HomeMy WebLinkAboutMaintenance of Traffic Signals - Signal Maintenance Inc - 1976 City Signal Maintenance Inc.
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.l «:0ME OP"rIC : OP M /-% RY LADY ® 8 A LTt MOPE '
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OT-1-77-1
1 nKkfuD Pertermnow De®d
He Work
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(The premium charged on this bond is$---------------------being at
the rate of$-------------------- per thousand of the contract price)
KNOW !'a1.d. MEN BY THESE PRESENTS:
I
THAT. WEmREAs, the__--City O f _C u p e r t i n o
-------------------------------------------------------
State of California, entered into a contract dated--------------------------------------10------- with
_ _ Traffic- Signal Maintenance Co. , Inc.
- --------------------------------------------------
--------------------- ----------------------------•------_hereinafter designated as the "Principal,"
for the work described as follows: ------ Or--K(lintPJ ancr.-0_f_-.Tr-af 1-c-ignal5--___-___-
Project No. 76-5
--------------------------------------------------------------------------------------- , and
- ,
3
WHEREAS, the said Principal is required under the terms of said contract to furnish a bond for the faithful
performance of said contract.
NUS•, THEREFORE, We, the Principal, and FrDELITY AND DFPOSIT COHP1tiY OF gIARYLAtiD, a corpOt-a-
tip n organized and existing under the laws of the State of Maryland.,and duly authorized �., transact business
under the laws of the State of California, as Surety, are held and firmly bound unto___C i ty of
s Gup�rl~tt7A---------------------------------------
-------------------------------------------
Twenty Five Thousand and no/100 ---
in the penal sum of---------------------------------- ------------------Dollars ($ 25 25 , -00000. 0 0 -0 )
lawful rlhG^ey of the t.-nited States, for the payment of which sum well and truly to be made, we bind our-
selves, ,,ur heirs, executors, administrators,aril successors, jointly and severally, firmly by these presents.
t _
THE CONDITION OF THIS 0111.I(;ATION Is Sucn, That, if the above bounden Principal, his or its heirs,
r' e.ecutors, vdminivtrators, successors r)r assigns, shall in ail things stand to and abide by, and well and truly
I.eep anul ptrforni the covenants, conditions and agreements in the said contract ap(. any alteration thereof
made as therein provided,on his or their,-)art, to be kept and perfornied at the time and in the manner therein
1 specified,and in all res)ects acc<•.rding to their true intent and meaning,and shad indemnify and save harmless
City of Cupertino
the ------ ✓-- --- ------- -- ------
its officers a ;d agents, as therein stipulated, then this obligation shall becor-ne null and void;otherwise.it shall
be and remain in full force and virtue.
i
i
And t-;e said Surety, four value received, hereby stipulates and agrees that no change, extension of tune,
i alteration ,r addition to th- terms of the contract or to the work to be performed thereunder or the specific;t-
r; lions ace ,rr arhyin;; the s+me shall in any wise affect its obligations on this bend, and it does hereby waive
notice of any such change, ccxt:ns on (if time, alteration or addition to the terns of the contract o.- to the nark
t, or to the s,.ecificathorr.
IN W17::tss WHLRL01 We have hereunto set our hands and seals this4th
tt� day of-- _January - -- -- -- 19 -77--
{ TRAFFIC SIGNAL MAINTENANCE C04 INC.
---- -- ----- r-------••
-
William-C. Sonder aid- -- --
-
g Principal t
Vice President
I FIDELITY' AND DEPt)SIT COMPANN' DF �iAit�`L.1\D
s I
Gary Ditfurth .one -in-tu ;
1 t
CAL.:173a--u)0 i-:d 11,3514 ++�
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s •rot •sraeu•..�a rs�a,
1 � and copWl Campaw
.,.r..n o•'v,* v OF` MARYLANO w.i.rr..,unv
ly
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Falt1iffaA Pert®rnmimee a
Dead a
ON BEHALF OF a
TO
i
Fidelity and Deposit Company
OF hSAUTLAN D
SAN FRANG8C0 BRANCH I *ANGstLas BRANCH
255 California Street One Wilshire Building
PLEASE READ YOUR 160NU
CERTIFICATE
'O F INSURANCE ABERTY
° MUTUAL
� e
This IS to Certify that uaumrunwrea�nascrcor�raw.iytsnruruar�seur;sssc,awur.�nro.
TRILFFIC SIGNAL MAINTENANCE CO. , IIf( .
M Corporation Name and
c/a Insurance Manager address of
1601 Trapelo Road Insured.
Massachusetts 02154 L Waltham,
is, at the date of this certificate. insured by the Company for the types of insurance and in accordance with the limits of hat,dr—'-
exclusions. conditions, and other terms of the policies hereinafter described. This certificate of insurance neither affirm3tively or r.
atively amends, extends or alters the coverage afforded by the policies listed below.
EXPIRATION
TYPE OF POLICY DATE POLICY NUMBER LIMITS OF LIABILITY
COVERAGE AFFORDED UNDER W ,IMIT OF LIABrU"' _ 1
LAW OF FOLLOWING STATE(S)
WORKMEN'S
COMPENSATION
F COMPREHENSIVE BODILY FORM INJURY PROPERTYrC�APt_A
I --
Q H SCHEDULE FORM
cc PRooucTs coM 611�77 ILl-112-035574-046 (� EACH - E�
Z m ❑PLETtO OPERATIONS I$ JOG,QOC OCCURRENCEI$ I00,000
Uj C7.a—.r ® Contractu.a 15 500,000 AGGREGATE �J 100,000 - _ _:E-,ATE1
❑ I I
EACH
® OWNED $ 250,000 PERSON
O F— _ !
� m El NON OWNED 6/1/'77 AE1-112-035574-056 I$ 500,000 AC IDEN I� �Q,QOQ
-j ® HIRED OR
CKC RRENCE` =EIJ
1
CC I I
LAJ I
S
LOCATION(S) OF OPERATIONS 6 JOB # of Apphcoble) DESCRIPTIO'+ CF OPERATIONS f
I
NOTICE OF CANCELLATION: NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW).
BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE E INSURANCE —'-DER
THE ABOVE POLICIES PRIOR TO 0 DAYS AFTER NOTICE OF SUCH CANCELLATION --P P_DUCTION HAS bi;'4 'O
r. �J
City of Cupertino !
Cupertino, California J . : '
AU HORREIs nEvL
1/20/771 _
TED OFF C=
L. J Lexington, �tk
This car"gote is esocuted by LIREM MUTUAL INSURANCE COAVANV an respects such insurance as is attorded by That Company.it is esecuNd by 1.1911TV MUTUAL FIRE W:e UEA#6Cc
COxNANV as mapects such insurance as is o"or"d by "ad COMP".
