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HomeMy WebLinkAboutCleary Consultants, Inc. (4) V J AGREEMENT THIS AGREEMENT is made and entered into on the(Sr day of A1450St , 2017 by and between the TOWN OF LOS ALTOS HILLS (hereinafter referred to as "TOWN") and Cleary Consultants, Inc., (hereinafter referred to as "CONTRACTOR"). In consideration of their mutual covenants, the parties hereto agree as follows: 1. CONTRACTOR. Shall provide or furnish the following specified services and/or materials: Provide soil engineering obsevation and testing services for the 2017 Sanitary Sewer Repair and Replacement Project 2. EXHIBITS. The following attached exhibits are hereby incorporated into and made a part of this Agreement: Proposal from CONTRACTOR dated July 28, 2017 3. TERMS. The services and/or materials furnished under this Agreement shall commence 08/01/17 and shall be completed by 12/31/17, unless terminated pursuant to Section 5(f). 4. COMPENSATION. For the full performance of this Agreement: a. TOWN shall pay CONTRACTOR an amount not to exceed eight thousand dollars and zero cents ($8,000) within thirty (30) days following receipt of invoice and completion/delivery of services/goods as detailed in Sections 1, 2, and 3 of this Agreement and only upon satisfactory delivery/completion of goods/services in a manner consistent with professional/industry standards for the area in which CONTRACTOR operates. TOWN is not responsible for paying for any work done by CONTRACTOR or any subcontractor above and beyond the not to exceed amount. b. Town shall not reimburse for any of CONTRACTOR's costs or expenses to deliver any services/goods. Town shall not be responsible for any interest or late charges on any payments from Town to CONTRACTOR. c. CONTRACTOR is responsible for monitoring its own forces/employees/agents/ subcontractors to ensure delivery of goods/services within the terms of this Agreement. TOWN will not accept or compensate CONTRACTOR for incomplete goods/services. Town of Los Altos Hills Page 1 of 4 Short form Updated 4/23/10 V 5. GENERAL TERMS AND CONDITIONS. a. HOLD HARMLESS. CONTRACTOR agrees to indemnify, defend and hold harmless the TOWN, its officers, agents and employees from any and all demands, claims or liability of personal injury (including death) and property damage of any nature, caused by or arising out of the performance of CONTRACTOR under this Agreement. With regard to CONTRACTOR'S work product, CONTRACTOR agrees to indemnify, defend and hold harmless the TOWN, its officers, agents and employees from any and all demands, claims or liability of any nature to the extent caused by the negligent performance of CONTRACTOR under this Agreement. b. INSURANCE. CONTRACTOR shall file with the TOWN a certificate of insurance before commencing any services under this Agreement as follows: i. WORKERS COMPENSATION INSURANCE: Minimum statutory limits. H. COMMERCIAL GENERAL LIABILITY AND PROPERTY DAMAGE INSURANCE: General Liability and Property Damage Combined. $1,000,000.00 per occurrence including comprehensive form, personal injury, broad form personal damage, contractual and premises/operation, all on an occurrence basis. If an aggregate limit exists, it shall apply separately or be no less than two (2) times the occurrence limit. iii. AUTOMOBILE INSURANCE: $1,000,000.00 per occurrence. iv. ERRORS AND OMISSIONS INSURANCE: $1,000,000.00 aggregate. v. NOTICE OF CANCELLATION: The City requires 30 days written notice of cancellation. Additionally, the notice statement on the certificate should not include the wording "endeavor to" or "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives." vi. CERTIFICATE OF INSURANCE: Prior to commencement of services, evidence of insurance coverage must be shown by a properly executed certificate of insurance and it shall name "The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers" as additional insureds. vii. To prevent delay and ensure compliance with this Agreement, the insurance certificates and endorsements must be submitted to: Town of Los Altos Hills 26379 Fremont Road Town of Los Altos Hills Page 2 of 4 Shwm� Updated 4123/10 40) Los Altos Hills, CA 94022 c. NON-DISCRIMINATION. No discrimination shall be made in the employment of persons under this Agreement because of the race, color, national origin, age, ancestry, religion or sex of such person. d. INTEREST OF CONTRACTOR. It is understood and agreed that this Agreement is not a contract of employment and does not create an employer-employee relationship between the TOWN and CONTRACTOR. At all times CONTRACTOR shall be an independent contractor and CONTRACTOR is not authorized to bind the TOWN to any contracts or other obligations without the express written consent of the TOWN. 