Loading...
HomeMy WebLinkAboutSilverado Contractors - 2014 Agreementf SECTION 00500 AGREEMENT PROJECT NAME: OLD YOUTH CENTER PROJECT NUMBER: 15 -PW 218 . THIS AGREEMENT, made this 7th day of August , 2014, by and between the City of Gilroy, hereinafter called the "City," and Silverado Contractors Inc. 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 OLD YOUTH CENTER, PROJECT NO. 15 -PW -218 located at 7400 Railroad Street, Gilroy CA., 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 or more specifically 80 Calendar days from the Notice to Proceed. Article 3. Liquidated Damages. The city and the contractor recognize that the city will suffer substantial damages Old Youth Center Project No. 15 -PW -218 Section 00500 -1 and significant financial loss as a result of the contractor's delays in performance of the work described in the contract documents. The city and the contractor hereby acknowledge and agree that the damages and financial loss sustained as a result of any such delays in performance will be extremely difficult and impractical to ascertain. Therefore, the city and contractor hereby agree that in the event of such delays in performance, the city shall be entitled to compensation by way of liquidated damages of $500 per each day in accordance with the Contract Documents within the time period required by Paragraph 00810- 2.0, Time Allowed for Completion, (and not penalty) for the detriment resulting therefrom in accordance with paragraph 00700 -6.5, liquidated damages, of the contract documents. The city and the contractor further agree that the amounts designated as liquidated damages are a reasonable estimate of the city's damages and financial loss in the event of any such delays in performance considering all of the circumstances existing as of the date of this agreement, including the relationship of such amounts to the range of harm to the city which reasonably could be anticipated as of the date of this agreement and the expectation that proof of actual damages would be extremely difficult and impractical. By initialing this paragraph below, the parties hereto signify their approval and consent to the terms of this article 3. �i City's Initials Contractors Initials Article 4. Contract Price. In consideration of the Contractors performance of the Work in accordance with the Contract Documents, the City shall pay the Contract Price set forth in the Contract Documents. Article 5. Contract Documents. The Contract Documents which comprise the entire agreement between City and Contractor concerning the Work consist of this Agreement (Section 00500 of the Contract Documents) and the following, all of which are hereby incorporated into this Agreement by reference with the same force and effect as if set forth in full. Invitation to Bid Instructions to Bidders Bid Documents Designation of Subcontractors Bid Guaranty Bond Old Youth Center Project No. 15 -PW -218 Section 00500 -2 Agreement Acknowledgements Performance Bond Payment Bond General Conditions Supplementary Conditions General Requirements Standard Specifications (Caltrans) Technical Specifications Drawings Addenda, if any Executed Change Orders, if any Maintenance Bond Notice of Award Notice to Proceed Article 6. Miscellaneous. Capitalized terms used in this Agreement which are defined in Section 01090, References, of the Contract Documents will have the meanings set forth in Section 01090, References. Contractor shall not assign any rights, obligations, duties or responsibilities under or interest in the Contract Documents without the prior written consent of the City, which consent may be withheld by the City in its sole discretion. No assignment by the Contractor of any rights, obligations, duties or responsibilities under or interests in the Contract Documents will be binding on the City without the prior written consent of the City (which consent may be withheld in City's sole discretion); and specifically but without limitation monies that may become due and monies that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment, executed by the City, no assignment will release or discharge the assignor from any liability, duty, obligation, or responsibility under the Contract Documents. Subject to the foregoing, the Contract Documents shall be binding upon and shall inure to the benefit of the parties hereto and their respective successors and