BS 234A R5
CERTIFICATE
OF INSURANCE
MUTUAL
IJ�IIr aatmlt SWAM=RMYt.I .iffriG ta! aot>saeb.mm
This is t� Certify that
Traffic Signal Maintenance Name and
9929 sward Way 4-0 addran of
S. Elwnte 0 CA. 91733 InSUMML
L J
ils, at the date of this cadfiIxto, iasaued by tt Cosp1y for the tWes of ===and m accorda we f0 the faaits of h abmy.
erm con"otas, aad Aber terms of the policies bweisafter Thy ceffifimft of it maw Rleitba affirmatively or mg-
abvelp ads,e:temb or afters the coverage afforded by the paps Gad below.
TYPE CF POLICY EXPIRATION DATE POLICY NUMBER LIMITS OF LIABILITY
COVERAGE AFFORDED UNDER W C. L4MlT OF LIABILITY-COV. B
6-1-77 WC1-112-035574-116 LAW of FOLLOWING STATE(S) MA. 10O,000
WORKERS' 6-1-77 WC2-112-035574-026 CA. 500,000
COMPENSATION 6-1-77 WC2-112-035574-1.26 *See Below 1002000
(yGCAn ivw Pt a VAC-r.R;
COMPREHENSIVE BODILY INJURY PROPERTY DAMAGE
FORM EACH EACH
°SCHEDULE FORM $ OCCURRENCE $ OCCURRENCE
PRODUCTS COM-
PLETED OPERATIONS INDEPENDF"-. CON-
$ AGGREGATE $ AGGREGATE
Q H
Z® TTRAC-
ORS PROTECTIVE N 0 T A P P L I C A B L E
Uj Q CONTRACTUAL
(7 ❑LIABILITY
� a
$ EACH
PERSON
O OWNED
Q Q n NON-OWNED $ EACH $ EACH
`'' NOT A P P L I C A E L E ACCIDENT ACCIDENT
HIRED OR OR
OCCURRENCE OCC,.JRRENCE
fr
W
H
O
LOCATION(S) OF OPERATIONS A JOB g (If Appl-tabbe) DESCRIPTION OF OPERATIONS:
l
AL, AR, CO, CT, DE, DC, FL, GA, IL, LA, M0, M2 MN, M0, NH, NY, OR, PA, TX, VI, WI.
MOTKI OF CAMMILATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW).
BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER
THE ABOVE POLICIES PRIOR TO�DAYS AFTER NOTICE OF SUCH CANCELLATION OR REDUCTION HAS BEEN .(AILED TO
City of Cupertino
_
Cupertino, California _ AUTHORIZED RE,, . `i�TATIVE
1120/77 Lefton; ^'
L DATED OFFICE
This cartifica4o is oneccuted by USEM AU ITUTAL INSURANCE COMPANY as responb ov A iasurmce as b afforded by TAat Company,it Is oaecated by U5112TY MUTUAL FIRE USSURANCIE
Co-MPANY as" auk awswcow"is=by M Cotp- l' EIS 234A FA
12131293-3733
MAIN OFF1C0—YSM CO..1NC. 9929 FiAYWARD WAY, SOWN El IlRoldlE,CAUFORNIA 91733
RE6MAt OFRCE 134 CARROLL AVENK StOOMAN, CAUFORNIA 94083
18081738-119D
BBEI�
January 21, 1977
Fir. Bert J. Viskovich
Director of Public Works
City of Cupertino
10300 Torre Avenue
Cupertino, California 95014
Dear Mr. Viskovich:
As requested in your letter of January 18, we are herewith
enclosing Performance Bond in the amount of $25, 000. 00 to
cover the remainder of the traffic signal maintenance
contract.
Also enclosed are certificates of insurance verifying our
liability and Workers' Compensation coverage to June 1,
1977 . I
Very ruly yours , _
William C. Sondergard
WCS/ej
Enclosures
i
SERVICE EXPERIENCE DEPENDABILITY
1
i
To Ellen Pagnini, Deputy City Clerk
From Bert J. Viskovich, Director of Public :forks Date Jan. 25, 1977
Our--file: 74,002
Subject Signal Maintenance Contract - Traffic Signal Maintenance Co. , Inc.
Transmitted for your f es are the following items relative to the
referenced project:
- - 1. Faithful Performance Bond - OT-1-77-1
2. Certificate of Insurance - Liberty Mutual - - --
sm attach.
i -
T° Ellen Pagnini, Deputy City Clerk.
From Bert J. Viskovich, Dir. of Public Works Da1e Dec. 28, 1976
Subject Assignment of Agreement for Maintenance of City Signals
Transmitted herewith are three sets of agreement for signatures of appropriate
City officials. Please return two copiEs when completed.
-9m -- --- - ---
attach.
Citaf of C"Perti"o
10300 Torre Avenue
Cupertino,California 95014
Telephane 1408) 252-4505
OFFICE OF Tlff_ DIRECTOR Or PUBLIC WORKS January 25, 1977
otir File: 74,002
Mr. Doug Payne, President
Signal P4aintenance, Inc.
1158 Kraemer PLace
Anaheim, California 92306
Re: Contract Bond - Fai.thful. Performance
No. tit. 7111.3-79
Comm errial Union insurance Comnanti
Dever Mr. Payne:
We wish to inform you that the refer(-nc•ed bond may now he
. retired.
Very trul - yours,
C11'Y OF CliPl ;;TTNO
Bert- 3. iskovich
1)i r. rtor of 1'uhi is (forks
l
i'ra f f ic. Ens ineer
GMG:sm
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0
ACREEMENT
PHIS AGREE-", '*1T, made and entered into by and between the CITY O
a Mu,iicipal Corporation of the State o" California, herein called CITY , :lllrl
SIGNAI. MAINTENANCE INC. , a California Corporation, herein c,-Ill.tti
CO ITRAC TOI'..
1:! I I' N E S S E T 1I:
1''HEPEAS, CITY C?C to contr2c% for the pre%ert.iLIM '! iltt'n :n + f
SCrJiCC alld I"t.o:Ii.r O: th[- tral f ,c Si _ al sysLc-.,
t
L)_; or at the, (x„ rCCL�*�_I (t' CIL . , LO; ('C.. WJ"I .t t,' _'C �. , .i L. i
the > .,. of L iiS r or i .. _ n
,
_•Lt,Ii+_ c ,,:IS tL'?, r . IT
Sul,
t
n
.1L'. .,.i i 't1 ., t l`�.. I:t- c.I c l Ifl tl+
.. lt'. .;!?. f' ..,, t.. . . .. . ... • '.I _,. � ?" ::I. tt:. x,'i !i: Ia l'iZl .tir!.. :� 1 it
l`It' ul., .•, t+i . i 'I- .i. 1ii ..1 tii IC' <.. �.� ...'it 1. it`ll
(b) In the e<<nt of conflict between the Specifications and this
Agreelrent, the Sperifricatiors shall prevail.