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 TOWN. e. CHANGES. This Agreement shall not be assigned or transferred without advance written consent of the TOWN. No changes or variations of any kind are authorized without the written consent of the City Manager. This Agreement may only be amended by a written instrument signed by both parties. f. TERMINATION. This Agreement may be terminated by TOWN upon seven (7) days written notice to CONTRACTOR. Monies owed for work satisfactorily completed shall be paid to CONTRACTOR within 14 days of termination. g. RECORDS. All reports, data, maps, models, charts, studies, surveys, calculations, photographs, memoranda, plans, studies, specifications, records, files, or any other documents or materials, in electronic or any other form, that are prepared or obtained pursuant to this Agreement and that relate to the matters covered hereunder shall be the property of the TOWN. CONTRACTOR hereby agrees to deliver those documents to the TOWN at any time upon demand of the TOWN. It is understood and agreed that the documents and other materials, including but not limited to those described above, prepared pursuant to this Agreement are prepared specifically for the TOWN and are not necessarily suitable for any future or other use. Failure by CONTRACTOR to deliver these documents to the TOWN within a reasonable time period or as specified by the TOWN shall be a material breach of this Agreement. TOWN and CONTRACTOR agree that until final approval by TOWN, all data, plans, specifications, reports and other documents are preliminary drafts not kept by the TOWN in the ordinary course of business and will not be disclosed to third parties without prior written consent of both parties. All work products submitted to the TOWN pursuant to this Agreement shall be deemed a "work for hire." Upon submission of any work for hire pursuant to this Agreement, and acceptance by the TOWN as complete, non-exclusive title to copyright of said work for hire shall transfer to the TOWN. The compensation recited in Section 4 shall be deemed to be sufficient consideration for said transfer of copyright. CONTRACTOR retains the right to use any project records, documents and materials for marketing of their professional services. Town of Los Altos Hills Page 3 of 4 Short form Updated 4123/10 h. ENTIRE AGREEMENT. This Agreement represents the entire agreement between the Parties. Any ambiguities or disputed terms between this Agreement and any attached Exhibits shall be interpreted according to the language in this Agreement and not the Exhibits. 6. INVOICING. Send all invoices to the contract coordinator at the address below. This Agreement shall become effective upon its approval and execution by TOWN. In witness whereof, the parties have executed this Agreement the day and year first written above. CONTRACT COORDINATOR and representative for TOWN: CONTRACTOR: Allen Chen Public Works Director Town of Los Altos Hills By: WV/7 26379 Fremont Road Sign re Date Los Altos Hills, CA 94022 firtalr /=-ruse_, V- P. Print name, Title TOWN OF FLOS ALTOS HILLS: By: (406,01200 �/ Carl Cahill, City Manager Da Town of Los Altos Hills Page 4 of 4 Short form Updaiea 4/23110 pp V Form W'�7 Request for Taxpayer Give Form to the (Rev.December 2014) identification Number and Certification requester.Do not Deparanent o tth°T�r� send to the IRS. Internal 1 Name(as shown onyour income tax return).Name w required on this lire;do not leave this line blank. Cleary Consultants ,Inc. N 2 Business namardaegarded entity name.If different from above a c 3 Check appropriate box for federal tax dassifi ation:check only one of the following seven boxes: 4 Exemptions(codes apply onto certain entities.not Individuals:see 0 IndMNduaysole proprietor or ® C Corporetbn ❑S Corporation 0 Paibwrstlip D 110-1stfestete instructions on page 31: m c single-member LLC g,2 ❑Umked liability company.Enter the tax classiflwtion(C=C corporation,S=S