00-092 Republic Electric~~~~
RECORDING REQUESTED BY
City of Cupertino
WHEN RECORDED MAIL TO
City Clerk's Office
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
I~N~~~~~~~~~~
Titles~2 /Pages
3
Fees....* No Fees
Taxes...
Copies..
AMT PAID
BRENCA DAM S
SANTP, CLARA COUNTY RECORDER
Recorded at the request of
Schoc>I/College District
RDE # 009
6/14/2001
143 PM
(SPACE ABOVE THIS LINE FOR RECORDER'S USE)
NO FEE INACCORDANCE
WITH GOY. CODE 6103
CERTIFICATE OF COMPLETION AND
NOTICE OF ACCEPTANI~E OF COMPLETION
SOUTH STEELING ROAD BICYCLE FACILITY IMPROVEMENTS
PROJECT 9412
Original
O For Fast Endorsement
4~ 1
CITY OF
CUPEI~TINO
City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
(408)777-3354
FAX (408) 777-3333
PUBLIC WORKS DEPARTMENT
CERTIFICATE OF COMPLETION
AND
NOTICE OF ACCEPTANCE OF COMPLETION
SOUTH STEELING ROAD BICYCLE FACILITY IMPROVEMENTS
PROJEC~C 9412
NOTICE IS HEREBY GIVEN THAT I, Ralph A. Qualls, Jr., Director of Public Works and
City Engineer of the City of Cupertino, California, do hereby certify that the work and improvements
hereinafter described in the contract for doing which was entered into by and between the City of
Cupertino and Republic Electric on September 6, 2000, in accordance with the plans and specifications
for said work, have been completed to my satisfacti~~n and acceptance of completion was ordered by
the City Council on June 4, 2001.
That said work and improvements consisted of furnishing all labor, materials, tools, and
equipment required to complete said project, all a.s more particularly described in the plans and
specifications for said project.
`yZ,4c,~u. u u
Director of Public Works and
City Engineer of the City of Cupertino
June 5, 2001
Printed on Recycled Paper
VERIFICATION
I have reviewed this Certificate of Completion and Notice of Acceptance of Completion.
To the best of my knowledge, the information contained herein is true and complete.
I verify under penalty of perjury under the laws of the State of California, that the
foregoing is true and correct.
Executed on the 11th day of June 2001 at Cupertino, California.
~~~ ad
Administrative Clerk
City Clerk's Office, City of Cupertino
o~~
RECORDING REQUESTED BY
City of Cupertino
WHEN RECORDED MAIL TO
City Clerk's Office
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Titles~2 /Pages 3
Fees.... No Fees
Taxes...
Copies..
AMT PAID
BREPJDA DAV 1 S
SANTA CLARA COUNTY RECORDER
Recorded at the request of
School/College District
RDE # 009
6/14/2001
143 PM
i SPACE ABOVE THIS LINE FOR RECORDEK'S U~r)
NO FEE INACCORDANCE
WITH GOV. CODE 6103
CERTIFICATE OF COMPLETION AND
NOTICE OF ACCEPTArTCE OF COMPLETION
MILLER AVENUE BICYCLE 1?ACILITY IMPROVEMENTS
PROJE('T 9438
as,
~~
G'
Original
~ For Fast Endorsement
V ./
CITY OF
CUPE~TINO
City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
(408)777-3354
FAX (408) 777-3333
PUBLIC WORKS DEPARTMENT
CERTIFICATE OF ~~OMPLETION
AND
NOTICE OF ACCEPTANCE OF COMPLETION
MILLER AVENUE BICYCLE F~,CILITY IMPROVEMENTS
PROJECT 9438
NOTICE IS HEREBY GIVEN THAT I, Ralph A. Qualls, Jr., Director of Public Works and
City Engineer of the City of Cupertino, California, do hereby certify that the work and improvements
hereinafter described in the contract for doing which was entered into by and between the City of
Cupertino and Republic Electric on September 6, 2000, in accordance with the plans and specifications
for said work, have been completed to my satisfaction and acceptance of completion was ordered by
the City Council on June 4, 2001.
That said work and improvements consisted of furnishing all labor, materials, tools, and
equipment required to complete said project, all a~. more particularly described in the plans and
specifications for said project.
`~,~dvG~~cu.u
Director of Public Works an
City Engineer of the City of Cupertino
June 5, 2001
Printed on RecycL~d Paper
VERIFICATION
I have reviewed this Certificate of Completions and Notice of Acceptance of Completion.
To the best of my knowledge, the information contained herein is true and complete.
I verify under penalty of perjury under the laws of the State of California, that the
foregoing is true and correct.
Executed on the 11th day of June 2001 at Cupertino, California.