(c) Except as otherwise sta• ed herein, any and all oblisations
of CITY and CON'TRA"17 OR are fully set forth and described in the Contract
Documents.
2. COtiTRA(-.iC: , for :.c' c^n i,�eratio I-erein r.:enti(ned, does }hereby
promise, and agree to and :cith C7'� ti-,at CO'711%CTOR ,,ill well and suffi,_iC•:I; ly
furnish hl.i lal or, tc,2 L,, �- :nt , anp.`tr<Lus, facilities, trait-*,-ortLLiG1":,
all materia is ne.c'P_ rt LC ierfcrm ai... cc- to in d wo r.i", nl l ? ,. c � �;oc and >: 3 its.
the ct ai�:.t zna. ` , c�. _ .g c��._ ;,r�. _ .tervice .._. repaa_ 1)s c}te
sisnal F,ysi.en an-1 t r F!IlL l i. :J LIeCl t).:' or i'_t tlli C "i r_t('i jC rl e
zny &c.,. ' _.,..,i Cyi n lilt'i'.. '�rii",�, t}tt tL'I.7., Of Y1 is}:.1-C r•_ t
or Ci i . 0_. ('r C'_.. _ ... ?..:"_C`C } t JI:; _..1 �i',_, C•o:'.'_.{ c i.Ca, C'I
t-11 i' Yf ._.i 4,._ C� , c l 7 7 - < _ �
L as t',. _G_ t .-.'. i- �- i r ii
.'C. , _ (al.
<itt\'(_ t :C _ \ :� l' i `' ._ • . c L:iCi... a . .."l. Cr,. _i. . 1'. .
? t ~ '
,:L 2i !2, z ..- 3L C._ ] 1. sti. _l I
said work perf.orled and completed as required in said 1 ;pecifications under
the stale dirCCtion and Cantrol of .,O.sTR-AC( CR, and Su,jJOCt. only LO inspecti011
and approval of. CITY and its representatives.
3. CITY agrees to pay and CO,'TR.-`.(:TOR agrees to accept, in full payment
for the work above agreed to be done, the su_1s of money :,peci fi ed in his
proposal. attached :'l£rt'to a:,d incorpor3'Led 'herein bV reference, SUJjCCL LO
final deterriinatinn of actual j�sork performed and irnterials furnished at t!it
prices stated in said prop sal .
4. CO': V'T(T1, shall. , of his L?:[�i' 1SG, C '✓CZi1ii ii_71 n�'C'G`,�."i?":` }1Ciill.t5•
1 l CC'i'l?e 9 for Lt)( F)C1,r;`t 2"11.l I12 c. i+r t.ift.' j t' of tit!: ? P;
"l - '"
a" f !l..Cl 4 _. Lt'' Oo- }+
L .i : .
l ..
l!1 I Cc t CT'
C i t t �.
Cu",.1 Lin.+, C.:1
,l
(b) If Ci ic notice i giver. to Q'R by T)er soi.:1 d e 1 ve ry
thereoll t its duly authorize(I represer,ta',ive, or Inv i � _, ttiE s ar-e
the Unite' Stztes cnclos�=d in a senic-d czwelclpe, pustage prepaid,
addressed as follov,s:
STGNAL
1158 YR-', PL 1C,F
ANA111ET", CAITFOFI',J...� 912806
7. iiet :ff.
Lhe pl--'(,,r ""rittcn al-�ru'.-Z'_! of
such r e
of f O"_
C.r
' L jj
tl,c. 1TA or s r u: tlkl
irrici ry 1 o il v " Ct
T'I 1 nrjefcndc-nt con t z-iir Lor <-n't not m ngc-: ;31)1) Ili;
or �niplcovc.o of C11"Y.
IN' WI'!*':!'SS the p;:rt--Jles hei-eto 'nave -awl ed t'!,..is
c-ce--uted b%, on the 29th d av o f- January, 1976
Cl'i')' on the day of
Dr
City Clerk
APPROVED AS TO FORM:
City Attorney
S. PAYNE,J PR J NT
CONTRACT BOND 2-1-77 TO 6-30-77-$42
FAIMWUL PERMRMANCE $167
U Z of Insurance Companies
Re i l I
COMMERCIAL UNION INSURANCE COMPANY
(Name of Insurance Corr-Pa
BOSTON'.. NIASSACHUS=S
f czwul all ..ern hu Ifirar Urrsents:
'niat we— SIGNAL MAINTENANCE , INC .
as Principz:. and COMMERCIAL UNION INSURANCE COMPANY
:0 :7.-,:7sact business under the laws of the State of California, as Surety, i-re and f-=Mly bound
un*cj CITY OF CUPERTINO I NO
10300 TCRRE AVE . , CUPERTINO , CA . 95014
TWENTY FIVE TKOUSAND AND NOIJQQ-------
as Obligee in `..e just and :;u!l surn of
lawful money of the United States of America, for we:l
�,c ,aid Pnnc'pa: a:-.d Surety bind theinselves,their heirs, exect-ors, 5 _SS07,1,a,
a Z: s' 0 _cvtra'ly, firnnly by these presents.
.4. 4 i5a=4, That, WHEREAS,the above
contract of even date herewith with zz"ne said Obligee to do and perform the work.
.'.T A V E MAT, SERVICE , TRAFFIC SIGNAL REPAIRS , AN'-.,
_' AMA-;E REPAIR PROJECT 76- 5 FOR THE CITY OF CUPERTINO .
contr made.
act, reference to v.-hich is hereby
77
I;r.'. t -x above bounden Principal shall well and truly perio. -.".0 to Le
"..-racz, zhct7 t!Iis to be null and void, otherwise to rcrna-_..--
accrue U:.dcr thiS to 01- for the use of an ram-_
Lr7tlll.
FFBRI)ARN' A,
SIGNA MA;NTE:! r.;E ,
�" p a
0,
I UNION A ?NY
COMMERCIAL _�U RAt COMPANY
I E 2AIR77�R It I T E R D WARD
G7.05.. $w it *A.
ON of Crepe
10300 Torre Avenue
Cupertino, California 95014
Telephone (409) 252-4505
DEPARTMENT OF ADMINISTRATIVE SERVICES
February 31, 1976
P
`ir. _•i_d i . ':dares
Attorne at-Law
907 1.J :^ti:.1 L Bank
111 '„est St. John St:re. t a
Can Jcse, California 9511
JOCU:eic.,T FOR
We are the fU11OW11l _, d(>Cu?;:,.nL fc r_ �'OUr z pprova1:
ro,-r (4) - re -.E It b;✓ and bete:een the CLty Of Cupertino and
tali:tE r:1iiC't Inc.
