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00-047 Silicon Valley PavingbO,Du~
E. CONTRACT FOR PUBLIC WORKS
This CONTRACT made on ~~~ b ~ ( by the CITY OF CUPERTINO, a
municipal corporation of the Stat of Califc-rnia, hereinafter called CITY, and SILICON
VALLEY PAVING, INC., hereinafter called CONTRACTOR.
IT IS HEREBY AGREED by CITY and CONTRACTOR as follows:
1. THE CONTRACT DOCUMENTS. Th~~ 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 PAVEMENT ieESTORATION, PROJECT 2001-02
d. Faithful Performance Bond and Materials Bend.
e. Insurance Agreement, Certificate of Insurance, Endorsement of Primary Insurance,
Additional Insured Endorsement, Endorsement of Aggregate Limits of Insurance per Project,
Waiver of Subrogation Endorsement Worker's Compensation Insurance and Notice of Policy
Cancellation Endorsement.
£ This Contract for Public Works.
All of the above documents are intended to coc-perate so that any work called for in one and not
mentioned in the other, or vice versa, is to be executed 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 confli~~t 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 PAVEMENT RESTORATION, PROJECT 2001-02, 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 CI~,Y, which Plans and Specifications are entitled,
respectively, PAVEMENT RESTORATIOl~; PROJECT ZOOI-02and 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, fac;ilities, labor, transportation and materials shall be
furnished, and that said work shall be performed and completed as required in said Plans and
Specifications under the sole direction of CONTRACTOR, but subject to the inspection and
approval of CITY, or its representative.
Contract Page 1 of 7
CITY hereby designates as its representative for the purpose of this Contract the Engineer, Mr.
Ralph A. Qualls, Jr.
3. CONTRACT PRICE. CITY agrees to p<<y, and CONTRACTOR agrees to accept, in full
payment for the work above agreed to be done, the sum of $170,540.20 (ONE HUNDRED
SEVENTY THOUSAND AND FIVE HUNDRED FORTY DOLLARS AND TWENTY
CENTS) subject to additions and/or deductions as provided in the Contract Documents, per
Exhibit A attached hereto.
4. DISPUTES PERTAINING TO PAYMENT 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 Contract, 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 of 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 easements 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. CONTRACTOR shall at all times maintain proper
facilities and provide safe access for inspection '~,y 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 thereo F or consent thereto by CITY. Should any such
work be covered up without such notice, approval, or consent, it must, if required by CITY, be
uncovered for examination at CONTRACTOR'.3 expense.
7. EXTRA OR ADDITIONAL WORK AN1C~ CHANGES. Should CITY at any time
during the progress of the work require any alterations, 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 t:he 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 determin~~d either by reference to the Unit Prices bid, if
applicable, the Standard Specifications, or in a~~cordance with the agreement of the parties. No
extra work shall be performed or change be made except by a written order from CITY, duly
authorized by resolution of the City Council, a1d 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 ENVIRONMEN'T'AL 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 environmental requirements or standards established by
State and Federal statutes and regulations after the Contract has been awarded or entered into.
Contract Page 2 of 7
CONTRACTOR shall be paid for such changers either by reference to the Unit Prices bid, if
applicable, or in accordance with the agreement of the parties.
9. TERMINATION, AMENDMENT OR MODIFICATION. 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 ire the work by the acts or neglect of CITY, or its
employees, or those under it by contract or othE:rwise, or by changes ordered in the work, or by
strikes, lockouts by others, fire, unusual delay in transportation, unavoidable casualties or any
causes beyond CONTRACTOR'S control, or ley 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 arr~mge for mill, factory or laboratory inspection and
testing of same.
12. TERMINATION FOR BREACH OR I:vSOLVENCY. 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 provi:>ions 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 thereon.' be 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 and perform the Contract, or does not
commence performance thereof within thirty 1;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 thy: account and at the expense of CONTRACTOR,
and CONTRACTOR AND CONTRACTOR'S surety 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 lie on the site of the work and necessary therefor.
Contract Pave 3 of 7
13. THE CITY'S RIGHT TO WITHHOLD CERTAIN AMOUNTS AND MAKE
APPLICATION THEREOF. In addition to amounts 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 CONTRACTOR such an amount or amounts as
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 amounts to the payment of such claims in its discretion.