~. ~
Administrative Clerk
City Clerk's Office, City of Cupertino
1 ~'~
CITY OF 4~ ,
CUPEI~TINO
City Hall
PUBLIC 1~IpRK~ 10300 Torre Avenue
Cupertino, CA 95014-3202
~~~~ ~ ~ ~~~aKr (408) 777-3354
FAX (408) 777-3333
PUBLIC WORKS DEPARTMENT
MILLER AVENUE BICYCLE FACILITY IMPROVEMENT PROJECT,
PROJECT N0.9438 AND SOUTH STEI,LING ROAD BICYCLE FACILITY
IMPROVEMENT PROJECT, PROJECT N0.9412
CONTRACT CHAN(TE ORDER NO. 1
Contractor
Republic Electric
7120 Redwood Boulevard
Novato, CA 94945-4114
The following changes are hereby approved:
lA. Installation of conduits for Miller Ave. bike loops $ 1,738.50
1 B. Additional striping on southb~~und Miller Ave. 634.00
1C. Removal & re-striping of South Stelling Road 1,260.00
$3,632.50
Total Project:
Original Contract
Change Order No. 1
Revised Contract
CONTRACTOR
Title ~~ P ~ir~v-Q~at.~?
Date ~ S 20 ~ d ~
$137,705.00
3,632.50
$141,337.50
CITY OF CUPERTINO
clluuc/
Ralph A. Qualls, Jr.
Director of Public Works
City Council: June 4, 2001
Resolution No. 01-
~ ~f~ 0a9• afi
a
Printed on Recycled Paper ,~' ~l~~ ~ij
.. 4. CONTRACT FOR. PUBLIC WORKS
This CONTRACT made on September 6, 2000,, by the CITY OF CUPERTINO, a municipal
corporation of the State of California, hereinafter called CITY, and Republic Electric, hereinafter
called CONTRACTOR.
IT IS HEREBY AGREED by CITY and CONTRACTOR as follows:
1. THE CONTRACT DOCUMENTS. The complete contract consists of the following
contract documents:
a. Notice to Contractors, Proposal, Time of Completion, Estimated Quantities, Noncollusion
Affidavit, Bidder Qualification Form, Subcontractors Form and Signature Form.
b. Standard Specifications, General Provisions and Special Provisions.
c. Plans and Specifications for South Stelling Rc,ad Bicycle Facility Improvement Project, Project
No. 9412 and Miller Avenue Bicycle Facility Improvement Project, Project No. 9438
d. Faithful Performance Bond and Materials Borid.
e. Insurance Agreement, Certificate of Insl~rance, Endorsement of Primary Insurance,
Additional Insured Endorsement, Endorseme~it of Aggregate Limits of Insurance per Project,
Waiver of Subrogation Endorsement Worker's Compensation Insurance and Notice of Policy
Cancellation Endorsement.
f. This Contract for Public Works.
All of the above documents are intended to cooperate so that any work called for in one and not
mentioned in the other, or vice versa, is to be e:~cecuted the same as if mentioned in all of said
documents. The documents comprising the complete contract are sometimes hereinafter referred
to as the Contract Documents. In case of conflict between the Plans and the Specifications on the
one hand, and this Contract on the other, the Plans and Specifications shall prevail.
2. THE WORK. CONTRACTOR agrees to furnish all of the tools, equipment, apparatus,
facilities, labor, transportation and materials necessary to perform and complete in a good and
working order, the work of modifications to existing traffic signals at four locations, and installation
of roadway signs and pavement delineation, as called for, and in the manner designated in, and in
strict conformity with, the Plans and Specifications prepared by the Engineer and adopted by CITY,
which Plans and Specifications are entitled, respectively South Stelling Road Bicycle Facility
Improvement Project, Project No. 9412 and Miller Avenue Bicycle Facility Improvement Project,
Project No. 9438, and which Plans and Specifications are identified by the signatures of the parties
to this Contract. It is understood and agreed that said tools, equipment, apparatus, facilities, labor,
transportation and materials shall be furnished, and that said work shall be performed and
completed as required in said Plans and Specific~~tions under the sole direction of CONTRACTOR,
but subject to the inspection and approval of CITY, or its representative. CITY hereby designates as
its representative for the purpose of this Contract the Engineer, Mr. Bert J. Viskovich.
CONTRACT PAGE l OF 6
3. CONTRACT PRICE. CITY agrees to pay, and CONTRACTOR agrees to accept, in full
payment for the work above agreed to be done, the sum of $138,887.50 (ONE HUNDRED
THIRTY-EIGHT THOUSAND EIGHT HIUNDRED EIGHTY-SEVEN AND 50/100
DOLLARS) subject to additions and/or deductions as provided in the Contract Documents, per
Exhibit A attached hereto.