.'after e:•;c:cution of thLF, CCCti:JcnLS, plec�-e r,'tUrn tU t(:is office.
ELLE'�
DEP T'i CI--Y CLJ�r�L.
rw
encIs.
Ilk
OFFICE OF rflE CIT`r Al 1ORM_1
10300 J-erc -N�rnut ,
f
February 4, 1976
Ellen Pagnini, Deputy City Clerk
s
City of Cupert-no
10300 Torre Avenue
Cupertino, California 95014
ar: Document for Approval
Dear Ellen:
Enclosed are four (4) copies of Agreement by and
between the City of Cupertino and Signal Maintenance Inc. ,
which I have signed in my capacity as City Attorney.
Very truly yours,
DAVID H. ADAMS
City Attorney
DHA:di
Enclosures (4 )
To— _ Ellen Pagnini, Deputy Ci- ty Clerk
i Frog, Bert J. Viskovich, Dir. of Public Works bate Jan. 30, 1976- .
f S,biect Agreement - Signal Maintenance Inc.
{ Transmitted herewith are four sets of the referenced agreement for execution
- ` 3 by City officials. Please return three sets to this office when completed.
- Also attac`,ed for-your-files are:
1. Contract Bond, Faithful Performance - Comme-rcial Union Insurance Company
2 Certificate of Insurance - Fireman's Fund i
3. Certificate of Insurance - Insurance Company of North America and
Pacific Employers Group of Ins. Companies
Sm
attach: i
I
{
i
• ASSIGNMENT OF AGREEMENT
AND CONSENT THERETO
ASSIGNMENT OF AGREEMENT AND CONSENT THERETO, made by
SIGNAL MAINTENANCE, INC. , a California corporation, hereinafter
referred to as SMI, TRAFFIC SIGNAL MAINTENANCE -CO. , INC. , a California
corporation, hereinafter referred to as TSM, and the CITY OF
CUPERTINO, a Municipal Corporation of the State of California,
hereinafter referred to as CITY.
RECITALS:
(a) On February 6, 1976, SMI and CITY made and entered into
an Agreement, by which SMI undertook to provide preventive main-
tenance, emergency service and repair of the traffic signal system
of CITY, which Agreement is incorporated herein and made a part
hereof by reference.
(b) Paragraph 7 of said Agreement provides as follows :
"CONTRACTOR shall not assign, underlet or sublet this
Agreement, nor any part thereof, without the prior
written approval of CITY, and in the event that such
consent be obtained CONTRACTOR shall be liable for
the faithful performance of this Agreement for tha
remainder of the term hereof, or any extension or
extensions thereof. Any assigning, subletting or
underletting without the written consent of CITY shall
be null and void. "
(c) The following paragraph is contained in the Specific-
ations (which are part of the Agreement) , at page 11:
"Faithful Performance Bond
The successful bidder, as contractor, shall furnish a
good and suffi7ient bond, in the amount of Twenty Five
Thousand DollarL- ($25, 000. 00) acceptable to the City of
Cupertino, which bond shall guarantee that the contractor
well and truly performs each and all of the requirements
and obligations of the maintenance agreement. If the
agreement is terminated because of failure of the con-
I
• • ® ®
tractor to perform, costs to the City to repair or
bring the system up to an acceptable level of service
shall be deducted from amounts owed to the contractor
or if sufficient amount is not owed the bond will re
called in the amount, up to the limits thereof, to
cover the actual cost to the City to effect said rel.air. "
(d) SMI now wishes to assign all of its rights and duties
under said Agreement to TSM, and TSM is prepared to accept such
an assignment.
(e) In the event of such an assignment, SMI would like to
have its faithful performance bond released, and TSM is prepared
to provide its own faithful performance bond.
(f) The CITY is grilling to consent to, and to agree to,
the foregoing.
IT IS THEREFORE AGREED as follows:
1. Assignment: SMI, pursuant to, and subject to the
provisions of Paragraph 7 thereof, hereby assigns to TSM all of
its rights and duties under said Agreement. TSM hereby .accepts
such assignment, and agrees to be bound by all of the terms and
provis:dons of said Agreement, including, but not limited to, the
duty to perform the services therein described, at the price
schedules contained in the original bid of SMI.
2. Faithful Performance Bond: TSM shall providi. its own
faithful performance bond, as required by the pro-isions of the
specifications referred to in Paragraph (c) above, in which event,
the faithful performance bond heretofore provided by SMI shall be
released by CITY.
3. Consent By City: CITY hereby consents to the fore-
going assignment, and agrees to the substitution of the faithful
performance bonds, as hereinabove provided.
2 -
4. Notice: Any notice given to TSM shall be by personal
delivery thereof to its duly authorized representative. or by
depositing the same in the United States Mail in a sealed en-
velope, postage prepaid, addressed as follows:
Traffic Signal Maintenance Co. , Inc.
9929 Hayward Way
South E1 Monte, California 91733
Attention: William Sordergard
IN WITNESS WHEREOF, the parties have executed this Assign-
ment of Agreement and Con.;ent Thereto this. __21st day of December e
19 76, effective as of January 1, 1977. I`
SIGNAL INTENAN�E, INC. ,
a Cal' ornnia C pora ion
B
By
ATTEST: TRAFFIC SIGNAL MAINTENANCE CO. , IN(_
a California Corporation
/", '2 1 .' - --7
By k
City Clerk William C. Sonder.gard, Vice Pr/�sident
By
CITY OF CUPERTINO,
a Mu n' ipal Corporation
APPROVED AS TO FORM: BY6-eyf
Mayor
Gale'zrz
City Attorney
- 3
RESOLUTION NO. 4346
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CUPERTINO
AUTHORIZING EXECUTION OF AGREEMENT ASSIGNING EXISTING
AGREEMENT FROM SIGNAL MAINTENANCE, INC. , TO TRAFFIC
SI sNAL ,`'(AAINTENANCE COMPANY, INC.
WHEREAS, on February 6, 1976, Signal Maintenance, Inc. and CITY made
and entered into an Agreement, by which Signal Maintenance, Inc. , undertook
to provide preventive maintenance, emergency service and repair of the traffic
signal system of. CITY; and
WHEREAS, Signal Maintenance, Inc. now wishes to assign all of its rights
and duties under said Agreement to Traffic Signal Maintenance Co. , Inc. ; and
TSM is prepared to accept such an assignment; and
WHEREAS, Traffic Signal Maintenance Co. , Inc. shall provide its own
faithful performance bond, as required by the provisions of the specifica-
tions; and
WHEREAS, CITY hereby c onsen•:s to the foregoing assignment;
NOW, THEREFORE, BE IT RESO'.:VED that the Mayor and the City Clerk are
hereby authorized to execute said agreement herein referred to in behalf
of the City of Cupertino.