corporation,P=pannerehip)F Exempt payee code litany) `ora Note.For a single-member LLC that is disregarded,do not check LLC;check the appropriate box in the line above for Exemption from FATCA reporting `[ e the tax classllcatlon of the single-member owner. code(if and I p ❑Other(see lnsWctle Ow ons) rcromennb mildewoxw mis9 5 Address(number,sweet.and apt or suits no.) • Requesters name and address(option) 560 Division Street 6 City.state,and ZIP code 8 Campbell, California 95008 T List account number(s)here(optivnep ken Taxpayer Identification Number(TIN) Enter your TIN in The appropriate box.The TIN provided must match the name given on line I to avoid I Social security number backup withholding.For individuals,this is generally your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Part I'Instructions on page 3.For other - - entities,it is your employer identification number(LIN).If you do not have a number,see How to get a 77N on page 3. or Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for Employer Identification number guidelines on whose number to enter. 9 4 - 2 6 8 6 6 0 9 ling Certification Under penalties of perjury,I certify that: 1. The number shown on this form Is my correct taxpayer identification number(or I am waiting for a number to be Issued to me);and 2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not bean notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of afailure to report all Interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3. I am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form Of any)Indicating that I am exempt from FATCA reporting Is correct. Certification instructions.You must cross out item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed 10 report all Interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage Interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 3. Sign Signature of gi Here us.person r- Dates 3// 7 General lnstruc ons n fir'10913(home mortgage interest),1098-E(student loan Interest),1098-T Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-C(canceled debt) Future developments.Information about developments affecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured as legislation enacted after we released)is at www.irs gov/Tw9. property) Use Form W-9 only If you we a U.S.person(including a resident alien),to Purpose of Form provide your correct 11N. An Individual or entity(Form W-9 requester)who Is required to file an information If you do not retum ROM W-9 to the requester with a TIN,you might be subject ream with the IRS must obtain your correct taxpayer Identification number m to backup withholding.See What is backup withholding?on page 2. which may be your social security number(SSN),Individual taxpayer Identification By signing the flied-mit form,you: number(rt1M.adoption taxpayer ltlemtlflradon number QATlM.or employer I.Certify that the TIN you are giving is correct(or you are waiting for a number Identification number(EIN) to report on an Information return the amount paid to to be issued), you,or other amount reportable on an Information return.Examples of infornaton returns Include,but am not limited to,the following: 2.Certify that you are not subject to backup withholding.or •Form 1099-I13ff(interest earned or pai ) 3.Claim exemption from backup withholding If you am a U.S.exempt payee.if •Form 1099-nn)(dividends,Including those from stocks or mutual funds) applicable,you am also certifying that as a U.S.person,your allocable share of any partnership Income from aU.s.share or business s not subject to the •Form 1099-MISC(various types of Income,prizes,awards,or gross proceeds) tax on foreign partners'share of effectively connected Income,entl •Form 1099-B(stock or mutual fund sales and certain'other transactions by 4.Codify that FATCA code(s)entered on this form Of any)indicating that you are brokers) exempt from the FATCA reporting,is correct Sea What is FATCA reporting?on •Form 1099-s(proceeds from real estate transactions) page 2 for further information. •Form 1099-K(merchant card and third parry network transactions) Cat.No.10231X Fenn W-9(Rev.12-2014) 6 Short-form Agreement Instructions and Checklist Professional Services (unrelated to public protects): ❑ Obtain a detailed quotation from the qualified vendor/contractor. ❑ Determine availability of funds in the current budget— consult