4. DISPUTES PERTAINING TO PAYMEl\(T FOR WORK. Should any dispute arise
respecting the true value of the work done, or any work omitted, or any extra work which
CONTRACTOR may be required to do, or respecting the size of any payment to
CONTRACTOR during the performance of this ('.ontract, said dispute shall be determined either
by reference to the Unit Prices bid, if applicable, or in accordance with agreement of prices, if
applicable, or in accordance with the agreement ~~f the parties, or in accordance with Section 6,
paragraph "f' of the General Provisions.
5. PERMITS, COMPLIANCE WITH LAW. CONTRACTOR shall obtain and bear all
expense for all necessary permits, licenses and ea:cements for the construction of the project, give
all necessary notices, pay all fees required by law, and comply with the laws, ordinances and
regulations relating to the work and to the preservation of the public health and safety.
6. INSPECTION BY THE CITY. CONTF..ACTOR shall at all times maintain proper
facilities and provide safe access for inspection by CITY to all parts of the work, and to the shops
wherein the work is in preparation. Where the Specifications require work to be specially tested
or approved, it shall not be tested or covered up without timely notice to CITY of its readiness
for inspection and without the approval thereof c)r consent thereto by CITY. Should any such
work be covered up without such notice, approv~il, or consent, it must, if required by CITY, be
uncovered for examination at CONTRACTOR'S expense.
7. EXTRA OR ADDITIONAL WORK AND CHANGES. Should CITY at any time during
the progress of the work require any alteration:, deviations, additions or omissions from the
Plans and Specifications or the Contract Documents, CITY shall have the right to do so, and the
same shall in no way affect or make void the Contract, but the cost or value thereof will be added
to, or deducted from, the amount of the Contract price, as the case may be, by a fair and
reasonable valuation, which shall be determined either by reference to the Unit Prices bid, if
applicable, the Standard Specifications, or in acc~~rdance with the agreement of the parties. No
extra work shall be performed or change be macie except by a written order from CITY, duly
authorized by resolution of the City Council, and by all agencies whose approval is required by
law, stating that the extra work or change is authorized, and no claim for an addition to the
Contract sum shall be valid unless so ordered.
8. CHANGES TO MEET ENVIRONMENTE~L REQUIREMENTS. CITY shall have the
right to make changes in this Contract during the- course of construction to bring the completed
improvements into compliance with environme~ltal requirements or standards established by
State and Federal statutes and regulations after the Contract has been awarded or entered into.
CONTRACTOR shall be paid for such changes either by reference to the Unit Prices bid, if
applicable, or in accordance with the agreement oi:'the parties.
CONTRACT PAGE 2 OF 6
9. TERMINATION, AMENDMENT OR A'IODIFICATION. This Contract may be
terminated, amended or modified, with the mutual consent of the parties. The compensation
payable, if any, for such termination, amendment or modification, shall be determined either by
reference to the Unit Price bid, if applicable, the Standard Specifications, or in accordance with
the agreement of the parties.
10. TIME FOR COMPLETION. All work: under this Contract shall be completed in
accordance with the Time for Completion section in the Proposal and the Specifications.of this
project. If CONTRACTOR shall be delayed in the work by the acts or neglect of CITY, or its
employees, or those under it by contract or otherwise, or by changes ordered in the work, or by
strikes, lockouts by others, fire, unusual delay iii transportation, unavoidable casualties or any
causes beyond CONTRACTOR'S control, or by delay authorized by CITY, or by any cause
which CITY shall determine justifies the delay, then the time of completion shall be extended
accordingly. This paragraph does not exclude the: recovery of damages for delay by either party
under other provisions in the Contract Documents.
11. INSPECTION AND TESTING OF MATERIALS. CONTRACTOR shall notify CITY
a sufficient time in advance of the manufacture, production or testing of materials to be supplied
under this Contract, in order that CITY may arrange for mill, factory or laboratory inspection and
testing of same.
12. TERMINATION FOR BREACH OR IrtSOLVENCY. If CONTRACTOR should be
adjudged a bankrupt, or should make a general ;assignment for the benefit of creditors, or if a
receiver should be appointed on account of insolvency, or if CONTRACTOR or any
subcontractor should violate any of the provisions of the Contract, CITY may serve written
notice upon CONTRACTOR and CONTRACTOR'S surety of its intention to terminate the
Contract. Such notice shall contain the reasons for CITY'S intention to terminate the Contract,
and unless within ten (10) days after serving of such notice, such violation shall cease and
satisfactory arrangements for corrections thereof lie made, the Contract shall, upon the expiration
of said ten (10) days, cease and terminate. In the event of any such termination, CITY shall
immediately serve notice thereof upon CONTRACTOR'S surety and CONTRACTOR, and the
surety shall have the right to take over and perform the Contract; provided, however, that, if the
surety within fifteen (15) days after the serving upon it of notice of termination does not give
CITY written notice of its intention to take over a~1d perform the Contract, or does not commence
performance thereof within thirty (30) days from the date of the serving of such notice, CITY
may take over the work and prosecute the same to completion by contract, or by any other
method it may deem advisable, for the account and at the expense of CONTRACTOR, and
CONTRACTOR AND CONTRACTOR'S suret;/ shall be liable to CITY for any excess cost
occasioned by CITY thereby, and in such event CITY may, without liability for so doing, take
possession of, and utilize in completing the work, such materials, appliances, plant and other
property belonging to CONTRACTOR as may be on the site of the work and necessary therefor.
