruitment advertising; layoff or termination; rates of pay, or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment notice to be provided by the municipality setting forth the provisions this nondiscrimination clause. Date Granite Rock Company DBA Pavex Construction Division Company i i License # ** *POST IN CONSPICUOUS PLACE OF EMPLOYMENT * ** ** *END OF SECTION * ** Gilroy Crossing Offsite Improvements 11 -CDD -183 SECTION 00670 -39 Bond # 929510254 SECTION 00610 Premium: $971.00 FAITHFUL PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS, THAT, WHEREAS, City of Gilroy, hereinafter designated the "City," has, on February 7, 2011, awarded to, Graniterock, hereinafter designated as the "Principal,' a Contract for the construction of the Gilroy Crossing Offsite Improvements (Project No. 11 -CIDD-1 83), and WHEREAS, said Principal is required under the terms of said Contract to furnish a bond for the faithful performance of said Contract: NOW, THEREFORE, WE, the Principal, and, as Surety, are held and firmly bound unto the City the penal sum of three hundred fifty nine thousand five hundred twenty four and no/100 dollars ($ 359,524.00 lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the above bounden Principal, it or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and abide by, and well and truly keep and faithfully perform the covenants, conditions, and agreements in the said contract and any alterations made as therein provided, on it or their part to be kept and performed, at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless, the City, its officers and agents as therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and virtue. It is acknowledged that the Contract provides for a one-year warranty period, during which time this bond remains in full force and effect. And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the Contract or to the work to be performed thereunder or the specifications accompanying the same shall, in any way, affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration, or addition to the terms of the Contract or to the work or to the specifications. Said Surety hereby waives the provisions of Sections 2819 and 2845 of the Civil Code of the State of California. Gilroy Crossing Offsite Improvements 11-GDD-183 SECTION 00610-29 Page 2 of Performance Bond # 929510254 to City of Gilroy for Gilroy Crossing Off site Improvements IN WITNESS WHEREOF, the above bounden parties have executed this instrument under their seals this 17th day of February, 2011, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. Granite Rock Company, d.b.a. Pavex Construction Division Prin ' 1 (Seal) cT By: ignature for Principal Title of Signator Continental Casualty Company Surety (Seal) By: Signature for Surety Deborah L. Tablak Attorney -in -Fact Title of Signator ** *END OF SECTION"" Gilroy Crossing Offsite Improvements 11 -COIF -183 SECTION 00610 -30 POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT • Know All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called "the CNA Companies "), are duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make, constitute and appoint Catherine Gustayson, F R Hudson III, Dennis M Carney, David J Bachan, Deborah L Tablak, Jeanette M Mazzarino, Matthew Reade, John R Ullmer, Individually of Watsonville, CA, their true and lawful Attomey(s) -in -Fact with full power and authority hereby conferred to sign, seal and execute for and on their behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Boards of Directors of the insurance companies. In Witness Whereof, the CNA Companies have caused these presents to be signed by their Senior Vice President and their corporate seals to be hereto affixed on this 29th day of September, 2010. Gjks w 0 OORPOAArE ►- • a SEAL 1897 ` Continental Casualty Company National Fire Insurance Company of Hartford ,Mamt►a+4"r American Casualty Company of Reading, Pennsylvania MY 11. Jac yne A Belcastro Senior Vice President State of Illinois, County of Cook, ss: On this 29th day of September, 2010, before me personally came Jacquelyne M. Belcastro to me known, who, being by me duly sworn, did depose and say: that she resides in the City of Chicago, State of Illinois; that she is a Senior Vice President of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company described in and which executed the above instrument; that she knows the seals of said insurance companies; that the seals affixed to the said instrument are such corporate seals; that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that she signed her name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance companies. WTMY M7113t woa ----- oars ----- My Commission Expires September 17, 2013 Eliza Price Notary Public CERTIFICATE I, Mary A. Ribikawskis, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance companies printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance companies this 17th day of F b ua ) 2011 r,AS <r OOAPOAAre F • °u SEAL 1897 Form F6853- 5/2009 %NSU114,� tea �ppAr oe IDLY 11 . isoz