PASSED AND ADOPTED at a regular meeting of the City Council of the City
of Cupertino this 21st day of Deramber 1976, by the following
vote:
Vote Members of the City 2�ncil
AYES: Jackson, Nellis, O'Keefe, Meyers
NOES: None
BSENT: Frolich
ABSTAIN: None
APPROVED:
/s/ Robert W. Meyers
Mayor, City of Cupertino
ATTEST:
/s/ Wm. E. Ryder
City Clerk
NOTICE OF CANCELLAMN
x YOUR POLICY NUMBEREFFE_ .VE DATE OFF rANSELLATION* ISS. CE. DATE MAILF,L
DAYS AFTERSERVICE OF THIS NOTICE
E/i!!L 14-13-761rei
1F YOU AND YOUR 3NSURANCE AGENT OR BROKER NAVE NOT ALREADY DISCUSSED ARRANGEMENTS FOR YOUR
INSURANCE .PRC-)TECTION MAY WE SUGGEST YOU DO SO IMMEDIATELY. WE REGRET THAT WE CAN NO LONGER PPC';iL_
YOU WITH THTS PROTECTION
In accordance with policy conditions you are hereby notified by the company designated therein that your policy is car.ceLec as
of the effective date st-led above, at the standard time specified in the policy. All liability of the company wili cease as ci the
effective date and time, provided, however, any claim originating prior thereto shall not be prejudiced hereby Any unearned pre--
ium to which you are entitled will be refunded on demand if not sent with this notice.
NAME AND ADDRESS OF INSURED AGENT OR BROKER
r i273 03 � I�
s�/em L
MI6 A iR'� UM � 6 Co.
?.O. 2ffi Was OMM ANA. CA.
ARAINIM C
fI 4V7 ^ a
Codes a
Applicable if checked:
You are further notified of your possible eligibility r►
for FAIR Plan coverage. Contact your agent or
broker fof further information.
Reason for cancellation is non-payment of 1 emium r j
The effective date of cancellation shaft-b��f70i
days after service of this notice as to any mortgagee
or loss payee who, by express provision of the policy.
is entitled to ten (14) drys notice of cancellation. How-
ever, if this notice affords a greater period of note
than that specified in, the policy contract, the provisions
of this notice shall control
FIREMAN'S FUND INSURANCE COMPANY
NAME AND ADDRESS OF MOR7GAGEE OR LOSS PAYEE. FIREMAN'S FUND INSURANCE COMPANY OF TEXAS
_ NATIONAL SURETY CORPORATION
I �� �� I THE AMERICAN INSURANCE COMPANY
XW AMERICAN AUTOMOBILE INSURANCE COMPANY
CM
amp OWERTM ASSOCIATED INDEMNITY CORPORATION
103M TOM AVE
{AdrLi 1l ILddV� {J►� �3R/1+ ,T.�
A RIZED Si:NATURE
485045-2-75 MORTGAGEE OR LOSS PA COPY
♦ f Y6 E c 3
CUMCATE 9 WURMCE
This i5 to Certify, that policies in the name of
NAMED INSURED SIGNAL MA IgNANCE INC. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR
and 1158 Kraemer- Place NEGATIVELY AMENDS. EXTENDS OR ALTERS THE COVERAGE
ADDRESS Anaheim, CA 92806 AFFORDED BY ANY POLICY DESCRIBED HEREIN.
a
are ,n force at the da- ereof as follows:
KIND OF POLUCY POLICY
INSURANCE NUMBER PERIOD LIMITS
STATUTORY
WORKMEN'S COMPENSATION Workmen's Compensation Ins.
AND EMPLOYERS LIABILITY 'Exp Employers'liability Ins. "s
BODILY INJURY PROPERTY DAMAGE
COMPREHENSIVE GENERAL �Eff OCR. 2ch occurrerr 400 Each occur
LIABILITY _ _ lEzp. - rS-- _.__. 000)Aggregate
FMANUFACTURERS' AND GAL 672- Eff, 4J23/76 E 4r. occu e�c �00Eachocr., ---
CONTRACTORS' LIABILITY 8249580 ?E.xp 41231-7-7 $500,000 CSL INC " !Azareyaip
OWNERS', LANDLORDS' i,"ff. ac-ccc.r once 5 a0 Each occu--.=
AND TENANTS' LIABILITY Exe +y- 000 Ai;�,prepate'
CONTRACTUAL Eftccc: -Pnv 000 Each oc,:
LIABILITY Exp. ^O A;rrcFa e
- - - -- - -
AUTOMOBILE LIABILITY
Owned Automobiles jEff � .,. persc^
Hired Automobiles �Exp _;c r; .•r i
Non-Owned Automobiles ' 1
COMPREHENSIVE AUTO- �Ep
0, Cn person T_ CC^0 Each occ
MOBILE LIABILITY x Uou Eacc occurrence
OTHER: ii. 4i 23I76
Completed GAL 672- IEYv 4123/77 $500,000 CSL INCL.
Operations '8249580 1 1
<aridh-�ra, Lind tenants Liability 1,lsLrarice exc,ud(S Si'Jctura� :itera,:uw, -ten -,%tu-iwn ano de,(—, I ..
.art of a-• --'a! manse in or c.inceilation of, said policies. the nders-gnecl cvppanv w,i1 to gne .%Biter no',v party to why"
re to pi.e such notice shall impose no obligation nor i:abri.:y upon the company
Dated: 4/26/76
Name of
Company: Mi ehoma Insurance Company
fr' -�TNua •cu titvk��entc .,�
CERTIFICATE ISSUED TO:
City of Cupertino
NAME 10300 Torre Ave.
and
ADDRESS Cupertino, CA 95014
ATTN:Glenn Grigg
CERTIFICATE -;
INSURANCE &RIERTY '
fA 8 MUTUAL
This is t® C ortlf•; that --_ Um.xaftft CWW.,wanalp"ISO aw.xxans...a.e�.�,
r I18 AIR SERVICE COL
SIGNAL M&nmWMCE INC '\� ;• - ����/ Name and
1710 GUARM ROAD SUITE 100 r I`c t 1�� address of
BURLINGME CA 94010 Insured.
L
is at the date of this certificate, insured by the Company for the types of insurance and in accordance with the limits of liabilirv_
exclusions. conditions. and other terms of the policies hereinafter described. This certificate of.insurance neither affirmatively or nc¢- _
atively amends. extends or alters the coverage afforded by the policies listed below.