13. THE CITY'S RIGHT TO WITHHOLD CERTAIN AMOUNTS AND MAKE
APPLICATION THEREOF. In addition to ~unounts which CITY may retain under other
provisions of the Specifications until final completion and acceptance of all work covered by the
Contract, CITY may withhold from payment to (:ONTRACTOR such an amount or amounts as
CONTRACT PAGE 3 OF 6
in its judgment may be necessary to pay just claims against CONTRACTOR or subcontractors
for labor and services rendered and materials furnished in and about the work.
City may apply such withheld amount or amount; to the payment of such claims in its discretion.
In doing so, CITY shall be deemed the agent of CONTRACTOR, and any payment so made by
CITY shall be considered as a payment made under the Contract by CITY to CONTRACTOR,
and CITY shall not be liable to CONTRACTOR for any payment made in good faith. Such
payment may be made without prior judicial determination of the claim or claims. With respect
to any retention of payment by CITY to ensure performance of the Contract, CONTRACTOR
will be entitled to substitute securities as provided in Section 4590 of the California Government
Code as more fully described in CITY'S Notice to Contractors.
14. NOTICE AND SERVICE THEREOF. A:ny notice from one party to the other under this
Contract shall be in writing, and shall be dated anal signed either by the party giving such notice,
or by a duly authorized representative of such party. Any such notice shall not be effective for
any purpose whatsoever unless served in the following manner: (a) if the notice is given to
CITY, either by personal delivery thereof to the Engineer of CITY, or by depositing same in the
United States mails, enclosed in a sealed envelope, addressed to CITY OF CUPERTINO; 10300
TORRE AVENUE; CUPERTINO, CA 95014; postage prepaid and certified; (b) if the notice is
given to CONTRACTOR, either by personal delivery thereof to CONTRACTOR, or to
CONTRACTOR'S duly authorized representative at the site of the project, or by depositing same
in the United States mails enclosed in a sealed envelope, addressed to REPUBLIC ELECTRIC,
7120 REDWOOD BOULEVARD, NOVATO, C,A 94945, postage prepaid and certified; and (c)
if notice is given to CONTRACTOR'S surety or any other person, either by personal delivery
thereof to CONTRACTOR'S surety or other person, or by depositing same in the United States
mails, enclosed in a sealed envelope, addressed to CONTRACTOR'S surety or person, as the
case may be, at the address of CONTRACTO E~' S surety or the address of the person last
communicated by such person to the party giving the notice, postage prepaid and certified.
15. ASSIGNMENT OF CONTRACT. Neither the Contract, nor any part thereof, nor moneys
due or to become due thereunder, shall be assigned by CONTRACTOR without the prior written
approval of CITY.
16. COMPLIANCE WITH SPECIFICATIONS OF MATERIALS. Whenever in the
Specifications, any material or process is indicated or specified by patent or proprietary name, or
by name of manufacturer, such Specifications must be met by CONTRACTOR, unless CITY
agrees in writing to some other material, process or article offered by CONTRACTOR which is
equal in all respects to the one specified. It shall be CONTRACTOR'S responsibility to prove
equality of any such material, process or article offered as a substitution to the one(s) specified.
17. WORKER'S COMPENSATION INSUIL~NCE AND EMPLOYER'S LIABILITY
INSURANCE. CONTRACTOR shall take out and maintain during the life of this Contract
Worker's Compensation Insurance and Employer's Liability Insurance for all of
CONTRACTOR'S employees employed at the sate of the project. In case any work is sublet,
CONTRACTOR shall require any and all sL~bcontractors similarly to provide Worker's
Compensation and Employer's Liability Insurance for all of the latter's employees unless such
employees are covered by the protection afforded ~to the CONTRACTOR.
CONTRACT PAGE~{OF6
In signing this Contract CONTRACTOR makes the following certification, required by Section
1861 of the Labor Code: "I am aware of the provisions of Section 3700 of the Labor Code which
requires every employer to be insured against liability for worker's compensation or to undertake
self insurance in accordance with the provisions of the Labor Code, and I will comply with such
provisions before commencing the performance of the work of this Contract."
18. ACCIDENT PREVENTION. Precaution shall be exercised at all times for the protection
of persons (including employees) and property. The safety provisions of applicable laws,
building codes and construction codes shall be observed. Machinery, equipment and other
hazards shall be guarded or eliminated in accordance with the safety provisions of the
Construction and Safety Orders issued by the Industrial Accident Commission of the State of
California.