a • Continental Casualty Company National Fire Insurance Company of Hartford American Casualty Company of Reading, Pennsylvania Mary A. ika kis Assistant Secretary Authorizing By -Laws and Resolutions ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY: This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company. "Article IX Execution of Documents Section 3. Appointment of Attorney -in -fact. The Chairman of the Board of Directors, the President or any Executive, Senior or Group Vice President may, from time to time, appoint by written certificates attomeys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority, shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thererto. The Chairman of the Board of Directors, the President or any Executive, Senior or Group Vice President or the Board of Directors, may, at any time, revoke all power and authority previously given to any attorney -in- fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17`h day of February, 1993. "Resolved, that the signature of the President or any Executive, Senior or Group Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted pursuant to Section 3 of Article DX of the By -Laws, and the signature of the Secretary or an Assistant Secretary and the seal of the Company may be affixed by facsimile to any certificate of any such power and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall, with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Company." ADOPTED BY THE BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA: This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company. "Article VI Execution of Documents Section 3 Appointment of Attorney-in- fact. The Chairman of the Board of Directors, the President or any Executive or Senior Vice President may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority, shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The President or any Executive, Senior Vice President or the Board of Directors may at any time revoke all power and authority previously given to any attorney -in- fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17`n day of February, 1993. "Resolved, that the signature of the President or any Executive, Senior or Group Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted pursuant to Section 2 of Article VI of the By -Laws, and the signature of the Secretary or an Assistant Secretary and the seal of the Company may be affixed by facsimile to any certificate of any such power and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall, with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Company." ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD: This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company. "Article VII — Execution of Documents Section 3. Appointment of Attorney-in-Fact. The Chairman of the Board of Directors, the President or any Executive or Senior Vice President may, from time to time, appoint by written certificates attomeys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. Such attomeys -in -fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The Chairman of the Board of Directors, the President or any Executive, Senior Vice President or the Board of Directors, may, at any time, revoke all power and authority previously given to any attomey -in- fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17`b day of February, 1993. "RESOLVED: That the signature of the President, an Executive Vice President or any Senior or Group Vice President and the seal of the Insurance Company may be affixed by facsimile on any power of attorney granted pursuant to the Resolution adopted by this Board of Directors on February 17, 1993 and the signature of a Secretary or an Assistant Secretary and the seal of the Insurance Company may be affixed by facsimile to any certificate of any such power, and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Insurance Company. Any such power so executed and sealed and certified by certificate so executed and sealed, shall with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Insurance Company." CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT State of California County of Santa Cruz On February 17, 2011, before me, Guadalupe Aboytes Jimenez, Notary Public, personally appeared Deborah L. Tablak, who proved to me on the basis of satisfactory evidence to be the person($) whose name(s) isle subscribed to the within instrument and acknowledged to me that heAheAhey executed the same in hio#her44@4 authorized capacity(, and that by his�her i€ signature($) on the instrument the person($), or the entity upon behalf of which the person(s) acted, which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. GUADALUPE ABOYTES JIMENEZ I N COMM. # 1889432 < NA, It, rV i"ALA /I IIANA-).