06-013, Pavement Engineering Inc.
AGREEMENT
BY THIS AGREEMENT, made and entered into this 1fh day of December, 2005~ by and between the CITY OF
CUPERTINO (Hereinafter referred to as CITY) and Pavement Engineering Inc.; Address; 1391 Relfd Stree', $",ite ) I.IJ
-B;- Petaluma, CA 94954; Phone 707-769-5330; Contact: Mike Wasden; e-mail: mikew@pavengr.com ~
(Hereinafter referred as CONTRACTOR), in consideration of their mutual covenants, the parties hereto agree as 0
follows: n
CONTRACTOR shall provide or furnish the following specified services and/or materials: Preparation of Contract ~
Documents for 2006 STP Overlay Project a
CD
CD
CITY OF CUPERTINO
10300 Torre Avenue
Cupertino, CA 95014
408-777 -3200
NOIlnZJ s-4? ->7
EXHIBITS: The following attached exhibits hereby are made part of this Agreement: Exhibit "A" proposal
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TERMS: The services and/or materials furnished under this Agreement shall commence on December 19, 2005
and shall be completed before May 31, 2006.
COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR: Not to Exceed
$33,335.00 and in accordance with the proposal
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California Labor Code, Section 1771 requires the payment of prevailing wages to all workers employed on a Public Works contract in excess of
$1,000.00.
GENERAL TERMS AND CONDITIONS
Hold Hannless. Contractor agrees to save and hold harmless the City, its officers, agents and employees from any and all damage and liability due
to negligence, errors and omissions, including all costs of defending any claim, caused by or arising out of the performance of this Agreement. City
shall not be liable for acts of Contractor in performing services described herein.
Insurance. Should the City require evidence of insurability, Contractor shall file with City a Certificate of Insurance before commencing any services
under this Agreement. Said Certificate shall be subject to the approval of City's Director of Administrative Services.
Non-Discrimination. No discrimination shall be made in the employment of persons under this Agreement because of the race, color, national
origin, ancestry, religion or sex of such person.
Interest of Contractor. It is understood and agreed that this Agreement is not a contract of employment in the sense that the relationship of master
and servant exists between City and undersigned. At all times, Contractor shall be deemed to be an independent contractor and Contractor is not
authorized to bind the City to any contracts or other obligations in executing this agreement. Contractor certifies that no one who has or will have
any financial interest under this Agreement is an officer or employee of City.
Changes. This Agreement shall not be assigned or transferred without the written consent of the City.
authorized without the written consent of the City.
CONTRACT CO-ORDINATOR and representative for CITY shall be:
No changes or variations of any kind are
JEJ ENTERED
NAME: Glenn Goepfert
DEPARTMENT: Public Works Department
This Agreement shall become effective upon its execution by CITY, in witness thereof, the parties have executed this
Agreement the day and year first written above.
::NT,Z::3t &'-
Title President
Soc. Sec. # or Tax I.D. 68-0461866
:~~~RTINOG .
Title: Glenn Goepfert, AsSt~r1<S
EXPENDITURE DISTRIBUTION
$33,335.00.
ACOl1Dm CERTIFICATE OF LIABILITY INSURANCE OP ID D~ DATE (MMlDD1YYYY)
PAVEM-1 06/17/05
I'RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Don Ramatici Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 551 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Peta1uma CA 94953
P>- '1e:707-782-9200 Fax:707-782-9300 INSURERS AFFORDING COVERAGE NAIC#
f-'
IN. .0 INSURER A: Transportation Ins. Co.
INSURER B: Amer. Casualty Co. Reading PA
Pavement En~ineering( Inc. INSURER C:
1301 Rand S reet, Su~te D INSURER 0:
Peta1uma CA 94954-1196
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'1'0,,1< NSRI: POLICY NUMBER ~o.LI<;l~ EFFEg~E POllCYrrXPIRAT~N LIMITS
LTR TYPE OF INSURANCE DATE MMlDDNY DATE MMlDDNY
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
---, 06/17/06 UAMAbl:; rv -(l:;N 'l:;U
A X X COMMERCIAL GENERAL LIABILITY TCP2072368648 06/17/05 PREMISES (Ea occurence) $ 100,000
- =:J CLAIMS MADE [!] OCCUR
MED EXP (Anyone person) $ 5,000
I--
PERSONAL & ADV INJURY $1,000,000
I--
GENERAL AGGREGATE $2,000,000
I--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
II n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
I-- $1,000,000
B X ANY AUTO BUA2072368651 06/17/05 06/17/06 (Ea accident)
I--
ALL OWNED AUTOS BODILY INJURY
I-- (Per person) $
SCHEDULED AUTOS
r--
~ HIRED AUTOS BODILY INJURY
(Per accident) $
X NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
-
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS1UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
A ~ OCCUR D CLAIMS MADE CUP2067044828 06/17/05 06/17/06 AGGREGATE $1,000,000
$
::l DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND I TORY lIMm31 IUJ~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETORlPARTNERlEXECUTIVE
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes. describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
Re: Operations of the Named Insured for the Certificate Holder
*10 day notice will be sent on the nonpayment of premium
30*G140331-A99 10/01
CERTIFICATE HOLDER
CANCELLATION
CUPERTI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Cupertino
City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
RD CORPORATION 1988
ACORD 25 (2001/08)
G- ]4033] -A99
(Ed. ] 0/1 )
CNA
For All Commitments You Make*
IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE
ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT.
SEE PARAGRAPH c.t. OF THIS ENDORSEMENT FOR THESE DUTIES.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED
ENDORSEMENT WITH PRODUCTS - COMPLETED OPERATIONS COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Designated Project:
City of Cupertino
(Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.)