In doing so, CITY shall be deemed the agent o:f CONTRACTOR, and any payment so made by
CITY shall be considered as a payment made cinder the Contract by CITY to CONTRACTOR,
and CITY shall not be liable to CONTRACTt~R 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. Any notice from one party to the other under
this Contract shall be in writing, and shall be dated and 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; C~UPERTINO, 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 dl~ly authorized representative at the site of the
project, or by depositing same in the United States mails enclosed in a sealed envelope,
addressed to, SILICON VALLEY PAVING,I:yC., P.O. BOX 26558, SAN JOSE, CA 95159-
6558 postage prepaid and certified; and (c) if n~~tice is given to CONTRACTOR' S surety or any
other person, either by personal delivery thereo:F 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 ca;~e may be, at the address of CONTRACTOR' 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',oe 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, proce;;s 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.
Contract Pale 4 of 7
17. WORKER'S COMPENSATION INSURANCE 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 site of the project. In case any work is sublet,
CONTRACTOR shall require any and all subcontractors 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.
In signing this Contract CONTRACTOR make; 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 provision~~ 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 restoring damage to the work caused by Acts of
God. NEVERTHELESS, CONTRACTOR shall, if the insurance premium is a separate bid item,
obtain the insurance to indemnify CITY for airy 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 l:y 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 about the same during its construction and before
acceptance.
20. CONTRACTOR'S GUARANTEE. CONTRACTOR unqualifiedly guarantees the
first-class quality of all work and of all materials, apparatus and equipment used or installed by
CONTRACTOR or by any subcontractor or supplier in the project which is the subject of this
Contract, unless a lesser quality is expressly authorized in the Plans and Specifications, in which
event CONTRACTOR unqualifiedly guarantees such lesser quality; and that the work as
performed by CONTRACTOR will conform vrith the Plans and Specifications or any written
authorized deviations therefrom. In case of Duly 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.
Contract Page 5 of 7
P.O• NO•--~
ht for the term of
The City reserves the rig rice. The
BRED ALTERNATE SELECTIC N•
E f none, any or all alternate bidritom o be constructed in the
21. DEF
the Contract, the deferred selection ° tes currently under constructio
alternates chosen would be for any t the day and
future.
~ WI`iTTESS WHEREOF,
year first hereinabove written.
CITY OF CUPERTINO
CONTRACTOR:
ing~ Inc.
Silicon v
_ Todd S~gstad
gy. Mayor
~C.
Attest:
City Cl
Dater-~
AppROVED AS TO FO
ect Name & Number: Pavem~ 200 a OZ ration,
Prof Probe
732923-A
Contractor's License No• ~~
paving, Inc•
Contractor's Name & Address: Silicon' x 26558
p,p. B
San Jose, Ca 95159-6558
Contract Amount: $170,540.20
Account Number' 270-8404-7015
File No: 98,493.68
he arties have executed this Contract, in duplica e,
t p
gy:
ment is required. If a
Notary aclmOV`'ledg orate
orate seal and core
corporation, Corp
ackno~,ledgment and Federal Tax
notary oration a
I.D. are required. If not auo d
Social Security No. is req
77-0503684
Social Security # Federal Tax I.D• #
Contract Page 6 of 7
1
CITY OF
CUPEI~TINO
City Hall
10300 Tone Avenue
Cupertino, CA 95014-3255
Telephone: (408)777-3354
FAX: (408)777-3333
PUBLIC WORKS DEPARTMENT
ANNUAL SLUURRY SEAL ~'~
b0~
PROJECT NUMBER 2000-101
CONTRACT CHArfGE ORDER NO.1
Contractor
VALLY SLURRY SEAL CO.