EXPIRATION
TYPE OF POLICY DATE POLICY NUMBER LIMITS OF LIABILITY
COVERAGE AFFORDED UNDER W C LIMIT OF LIABILITY-COY c_
I LAW OF FOLLOWING STATE(S),
WORKMEN'S
COMPENSATION
a j
(14pK_A Tf feu/r0.fEl K�
I coMPREHENSIvE BODILY INJURY PROPERTY DAMAGE
FOR1a C
-J} SCHEDULE FORM
Q �
PRODU -S COraI I EACH EACH
er I® ❑ TED O PLEPERATIONS $ OCCURRENCE $ OC RREACE
Wff�� j f j $ AGGREGATE $ AGG—RcGATE
V J U
I
> �] OWNEa Eff. t 500'000 EACH Combined Single
O . 5-1-76 *11;"i
NON OWNED AEl-161-010233-366 $
occuTfr ce Limit
Q Q ® HIRED Exp. 5-1-77�
J I
W t
= 1
' o
LOCATICN(S) OF OPERATIONS M JOB A (II Apphcable) DESCRIPTION OF OPERATIONS
NOTICE OF CANCELLATION: 'NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW;
BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFODOE: ENDER
'HE ABOVE POLICIES PPIOR TO 10 DAYS AFTER NOTICE OF SUCH CANCELLATION OR REDUCTION HAS BEEN "%A _ED TO
CITY OF CUPERTINO
AT1N GLENN GRIGG I
10300 TORRE AVENUE
AUTHORIZED
CUPERTINO CA 95014 5-1-76 glt 1737 North First St.
DATED OFFICE
L J San Jose CA 95112
IF%"certificate it executed by 11,111LEM MUTUAL INSURANCE COMPANY as rospeefs such inwronce as is afforded by That Company.it is executed by LIRERTT MUTUAL FIRS INSURANCE
COMPANY as respects such iawronce as is afforded by "tat Camp".
BS 234A R5
r
Power of Attorney is
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
HOW ORKS taAlliDAM=6
KNow ALL MEN BY THESE PRESENTS:That the FIDELITY AND DEPOSIT COMPANY OF MARYL.AND, a corpora-
tion of the State of Maryland,by C. M. Pam, JR. ,Vice-President,and C. W. ROBBINS ,
Assistant Secretary, in pursuance of authority granted by A--ticie V1. Section 2, of the By-Laws of said Com-
pany, which reads as fo lows:
.,The President,or a tw one of the Executive Vice-Presidents, or any one of the additional Vice-Presidents specially authorized
so to do by the Board of Directors or by the Executive Committee, shall have power, by and with the toner:--once of the Sec-
retary or any one of the Assistant Secretaries, to appoi it Resident Vice-Presidents, Assistant Vice-Presidents, Resident Assistant
Secretaries and Attorneys-in-Fact as the business of the Company may require,or to authorize any person or persons to execute on
behalf of the Company any, bonds, undertakings,recognizances,stipulations,politic:.,contracts,agreements.deeds,and releases and
assignments of judgments,decrees, mortgages and instruments in the nature of mortgages,and also all other instruments and docu-
ments which the business of the Company may require, and to affix the seal of the Company thereto."
does hereby nominate. constitute and appoint Gary Ditfurth of Los Angeles, Califo
e an awful aztnt and Attornev-in-Fart. to make, execute, seal and deliver, for, and ern its t,ehalf as
surety, and as its act :Ind deed: any and all bonds and undertakings.... . .... .. . ....
n e execution of =u< h bonds or undert,:kini in pursuance (if these presents, shall I,e as hinding upon said
Company. as fully;;-r.-'amply, to all intents and nur-pose.; as if they had 1N-en deli-ext:cuted -Intl a(kno;a•ledged
bY the regularly elec—f-i o fivers of the Cornp,:11- :tr its oitice in Miltimorc. _Md , in their n,.%n pro1wr l-tersons.
This power of a?.orrey revokes that issued on behalf of Gary Ditfurth, dated
July 1 . 1975.
'I he aid :\- i-ta _7_1arn doe- hereby certif-, that th, .it,,r, ,i },•, ,:f .1rL;',t• l'I _ t t!tt L'.-I alp-
5.1: Conipall , anal i, force.
. .
N'i1IN1_SS %� ::YRLOI:, the said Vice-I't .:<irrlt arld llcrci:;11• -111,sCri"e_
their name= and affix•-: the Corporate Seal Of the rim, i_.1ti I)i t; CU\11.Y\1 t'i al %R',: \\ir. th1=
19tr_ - -riat': of..... M-v A 1) 19 76
Z-113 DE°o FIDELITY AND IDEPOSl'1' 0F WAR)- VM)
,o SEAL. '¢
n t r ,
Fr
STATE OF AIARI LAND
CIT'f OF F:AUIIN!ORF_
On this 1 9th Mwr 1 I i ,•t .!G f• :; a h•t rites r, , \ P.i,ii< t tilt �-f .
\l,r and, it; d fr;r th (, f Baltini rr, (I I tl i t. .tar the A)"%v-r.t -I', -idr: t.uxi A
tr tarCr,ftiltFlest:- cr,t, litPOITrG*1PA:N Y trF.\1A1:VIA.%1,.tarme1, ,':'. ' V.I, t"tw•tlica,;..ic! zat;ri,;t:c-r,d -tr.t*d
i:t al:d Who executed th-_---,dii K in-trutner.t, and they each:,ekr t,.Yiedt;,d the e+.t, tat":,.d tilt-.,tnie.,t rl ht i:.;i,% n•e dui%•'u• r:.
t,e'.'trally and Bath f,,r h.--- rhr C olllj,.,aa o.,rr• .:id :t:A that tht
to the prt•tcdil,g_ IN-tr . _ + the G,rporatr- `-+earl ,d•-aid Ct,:1:l,,.0 .A:A th it tit, -airi t'„rlr,r'.,it ti..t. . : 1 their >r�l:aturt�
offct•rs were dt., aft,,,r' _ _;-ub,crihtd t., the -rid itz!r.:n:et.t tic tilt a ithnrtt%' .i•ti dir:t'ti.,t f th;- >t'd ( ,q• ra'a,:,.
IS CEsrr.Iosti '.;_.F F I ha\t• hcr(w I. . . .:: Far.rl and a:fxe,l f :� (It=aia. at tilt ( It<_ <t I;.,'t3r. rt, 14+r d,t .tnd .e:r
a!„)re WF. ;.,-N��..�,.h`.. `�� •�
•49f•'•�UBIIG:'+;_ Nrrr c, I'F,' ht" C oli win-, oil Fx( i -, Y ,._19/
1.1'.1 t 1 11 1 f.% 1 F_
tilt t:,.dt r ).arty t ,,t(rt t rr. : 1 rite l iw-t i rY Ar.t, I)F.PO'r;( 1 04: a. I MARYLAM),(Jo hereby ccrt.1 that till t rii4i:;:
Power of Attvraet of wit_ :%e f„rvk:umg u.,f ui_trUt-and t:rrr,�t cupy,is in f.,.i f rr ai.d affect on the date of thi.ct•rtiticatt ; i:;d I
do f;:rther certify that th- l ice-Prt--idea t Aht,txec,ited the—id Power 4 Att,,r.. , %i, ont.•of the additional %'ict-f''residerttr spe-
cla., auth,,rized by the El, 1 t�f Chre(,ti,r- t„.ipI),,i:.I a• _1tt•=r:t•t-i: -Fact a>t,r,,�i,led ii:Article %A. `c-ctio:: 2 r,f th -L w e Itras
the F1Di°lt I AND bi,Pin I' COMPANY OF ARYLAN D.