- Notary Public California County of Santa Cruz N My Comm. Exo. Mav 15.20141 Gua alupe A ytes Jm4nelj -------------------------------------- - - - - -- OPTIONAL-------------------------------------- - - - - -- DOCUMENT AND SIGNER Type: Performance Bond # 929510254 Principal: Granite Rock Company, d.b.a. Pavex Construction Division Obligee: City of Gilroy Description: Gilroy Crossing Offsite Improvements Deborah L. Tablak is Attorney -in -Fact representing Continental C Bond # 929510254 Premium included with Perf, Bond SECTION 00620 KNOW ALL PERSONS BY THESE PRESENTS, THAT, WHEREAS, City of Gilroy , hereinafter designated as the "City," has, on February 7, 2011, awarded to Graniterock, hereinafter designated as the "Principal," a Contract for the construction of the Gilroy Crossing Offsite Improvements (Project No. 11 -CDD -183), and WHEREAS, said Principal is required to furnish a bond in connection and with said Contract, providing that if said Principal, or any of it or its subcontractors shall fail to pay for any materials, provisions, or other supplies used in, upon, for, or about the performance of the work contracted to be done, or for any work or labor done thereon of any kind, the Surety of this bond will pay the same to the extent hereinafter set forth: NOW, THEREFORE, we, the Principal, and, as Surety, are held and firmly bound unto the City the penal sum of three hundred fifty nine thousand five hundred twenty four and no /100 dollars ($ 359,524.00 ) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors jointly and severally, firmly by these presents. The Payment Bond for which this Section provides shall secure the payment of those persons or entities to whom the Principal, its Subcontractors or its heirs, executors, administrators, successors, or assigns, shall be become legally indebted for labor, materials, tools, equipment or services of any kind used or employed by the bidder in performing the work, or taxes or amounts to be withheld thereon. The Surety or Sureties will pay the following amounts should the Principal or a Subcontractor fail to pay the same, plus reasonable attorneys' fees to be fixed by the court if suit is brought upon the bond: (1) amounts due to any of the persons named in California Civil Code Section 3181; (2) amounts due under the Unemployment Insurance Code with respect to work contracted to be done or any work or labor thereon of any kind; and (3) any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work and labor. This Payment Bond shall inure to the benefit of any of the persons named in Civil Code Section 3181 so as to give a right of action to those persons or their assigns in any suit brought upon this bond. And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or addition of the terms of the Contract or to Gilroy Grossing Offsite Improvements 11 -:ADD -183 SSCI ION 00620 -31 Page 2 of Payment Bond # 929510254 to City of Gil.roy for. Gilroy Crossing Offsite Improvements the work to be performed thereunder or the specifications accompanying the same shall, in any way, affect its obligations of this bond, and it does hereby waive notice of any change, extension of time, alteration, or addition to the terms of the contract or to the work or to the specifications. Said Surety hereby waives the provisions of Sections 2519 and 2845 of the Civil Code of the State of California. IN WITNESS WHEREOF, the above bounded parties have executed this instrument under their seals this 17th day of February, 2011, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. Granite Rock Company, d.b.a. Pavex Construction Division 0 By: Signature for Principal Title Continental. Casualty Company Surety y /? (Seal) By: Deborah L. Tablak, Attorney -in -Fact Signature for Surety Title 'END OF SECTION ' Gilroy Crossing Offsite Improvements 11 -CDD -183 SECTION 00620 -32 POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called "the CNA Companies "), are duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make, constitute and appoint Catherine Gustayson, F R Hudson III, Dennis M Carney, David J Bachan, Deborah L Tablak, Jeanette M Mazzarino, Matthew Reade, John R Ullmer, Individually of Watsonville, CA, their true and lawful Attomey(s) -in -Fact with full power and authority hereby conferred to sign, seal and execute for and on their behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Boards of Directors of the insurance companies. In Witness Whereof, the CNA Companies have caused these presents to be signed by their Senior Vice President and their corporate seals to be hereto affixed on this 29th day of September, 2010. 