PO. Box 1620
West Sacramento, CA 95691
The following change is hereby approved:
lA. Quantity Adjustments and Addition Striping Items $ 6.594.98
Total Change Order No. 1 $ 6,594.98
Total Project:
Original Contract $ 154,237.80
Change Order No. 1 6,594.98
Revised Contract $160,832.78
CONTRACTOR
Title ~! ~ ~ ~ ~t ~e ~ -~~'
Date / o% ~ ~ ~ y
CITY OF CUPERTINO
~~
~G~U~~
Bert J. Viskovich
Director of Public Works
City Council: ~O " z ' " ~ (Date)
Resolution No. 00 - ~ S O
Printed on Rec~~cled Paper
CONTRACT FOR PUBLIC WORK ~ r
This CONTRACT made on by the CITY OF CUPERTINO, a municipal
corporation of the State of California, hereinafter called CITY, and SILICON VALLEY PAVING, INC.
hereinafter called CONTRACTOR.
TT IS HEREBY AGREED by CITY and CONTRAC']COR 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 Fortn.
b. Standard Specifications, General Provisions and Special Provisions.
c. Plans and Specifications
d. Faithful Performance and Labor & Material Bonds
e. Insurance Agreement, Certificate of Insurance, Endorsement of Primary Insurance, Additional Insured
Endorsement, Endorsement of Aggregate Limit:. of Insurance per Project, Waiver of Subrogation
Endorsement Worker's Compensation Insurance z~nd Notice of Policy Cancellation Endorsement.
f. This Contract for Public Works.
All of the above documents aze intended to cooperate so that any work called for in one and not mentioned
in the other, or vice versa, is to be executed the szune 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 necesssiry to perform and complete in a good and working
order, the work of , as called for, and in the manner designated in, and in strict conformity with, the Plans
and Specifications prepazed by the Engineer and adopted by CITY, which Plans and Specifications are
entitled, respectively, PAVEMENT RESTORATIO[~i, PROJECT NO. 2000-101, and which Plans and
Specifications aze 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 r~rquired in said Plans and Specifications 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 liurpose of this Contract the City Engineer, Mr. Bert J.
Viskovich.
Contract Page. 1 of 16
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 $64,049.39 (Seventy Four Thousand Forty
NineDollars and Thirty Nine Cents) subject to additions and/or deductions as provided in the Contract
Documents, per Exhibit A attached hereto.
4. DISPUTES PERTAINING TO PAYMEN'C FOR WORK. Should any dispute arise
respecting the true value of the work done, o r 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 Contract, said dispute shall be determined either
by reference to the Unit Prices bid, if applicably;, or in accordance with agreement of prices, if
applicable, or in accordance with the agreement of 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 e<<sements 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. CONTRACTOR shall at all times maintain proper
facilities and provide safe access for inspection b:~ 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 u~~ without timely notice to CITY of its readiness
for inspection and without the approval thereof or consent thereto by CITY. Should any such
work be covered up without such notice, approval, 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 alterations, deviations, additions or omissions from
the Plans and Specifications or the Contract Doc;uments, 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 aa~ordance with the agreement of the parties. No
extra work shall be performed or change be m;~de 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 ~iuthorized, and no claim for an addition to the
Contract sum shall be valid unless so ordered.
8. CHANGES TO MEET ENVHtONMENTAL 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 environment:al 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 changers either by reference to the Unit Prices bid, if
applicable, or in accordance with the agreement ~~f the parties.
Contract Page: 2 of 16
9. TERII~IINATION, AMENDMENT OR MCIDIFICATION. 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. TIlVIE 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 in 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 IhTSOLVENCY. 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 :>urety 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 be 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 and 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 surety shall be liable to CITY for any excess cost occasioned by CITY
thereby, and in such event CITY may, without li;~bility for so doing, take possession of, and utilize
in completing the work, such materials, appliances, plant and other property belonging to
CONTRACTOR as maybe on the site of the work and necessary therefor.
Contract Page: 3 of 16
13. THE CITY'S RIGHT TO WITHHOLD CERTAIN AMOUNTS AND MAKE
APPLICATION THEREOF. In addition to amounts 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 t~ONTRACTOR such an amount or amounts as
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 dEmed 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 Corn~ractors.
14. NOTICE AND SERVICE THEREOF. Any notice from one party to the other under
this Contract shall be in writing, and shall be d;~ted and 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; hostage prepaid and certified; (b) if the notice is
given to CONTRACTOR, either by persona], 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 Silicon Valley Paving,
Inc., 812 W. Home St., San Jose, CA 95126, 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 ley 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 CONTRACTOR'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 tie 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.