19. CONTRACTOR'S RESPONSIBILITY FOR THE WORK. CONTRACTOR shall not
be responsible for the cost of repairing or restori~ig damage to the work caused by Acts of God.
NEVERTHELESS, CONTRACTOR shall, if tree insurance premium is a separate bid item,
obtain the insurance to indemnify CITY for any damage to the work caused by Acts of God.
"Acts of God" shall include only the following occurrences or conditions and effects:
earthquakes and tidal waves, when such occurrences or conditions and effects have been
proclaimed a disaster or state of emergency by the President of the United States or by the
Governor of the State of California, or were of a magnitude at the site of the work sufficient to
have caused a proclamation of disaster or state of emergency having occurred in a populated
area. Subject to the foregoing, CITY shall not, in any way or manner, be answerable or suffer
loss, damage, expense or liability for any loss or damage that may happen to said building, work,
or equipment or any part thereof, or in, on, or ab~~ut the same during its construction and before
acceptance.
20. CONTRACTOR'S GUARANTEE. CON'T'RACTOR unqualifiedly guarantees the first-
class quality of all work and of all materials, ~~pparatus and equipment used or installed by
CONTRACTOR or by any subcontractor or sup~~lier in the project which is the subject of this
Contract, unless a lesser quality is expressly auth~~rized in the Plans and Specifications, in which
event CONTRACTOR unqualifiedly guarantees such lesser quality; and that the work as
performed by CONTRACTOR will conform with the Plans and Specifications or any written
authorized deviations therefrom. In case of any defect in the work, materials, apparatus or
equipment, whether latent or patent, revealed ~to CITY within one (1) year of the date of
acceptance of completion of this Contract by CITY, CONTRACTOR will forthwith remedy such
defects without cost to CITY.
21. DEFERRED ALTERNATE SELECTION. The City reserves the right for the term of the
Contract, the deferred selection of none, any or all alternate bid items at the bid price. The
alternates chosen would be for any sites currentl}~ under construction or to be constructed in the
future.
CONTRACT PAGE 5 OF 6
P.O. No.
IN WITNESS WHEREOF, the parties have executed this Contract, in duplicate, the day and
year first hereinabove written.
CITY OF CUPE TINO:
~'~
~-
By:
MAYOR
.~~
Attest: tS---~_
~; . ~ 1 City Clerk
Dater ~ ll , 2000
City Clerk
CONTRACTOR:
Renubli,~lectra
BY~ /~r~:5/y~i
Notary acknowledgment is required. If a
corporation, corporate seal and corporate
notary acknowledgment and Federal Tax
I.D. are required. If not a corporation, a
Social Security No. is required.
Social Security #
_l8-0~~67~~
Federal Tax I.D. #
APPROVED AS TO FORM:
Contractor's License No. ~/7/S~~/
City Attorney
PROJECT NAME & NUMBER: South Stellin~; Road Bicycle Facility Improvement Project,
Project No. 9412 and Miller Avenue Bicycle Facility
Improvement Project, Project No. 9438
CONTRACTOR NAME & ADDRESS: Republic Electric
7120 Redwoc-d Boulevard
Novato, CA 5-4945
CONTRACT AMOUNT:
ACCOUNT NUMBER:
$138,887.50
270-9412 ands 270-9438
FILE NOS: 74,009.06 anti 74,009.13
CONTRACT PAGESOF6
INSURANCE FORMS INSTRUCTIONS
FOR ITEMS 3, 4, 5 AND 6, THE FORMS PROVIDED BY THE CITY OF CUPERTINO
MUST BE USED. FORMS OTHER THAN THESE WILL NOT BE ACCEPTED.
ALL DOCUMENTS MUST BE ORIGINALS -• SUBMIT IN TRIPLICATE
1. Insurance Agreement -Must be signed by Contractor.
2. Certificate of Insurance to the City of Cuperti~io -must be completed by the insurance agent
or must provide a certificate on the company's foam. They must contain the same information.
3. Endorsement of Primary Insurance -must be signed by the insurance agent for general
liability and automobile liability only.
4. Additional insured endorsement -must be signed by the insurance agent for general liability
and automobile liability only.
5. Comprehensive general liability/commercial general liability endorsement of aggregate limits
of insurance per project -must be signed by the insurance agent for general liability only.
6. Waiver of subrogation endorsement worker's compensation insurance -must be signed by the
insurance agent for worker's compensation only.
7. Notice of policy cancellation endorsement - ~r~ust be signed by the insurance agent or must
be on the company's certificate of insurance form for all insurances.
,~..
CUPEI~TINO INSURANCE AGRIEEMENT
A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires
every employer to be insured against liability for worker's compensation or undertake self-
insurance in accordance with the provisions of that Code, and will comply with such provisions
before commencing the performance of the work of this Contract.
