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HomeMy WebLinkAboutPacific Electric - Pedestrian Crosswalk Project No. 15-PW-226SECTION 00500 AGREEMENT PEDESTRIAN CROSSWALK AT WREN AVENUE AND BYERS STREEET PROJECT NUMBER 15 -PW 226 THIS AGREEMENT, made this 2,52" day of .MAI?G14 , 00 ,by and between the City of Gilroy, hereinafter called the "City," and LCC74C, rJ?4kdl^16 ��: 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 Pedestrian Crosswalk at Wren Avenue and Byers Street, PROJECT NO. 15 -PW 226, 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 Pedestrian Crosswalk at Wren Ave and Byers St 15- PW- 226SECTION 00500 -24 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 (and not penalty) for the detriment resulting therefrom in accordance with paragraph 00700 -6.5, liquidated damages, of the contract documents. The city and the contractor further agree that the amounts designated as liquidated damages are a reasonable estimate of the city's damages and financial loss in the event of any such delays in performance considering all of the circumstances existing as of the date of this agreement, including the relationship of such amounts to the range of harm to the city which reasonably could be anticipated as of the date of this agreement and the expectation that proof of actual damages would be extremely difficult and impractical. By initialing this paragraph below, the parties hereto signify their approval and consent to the terms of this article 3. City's Initials Contractors Initials Article 4. Contract Price. In consideration of the Contractors performance of the Work in accordance with the Contract Documents, the City shall pay the Contract Price set forth in the Contract Documents. Article 5. Contract Documents. The Contract Documents which comprise the entire agreement between City and Contractor concerning the Work consist of this Agreement (Section 00500 of the Contract Documents) and the following, all of which are hereby incorporated into this Agreement by reference with the same force and effect as if set forth in full. Invitation to Bid Instructions to Bidders Bid Documents Designation of Subcontractors Bid Guaranty Bond Agreement Pedestrian Crosswalk at Wren Ave and Byers St 15- PW- 226SECTION 00500 -25 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 Pedestrian Crosswalk at Wren Ave and Byers St 15 -PW 226SECTION 00500 -26 License Board which has jurisdiction to investigate complaints against Contractors if a complaint regarding a latent act or omission is filed within four years of the date of the alleged violation. A complaint regarding a latent act or omission pertaining to structural defects must be filed within 10 years of the date of the alleged violation. Any questions concerning the Contractor may be referred to the Registrar, Contractors' State License Board, P.O. Box 26000, Sacramento, California 95826. IN WITNESS WHEREOF, this agreement has been executed on this day of PiVA& Name of Contractor Signature of City C F4,�w i! • C ft'sAw° f Title of Signator ATTEST: gnature 017 Title of Signator �J Title of Signator Approved as to Form: Gilroy City Attomey's Office By: City Attorney ** *END OF SECTION * ** ATTEST: nature Title of Signator Pedestrian Crosswalk at Wren Ave and Byers St 15- PW- 226SECTION 00500 -27 ACOR T 0 v CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 3/18/2015 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 Fryar Insurance and Risk Management, Inc 22320 Foothill Blvd., Ste 130 Hayward CA 94541 CO TACT Patricia Antoine }. PHONE (510)583 -2203 FAX (S10)583 -2204 C. E-MAIL ADDRESS,patricia@4thefirnLinc. com INSURER(S) AFFORDING COVERAGE NAIC # INSURERAiJames River Insurance Company LIMITS - INSURED Pacific Electric Contracting, Inc. 330 Phelan Avenue San Jose CA 95112 INSURER B:: California Capital Insurance C INSURER C.National Union Fire Ins Cc INSURER D: INSURER E: $ 1,000,000 INSURER F : X ! COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Ex_] OCCUR COVERAGES CERTIFICATE NUMBER:CL1531801809 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. TYPE OF INSURANCE DD U R POLICY NUMBER POLICY EFF POLICY EXP LIMITS - GENERAL LIABILnY EACH OCCURRENCE $ 1,000,000 rA X ! COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Ex_] OCCUR 00022715 -9 /17/2015 /17/2016 DAMAGE T a N _ $ 50,000 MED EXP (Any one person) $ Exclude PERSONAL & ADV INJURY $ 3,00.0,000 X .