Contract Page 4 of 16
17. WORKER'S COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY
INSURANCE. CONTRACTOR shall take out and maintain during the life of this Contract
Worker's Compensation Insurance and E:mployer's Liability Insurance for all of
CONTRACTOR'S employees employed at the site of the project. In case any work is sublet,
CONTRACTOR shall require any and all :subcontractors similazly to provide Worker's
Compensation and Employer's Liability Insurance for all of the Tatter's employees unless such
employees aze covered by the protection afforded to the CONTRACTOR.
In signing this Contract CONTRACTOR make:, 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
guazded or eliminated in accordance with the safety provisions of the Construction and Safety
Orders issued by the Industrial Accident Commi:,sion of the State of California.
19. CONTRACTOR'S RESPONSIBILTT'Y FOR THE WORK CONTRACTOR shall
not be responsible for the cost of repairing or restoring damage to the work caused by Acts of
God. NEVERTHELESS, CONTRACTOR shall, if the insurance premium is a sepazate 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 o~;currences 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 jJnited States or by the Governor of the State of
California, or were of a magnitude at the site of ~:he work sufficient to have caused a proclamation
of disaster or state of emergency having occurrE;d 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 about the same during its construction and before acceptance.
20. CONTRACTOR'S GUARANTEE. CONTRACTOR unqualifiedly guazantees the
first-class quality of all work and of all materials, apparatus and equipment used or installed by
CONTRACTOR or by any subcontractor or supplier in the project which is the subject of this
Contract, unless a lesser quality is expressly authorized in the Plans and Specifications, in which
event CONTRACTOR unqualifiedly guazantees 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, appazatus or
equipment, whether latent or patent, revealed to CITY within one (1) yeaz of the date of
acceptance of completion of this Contract by C:[TY, CONTRACTOR will forthwith remedy such
defects without cost to CITY.
Contract Page 5 of 16
the Contract, the
alternates chose deferred s~Ai~ DEFLECTION
future, none, The City reserves the
n would be for arty sites cu any °r ~ alternate bid ite might for the terra of
rTently under construction ms at the bid price. The
IN ~TNESS °r to be constructed in the
Year Srst hereinabovW~~OF' the parties have
Witten. eXF'cuted this Contract
in duplicate, the day and
CITY OF CT ~D Tr ~--,
By:
/jig
CI MANAGER _
Attest: ~
City C erk
Date: ~~
City Clerk ~aO°~
---~~
c~ONTRACTOR:
t;S/,
-~
Notary acknowled
corporation, co grnent is required. If a
not~iry acknowledorate seal and
I.D. gnent and Feder T ate
are required. If not a co ~
Soci;~ Security No is re rP°ration a
quired.
Socia! Secu ~ #
Contractor's License No.
7329~3
PROJECT NAME & NUMBER PA,~'EMEN
CONTRACTOR'S NAME & DRESS: S T RESTO~TION, PROJECT NO. 2000-10
1LICpN 1
CONTRACT AMOUNT: 564,049.39
ACCOUNT NUMBER; 270-8404-7016
FILE Np; 94,493.64
812 ~'• gom~~ EY PAVl7vG, INC,
San Jose, CA 95126
Phone: 408-286-9101
Contact Page 6 o f 16
a~ ---
© 1996 National Notary Association • 823fi Remmet Ave.. P.O. Box 7184 • Canoga Park. CA 913va-, .
77•p~~~~ 4
Federal Tax I D #
ree 1-800-876-6827
INSURANCE FORrvIS INSTRUCTIONS
FOR ITEMS 3, 4, 5 AND 6, THE FORMS PROVIDED BY THE CITY OF CUPERTINO
MUST BE USED. FORMS OTHER THAN 'GREBE 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 Cupertino -must be completed by the insurance
agent or must provide a certificate on the company's form. 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 :>igned by the insurance agent for general liability
and automobile liability only.
5. Comprehensive general liability/commercial f;eneral liability endorsement of aggregate limits of
insurance per project -must be signed by the in:~urance 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 -must be signed by the insurance agent or must be
on the company's certificate of insurance form for all insurances.