finance for appropriate budget number if necessary ❑ Request approval from the City Manager ❑ Complete the agreement template: o Section 1 — Detail the goods and/or services the vendor/contractor will provide to the Town. o Section 2—Attach the detailed quotation as an exhibit. o Section 3— Provide the contractor with a deadline to provide the goods/or services. If services are on-going, the contracts should expire no later than the end of the current fiscal year. A new contract will be prepared in June for the next fiscal year. ❑ Send the complete agreement, exhibit(s), to the contractor along with the standard transmittal memo and the IRS Form W-9 (included below). ❑ Contractor should return at least one signed original copy and a completed W-9 to the Town. If you receive the documents, please forward everything to finance. Public Works Projects: The California Labor Code beginning at section 1720 deals with this issue. Labor Code sections 1720 and 1771 define public works as work done under contract and paid for in whole or in part out of public funds that involves one or more of the following: Construction;Alteration, Demolition, Installation; Repair/ Maintenance work. Contractor shall comply with all prevailing wage laws, rules and regulations on public works projects. A complete definition may be found at: http://www.leoinfo.ca.ov/calaw.html. ❑ Submit a request for quotations to the Town's authorized vendor list for the services requested. Determine availability of funds in the current budget—consult finance for appropriate budget number if necessary ❑ Prepare a written recommendation to the City Manager to award the contract to the vendor whose bid is most advantageous to the Town with a compelling reason why the selected bid is most advantageous. 7 With City Manager approval, complete the agreement template: o Section 1 - Detail the goods and/or services the vendor/contractor will provide to the Town. o Section 2 —Attach the detailed quotation as an exhibit. o Section 3— Provide the contractor with a deadline. If services are on- going, the contracts should expire no later than the end of the current fiscal year. A new contract will be prepared in June for the next fiscal year. C Send the complete agreement, exhibit(s), to the contractor along with the standard transmittal memo and the IRS Form W-9 (included below). ❑ Contractor should return at least one signed original copy and a completed W-9 to the Town. If you receive the documents, please forward everything to finance. Exhibit M�' Christophe A. Clechanowski, President,GE CLEARY CONSULTANTS, INC. Grant F.Foster, Vice-President, GE Geotechnical Engineers and Geologists J.Michael Cleary,Principal, CEG, GE July 28, 2017 Ser. 5578 Ms. Tina Tseng, Senior Engineer, PE Los Altos Hills Town Hall Offices 26379 Fremont Road Los Altos Hills, CA 94022 RE: PROPOSAL FOR SOIL ENGINEERING SERVICES DURING CONSTRUCTION CIP REPLACEMENT PROJECT LOS ALTOS HILLS,CALIFORNIA Dear Ms. Tseng: Introduction As requested, we are submitting this proposal to provide soil engineering observation and testing services during the CIP Replacement project in Los Altos Hills, California. Based on discussion with Jen Chen of the Town,we understand the planned project will include the backfilling of 16 bore pits (5 feet by 5 feet) of varying depths with Class 2 aggregate baserock compacted to at least 95%relative compaction at eight sites in Los Altos Hills. You have estimated that we will be required for approximately 4 to 5 man-days(32 to 40 hours total)during the project for observation and testing of the baserock backfill. Scope of Services Based on the planned construction as described above, our scope of services for the project will include full time to intermittent on-site observation and field density testing as required during the baserock backfilling and compaction phases of the work. We estimate that one compaction curve on the baserock material will also be required in our lab at$250 each. Specific details of the contractor's schedule to complete the various phases of the work are not known, therefore we propose to provide our services on an hourly time and expense basis. 