I hi CcrttfiCatc nix, },r=tg:,cd by facsirnile nttdrr a.d t,y authuritx i,: t':it f••;,wi:.g rc•ohlti,n,of the Bu,trd - f Director,of the
FIDFLIIV AND DF`POSIT C--.>YPA.\Y OF MARYLAND at a mertc.); duly calk,-f aiA htA ,, the 16th day of July, 1944•
RES0L%LD' "That tt:.F facsimile or mechar.ica!ly rupr,A iced sign„iture of a:.% :1_-irtant Secretary of the C:ornpat,�, whether
made heretofore or herea;trr. wherever appearii.l, upuf. a certified copy of any po,*ur of attorney isaued by the Company, shall be
valid and binding ulwr, t Company with the same force i,,d effect as though nianually affixed."
Iv '11STIMONY WH.=2.EOF, I have hereunto subxribed nt% name and affixed the corp..rtte seal of the said Company, this
4 t h -_-------.day of._ -. Jan u a-r y_..__ 19 77,
i.t�t4—t'1t col.is
Asssstant So etar
'' t
GU Till
lr.Ij l a
CERTIFICATE Of INSURANCE �F .
✓�ii
This IS to Certify, that policies in the name of
RAINED INSURED SIGNAL MAINTENANCE INC. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NO&
and 1158 Kraemer Place NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE
ADDRESS r�n a he im . CA 92 806 AFFORDED BY ANY POLICY DESCRIBED HEREIN.
``rce at the da:P hereof, as follows
T -- - - - ----- r --- -- -- - _.- -- -- - _—,_
KIND OF POLICY POLICY I LIMITS
INSURANCE NUMBER PERIOD
WORKMEN'S COMPENSATIONEff. Workmen's Compensation Ins. STATUTORY
Erp I Employers'Liability Ins.
AND EMPLOYERS'LIABILITY l i'
BODILY INIURY ~PROPERTY DAMAGE
COMPREHENSIVL GENERAL IEff f f __-- 0 _ac- _
Q00� ch eccurre�rc � ,000 Each Dcc_—_-c=
LIABILITY
Exp 'S ,L•J A.gkre.=;ase __ 000 Aggregate _
MANUFACTURERS' GiNO (- _ t'f 2 3 ' %h r �0�Eac� c In 000 Each Dcc -
CONTRACTORS' LIABILITY �?.�9 {� E� E ?'� '7 $500 000 CS f, nno A frFra .
-- -- - -
OWNERS', LANDLORDS' G00 Each oc�
AND TENANTS' LIABILITY E; ono aFgre�ate
---- --
CONTRACTUAL E" ? :n0 Eac,,occ.,rrYnce IS 000 Each acc_--:_
LIABILITY )OOAg�T�a '-
AUTOMOBILE LIABILITY
Owned Automobiles E" 'i 0100 Each person
Hired AutomotrlesEach
Non Owned Automoides
COMPREHENSIVE AUTO E" 000 Each person {5: Eacr;c::. - ..
MOBILE LIABILITY Egolit000Eaeh occur rence
OTHER ^� _ rN 4 .� T .6 f {
Coo--Iotr:d L r , _. E,D + ' { -17r1 $500 ,000 sI T I
-,d
:^T r(-F 0,F' C." CFLL..'TION: 'Be fore the s t it ted expi ra tion d:a te. the Comnanv wi l l
can Cc- i car reduce the i.nsur�ance afforded under t'1e above nolic;' prior -o 10i
r ,notice of such cancellation or reduction ''ias been nt�:.iled *CC):
, pose
Dated: '11. 7 j
Name of
Company: TI1nTl""oTn:? Insurance Coi'.-,
ALITHGR LED REFRESENTAT:,E
CERTIFICATE ISSUED TO:
C' t �,,f Cupertii:o
NAME 1 �0- To
ve .
ADDRESS cupartino , 1? 950i':
;t t-- n: Glenn Gri "!
CM OF CUPERT.1,,
CERTIFICATE
PU61-IC WOW—,
,, OF INSURANCE Jai... LIBERTY
IIffOYED
MUTUAL }�
11S IS t0 Certify thattAff" emw .was.ce cow.e+•�»m rmw Alrews/ut!ti!•l.ECS'�s
nnWMTj0ML AIM SERVICE CO LTD/
SIGN" MAINTMANCE INC Nome and
1710 GII.ERETA R£�ADt SUITE 100 address Insured..
Lwn Chi 94010
Tot s Ce mlicate Cancels & Supersedes Certificate dated 5/1/76
is at date Is certificate, insured by the Company for the types of insurance ar:d in accordance with the limits of liaNhtx
exclusiom conditions, and other terms of the policies hereinafter described. This certificate of insurance neither affirmatively or nra
atively amends, extends or alters the coverage afforded by the policies listed below.
EXPIRATION I
TYPE OF POLICY DATE POLICY NUMBER LIMITS OF LIABILITY
!ICOVERAGE AFFORDED LiNDER W OF —ABtLj-<�7O. s
!LAW OF FOLLOWING S'A.E S
J WORKMEN'S III
COMPENSATION
❑Cow'REHENCORMSIVE— E I --- � �_ BODILY INJURY I PROPERTY DAW REF
Q11 St!fEDUCE FORM
W �?PRCGii.;'S CORA 1 EA1,H
Z q� 11 lJ PL E?ED cr'EtiA iIONSj !� 0".URRENCE 1_ .YFGN.E;
WQI ❑ (i
0If($ A;:-,PEGATE A a su_,,A ES
❑ { I
i
' t: (� OWNED ff 5/1/76 f$500,000 , ]Combined Single it
1 ® NONQ.NED AE1-161-010233-366 $ I$
® HIRED eXp 1/11/77 In ]s3'L F
tY ( ��
W
O
LOCATION{Sr OF OPERATIONS I JOB p !If Appl,coble) DESCRIPTION OF OPERATIONS
t
NOTICE OF CANCELLATION: ;NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW)
BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFOR;,E': Ep
THE ABCVE POLICIES PRIOR TO 10 DAYS AFTER NOTICE OF SUCH CANCELLATION OR REDUCTION HAS BEE'. vs
F CITY OF CUPERTINO X/
A TTN GLENN GR IGG r
10300 TORRE AVENUE AUTHORIZED /F
CUPERTINO CA 95014 July 14, 1976 tlb 1737 North First St
l DATED 17jFFiC,,
San Jose, CA 93112
This certificate is osocuted by LISEM MUTUAL INSURANCE COMPANY as rospects such insvronco os is afforded by That Co:apony,,t is•secvtod by LISEM MUTUAL FIRE IW VIANCII
COM/`ANY as respects such insurance as is offo.dod by That Company.