Contract Page 7 of 16
C3tp of
Cupertino
INSURANCE AGREEMENT
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 of 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 arr~ounts 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 satisfactory to the City for all operations, sub-contract work, contractual
obligations, product or completed operations, all owned vehicles and non-owned vehicles. Said
insurance coverage obtained by the Contractor, excepting worker's compensation coverage, shall ~,
name the City, its engineer, and each of it:; 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 rating of at least Class VII in accordance with the current Best's Guide Rating.
D. Before Contractor performs any work at, or prepazes or delivers materials to, the site of
construction, Contractor shall furnish certificates of 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 fizlly 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 obligations of Contractor with respect to the foregoing, Contractor shall maintain
in full force and effect during the life of this Co~itract, 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
Contract Page 8 of 16
Act of the State of California - $1,000,000 per
occurrence.
Public Liability -either commercial general liability Combined single limit of $1.0 million per
or comprehensive general liability; including occurrence; $2.0 million in the aggregate.
provisions for contractual liability, personal injury,
independent contractors and property damage
coverages.
Automobile Liability -comprehensive covering
owned, non-owned and hired automobiles.
Consultants only: Errors and Omissions liability.
cSlL/CON V'~G1.~Y /~i~V/~J~, ~iJC•
(Contractor's Name)
By:
Combined single limit of $1.0 million per
Dared: f~-~12.lL /S SOD
Contract Page 9 of 16
occurrence.
,;::.
ACORD
7~ ~F
~ERT
~~I
~
"" ~ ~~~ I' DATE (MM/DD/YY)
~N~U~~NGE '
L~R~L~1~Y
,M
,
>
L
;
;:.
;;:: _
4/1100
_.... .
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Aon Risk Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
of Northern California ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
99 Almaden Blvd. , Ste. 400 COMPANIES AFFORDING COVERAGE
San Jose, CA 95113-1604 COMPANY
408-288-8000 _ A Admiral Insurance Com an
INSURED
Silicon Valley Paving, Inc. ~-~~~-~#~ ~~~~~s COMPANY
B Hartford Fire Ins Com an
P.O. BOX 26558 COMPANY
San Jose, CA 95159 ~}"~~ ~ ,~ ~QO~ C
COMPANY
D State Com ensation Ins Fund
`C(JVERQ+~~S
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HP.VE 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 IN SURANCE 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.
CO
LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE
CATE (MM/DD/YY) POLICY EXPIRATION
DATE (MM/DD/YY) LIMITS
GEN ERAL LIABILITY GENERAL AGGREGATE S 2000000
A X COMMERCIAL GENERALLIARILITY AOOAG08360 3~20~00 3~20~01 PRODUCTS-COMP/OPAGG 5 2000000
CLAIMS MADE X^ OCCUR PERSONAL & ADV INJURY S lOOOOOO
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE S 1000000
FIRE DAMAGE (Any one fire) S 100000
MED EXP (Any one person) S 5000
AUT OMOBILE LIABILITY
COMBINED SINGLE LIMIT
S
$ X ANY AUTO 57UUNIF9109 3~20~00 3~20~Q1 1000000
ALL OWNED AUTOS BODILY INJURY
S
SCHEDULED AUTOS
(Per person)
][ HIRED AUTOS BODILY INJURY
S
$ NON-OWNED AUTOS (Per accident)
P
RTY DAMAGE S
PRO
E
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT S
AGGREGATE S
EXCESS LIABILITY EACH OCCURRENCE S
UMBRELLA FORM AGGREGATE S
OTHER THAN UMBRELLA FORM S
WC STATU- OTH-
WORKERS COMPENSATION AND TORY LIMITS ER
D EMPLOYERS'LIABILITY 154079600 3/20/00 3/20/01 EL EACH ACCIDENT s 1000000
THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT S lOOOOOO
PARTNERS/EXECUTIVE
OFFICERS ARE:
EXCL
EL DISEASE- EA EMPLOYEE
S lOOOOOO
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Re: Pavement Restoration, Project No. 2000-101.