560 DIVISION STREET • CAMPBELL,CALIFORNIA 95008 • (650)948-0574 www.clearyconsultantsinc.com Ike Ms. Tina Tseng, Senior Engineer, PE Los Altos Hills Town Hall Offices July 28, 2017 Page 2 Arrangements Delays due to inclement weather, construction periods longer or shorter than those estimated, or reinspection/retesting of unsatisfactory work could result in an increase or decrease of our costs accordingly. Our field observation services including office supervision,and the necessary office and laboratory work, will be provided in accordance with the terms and rates of our Schedule of Fees and Conditions presented on the reverse side of the last page of this proposal. Usually, the cost of our services on the basis of full-time observation and testing during a normal eight-hour work day would be about $1100 per day, $550 per half-day, and $150 per site visit. Consultations and report preparation are billed in addition at the appropriate hourly rate. Our billings will be submitted monthly or upon completion of those phases of the work involving our services. Based on our understanding of your contractor's schedule to complete the above work, and as discussed with you, the estimated total cost for our geotechnical engineering services is $4,650 to $5,750. Our billings will be submitted monthly. All services rendered by us consist of professional opinions and recommendations made in accordance with generally accepted soil and foundation engineering principles and practices. This warranty is in lieu of all other warranties, either expressed or implied. Under no circumstances is it our intent to directly control the physical activities of the contractor or the contractor's workmen's accomplishment of work on this project. The presence of our field representative at the site is to provide the Town with a continuing source of professional advice, opinions, and recommendations based on the field representative's observation of the contractor's work and does not include any superintending, supervision, or direction of the actual work of the contractor or the contractor's workmen. Any construction review of the contractor's performance conducted by us is not intended to include and does not include review of the adequacy of the contractor's safety measures in,on,or near the job site. CLEARY CONSULTANTS, INC. V V Ms. Tina Tseng, Senior Engineer, PE Los Altos Hills Town Hall Offices July 28,2017 Page 3 As our authorization to provide the above services,please sign and return one copy of this proposal. Should you have any questions,please do not hesitate to call. Yours very truly, CLEARY CONSULTANTS, INC. Gran Foster Geotechnical Engineer 2662 GF:cm Copies: Addressee (email) AUTHORIZATION Approved By Date CLEARY CONSULTANTS, INC. 1/41 CLEARY CONSUL'TAN'TS INC SCHEDULE OF FEES AND CONDITIONS PERSONNEL CHARGES Administrative Assistant 60.00/hr Drafting/Laboratory 65.00/hr Senior Engineering Technician I15.00/hr StaffEngineer/Slaff Engineering Geologist 120.00/hr Project Engineer/Project Engineering Geologist 130.O11fin Associate Engineer/Aasociare Engineering Geologist 145.00/hr Principal $18000/hr• *Expert witness fees for appearance at court and depositions are II 800/day and$900 half day, There is a minimum of one-half day for all court and deposition appearances. EQUIPMENT/LABORATORY CHARGES Automobile $0.55/mile Mobile laboratory 5.00/hour Nuclear Moisture/Density Gauge 5.00/test Laboratory Compaction Curve,ASTM D1557 225.00/test DIR Certified Payroll Reporting 100.00/report Jd1SCEI LANEOUS CHARM'S Drilling services,printing and reproduction,special andconsultant fees,permits,insurance,equipment and vessel rental,travel and subsistence expenses and other similar related costs are billed at cost plus 15 percent.Copies of previously issued reports will be billed al$50.00 for the first copy and$25.00 for each additional copy,or at cost of reproduction for larger reports. STANDARD OF CARE ClearyConsultants,Inc.