SS 234A R5
}t� FIREMAN'S FUND INSURANCE C:O.%4VAt4Y
THE /'l"ERICAN INSURANCE COMPANY CERTIFICATE
f1� j NATIONAL SURETY CORPORA-riot'! OF INSURANCE
_ gq Ll ASSOCIA-rED IN01-- -'.NITY CORPORATION
rS.�.L ..i•ia'n"..� �' AMF_RICAN UTo'•'.0F3ILF 1NSL2rtANCF COMPANY
•�f:_iv ♦..s.Kf CQrNW1
1�)
CITY MANAGER
CITY OF CUPE=7__NO
10300 TORRE "ENUE DATE JANUARY 26 , 1976
CUPERTINO , CALIFCR!41A 95014
t
TIfl IS TO CFRTIF-Y"ri+A' —� _••�_-.- :,-' GO'•'F'ANI,', A9^)JF ttAVF' I,t FGR^C AS O° THE C,ATL/ t Ir Of 7ii F' fG'!
F:A•.O ADDRESj Cr _ - "_^vER ' EO:.:ATlO•;Cr ^t^."EPr Y.O°.SC(`,'TIGh 0' 4j'F.-iitG'1 i,6_
1
SI"i.f.L I•SAI __:_..: _ INC. . PREVENTATIVE MATNTENANCE Si:.�'rTCE ,
P . O . BOX _ u TRAFFIC SIGNAL RE_PA.IPS , A'.D ACCIDc. i {
A?;AHF.II3, C?" . 1 03 DAMAGE REPAIR PPOJECT 76-5 FCP THE
--CITY-- OF_ CupEB.T I.Nri ."
I KIND C- Ih:�URA..CE 1 PCLIC'I' t.0 B_R EXPIRA-t-10N i ,Mil`; C`P LtA%I
1'.ORK_N S COMPENI. TI
i
L f•t Pi C) :tS LI A1t I:I T Y
1 �. '
boo , , ;r Cr .;1 r
ci:. , < .
`,
C
I �
,- I , 1' �.1, ,l ? - i0
I �
1
I t
i TS 7GP A. 'I'FITS P i r� REDUC L It: COT,I,.:t I
U.. . T!, 1.s( S
o D.. _ St,I TT F!: _ _,. ._.. _A: c_;t, ..� r 1 . :: 0R R L•'LUC—TI �. t rj 1
t C!,V":'RAG ..t: _.. J...t�jv 1:.1_ _.. ..... \. I. _ r\r..fi'r�, it L.7 r,.)t' Il
;°m'A IVF-L.Y NCW :iGATiVF=Lti" AMENEJ`S, EMEND- 0
T,t- F'UL.IC.Y U •"7: IGIL.� `-�rtOY/N A�7JYE. ZEW t!i II�Jic
1 RRISn
1•. {V ::T i'I A:., ' _ > .:!. t'. OR
1'(,cl i l/,E CO:'i.-. � �•�.�E L'it.+i LFFC.'HT 70 t:OTIrV Te I ,..t•F`:.'�t.It�J"( - �
VNUE.:Is,r l..i,1: i,Eir"'�51 +itTY Y IN,NIF 1F 'W.4T ?r; S' ,ny
•,:xl
1r,*ANCE COMMMY OF NORTH A
A IN D
PAC.10FIC EMPLOYERS GROU? Of INSURANCZ C0j"APANIES
CERTIFICATE OF INSURANCr
-1y nor nt��,,�)fively amc.i,li. cxfcnd�
(This CO3Nft,-ci!e of lnsurunc_,_ C'ffirmot%vt.
or c,!t-.-s the coves,,_-, terms or cond,f;c),is of the vo!:cIes i! C-2dificat'n
CO.,APANY CODES
FCITY MANAGER [11 A111ED INSURANCF CO.
CITY OF CUPERTINO
10300 TORRE AVENUE PACIFIC EMPLOYERS INDEMNITY CO
CUPERTINO , CALIFu'P.';IA 95014 [51 PACIFIC EMPLOYERS INSURANCE CO
U93 INSURANCE CO,'APANY
L OF NORTH AMEIRICA
the lo"Dw:n.j described po' e;, 'Swied by The Compony cs coded h0ow, providing insurance only for
-I,tzkcj by *'X'* be!ow, i-,sjed to:
ebme and Address '-'AINTENANCE1 INC.
of lmsu!' d— P. 3 . --DX 3086 , ANAHEIM, CA ., 92803
covetirej in accordance with the ter-rs --'Tre-,f, at Che following i0c�atir'n(0: PREVENTATIVE MAINTENANCE SERVICE , -'��AFFIC
SIGN7,1. REPAIRS , AND ACCIDENT DAMAGE REPAIR PROJECT 76-5 FOR THE CITY 0-7 CU.H`1' _' :;O -
Pz 07
POLICY HAZARDS CO.CODE I POLICY HUM3ER POLICY PERIOD LIMITS 0;
Workman%
WC 37 40 25 1-1-76/77 p0 '000 C)--
A-.
$
....... El I J $
nt El Fl
I Y,
f I,
rjt: 0 n
C10
FJ
C r r
I Cli
f
J
7TV I!
$
F1 F
C
1� AGREED THAT T.- rS i Policy 3HALL NOT BE CANCELLED NI(: R REDUCED IN OV 7 P A
30 DAYS AFTER -�KTT N NO710E OF SUCH CANCELLATIO OR REDUCTION IN
_'VERAGE SHALL HAVHE EEN JAILED TG THE CERIIFICATE HOLEER .
cvnerd,,c il provid-M v-. respi-os [J j t
L
O+wr Pj
D'.-I 6i No. (if
A OHIO I%It,
eawery,enuarim Pm C ..Jr) or c!_-m it
rjjUjjjCi;jZ C1 t jfuij'C-j by fnUnicipl ofd-n ii-cej? in C'cl,�.,n
'�n.)
wuek _o t;( s,irack or (5)vIev,itar m4"en 4
It.e frilenno" of thL '-Ojt ir, li.e eve nt of -jnc0jtizwt c,I Ole R L