B. Contractor and all subcontractors will carry worker's compensation insurance for the
protection of its employees during the progress oil the work. The insurer shall waive its rights of
subrogation against the City, the City's officers, agents and employees and shall issue an
endorsement to the policy evidencing same.
C. Contractor shall carry at all times, on all operations hereunder, commercial or
comprehensive general liability insurance, automobile liability insurance and builder's all risk
insurance. All insurance coverage shall be in amounts required by the City and shall be
evidenced by the issuance of a certificate in a form prescribed by the City and shall be
underwritten by insurance companies satisfacto~.y to the City for all operations, sub-contract
work, contractual obligations, product or compP~eted operations, all owned vehicles and non-
e, owned vehicles. Said insurance coverage obtained by the Contractor, excepting worker's
compensation coverage, shall name the City, it;~ engineer, and each of its directors, officers,
agents and employees, as determined by the City, as additional insureds on said policies.
Insurers must be licensed to do business in the State of California. The Insurers must also have
an "A" policyholder's rating and a financial ratilig of at least Class VII in accordance with the
current Best's Guide Rating.
D. Before Contractor performs any work at, or prepares or delivers materials to, the site of
construction, Contractor shall furnish certificates ~~f insurance evidencing the foregoing insurance
coverages and such certificates shall provide the: name and policy number of each carrier and
policy and that the insurance is in force and will not be canceled or modified without thirty (30)
days written notice to the City. Contractor shall maintain all of the foregoing insurance
coverages in force until the work under this Contract is fully completed. The requirement for
carrying the foregoing insurance shall not derogate from the provisions for indemnification of the
City by Contractor under this Contract and for the duration of the warranty period.
Notwithstanding nor diminishing the obligation: of Contractor with respect to the foregoing,
Contractor shall maintain in full force and effect during the life of this Contract, the following
insurance in amounts not less than the amounts :specified and issued by a company admitted in
California and having a Best's Guide Rating of A., Class VII or better.
Worker's Compensation Liability In accordance with the Worker's Compensation
Act of the State of California - $1,000,000 per
occurrence.
Insurance Agreement Page ] of 2
Public Liability -either commercial general Combined single limit of $1.0 million per
liability or comprehensive general liability; occurrence; $2.0 million in thz aggregate.
including provisions for contractual liability,
personal injury, independent contractors and
property damage coverages.
Automobile Liability -comprehensive covering Combined single limit of $1.0 million per
owned, non-owned and hired automobiles. occurrence.
Consultants only: Errors and Omissions liability. $1.0 million per occurrence.
(Contractor's Name)
Dated: ~~T' 7 , 2000
Insurance Agreement Page 2 of 2
,'`~~ sJ .
'ITY OP
CUPEIiLTINO CERTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO
This certifies to the City of Cupertino that the following described policies have been issued to
the insured named below and are in force at this time.
Insured:
Address:
Description of operations/locations/products insul•ed (show contract name and/or number, if
any):
WORKER'S COMPENSATION * Statutory 1v1in.
* Employer' s
Liability
(name of insurer)
$ $ $
Insurance Company's State License No.
Check Policy Type: Each. Occurrence $
COMPREHENSIVE GENERAL
LIABILITY
[ ] Premises/Operations General Aggregate $
(if a~~plicable)
[ ] Owners & Contractors
Protective Aggregate $
[ ] Contractual for Specific
Contract Personal Injury $
[ ] Products Liability
[ ] XCU Hazards
[ ] Broad Form P.D. Fire ]damage (any one fire) $
[ ] Severability of Interest
Clause
[ ] Personal Injury with Medical Expense $
Employee Exclusion Removed (any one person)
or Self-Insured
COMMERCIAL GENERAL LIABILITY Retention
$
(name of insurer)
Policy No. Expiration Date
Certificate of Insuram;e Page 1 of 2
AUTOMOTIVE/VEHICLE LIABILITY E~ODILY INJURY PROPERTY DAMAGE
Commercial Form Each Person Each Accident
Liability Coverage
$ $
Each Accident
(name of insurer)
$ or
C~~mbined Single Limit $
Policy No.
Expiration Late
(agent's initial)
A copy of all Endorsement:; to the policy(ies) which in any way
limit the above-listed types of coverage are attached to this
Certificate of Insurance.
This Certificate of Insurance is not an insurance policy and does not amend, extend or alter the
coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or
condition of any contract or any 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 subject to all the terms, exclusions and conditions of such policies.
IT IS HEREBY CERTIFIED that the above polic,y(ies) provide liability insurance as required by
the Agreement between the City and the insured.
By:
Dated:
Attach Certificate of Insurance and Additional Insured Endorsement on company forms.
2000
Certificate of Insurance; Page 2 of 2
:~."'