(CCI)under this Agreement will strive to conduct services in a manner consistent with that level of care andskill ordinarilyexereised bymembers of the profession currently practicing in the same locality under similar conditions. No other warranty,expressed or implied,is made. Client recognizes that subsurface conditions may vary from those encountered at the locations where our borings,surveys,or explorations are made and that our data, interpretations and recommendations are based solely on the information available to us.We will be responsible for those data,interpretations,and recommendations but shall not be responsible for Re interpretation by others of the information developed. RIGHT OF ENTRY TheClient shall provide for CCl's right ofentryand all our necessary equipment,in order to complete thework.While CCI shall take all reasonable precautions to minimize any damage to the property,it is understood by Client that in the normal course of work some damage may otter,the correction of which is not part of this Agreement. GENERAL LIABILITY INSURANCE CCI represents and warrents that itis protected by worker's compensation insurance and that we have such coverage under public liability and property damage insurance policies which we deem to be adequate. Certificates for all such policies of insurance shall be provided to Client upon request in writing. Within the limits and conditions of such insurance,we agree to indemnify and save Client harmless from and against any loss,damage,or liability arising from anynegligent acts byCCI and its staff.We shall not be responsible for any loss,damage or liability beyond the amounts,limits,and conditions of such insurance. We shall not be responsible for any loss,damage,or liability arising from anynegligent acts or willful misconduct of Client,its agents,staff,and other consultants employed byit. Certificates of our general liability insurance shall be provided upon request. UTE-TIPS In the prosecution of our work,CCI will lake all reasonable precautions to avoid damage or injury to subterranean structures orutilities. The owner agrees to waive any claim against CCI and to defend,indemnifyand hold CCI harmless from any claim or liability for injuryor loss allegedlyarising from COs damaging undergroundutilifies or other man-made objects that were not called to CCI's attention or which were not properly located on plans furnished to CCI. LIMITATION OF LIABILITY To the fullest extent permitted by law,and not withstanding any other provision of this agreement,the total liability,in the aggregate,of CCI and Its officers, directors,partners,employees,agents and subconsultants,and any of them,to the Client and anyone claiming by,through or under the Client,for any and all claims,losses,cosh or damages of any nature whatsoever arising out of,resulting from or In any way related to this project or the Agreement from any came or causes,including hut not limited to the negligence,professional errors or omissions,strict liability,breach of contract or warranty,express or implied,ofCCI or its officers,directors,employees,agents or subconsultants,or any of them,shall not exceed the total compensation received by CCI under this Agreement,or the total amount of$10,000,whichever is greater. P(SPUIES The parties to this Agreement covenant and agree that all claims,disputes and other matters in question between the parties to this Agreement,arising out of or relating to this Agreement or the breach thereof,shall be submitted to non-binding mediation prior to initiation ofany lawsuit or other litigation,unless the parties mutually agree otherwise. The cost of said Mediation shall be split equally between the parties. DISCOVERY OF UNANTICIPATED HAZARDOUS MATERIALS Hazardous materials or certain types of hazardous materials mayexist at a site where there is no reason to believe theycould or should be present. CCI and Client agree that the discovery of unanticipated hazardous materials constitutes a changed condition requiring a renegotiation of the scope of the work or termination of services. OWNERSHIP OF DOCUMENTS All reports,boring logs,field data,field notes,laboratory test data,calculations,estimates,andother documents prepared by CClm instruments of service,shall remainour property. Client agrees that all reports and other work furnished to the client or his agents,which is not paid for,will be returned upon demand and will not be used by the Client for any purpose whatever. THIRD PARTY BENEFICIARIES Nothing contained in this Agreement shall create a contractual relationship with or a cause of action in favor of a third party against either the Client or CCI. CCI's services under this Agreement are being performed solely for theClient'sbenefit,and no other entityshall have anyclaim against CCI because of this Agreement or theperformnce or nonperformance of services hereunder.The Client agrees to include a provision in all contracts with contractors and other entities