0SUR4,yc rWORAte �v SEAL 1897 y`oe "ap wCaRrow co x Jutr n, �a • Continental Casualty Company National Fire Insurance Company of Hartford American Casualty Company of Reading, Pennsylvania Jac yne NY. Belcastro Senior Vice President State of Illinois, County of Cook, ss: On this 29th day of September, 2010, before me personally came Jacquelyne M. Belcastro to me known, who, being by me duly sworn, did depose and say: that she resides in the City of Chicago, State of Illinois; that she is a Senior Vice President of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company described in and which executed the above instrument; that she knows the seals of said insurance companies; that the seals affixed to the said instrument are such corporate seals; that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that she signed her name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance companies. CFPCKSEAL gliA PR10E �,'✓ WYMYPU"•irANCitutdt w carreaow ovwU.artM My Commission Expires September 17, 2013 Eliza Price Notary Public CERTIFICATE I, Mary A. Ribikawskis, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance companies printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance companies this 17th day of February 2011 r,wopmr H • u SEAL 1897 Form F6853- 5/2009 tNSUR,1 i HA qlaw Vc uz Continental Casualty Company National Fire Insurance Company of Hartford American Casualty Company of Reading, Pennsylvania Q �P_ 0 cp��� Mary A. Ribikaiekis Assistant Secretary Authorizing By -Laws and Resolutions ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY: This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company. "Article IX— Execution of Documents Section 3. Appointment of Attorney -in -fact. The Chairman of the Board of Directors, the President or any Executive, Senior or Group Vice President may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority, shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thererto. The Chairman of the Board of Directors, the President or any Executive, Senior or Group Vice President or the Board of Directors, may, at any time, revoke all power and authority previously given to any attorney -in- fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17a' day of February, 1993. "Resolved, that the signature of the President or any Executive, Senior or Group Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted pursuant to Section 3 of Article DC of the By -Laws, and the signature of the Secretary or an Assistant Secretary and the seal of the Company may be affixed by facsimile to any certificate of any such power and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall, with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Company." ADOPTED BY THE BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA: This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company. "Article VI Execution of Documents Section 3 Appointment of Attorney -in -fact. The Chairman of the Board of Directors, the President or any Executive or Senior Vice President may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. Such attomeys -in -fact, subject to the limitations set forth in their respective certificates of authority, shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The President or any Executive, Senior Vice President or the Board of Directors may at any time revoke all power and authority previously given to any attorney -in- fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17th day of February, 1993. "Resolved, that the signature of the President or any Executive, Senior or Group Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted pursuant to Section 2 of Article VI of the By -Laws, and the signature of the Secretary or an Assistant Secretary and the seal of the Company may be affixed by facsimile to any certificate of any such power and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall, with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Company." ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD: This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the Board of Directors of the Company. "Article VII— Execution of Documents Section 3. Appointment of Attorney -in -Fact. The Chairman of the Board of Directors, the President or any Executive or Senior Vice President may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. Such attomeys -in -fact, subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The Chairman of the Board of Directors, the President or any Executive, Senior Vice President or the Board of Directors, may, at any time, revoke all power and authority previously given to any attomey -in- fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17'h day of February, 1993. "RESOLVED: That the signature of the President, an Executive Vice President or any Senior or Group Vice President and the seal of the Insurance Company may be affixed by facsimile on any power of attorney granted pursuant to the Resolution adopted by this Board of Directors on February 17, 1993 and the signature of a Secretary or an Assistant Secretary and the seal of the Insurance Company may be affixed by facsimile to any certificate of any such power, and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Insurance Company. Any such power so executed and sealed and certified by certificate so executed and sealed, shall with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Insurance Company." CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT State of California County of Santa Cruz On February 17, 2011, before me, Guadalupe Aboytes Jimenez, Notary Public, personally appeared Deborah L. Tablak, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(*) ism subscribed to the within instrument and acknowledged to me that heAhe4hey executed the same in 6her4h484 authorized capacity(, and that by 6herA64 signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, which the person(g) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official s al. @GUADA7PE780YTM�'1VM"ENEjZ COMM. # 1889432 N^;av %brc- Calrfornia C;. < <-ay ofi Santa Cruz N y Corr ., Lxp. May 15 2014 Gu alupe Ab ytes Ji e - - - -- OPTIONAL -- DOCUMENT AND SIGNER Type: Payment Bond # 929510254 Principal: Granite Rock Company, d.b.a. Pavex Construction Division Obligee: City of Gilroy Description: Gilroy Crossing Offsite Improvements Deborah L. Tablak is Attorney -in -Fact representing Continental Casualty Co .