C Y OF
CUPEI~TINO ENDORSEMENT OF PP;IMARY INSURANCE
In consideration of the policy premium and notwithstanding any inconsistent statement in the
policy to which this Endorsement is attached oc any other Endorsement attached thereto, it is
agreed as follows:
The insurance afforded by this policy is primary insurance, and no additional insurance
held or owned by the designated additional insureds) shall be called upon to cover a loss under
said additional policy.
POLICY INFORMATION
1. Insurance Company:
2. Insurance Policy Number:
3. Effective Date of this Endorsement:
4. Insured:
2000
All notices herein provided to be given by the Insurance Company to the City in
connection with this policy and this Additional Insured Endorsement, shall be mailed to or
delivered to the City at 10300 Torre Avenue; Cupertino, California 95014.
I, (print/type 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 all Endorsements furnished to the District)
Name of
Agent/Agency:
Address:
Title:
Telephone:
Facsimile:
Primary Endorsement Page 1 of 1
~vM J
CITY OF
CUPEf~T1N0 ADDITIONAL INSUREII ENDORSEMENT
In consideration of the policy premium and nc-twithstanding any inconsistent statement in the
policy to which this Endorsement is attached or any other Endorsement attached thereto, it is
agreed as follows:
The City of Cupertino ("City") and its directors, officers, engineers, agents and employees,
and all public agencies from whom permits vrill be obtained and their directors, officers,
engineers, agents and employees are hereby declared to be additional insureds under the terms of
this policy, but only with respect to the operations of the Contractor at or upon any of the
premises of the City in connection with the Contract with the City, or acts or oi<nissions of the
additional insureds in connection with, but limited to its general supervision or inspection of said
operations.
POLICY INFORMATION
1. Insurance Company:
2. Insurance Policy Number:
3. Effective Date of this Endorsement:
4. Insured:
2000.
All notices herein provided to be given by the; Insurance Company to the City in connection
with this policy and this Additional Insured Endorsement, shall be mailed to or delivered to the
City at 10300 Torre Avenue; Cupertino, Californi,~ 95014.
I, (print/type 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 all Endorsements furnished to the District)
Names of
Agent/Agency:
Address:
Title:
Telephone:
Facsimile:
Additional Insured Endors~:ment Page 1 of 1
-~~~
CUPEI~TINO COMPREHENSIVE GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
ENDORSEMENT OF AGGREGATE LIIIZIT5 OF INSURANCE PER PROJECT
In consideration of the policy premium and n~~twithstanding any inconsistent statement in the
policy to which this Endorsement is attached or any other Endorsement attached thereto, it is
agreed as follows: I,
This Endorsement modifies the insurance provided under the General Liability Coverage part
of the below-referenced policy of insurance.
The general aggregate limit under LIMITS OI~ INSURANCE applies separately to the project
described as
POLICY INFORMATION
1. Insurance Company:
2. Insurance Policy Number:
3. Effective Date of this Endorsement:
4. Insured:
5. Additional Insured: City of Cupertino, its directors, officers, agents and employees.
0
All notices herein provided to be given by thy; Insurance Company to the City in connection
with this policy and this Additional Insured Endorsement, shall be mailed to or delivered to the
City at 10300 Torre Avenue; Cupertino, California 95014.
I, (print/type 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 all Endorsements furnished to the District)
Names of
Agent/Agency:
Address:
Title:
Telephone:
Facsimile:
Aggregate Limits F~age ] of 1
,~~`~
c"
CUPEI~TINO
WAIVER OF SUBROGATION ENDORSEMENT
WORKER'S COMPENSATION INSURANCE
In consideration of the policy premium and notwithstanding any inconsistent statement in the
policy to which this Endorsement is attached or any other Endorsement attached thereto, it is
agreed as follows:
It is agreed that with respect to such insura~ice as is afforded by the policy, the Insurance
Company waives any right of subrogation it may require against the City of Cupertino, and each
of its directors, officers, agents, consultants and employees by reason of any payment made on,
account of injury, including death resulting therefrom, sustained by any employee of the insured,'
arising out of the performance of the above-referenced Contract.
POLICY INFORMATION
Insurance Company:
2. Insurance Policy Number:
3. Effective Date of this Endorsement:
14. Insured:
2000
All notices herein provided to be given by the Insurance Company to the City in connection
with this policy and this Additional Insured End~~rsement, shall be mailed to or delivered to the
City at 10300 Torre Avenue; Cupertino, California 95014.
I, (print/type 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 all Endorsements furnished to the District)
Names of
Agent/Agency:
Address:
Title:
Telephone:
Facsimile:
Waiver of Subrogation Endorsement Page 1 of 1
,:_~~~
CfT OF
CUPEfiTINO
NOTICE OF POLICY
CANCELLATION :ENDORSEMENT
In consideration of the policy premium and notwithstanding any inconsistent statement in
the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is
agreed as follows:
Cancellation Notice. The insurance afforded by this policy shall not be suspended,
voided, canceled, reduced in coverage or in limits, or materially altered, except after thirty (30)
days' prior written notice by certified mail, return receipt requested, has been given to the City of
Cupertino ("City"). Such notice shall be addressed to the City as indicated below.