involved in this project to carryout the intent of this paragraph. ASSIGNMENT Neither party to this Agreement shall transfer,sublet or assign anyrights under or interest in this Agreement(including but not limited to monies that are due or monies that may be due)without he prior written consent of the other party. INVOICES Invoices for cur services will be submitted,at our option,on a monthly basis or when the work is completed. Invoices will be due immediately,but will not be delinquent within 10 days from which the invoice is dated. If payment is not so made,a service charge will be due on the amount of the invoices at the maximum rete permissible by law from the date ofthe invoice until the same is paid. In the event legal action is required to enforce the payment terms of this agreement,CCI shall be entitled to collect from the client any judgement or settlement sums due plus reasonable attorneys'fees,court costs and other expenses incurred by CCI for such collection action. SAMPLES All samples of soil and rock will be disposed of from the laboratory30 days finer issuance of the report unless the Client advises otherwise. Upon request,we will deliver the samples to the Client,charges collect,or will store them for an agreed storage charge. Client#:71 LEARCONS • ACORD, CERTIFIMTE OF LIABILITY INSU CE DATE iMMNDMYY) 8/03/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.H SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Alison Muller Deaiey, Renton&Associates I T EM):510 465-3090 FAx P.O.Box 12675 EJIAIL (Ati;.No): 510 452-2193 Oakland,CA 94604-2675 Loam: amuller@dealeyrenton.com INSURER(S)AFFORDING COVERAGE XAICA 5104653090 INSURER A:Sentinel insurance Co.LTD 11000 INSURED INSURER B:American Automobile Ins.Co. 21849 Cleary Consultants,Inc. INSURER C:Berkley insurance Company 32603 560 Division Street Campbell,CA 95008 INSURER o: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUB M/ POLICY POLICY EXP LTR TYPE OF INSURANCE NSR VND POLICY NUMBER (MMIDDfYYYY) (MM00YY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 57SBWLV3866 08/22/2017 08/22/2018 EACHOCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR PREMISE SIEaSomw,Enancs) $1,000,000 MED EXP(Any one person( $10,000 PERSONAL&ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE $2,000,000 POLICY X JECRO- T LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER $ A AUTOMOBILE LIABILITY V Y 57SBWLV3866 08(22/201708/22/20182MBLNEo SINGLE LIMIT Included ANY AUTO BODILY INJURY(PeS. Person) ALL OWNED SCHEDULED BODILY INJUURYY(Pe,r accident( $ AUTOS AUTOS X HIRED AUTOS X NON-0WNEO PROPERTY DAMAGE AUTOS IPeram'Nenll f A j( UMBRELLA LIAB n OCCUR 57SBWLV3866 08/22/2017 08/22/2018 EACH OCCURRENCE s2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 OED X RETENTION 810,000 _ $ B WORKERS EMPLOYERS' Y WZP81039621 07/01/2017 07/0112016 X STATUTE ER AND EMPLOYERS'LABILITY ANY CER/MEMBEREXCLUDED? VTIVE YIX E.L.EACH ACCIDENT $1,000,000 (Mandatory EXCLUDED? N X/A Ity ,descybe NH) EL.DISEASE.EA EMPLOYEE 51,000,000 Ifyes, Fer DESCRIPTION OF OPERATIONS below _ EL.oISF&cc-Poucv LIMIT $1,000,000 C Professional AEC901230201 12/02/201612/02/2017 $2,000,000 per Claim Liability $4,000,000 Ann!Aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks SG,edUM,may be attached amore space Is required) Re:Project#1232.4,Town of Los Altos Hills-CIP Replacement Project•Town of Los Altos Hills,Its elective and appointed officers,employees and volunteers are named as Additional Insured as respects General and Auto Liability as required per written contract or agreement.Insurance coverage includes Waiver of Subrogation per the attached.Cancellation:30 Day for Non-Payment of Premium. CERTIFICATE HOLDER CANCELLATION Town of Los Altos Hills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ms.Tina Tseng,Senior ACCORDANCE WITH THE POLICY PROVISIONS. Engineer, PE 26379 Fremont Road AUTHORIZED REPRESENTATIVE Los Altos,CA 94022 X21 ©1988-20014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD IAS20833491M2062767 PA2 411/ S Insured: Cleary Consultants,Inc. Insurer: Sentinel Insurance Co.LTD Policy Date: 0802)2017 Policy Number: STSBWLveeee Additional nsured'ge.PrtpIt1931,Town al Los Mos Hills.