assigns. Nothing contained in the Contract Documents shall in any way constitute a personal obligation of or impose any personal liability on any employees, officers, directors, 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 Old Youth Center Project No. 15-PW -218 section 00500 -3 complaint regarding a latent act or omission is filed within four years of the date of the alleged violation. A complaint regarding a latent act or omission pertaining to structural defects must be filed within 10 years of the date of the alleged violation. Any questions concerning the Contractor may be referred to the Registrar, Contractors' State License Board, P.O. Box 26000, Sacramento, California 95826. IN WITNESS WHEREOF, this agreement has been executed on this 2l �to, day of Av 4y i e Silverado Contractors Inc. Name Of Contractor A , 47 , 'a re ontractor Title of Signator ATTEST: / /X/1 l Signature Title of Signator Old Youth Center Project No. 15 -PW -218 Signature Titlejf Signator U*1 r Title o ignator ** *END OF SECTION * ** Approved as to Form: Gilroy City Attorney's Office Br City Attomey Section 00500 -4 ACC>RV CERTIFICATE OF LIABILITY INSURANCE DATE (MMID 1 7/31/2014 DrYYrr) 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 CONTACT NAME: PHONE FAX A/C No): Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 1255 Battery Street, Suite 450 E4MA,L ADDRESS: INSU 5 AFFORDING COVERAGE NAIC f/ San Francisco CA 94111 INSURER A:LeXington Insurance Company 19437 $100,000 INSURED SILVCON -03 INSURER B:WeSc� Insurance Company 25011 INSURER C: X Silverado Contractors, Inc. 2855 Mandela Parkway, 2nd Floor Oakland, CA 94608 INSURER D:RSUI Indemnity Company GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS - COMP/OP AGG $2,000,000 Ded Per Occurrence INSURER E B INSURER F: LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NU; WNED HIRED AUTOS AUTOS Y COVERAGES CERTIFICATE NUMBER: 2108732543 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 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 IN O POLICY NUMBER POLICY EFF- MMIDD/YYYY POLICY EXP MM D WY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Bodily Inj./ Y Y 065463565 1/15/2013 1/15/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO R ED PREMISES Eab currents $100,000 MED EXP (Any one person) $Excluded PERSONAL & ADV INJURY $1,000,000 X Prop. Dam GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS - COMP/OP AGG $2,000,000 Ded Per Occurrence $10,000 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NU; WNED HIRED AUTOS AUTOS Y Y WPA102926002 1/15/2013 1/15/2014 UQM5INFD SINGLE LIMIT Ea accident ) $1,660,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per ac Itl $ Comp/Coll Ded $1,000 D UMBRELLA LIAB EXCESS IJAB X OCCUR CLAIMS -MADE NHA065636 1/1512013 1/15/2014 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,000,000 DED X I RETENTION $ WA $- C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? N❑ (Mandatory in NH) Ifs describe under DESCRIPTION OF OPERATIONS below N/A y 6676076 676076 011/2013 10/1!2013 0/1/2014 0/1/2014 X WCSTATU= OTH- LIMITS ER E.L. EACH ACCIDENT .,000,000 :$1 E.L. DISEASE - EA.EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT_ - - _ $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project #: 15 -PW -218 I Old Youth Center Project - 7400 Railroad St. ADDITIONAL INSURED(S): City of Gilroy ua SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Gilroy ACCORDANCE WITH THE POLICY PROVISIONS. 7351 Rosanna St. Gilroy CA 95020 ..AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION_ All.riehts reserved The ACORD name and logo are registered marks of ACORD POLICYNUMBER: 065463565 ENDORSEMENT# 008 COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. •- A • This endorsement modifies insurance provided under the folloWing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only oath respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the folloWng exclusion is added: 2 Exclusions This insurance does not apply to "bodily in- jury" or "properly damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection oath such vwrk, on the project (other than service, maintenance or repairs) to be performed by or on 'behalf of the additional insured(s) at the site of the covered operations has been completed; or (v That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing ,operations for a principal as a part of the same project CG 20 1010 01 0 ISO Properties, Inc., 2000 Page 1 of 1 ❑ LX9fi05 POLICYNUMBER: 065463565 ENDORSEMENT# 009 COMMERCIAL GENERAL LIABILITY CG 20 37 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Hot I; I NI. This endorsement modifies insurance provided under the folloWng: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: . As required by written contract Location And Description of Completed Operations: Additional Premium: (If no entry appears above, information required to complete this endorsement WII be shown in the Declara- tions as applicable to this endorsement.) Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your vvork" at the location designated and described in the schedule of this endorsement performed for that insured and included in the "products - completed operations hazard ". CG 20 37 10 01 0 ISO Properties, Inc., 2000 Page 1 of 1 D LX9604 ENDORSEMENT # 003 This endorsement, effective 12:01 AM 11/15/ 2013 Forms a part of policy no.: 065463565 Issued to: S I LVERADO CONTRACTORS, INC. By:LEXINGTON INSURANCE COMPANY AGGREGATE LIMITS OF INSURANCE - PER PROJECT AMENDMENT AND OVERALL GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the policy: Subject to the Overall General Aggregate Limit stated in Item 3 of the Declarations, the General Aggregate Limit under LIMITS OF INSURANCE (Section III) applies separately to each of your "projects" away from premises owned by or rented to you. It is further understood and agreed that the following changes are made to the policy: (1) Item 3, Limits of Insurance in the Declarations is amended by the addition thereto of the following Limit: Overall General Aggregate Limit - $ 10, 000, 000 (2) SECTION III- LIMITS OF INSURANCE is amended by the addition thereto of the following paragraph under paragraph 6. 7. The Overall General Aggregate Limit is the most vre will pay under Coverages A and B for the sum of all Limits of Insurance as provided in this SECTION 111 regardless of the number of your "projects "; except for damages because of "bodily injury" and "property damage" included in the "products- completed operations hazard ". For the purpose of this endorsement, "project" means the work for Mich the Named Insured is responsible according to a contract betvmen the Named Insured as the contractor or sub - contractor, and an owner, developer or general or sub - contractor. All other terms and conditions remain unchanged. Authorized Representative OR Countersignature (in states where applicable) LX9695 (02/041 i ENDORSEMENT # 007 This endorsement, effective 12:01 AM 11 /15/ 2013 Forms a part of policy no.: 065463565 Issued to: S I LVERADO CONTRACTORS, I NC. By:LEXINGTON INSURANCE COMPANY WAIVER OF SUBROGATION (BLANKET) It is agreed that we, in the event of a payment under this policy, waive our right of subrogation against any person or organization where the insured has waived liability of such person or organization as part of a written contractual agreement between the insured and such person or organization entered into prior to the "occurrence" or offense. All other terms and conditions remain unchanged. Authorized Representative OR Countersignature (In states where. applicable) LEXOCC234 (I V03) LX0485 ENDORSEMENT # 006 This endorsement, effective 12:01 AM 11 / 15/ 2013 Forms a part of policy no.: 065463565 Issued to: SILVERADO CONTRACTORS, INC. By:LEXINGTON INSURANCE COMPANY PRIMARY/NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: NotWthstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional Insured shall be non - contributing. All other terms and conditions of the policy remain the same. DX-J. Authorized Representative OR Countersignature (In states where applicable) L X9888 l 08105) Policy Number: WPA102926002 (2) Immediately send us copies of any re- quest, demand, order, notice, summons or legal paper received concerning the claim or "suit ". (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit ". (4) Authorize us to obtain medical records or other pertinent information. (5) Submit to examination, at our expense, by physicians of our choice, as often as we reasonably require. c. If there is "loss" to a covered "auto" or its equipment you must also do the following_ (1) Promptly notify the police if the covered "auto" or any of its equipment is stolen. (2) Take all reasonable steps to protect the covered "auto" from further damage. Ai- so keep a record of your expenses for consideration in the settlement of the claim. (3) Permit us to inspect the covered "auto" and records proving the "loss" before its repair or disposition. (4) Agree to examinations under oath at our request and give us a signed statement of your answers. 