� CQR:�0 � , . CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 02/16/2011 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(les) 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 A/C No): McSherry & Hudson E-MAIL ADDRESS: 575 Auto Center Drive PRODUCER CUSTOMER ID P. 0. Box 2690 Watsonville, CA 95076 X COMMERCIAL GENERAL LIABILITY INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: ZURICH AMERICAN INS CO 16535 INSURER B: $ NIL GRANITE ROCK COMPANY DBA PAVEX CONSTRUCTION DIVISION CLAIMS -MADE T OCCUR P. 0. BOX 50001 INSURERC: INSURER D: PERSONAL &ADV INJURY WATSONVILLE, CA 95077 X -CU Hazards INSURER E: INSURER F: X envl:RAaFS CFRTIFICOTF NIIMRFR- 19784507 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 INSR WVn POLICY NUMBER MM /DDY EFF MM /DD EXP LIMITS • GENERAL LIABILITY X X GL03472668 -09 09/30/1 09/30/11 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE NTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ NIL CLAIMS -MADE T OCCUR PERSONAL &ADV INJURY $ 1,000,000 X -CU Hazards X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO- LOC • AUTOMOBILE LIABILITY X X BAP3472669 -09 09/3671c 09/30/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ X NON -OWNED AUTOS $ X Contractual Liability I I UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DEDUCTIBLE $ $ RETENTION $ • WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED4 (Mandatory in NH) N/A X WC3472667 -09 09/30/1 09/30/11 X WCSTIMIT ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) JOB #4162 GILROY CROSSING OFFSITE IMPROVEMENTS CITY OF GILROY AND CITY OF GILROY EMPLOYEES, OFFICERS, DESIGN CONSULTANTS, ELECTED OFFICIALS, CONSTRUCTION MANAGER, AGENTS AND SUB- CONSULTANTS ARE HEREBY NAMED ADDITIONAL INSUREDS PER THE ATTACHED ENDORSEMENTS (U -GL- 1175 -B) SEE ATTACHED CANCELLATION WORDING FROM POLICIES BROAD FORM PPTY DAMAGE; GLO PER ISO FORM CG0001 (12/04), BAP PER ISO FORM CA0001 (03/06) 1%C0T1c1f`ATC Lint nco r`ANCFI I OTInN 4162 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. 7351 ROSANNA STREET AUTHORIZED REPRESENTATIVE GILROY, CA 95020 USA yrivera V 19Stf -ZUUU AGUKU GUKYUKA I IUN. All ngnLS re5erVeu. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD 19784507 DATE SUPPLEMENT TO CERTIFICATE OF INSURANCE 02/16/2011 NAME OF INSURED: GRANITE ROCK COMPANY DBA PAVEX CONSTRUCTION DIVISION SUPP (10/00) Additional Insured — Automatic — Owners, Lessees Or Contractors 0 ZURICH Policy No. Eff. Date of Pol. Exp Date of Pol. Agency No. Addl. Prem. Return Prem. GLO 3472668 -09 9/3012010 9/30/2011 McSherry & Hudson THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 1 - 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 contract or 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 1.1-GL-IM-13 CW (3/2007) Page 1 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 (3/2007) Page 2 of 2 Policy Number: GLO 3472668 -09 Zurich American Insurance Co. Effective Date: 9/30/2010 Commercial General Liability Coverage Part Severability of Interest The insurance afforded by this policy applies severally as to each insured except that the inclusion of more than one insured shall not operate to increase the limit of the company's liability and the inclusion hereunder of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. Waiver of Subrogation The Company waives any right of recovery the Company may have against the person or organization shown in the Schedule because of payments the Company makes for injury or damage arising out of the named insured's ongoing operations or work done under a contract with that person or organization and included in the "products - completed operations hazard ". Schedule Name of Person or Organization: Any person or organization that requires that the named insured waive the named insured's rights of recovery in a written contract or agreement with the named insured that is executed prior to the accident or loss. Notice of Cancellation If the Company cancels this Coverage Part by written notice to the first Named Insured for any reason other than nonpayment of premium, the Company will mail a copy of such written notice of cancellation to the person or or- ganization shown in the Schedule at least 30 days prior to the effective date of the cancellation. If the Company cancels this Coverage Part by written notice to the first Named Insured for nonpayment of premium, the Company will