-GIP Rglsel11111Prq¢b NAME Of ADDITIONAL INSURED PERSCICSI OR CRGANIZATI0N151.CONT:Town d Los Abs Hdlx I6 Seoee aid aPPunted offices,mpoya:and vun@ars EXCERPTS FROM: Hartford Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM C.WHO IS AN INSURED 6.Additional Insureds When Required By Written Contract,Written Agreement Or Permit The person(s)or organization(s)identified in Paragraphs a.through f.below are additional insureds when you have agreed,in a written contract,written agreement or because of a permit issued by a state or political subdivision,that such person or organization be added as an additional insured on your policy,provided the injury or damage occurs subsequent to the execution of the contract or agreement,or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract,agreement or permit. f.My Other Party (1)Any other person or organization who is not an insured under Paragraphs a.through e.above, but only with respect to liability for"bodily injury,"property damage"or"personal and advertising injury"caused,in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you;or (c) In connection with"your work"and included within the"products-completed operations hazard, but only if (i)The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii)This Coverage Part provides coverage for"bodily injury"or"property damage"included within the"products- completed operations hazard. (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to: "Bodily injury, "property damage"or"personal and advertising injury"arising out of the rendering of,or the failure to render,any professional architectural,engineering or surveying services, including: inspection,or engineering E.5.Separation of Insureds Except with respect to the Limits of Insurance,and any rights or duties specifically assigned in this policy to the first Named Insured,this insurance applies: a.As if each Named Insured were the only Named Insured;and b.Separately to each insured against whom a claim is made or"suit"is brought. E.7.b.(7).(b) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract,written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance,this insurance is primary and we will not seek contribution from that other insurance. E.8.b. Waiver Of Rights Of Recovery(Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for alt or part of any payment, including Supplementary Payments,we have made under this Coverage Part,we also waive that right,provided the insured waived their rights of recovery against such person or organization in a contract,agreement or permit that was executed prior to the injury or damage. EXCERPT FROM Hartford Form SS 04 38 09 09 HIRED AUTO AND NON-OWNED AUTO B.With respect to the operation of a"non-owned auto",WHO IS AN INSURED is replaced by the following: The following are"insureds": d. Anyone liable for the conduct of an"insured", but only to the extent of that liability. Insured: Cleary Consultants,Inc. 4 Policy Number: WZP81039621 Effective Date: 07/012017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Re:Project#12324 Town of Los Altos Hills-CIP Replacement Project-PERSON OR ORGANIZATION,CONT.:Town of Los Altos Hills,its elective and appointed officers,employees anc Town of Los Altos Hills volunteers. Ann:Ms.Tina Tseng,Senior Engineer,PE 26379 Fremont Road Countersigned by 4 "•4—' Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: Policy Expiration Date: fa To: CONTRACTOR From: Town of Los Altos Hills Re: Agreement Transmittal Memo Enclosed, please find the following documents: AGREEMENT — If you require a fully executed, signed original of the Agreement for your records, please photocopy the Agreement prior to signing the enclosed document. Return both originals with your signature to the Town and a fully executed Agreement will be returned. IRS FORM W-9 — Request for Taxpayer Identification Number (TIN) and Certification. This form is required for all vendors of the Town and it is important that you provide the Town with the correct TIN. If your company is a: Sole Proprietorship - The taxpayer identification number must be the social security number of the sole proprietor. -OR- Partnerships or Corporations — The taxpayer identification number must be the employer identification number issued to the partnership or corporation. Once all documents have been completed, please return the signed Agreement(s) and IRS Form W-9 to the following address: Town of Los Altos Hills Contracts 26379 Fremont Road Los Altos Hills, CA 94022 RECEIVED AUG 0 7 2017 TOWN OF LOS ALTOS HILLS