A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization, including
any person or organization shown in the schedule above, (called additional insured) whom you are required to add as
an additional insured on this policy under a written contract or written agreement; but the written contract or written
agreement must be:
1. Currently in effect or becoming effective during the term of this policy; and
2. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury."
B. The insurance provided to the additional insured is limited as follows:
1. That person or organization is an additional insured solely for liability due to your negligence and
specifically resulting from "your work" for the additional insured which is the subject of the written contract
or written agreement. No coverage applies to liability resulting from the sole negligence of the additional
insured.
2. The Limits of Insurance applicable to the additional insured are those specified in the written contract or
written agreement or in the Declarations of this policy, whichever is less. These Limits ofInsurance are
inclusive of, and not in addition to, the Limits of Insurance shown in the Declarations.
3. The coverage provided to the additional insured by this endorsement and paragraph f. of the definition of
"insured contract" under DEFINITIONS (Section V) do not apply to "bodily injury" or "property damage"
arising out of the "products-completed operations hazard" unless required by the written contract or written
agreement.
4. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or
"personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or
failure to render any professional services including:
a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions,
reports, surveys, field orders, change orders or drawings and specifications; and
b. Supervisory, or inspection activities performed as part of any related architectural or engineering
activities.
G-]4033]-A99
(Ed. 10/0])
G- ]4033] -A99
(Ed. ] 0/])
C. As respects the coverage provided under this endorsement, SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS are amended as follows:
1. The following is added to the Duties In The Event of Occurrence, Offense, Claim or Suit Condition:
e. An additional insured under this endorsement will as soon as practicable:
(1) Give written notice of an occurrence or an offense to us which may result in a claim or
"suit" under this insurance;
(2) Tender the defense and indemnity of any claim or "suit" to us for a loss we cover under
this Coverage Part;
(3) Tender the defense and indemnity of any claim or "suit" to any other insurer which also
has insurance for a loss we cover under this Coverage Part; and
(4) Agree to make available any other insurance which the additional insured has for a loss
we cover under this Coverage Part.
f. We have no duty to defend or indemnify an additional insured under this endorsement until we
receive written notice of a claim or "suit" from the additional insured.
1. Paragraph 4.b. of the Other Insurance Condition is deleted and replaced with the following:
4. Other Insurance
b. Excess Insurance
This insurance is excess over any other insurance naming the additional insured as an
insured whether primary, excess, contingent or on any other basis unless a written contract
or written agreement specifically requires that this insurance be either primary or primary
and noncontributing to the additional insured's own coverage. This insurance is excess
over any other insurance to which the additional insured has been added as an additional
insured by endorsement.
When this insurance is excess, we will have no duty under Coverages A or B to defend the
additional insured against any" suit" if any other insurer has a duty to defend the additional
insured against that "suit." Ifno other insurer defends, we will undertake to do so, but we
will be entitled to the additional insured's rights against all those other insurers.
When this insurance is excess over other insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the sum of:
(1) The total amount that all such other insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-insured amounts under all that other
insurance.
We will share the remaining loss, if any, with any other insurance that is not described in
this Excess Insurance provision and was not bought specifically to apply in excess of the
Limits of Insurance shown in the Declarations of this Coverage Part.
G-]4033]-A99
(Ed. 10/0])
NC
POLICYHOLDER COpy
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 07 -0 1- 2005
GROUP: 000092
POLICY NUMBER: 0000292-2005
CERTIFICATE 10: 331
CERTIFICATE EXPIRES: 07-01-2006
07-01~2005/07-01-2006
CITY OF CUPERTINO
10}OOTORRE AVENUE
CUPERTINO CA 95014
NC
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 policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer.
We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration.
This certiftcate 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 V\(hich 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.
~
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AUTHORIZEDREPRESENTA TIVE PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
ENDDRSEMENT#2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2005 IS ATTACHED TO AND
FORMS A PART OF THIS POLICY.
EMPLOYER
LEGAL NAME
PAVEMENT ENGINEERING INC
1301 RAND ST STE>D
PETALUMA CA 94954
PAYEMENT ENGINEERING, INC
(REV.3-03)
PRINTED: 06/17/2005 P0410
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10265
ACORDN CERTIFICATE OF LIABILITY INSURANCE OP ID D~ DATE (MMlDD1YYYY)
PAVEM-1 08/16/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Don Ramatici Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 551 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
T '1luma CA 94953
... "ne:707-782-9200 Fax:707-782-9300 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Admiral Insurance CO.
INSURER B:
Pavement En~ineering( Inc. INSURER C:
1301 Rand S reet, SU1te D INSURER 0:
Petaluma CA 94954-1196
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PD~~~lJ~JIf~E P~k~CEY(~b~~~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
- ~~~~;SEs (Ea occurence)
COMMERCIAL GENERAL LIABILITY $
-.J CLAIMS MADE D OCCUR MED EXP (Anyone person) $
-
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
-
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I T8'~v"'~I~:f'S I IU~~-
EMPLOYERS' LIABILITY
ANY PROPRIETORlPARTNERlEXECUTIVE E.L EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
A Professional Liab. EOOOOOO028207 08/05/05 08/05/06 Limit ** $2,000,000
Ded** $10,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
**Limit: $2,000,000/aggregrate & $2,000,000/claim, Deductible: $10,000/claim
JOB: City of Cupertino Annual Overlay Project.
***City of Cupertino, Its Engineers,Agents & Employees as determined by the
city
10
CERTIFICATE HOLDER
CANCELLATION
CUPERTI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Cupertino***
10300 Torre Avenue
Cupertino, CA 95014-3255
RD CORPORATION 1988
ACORD 25 (2001/08)