POLICY INFORMATION
1. Insurance Company:
2. Insurance Policy Number:
3. Effective Date of this Endorsement:
4. Insured:
2000
All notices herein provided to be given by thl: Insurance Company to the City in connection
with this policy and this Additional Insured Endorsement, shall be mailed to or delivered to the
City at 10300 Torre Avenue; Cupertino, California 95014.
I, (print/type 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 all Endorsements furnished to the District)
Names of
Agent/Agency:
Address:
Title:
Telephone:
Facsimile:
Cancellation Endorsement Page 1 of 1
FAITHFUL PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENT:
THAT WE,
Principal, (contractor's name)
and
Surety, (bonding company/'s name)
as
as
are held and firmly bound unto the City of ~~upertino, State of California, in the sum of
lawful
money of the United States, for the payment of which will and truly to be made, we bind
ourselves, our heirs, executors, successors and assigns, jointly and severally, firmly by these
presents.
THE CONDITION of the foregoing obligation is such that,
WHEREAS, the Principal has entered into a contract with the City dated
20 with the obligee to do and perform the following work to-
wit:
NOW, THEREFORE, if the said principal shall well and truly perform the work
contracted to be performed under said contract, then this obligation shall be void; otherwise to
remain in full force and effect.
IN WITNESS WHEREOF, this instrument has been duly executed by Principal and
Surety this ~ day of _, 20_
(To be signed by Principal and Surety, Notary acknowledgment required)
CONTRACTOR
Principal
Surety
Street Address:
City, State, Zip
By:
Attorney-In-Fact
The above bond is accepted and approved this _ day of , 20_
Faithful Performance Page 1 of 1
LABOR AND MATERIAL BOND
KNOW ALL MEN BY THESE PRESENT:
WHEREAS, the City of Cupertino, State of California, and
hereinafter designated as "Principal" have entered into or are about to enter into a contract
providing for the installation, construction, and erection by Principal of
more particularly described in said contract; and i~lcorporated herein by reference.
WHEREAS, said principal is required to furnish a bond in connection with said contract,
providing that if said Principal, or any of his or its subcontractors, shall fail to pay for materials,
provisions, provender or other supplies or teams used in, upon, for or about the performance of
work contracted to be done, or for any work or lat,or done thereon of any kind, the Surety on said
bond shall pay the same to the extent hereinafter set forth;
NOW, THEREFORE, WE, as Principal,
(contractor's name)
and as Surety,
(bonding company':; name)
firmly bind ourselves, our executors, administrators, successors and assigns, jointly and
severally, unto the City of Cupertino, and any and all materialmen, persons, companies, or
corporations furnishing materials, provisions, provender or other supplies used in, upon, for or
about the performance of the aforesaid work contracted to be executed or performed under the
contract hereinabove mentioned, and incorporated herein by reference, and all persons,
companies or corporations lending or hiring team:;, implements or machinery, for or contributing
to said work to be done, and all persons who perform work or labor upon the same, and all
persons who supply both work and materials, whose claim has not been paid by Principal or by
any other person, in the just and full sum of .
THE CONDITION OF THIS OBLIGATION IS SUCH THAT if said principal, his or its
subcontractors, heirs, executors, administrators, successors or assigns, shall fail to pay for any
materials, provisions, provender or other supplies or teams used in, upon, for or about the
performance of the work contracted to be done, o:r for any work or labor thereon of any kind, or
for amounts due under the Unemployment Insurance Act with respect to such work or labor, or
any and all damages arising under the original contract, then said Surety will pay the same and
also will pay in case suit is brought upon this bond, such reasonable attorney's fee as shall be
fixed by the court.
This bond shall insure to the benefit of an;y and all persons, companies, and corporations
entitled to file claims under Section 1184.1 of the Code of Civil Procedure, so as to give a right
of action to them or their assigns in any suit brought upon this bond.
Labor and Material Page 1 of 2
And the said Surety, for value received, hereby stipulates, and agrees that no change,
extension of time, alteration or addition to they terms of the contract or to the work to be
performed thereunder or the specifications accompanying the same shall in any wise affect its
obligations on this bond, and it does hereby waive notice of any such change, extension of time,
alteration or addition to the terms of the contract c-r to the work or to the specifications.
IN WITNESS WHEREOF, this instrument has been duly executed by Principal and
Surety this day of _, 20
(To be signed by Principal and Surety. Notary acknowledgments required.)
CONTRACTOR
Principal
Surety
Street Address:
City, State, Zip
By:
Attorney-In-Fact
The above bond is accepted and approved this __day of , 20_
Labor and Material Prge 2 of 2