3. Legal Action Against Us No one may bring a legal action against us un- der this Coverage Form until: a. There has been full compliance with all the terms of this Coverage Form: and b. Under Liability Coverage, we agree in writ - ing that the "Insured" has an obligation to pay or until the amount of that obligation has finally been determined by Judgment af- ter trial. No one has the right under this poli- cy to bring us into an action to determine the "insured's" liability. 4. Loss Payment — Physical Damage Coverages At our option we may: a. Pay for, repair or replace damaged or stolen property; b. Return the stolen property, at our expense. We will pay for any damage that results to the "auto" from the theft; or c. Take all or any part of the damaged or sto- len property at an agreed or appraised val- ue. If we pay for the "loss ", our payment will include the applicable sales tax for the damaged or sto- len property. 6. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or or- ganization must do everything necessary to se- cure our rights and must do nothing after "acci- dent" or "loss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the "insured" or the "insured's" estate will not relieve us of any obli- gations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured ", at any time, intentionally con- ceal or misrepresent a material fact concern- ing: a. This Coverage Form; b. The covered "auto "; c. Your interest in the covered "auto "; or d. A claim under this Coverage Form. 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revi- sion is effective in your state. 4. No Benefit To Ballee — Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provi- sion of this Coverage Form. Page 8 of 112 Q ISO Properties, Inc,, 2005 CA 00 0103 06 Policy Number: WPA102926002 5. Other Insurance 7. Policy Period, Coverage Territory a. For any covered "auto" you own, this Cov- Under this Coverage Form, we cover "acci- erage Form provides primary insurance. For dents" and "losses" occurring: any covered "auto" you don't own, the in- a. During the policy period shown in the Decla- surance provided by this Coverage Form is rations; and .excess over any other collectible insurance. However, white a covered "auto' which is a b. Within the coverage territory. "trailer" is connected to another vehicle, the The coverage territory is: Liability Coverage this Coverage Form pro- "trailer" a. The United States of America; vides for the is: (1) Excess while it is connected to a motor b. The territories and possessions of the Unit - vehicle you do not own. ed States of America; (2) Primary while it is connected to a cov- c. Puerto Rico; ered "auto" you own. d. Canada; and b. For Hired Auto Physical Damage Coverage, e. Anywhere in the world if: any covered "auto" you lease, hire, rent or (1) A covered "auto" of the private passen- bbrrow is deemed to be a covered "auto" ger type is leased, hired, rented or bor- you own. However, any "auto" that is rowed without a driver for a period of 30 leased, hired, rented or borrowed with a days or less; and driver is not a covered "auto ". (2) The "insured's" responsibility to pay c. Regardless of the provisions of Paragraph damages is determined in a "suit' on the a. above, this Coverage Form's Liability merits, in the United States of America, Coverage is primary for any liability as- the territories and possessions o f the sumed under an "insured contract ". United States of America, Puerto-Rico, d. When this Coverage Form and any other or Canada or in a settlement we agree Coverage Form or policy covers on the to. same basis, either excess or primary, we We also cover "loss" to, or "accidents" involy- will pay only our share. Our share is the ing, a covered "auto" while being transported proportion that the Limit of Insurance of our between any of these places. Coverage Form bears to the total of the lim- its of all the Coverage Forms and policies covering on the same basis. Issued By Us S. Premium Audit If this Coverage Form and any other Coverage Form or policy issued to you by us or any com- a. The estimated