$5,.000. Deductible GENERAL AGGREGATE $ 2,000,000 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,'000, 0 00 - $ POLICY- X. ,PRO- LOC AUTOMOBILE LIABILITY Ea BIKED SINGLE 'DO 1,000,000 B X ANY AUTO ALL OWNED SCHEDULED X AUTOS X NON -OWNED HIRED AUTOS AUTOS BAA11713794 /17/2015 /17/2016 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per. . c,d ri _ $ Uninsured motorist combined $ 11000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5, 000, 000 AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE DEC I (RETENTION $ 024548324 /17/2015 /17/2016 WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (11111arjdatmy7n NH) N/A E. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ H yes, describe under DESCRIPTIONOF OPERATIONS below E.L. DISEASE - : POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Gilroy its agents, officers 6 employees are included as additional insureds as .respects to Project No. 15 -PW -226, Pedestrian Crosswalk at Wren Avenue and Byers Street *subject to the actual terms and conditions of the policy* *30 days notice given for cancellation except 10 days for non - payment of premium* L"RAII212h_1111M City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED FRYAR /PAT 0IQ4&P ©1988 -2010 ACORD CORPORATION. All rights reserved. INS025 r7mnns) m Tho Ara1Rr1 name and Innn ara ronieforarl martre of AR(1Rn POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ ization s : Locations Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising 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; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip, ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 2010 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑ SECTION 00630 CERTIFICATE OF INSURANCE Return Completed Certificate to City of Gilroy (Agency) This certifies to the Agency that the following described policies have been issued to the insured named below and are in force at this time. Insured 1' nc % -t- l C. P�L e c—( Q ► G C-o S—( Q C.�, ^5 Address 3 30 -Ph- L.aii v� 5�a q 5 ! 2 Description of operations/locations/products; ir(sured (shov�csn ract n e nd/or number, if any): POLICIES AND INSURERS Bodily LIMITS Property POLICY EXPIRATION Injury Damage NUMBER DATE Workers' Compensation Em p rs Lia ility (Name of Insurer) (Best's Rating) Check policy type: "Claims Made" Occurrent COMPREHENSIVE Each Each GENERAL Occurrence Occurrence LIABILITY , or $ 1J o00 4-c) O p $ COMMERCIAL GENERAL Aggregate Aggregate 2Z7 / LJ,ABILITY �} go vc or Combined Single Li . (Name of Insurer) - _ Aggregate $ (Best's Rating) BUSINESS AUTO POLICY Each Pe,son Each Accident Liability Coverage Symbol $ $ $ j l 7! i s QAC,.F 0-j=)f) j-T Iq L Each Accident or Combined Single Limit $ r , t3cb) o UMBRELLA LIABILITY "Claims Made" Occurrence N per)rA A L UoJ, O r( Occurrence/Aggregate $ �Eo,l¢1 )711 5 (Name of Insurer) Self- Insured Retention (Best's Rating) Pedestrian Crosswalk at Wren Ave and Byers St 15-PW -226 SECTION 00630 -32 W The following coverage or conditions are in effect: Yes No The Agency, its officials, and employees are named on all liability policies described above as insureds as respects: (a) activities performed for the Agency by or on behalf of the Named Insured, (b) products and completed operations of the Named Insured, and (c) premises owned, leased or used by the Named Insured. Products and Completed Operations r The undersigned will mail to the Agency 30 days written notice of cancellation or reduction of coverage or limits �--- Cross Liability Clause (or equivalent wording) i✓ Personal Injury, Perils A, B and C Broad Form Property Damage X. C, U& Hazards included L--� Contractual Liability Coverage applying to this Contract Liquor Liability t-- Coverage afforded the Agency, its officials, employees and volunteers as Insureds applies as primary and not excess or contributing to any insurance issued in the name of the Agency Waiver of subrogation from Workers' Compensation Insurer This certificate is issued as a matter of information. This certificate is not an insurance policy and does not amend, extend or after the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or conditon of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is sub;ect to all the terms, exclusions and conditions of such policies. T;7i-V Ae- s , 4:;�F,.? -Y ► C-e- Agefty or Brokers e 2Z5 2U o 1 N ILL e Lva i#) 3C) 1+Iq y W Cq q Address Name of Person to be Contacted" C 5 D) 593 -- Z.2-03 Telephone No. Insurance Company Ho a ice , A" �a7%,VC Aftrized Signatutej Date Note: Authorized signatures may be the agent's if the agent has placed insurance through an agency agreement with the insurer. If insurance is brokered, authorized signature must be that of officia of insurer. Pedestrian Crosswalk at Wren Ave and Byers St 15-PW -226 SECTION 00630 33 City of Gilroy ( "the Agency ") GENERAL LIABILITY ENDORSEMENT 7351 Rosanna Street Gilroy, CA 95020 Attn: Risk Manager A. POLICY INFORMATION Endorsement No. 1. Insurance Company JAMES RIVER INSURANCE COMPANY Policy No. ocDo 227 I rig 2. Policy Term (from) 3/17/2014 (to) 3/17/2015 3. Named Insured_ PACIFIC ELECTRIC CONTRACTING, INC 4. Address of Named Insured 330 PHELAN AVENUE, SAN JOSE, CA 95112 5. Limit of Liability Any One Incident/Aggregate $ 51,000,00032,000,000 6. Deductible or Self- Insured Retention: (Nil unless otherwise specified): $ $5,000 PER OCCURRENCE 7. Coverage is equivalent: Comprehensive General Liability form GL0002 (Ed 1/73) Comprehensive General Liability "occurrence" form CG0001 YES, 12/07 EDITION Comprehensive General Liability 'claims-made" form CG0002 ........................ ............................... 8. Bodily Injury and Property Damage Coverage is: "claims -made" - "occurrence" if claims -made, the retroactive date is n/a NOTE: The Agency's standard insurance requirements specify "occurrence" coverage. "Claims -made' coverage requires special approval. B. POLICY AMENDMENTS This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or any other endorsement attached thereto, it is agreed as follows: 1. INSURED. The Agency, its elected and appointed officers, officials, employees and volunteers are included as insureds with regards to damages and defense of claims arising from: (a) activities performed by or on behalf of the Named Insured, (b) products and completed operations of the Named Insured, or (c) premises owned, leased or used by the Named Insured. 2. CONTRIBUTION NOT REQUIRED. As respects: (a) work performed by the Named Insured for or on behalf of the Agency; or (b) products sold by the Named Insured to the Agency; or (c) premises leased by the Named Insured from the Agency, the insurance afforded by this policy shall be primary insurance as respects the Agency, its elected or appointed officers, officials, employees or volunteers: or stand in an unbroken chain of coverage excess of the Named Insured's scheduled underlying primary coverage. In either event, any other insurance maintained by the Agency, its elected or appointed officers, officials, employees and volunteers shall be in excess of this insurance and shall not contribute with it. 3. SCOPE OF COVERAGE. This coverage, if primary, affords coverage at least as broad as: (1) Insurance Services Office form number GL 002 (Ed. 1/73), Comprehensive General Liability Insurance and Insurance Services Office form number GL 0404 Broad Form Pedestrian Crosswalk at Wren Ave and Byers St 15-PW -226 SECTION 00630 -34 comprehensive General Liability endorsement or (2) Insurance Services Office Commercial General Liability Coverage,. "occurrence" form CG 0001 or °claim_s -males form CG 0002; or (3) If excess, affords coverage which is at least as broad as the primary insurance forms referenced in the preceding sections (1) and '(2). 3. SEVERABILITY OF INTEREST. The insurance afforded by this policy applies separately to each. insured who is seeking _coverage or against whom a claim is made or a suit is brought, except with respects to the Company's limit of liability. 4. PROVISIONS REGARDING THE INSURED'S DUTIES AFTER ACCIDENT OR LOSS. Any failure to comply with reporting provisions of the policy shall not affect coverage provided to the Agency, its elected or appointed officers, officials, employees or volunteers. S. CANCELLATION NOTICE. The insurance afforded by this policy shall not be suspended, voided, cancelled, reduced in coverage or in limits except after thirty (30) days prior written notice by certified mail return receipt requested -has been given to the Agency. Such notice shall be addressed as shown in the heading of this endorsement. C. INCIDENT AND CLAIM REPORTING; PROCEDURE Incidents and claims are to be reported to the insurer at ATTN: Courtney Porter - Claims manager (rcle)JAMES RIVER INSURANCE COMPANNY (66641) WEST BROAD STREET, SUM 300 (Address) RICHMOND, VA 23230 804- 289 -2101 (Telephone) D. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER 1, HEATHER BARKER (pn n name), warrant that I have authority to bind the below listed insurance company and by my signature hereon do so bind this company. SIGNATURE OF AUTHORIZED REPRESENTATIVE (original signature required on endorsement famished to the Agency) ORGANIZATION RT SPECIALTY, LLC TITLE WHOLESALE BROKER ADDRESS 1 EMBARCADERO CENTER, #2700 TELEPHONE 415 -445 -5023 SAN F$MCIS i Pedestrian Crosswalk at Wren Ave and Byers St 16-PW -226 SECTION 00630 -35 J �COI?L7� CERTIFICATE OF LIABILITY INSU�iVE DATeP�Dmm�1 3/is/zois THIS CERTIFICATE IS LSSBUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RMHU UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIHELY OR NEGATIVELY AAmEND, EXTEND OR ALTER TMJE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTffICJ1TE OF US ----- DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED `REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.