C>=RT.[£~GATE HQL~JER CANC£LkATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Clty of Cupertino, City Hall EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn: Carmen Lynaugh 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
10300 Torre Avenue BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Cupertino, CA 95014-3255 OF NY KIND UPON THE COMPAN , ITS AGENTS OR REPRESENTATIVES.
AUTH 1 P E TATIVE ~~ 005431000
'
;~~c~~~ zs s ~:~ts~r :~~~wc~~aTloro ~~~s
o.aGC~~~:
POLICY NUMBER: AOOAG08360
Silicon Valley Paving, Inc.
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -OWNERS, LESSEES OR
CONTRACTOI~S (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVER,4GE PART.
Name of Person or Organization:
SCHEDULE
The Ciry of Cupertino ("City")and its directors,
officers, engineers, agents and employees, and
all public agencies from whom permits will be RE:: Pavement Restoration
obtained and their directors, officers, engineers, Project No. 2000-101
agents and employees
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarationsas applicableto this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in
the Schedule, but only with respect to liability arising of "~~ourwork" for that insured by or for you.
Such insurance as is afforded by the General Liability policy is primary insurance and no other
insurance of the additional insured will be called upon to contribute to a loss.
CG 20 10 11 85
Copyright, Insurance Servia:s Office, Inc., 1984
STATE
COMPENSATION
I N S U R A N C E
~u ni v
P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807
CERTIFICATE OF WORKERS' COMMPENSATION INSURANCE
~: ~t ~.~x f ~~-r~a ;~t3
L_
POLICY NUMBER: j,:'f'= ~3'-,-_f;{1
CERTIFICATE EXPIRES:(F'j..~,^f.',•--t ~.
RECEIVED
000
APR I 1 2 .:;:~~ . ~:L ~.,...~~ ~~~~> >~~,: , ~ ~.... _f~.,:
~~:
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the poli`;y period indicated.
This policy is not subject to cancellation by the Fund except upon tt~ days' advance written notice to the employer.
`t )
We will also give you :LFN days' advance notice should this policy b.' cancelled prior to its normal expiration.
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 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 conditio is of such policies.
i~~/~~~~
AUTHORIZED REPRESENTATIVE
~~~~
PRESIDENT
,., Y
:~ ..~; ~ ~ T°rl ~~ ) ~t t
ii. :) .'~..3 _. .. ,.1 _. ~, i .iw .;~~.i~~ i ~,.-...''. _' ('{~.~,r .. y o'j~.i. I~; :~:~. f9 .~. .5.,~~.~V~~~..
n„ ,_. .
.. .. ,... ;.:. .. '. t.~Jf).i i:.. i. '... ?_:'•i) ~~lii .. ?: L~~i.. ~}, I-, li...~;_. ,~,y ~r(1Yi~.. i, ..I ~f. ,.,1 V~
~ ? t 7
~~lt)():~iy~LfFA.r't+ ?4".~t'~ I~h,'il~. ,l.... ~~.L' ~r~ (}y '~}i.l'.?ti~`~i..)'r ..t+'''~'+tiu'!r
il4 'i :. .F1!~ J rq{+.~rCE~t;. ~}!,.ti j~'(3 <t it ..) i(l ~'{.r,,r -~ .'~"t.. (fr Via. .. ~ ~:_r~_ ,
EMPLOYER
x
;'~
®.,<
P:~J
City of
Cupertino
ENDORSEMEr1T OF PRIMARY 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 i;
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: Admiral Insurance Company
2. Insurance Policy Number: aooAC0836o
3. Effective Date of this Endorsement: A~~ril 7 ~ 2000
4. Insured: Silicon Valley Paving, Inc.
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; C~ipertino, California 95014.
I Susan Stovall (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:~,~~/~[ ~~~~/y) r,~ `~ ,.~'~ i~~
(Original signature required on all Endor;;ements furnished to the District)
[Name of
Agent/Agency: Aon Risk Services, Inc of No. Ca Title: Account Manager
Address: 99 Almaden Blvd., Ste. 400
San Jose, CA 95113-1604
Telephone: (408) 534-6337
Facsimile: (408) 534-6330
Contract Page 12 of 16
City of
Cupertino
ADDITIONAL IN;iURED 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:
The City of Cupertino ("Cit}~') and its directors, off cers, engineers, agents and employees,
and all public agencies from whom permits will be obtained and their directors, officers, engineers,
agents and employees are hereby declazed 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 omissions of the additional insureds
in connection with, but limited to its general supervision or inspection of said operations.