premium for this Coverage pany affiliated with us apply to the some "acci- Form is based on the exposures you told us dent ", the aggregate maximum Limit of Insur- you would have when this policy began. We ance under all the Coverage Forms or policies will compute the final premium due when shall not exceed the highest applicable Limit of we determine your actual exposures. The Insurance under any one Coverage Form or estimated total premium will be credited policy. This condition does not apply to any against the final premium due and the first Coverage Form or policy issued by us or an af- Named Insured will be billed for the bal- filiated company specifically to apply as excess ance, if any. The due date for the final pre- insurance over this Coverage Form. mium or retrospective premium is the date shown as the due date on the bill. If the es- SECTION V— DEFINITIONS timated total premium exceeds the final A. "Accident" includes continuous or repeated expo - premium due, the first Named Insured will sure to the same conditions resulting in "bodily in- got a refund. jury" or "property damage ". b. If this policy is issued for more than one B. "Auto" means: year, the premium for this Coverage Form 1. A land motor vehicle, "trailer" or semitrailer de- will be computed annually based on our signed for travel on public roads; or rates or premiums in effect at the beginning of each year of the policy. CA 00 0103 06 0 150 Properties, Inc., 2006 Page 9 of 12 ❑ A0PQ7VG POLICY NUMBER: WPA102926002 COMMERCIAL AUTO CA 20 48 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 modi- fied by this endorsement. This endorsement Identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion 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 indl- cated below. Endorsement Effective: 11/15/2013 Countersigned By: L - uth ' d j Re resent Named Insured: SILVERADO CONTRACTORS, INC . SCHED(LE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION WHO14 YOU HAVE AGREED IN A WRITTEN CONTRACT, EXECUTED PRIOR TO,LOSS, TO NAME AS ADDITIONAL XNSURED. (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. WAIVER OF SUBROGATION APPLU, CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 F3 LE ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE OCTOBER 1, 2013 AT 12.01 A.M. ALLEFFECTIVE DATESARE AND EXPIRING OCTOBER 1, 2014 AT 12.01 A.M. AT 1201 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME SILVERADO CONTRACTORS INC 2855 MANDELA PKWY 2ND FL OAKLAND, CA 94608 REP D8 6676076 -13 RENEWAL NC 5- 33 -13 -74 PAGE 10F 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: AUTHORIZED REPRESENTA IVE SCIF FORM 10217 (REV.1 -20121 OCTOBER 41 2013 i� 1 PRESIDENT AND CEO 2572 OLD DP 217 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE OCTOBER 1, 2013 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AND EXPIRING OCTOBER 1, 2014 . AT 12.01 A.M. AT 1201 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME SILVERADO CONTRACTORS INC 2855 MANDELA PKWY 2ND FL OAKLAND, CA 94608 REP D8 7676076 -13 RENEWAL NC 5- 33 -13 -74 PAGE 1 OF 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR 'LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAWN FRANCISCO: l/4 AUTHORIZED REPRESEqTAIVE SCIF FORM 10217 (REV.1 -2012) OCTOBER 4, 2013 _ 1 PRESIDENT AND CEO 2572 OLD D? 217 AGENCY CUSTOMER ID: LOC N: V ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMM NSURED POLICY NUMBER CARMER NAIC CODE EFFECTM DATE: ADDITIONAL REMARKS ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: FORM TITLE: The Producer will endeavor to mail 30 days written notice to the Certificate Holder named on the certificate If any policy listed on the certificate is cancelled prior to the expiration date. Failure to do so shall impose no obligation or liability of any kind upon the Producer or otherwise alter the policy terms. Additional Information GENERAL LIABIILITY Additional. Insured - Owners, Lessees or Contractors Scheduled Person or Organization CG2010 1001 Additional Insured - Owners, Lessees or Contractors Completed Operations CG2037 1001 Primary Insurance Clause Endorsement LX9838 (08105) Waiver of Subrogation LEXDCC234 (11/03) AGGREGATE LIMITS OF INSURANCE - PER PROJECT AMENDMENT AND OVERALL GENERAL AGGREGATE LIMIT LX9695 (02/04) AUTO LIABILITY Designated Insured CA20480299 Waiver of Subrogation CAD0010306 Excess: Follows Primary Forms Subject to Policy Term, Conditions & Exclusions WORKERS COMPENSATION Waiver of Subrogation 10217 (Rev, 1 -2012) ACORD 101 120081011 M 200a ACORD CORPORATION_ All rinhta raearvarl The ACORD name and logo are registered marks of ACORD i' CITY OF GILROY BUSINESS LICENSE APPLICA 7351 Rosanna Street Gilroy, CA 95020 -6141 (408) 846 -0420 Fax (408) 846 -0421 Please complete both sides of thh form and the supplemental form. Omissions or misrepresentations will immediately cause revocation of this license. Sales or use tax may apply to your business activities. You may seek advice regarding the application of tax to your particular business by contacting the nearest State Board of Equalization Office, Procedure- Bach division in the sequence listed must sign the back of this application form. A business license must be issued before starting your business activity. If your business requires any other permits or licenses, you may not open your business until the required permits have been obtained. Commercial businesses please complete the "SUPPLEMENTAL FORM ". ADA NOTE: Do you have a qualified disability for which you request an accommodation? (Circle one) YES ( "NO If yes, what accommodation do you desire? Regulatory Inspection/Review Fees: Codes New/Moved -Home Occupation $ 70.00 + $1.00 State Feeri (2602 $70, 2615 $0 New/Moved -Other $120.00 - $370.00 + $1.00 State Feett (2603 $120, 2607 $130, 2609 $120, 2615 $1) New/Moved- Regulated $190.00 - $560.00 + $1.00 State Feett (2603 $120, 2607 $130, 2608 $190, 2609 $120, 2615 $1) Out -of -town business $ 30.00 + $1.00 State Feet+ ';x-(2604 $30, 2615 $1) Pretreatment/CUPA Review $ 40.00 (2611) Change $ 15.00 (260 1) (excluding changes in ownership) Business License Fees- See Fee Schedule ' it Other Licenses/Permits (Fire/Hazmat/PD) TOTAL FEES: $ THIS BOX TO BE COMPLETED BY FINANCE: Business is located within the city limits Business is located outside the city limits Non-exempt business Misc. business New business Change of ownership Change in location Facemptbusiness (Non- profits must attach copy of certification) Home Occupation CONTRACTORS LOCATED OUTSIDE OF GI ROY CITY LIMITS COMPLETE THIS BOX: STATE LICENSE # I "I CLASS _ EXP DATE z� Z/ / `- '�•,ti �c� \ , S. , N6Z ; jA N7- (July,Aug,Sep,Oct,Nov,Dec -June) (Jan,Feb,Mar -June) (Apr,Mav,June -Sep) (Julv,Aug,Sep -Dec). (Oct,Nov,Dec -Mar) Yearly $150 Semi- Annual $90_ Semi - Annual S90_ Semi - Annual $90� Semi- Annual $90_ BUSINESSES COMPLETE THIS SECTION: BUSINESS TYPE (check one): ( ) SALES /COM LEASE/MEMBERSHIPS /ALL OTHER- Annual gross receipts $ (CONTRACTOR ( ) PROF ( ) MASSAGE ( ) APTS (# units) TRANSIENT NON - PROFIT /EXEMPT_ ( ) SERVICE ( ) VENDING MACHINE(S) ( #) ( ) DELIVERY VEH(S) ( #) TAXI CABS( #) OWNERSHIP TYPE (circle one) SOLE PROPRIETORSHIP PARTNERSHIP 1, CORPORATION) TRUST HOME -BASED BUSINESS? (circle one) YES BUSINESS DESCRIPTION: C'.C�s 1��t�1 t �r -� C'r : `.: \-e (C.: C.: C:`(, START DATE: a_/2a/ t On September 19, 2012 Governor Brown signed into law SB 1 l ii6 which adds a state fec of $ I on any applicant for a local business license or similar instrument or permit, or renewal thereof. The purpose is to increase disability access and compliance with construction - related accessibility requirements and to develop educational resources for businesses in order to facilitate compliance with federal and state disability laws, as specified. t• Under federal and state law, compliance with disability access laws is a serious and significant responsibility that applies to all California building owners and tenants with buildings open to the public. You may obtain information about your legal obligations and how to comply with disability access laws at the following agencies: • The Division of the State Architect at www.dgs.ca.gov dsit /Home.aspx. • The Department of Rehabilitation at www.rehab.cahwngLgov. • The California Commission on Disability Access at www.ccda.ca.,co%. BUSINESS NAME/DBA: -, ,. �N,)Arak c, �{ �, BUSINESS ADDRESS: (street) Qqa 7`f 5 a -V(l i tje;1,', j)k I ; ' I 4 �� (suite #) (ci (state) -f--L (Zip) c:, t irk•- (phone) " MAILING ADDRESS (street kr ,� f' C�{�, (�> �, (city).._ _ (St) (zip OWNER(s) /CORP. NAME (fast)_ (first) (last)_ (mi.) (last OWNER ADDRESS: (street)_ (city), (state)_ (zip)_ (phone) FEDERAL TAX ID # I?4 SOCIAL SECURITY # STATE TAX ID # STATE B RD OF EQUALIZATION # APPLICANT: Signature Title °� Date rev.7 /1/2014