- IMPORTANT. 711 the eertNicsta "holder is an ADDITIONAL INSURED. th® 00liay(ies) must be endorsed. H:SUBROGATIOW WAIVED, Subject to the temts and conditions of the po0ry. ve in popdes may require an endomsemeft A statement on this certiflcete does,not confer rights to the __ certHica te:hotder_in.liisuoisuchen s) ----------- Patricia - Antoine Irryar 3nsUrance and Risk ltaSagament, . Inc -- (510) 583- 2203 - — F/ul -- 49401583-2204 22320 Foothill. Blvd. Ste 130 - r e patrioia@4thefirmiaa.aom INSUMM Pacific Faectric Contracting, Inc. 330 Phelan Avenue 871 =:rte --3' NUMBER:=A31801809 — .....mom..... THIS IS TO CERTIFY THAT THE POLICIES. OF INSURANCE LISTED BELOW HAVE' BEHi I.S 1ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERM INDICATED. NOTWTFISTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS cERnFICATE MAY BE 01JED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES_ DESCRIBED MOM IS SULIEC:T TO ALL THE TERMS, 80A)SIONS -AND CONDITIONS OF SUCH POLICIES. LIMITS MOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPHOFOIBtiRgI10E LORTS A 06�tAt.LlAalUrlf _ _ . _" . Z CORNAERCUL cENBW U48UW d AaASMADE OCCUR x $5,000 Deductible 0022715 -8 117/2015 - /17/2016 EACH oocr ux AS 1,000 00 E 50.6 0 amEXP one - - -- t xxol PERSONALAADVINJURY a 1,000,00 GE34 RAL AGOMOATe- s 2, 000, 00 O6+LAGGREGAEumPUEPEFt Mai: X _ . PRO-M- CM . . S 2,000,000 B �;;► ANY.AUTO ALL A OYYI!1® A SCHEDIAED HIRED AUTOS AUTOS EALL2713794 /17/2015 /17/2016 "` eooarrl�IaevlParoesen) 1, 000 0o s Ix B�aY 1NJtIRY IPsr�n) E S C S YIOiR8L1 A LWa ®c LIAS x OCCUR C�.alws�lAOE 024NO324 /17/2015 /17/9016 EACH OCCURRENCE s 5,00 000 AGATE S 5, 000, 000 f AND Cf ATION ANY PAOPigETaRJPAg7N- " DO TIN CUTWE O r p(CWpED7 � It wy bf MCI R emer®6 Law OF OPERATIONS below MIA _ E L. EACH ACCIDENT S E.L. DISEASE. EA FJVLOYEI S EL ORWASE -POLICY LM YT S OEOCAW"O I OF NATIONS /LOCATIONS I VEiN:LEe (Alfaeb A60RD IOC, AddVand Remgb 8aM4�de, M lapis eoste M teatMe4) City of Gilroy its agents, officers .a employes are i0111d d as additional insureds as respects to Project No. 15 -PW -226, Pedestrian Crosswalk at Wren Avenue and Byers Street *subject to the actual terms and conditions of the policy* *30 daps notice given for cancellation szcapt 10 days for non- payment of Premium* 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. 7331 Rosanna Street Gilroy, CA 95020 AUtHDNZED REPROSENTAWA TER FRYAR/PAT ACORD 25 (2010/05) 0 IM -2010 ACOIID CORPORATION. AE tights reserved. rm nrrnan name Am Innn we mnlatma,l msrke of arson POLICY NUMBER: 00022715 -9 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS.- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Addidohad insured Perscn(s) Or Or izadon s :._ _ _ . Locations Of Covered Opeireflons City of Gilroy its, agents,,officers ti Project #15 —PW -226 employees Pedestrian Crosswalk at Wren Ave 7351 Rosanna Street & Byers Street Gilroy, CA 95020 Information required to complete this _8chedule if not shown above wig be shown to the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the persons) or organization(s) shown in the Schedule, but only with respect to liability for "bodily fury°. "properly damage or 'personal and advertising injury' caused, In whole or in part, by. 1. Your acts or omissions; or 2. The acts or omissions of those aging on your behalf, in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With , respect to the Insurance afforded to these additional insureds, the following additional exclu- sions apply. This insurance does not apply to "bodily injury' or °property damage" occurring after. 1. AD work, Including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of 'your worfu" out of which the Injury or damage arises has been put to he In- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project CO 2010 07 04 0 ISO Properties, Inc., 2004 - Page 1 of 1 0 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC .04 03 06 (ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to reco%er our payments from anyone liable for an injury co%ered 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 _ZJQ2% of the Califomia workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract 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 Date: 6/1/2014 Policy No. CST5005256 Policy Effective Dates: 06/01/2014 - 06/01/2015 Insured: Pacific Electric Contracting, Inc Carrier Name / Code: Benchmark Insurance Company A WC 04 03 06 (Ed. 4-84) Countersigned by Endorsement No. Premium $ Page 1 of 1