POLICY INFORMATION
1. Insurance Company: Admiral Insurance Company
2. Insurance Policy Number: AooAG08360
3. Effective Date of this Endorsement: E~pril 7
~~ 2
4. Insured: Silicon Valley Paving, Iric
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, Califonua 95014.
I~ Susan Stovall (printltype name)
warrant that I have authority to bind the belov~~ 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)
Vames of
Agent/Agency: Aon Risk Services, Inc. o:E No Ca Title: Account Manager
address: 99 Almaden Blvd., Ste. 400
San Jose, CA 95113-1604
Telephone: (408) 534-6337
Facsimile: (408) 534-6330
Contract Page 13 of 16
City of
Cupertino
COMPREHENSIVE: GENERAL LIABILITY
CONIlVIERCIAL (JENERAL LIABILITY
ENDORSEMENT OF AGGREGATE LIlVIITS OF INSURANCE PER PROJECT
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:
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 (~F INSURANCE applies separately to the project
described as Pavement Restoration, Project No. 2000-101
POLICY INFORMATION
Insurance Company: Admiral Insurance Company
2. Insurance Policy Number: AooAG08360
3. Effective Date of this Endorsement: April 7
4. Insured: Silicon Valley Paving, Inc
x~ 2000
5. Additional Insured: City of Cupertino, its directors, officers, agents and employees.
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~ Susan Stovall (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:__ ~~~~~~~~C/~~ ,~,'(~ ~ .~~J ~I
(Original signature required on all Endorsements furnished to the District) ~~
Names of
Agent/Agency: Aon Risk Services, Inc. of No Ca Tltle: Account Manager
Address: 99 Almaden Blvd., Ste. 400 Telephone: 408 534-6337
San Jose, CA 95113-1604 Facsimile: (408) 534-6330
Contract Page 14 of 16
~~ ~
Cupertino
WAIVER OF SUBROGATION ENDORSEMENT
WORKER'S COMPENSATION INSURANCE
In consideration of the ~po~ cy 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 insurance as is afforded by the policy, the Insurance
Company waives any right of subrogation it m:iy require against the City of Cupertino, and each
of its directors, officers, agents, consultants grid 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
1. Insurance Company: State Compensation Ins Fund
2. Insurance Policy Number: 154079600
3. Effective Date of this Endorsement: April 7
~~- 20
4. Insured: Silicon Valley Paving, Inc
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.
j Susan stovail (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: ~~~1 ,,~~/( ~ l~~ ~~~
(Original signature required on all EndorsemE:nts furnished to the District)
Names of
Agent/Agericy: Aon Risk Services, Inc. oi_ No Ca
AddcesS: 99 Almaden Blvd., Ste. 400
San Jose, CA 95113-1604
Title: Account Manager
Telephone: (408) 534-6337
Facsimile: (408) 534-6330
Contract Page 15 of 16
City of
Cupertino
NOTICE OF POLICY
CANCELLATION ENDORSEMENT
In consideration of the policy premium and notwithstanding any inconsistent statement in
the policy to which this Endorsement is attache;d 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 lunits, 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. only ten (1(
days notice will be given for non payment of premium.
'',POLICY INFORMATION
1. Insurance Company: Admiral Ins Co/Hartford Fire Ins Co/State Compensation I
2. Insurance Policy Number: Ao0AG08360/57UUNIF9109/ 154079600
3. Effective Date of this Endorsement: April 7 }fit 20
4. Insured: Silicon Valley Paving, Inc
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, Susan Stovall (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: ~ ~~~~~ ~ / i'~~
-~
(Original signature required on all Endorsements furnished to the District)
[Names of
Agent/Agency: Aon Risk Services, Inc. oi: No Ca
Address: 99 Almaden Blvd. , Ste. 400
San Jose, CA 95113-1604
Title: Account Manager
Telephone: (408) 534-6337
Facsimile: (408) 534-6330
Fund
Contract Pagf; 16 of 16