mail a copy of such written notice of cancellation to the person or organization shown in the Schedule at least 10 days prior to the effective date of such cancellation. If the Company reduces the coverage afforded by this Coverage Part, the Company will mail a written notice of such reduction in coverage to the person or organization shown in the Schedule at least 30 days prior to the effective date of the reduction in coverage. Schedule Name of Person or Organization: Any person or organization to whom the named insured is required by written contract or agreement to mail prior written notice of cancellation and /or reduction in coverage. POLICY NUMBER: BAP 3472669 -09 COMMERCIAL AUTO ZURICH AMERICAN INS. CO. p CA 20 49 02 99 EFFECTIVE DATE: 9/30/2010 THN ENDORSEIVIENTCHANGE3 THE POLICY. PLEASE READ fl` CAl 1-',FULLY. 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 en- dorsement. 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: Countersigned By: 9 -30 -10 Z k Authorized Re resentative SCHEDULE Name of Person(s) or OrganIzation(s): ANY PERSONS 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 A WRITTEN 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 applica- ble to the endorsembnt.) 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 4802 99 1 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 Policy Number: BAP 3472669 -09 Zurich American Ins. Co. Effective Date: 9/30/2010 Commercial Automobile Coverage Part Severability of Interest Except with respect to the limit of insurance, the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or suit is brought. Waiver of Subrogation The Company waives any right of recovery the Company may have against the designated person or organization shown in the schedule because of payments the Company makes for injury or damage caused by an "accident' or "loss" resulting from the ownership, maintenance, or use of a covered "auto" for which a Waiver of Subrogation is required in conjunction with work performed by the named insured for the designated person or organization. Schedule Name of Person or Organization: All persons and /or organizations that require by written contract or agreement with the named insured, executed prior to the accident or loss, that waiver of subrogation be provided under this policy. Notice of Cancellation If the Company cancels or non - renews this Coverage Part by written notice to the first Named Insured for any reason other than nonpayment of premium, the Company will mail a copy of such written notice of cancellation or non - renewal to the person or organization shown in the Schedule at least 30 days prior to the effective date of the cancellation or non - renewal. If the Company cancels this Coverage Part by written notice to the first Named Insured for nonpayment of premium, the Company will mail a copy of such written notice of cancellation to the person or organization shown in the Schedule at least 10 days prior to the effective date of such cancellation. If the Company reduces the coverage afforded by this Coverage Part, the Company will mail a written notice of such reduction in coverage to the person or organization shown in the Schedule at least 30 days prior to the effective date of the reduction in coverage. Schedule Name of Person or Organization: Any person or organization to whom the named insured is required by written contract or agreement to mail prior written notice of cancellation and /or reduction in coverage WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 000313 (Ed. 4 -84) WAIVER OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our pay ments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 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 ORGANI ZATION. 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: 9130110 Policy No.: WC 3472667 -09 Insurance Company Zurich American Insurance Company WC 00 03 13 (Ed. 4 -84) Notice of Cancellation If the insurer cancels this policy by written notice to the named insured for any reason other than nonpayment of premium, the insurer will mail a copy of such written notice of cancellation to the person or organization shown in the Schedule. Notification to such person or organization will be provided at least 30 days prior to the effective date of the cancellation. If the insurer cancels this policy by written notice to the named insured for nonpayment of premium, the insurer will mail a copy of such written notice of cancellation to the person or organization shown in the Schedule at least 10 days prior to the effective date of such cancellation. If the insurer reduces the coverage afforded by this policy, the insurer will mail a written notice of such reduction in coverage to the person or organization shown in the Schedule at least 30 days prior to the effective date of the reduction in coverage. Schedule Name of Person or Organization: Any person or organization to whom the named insured is required by written contract or agreement to mail prior written notice of cancellation and /or reduction in coverage.