HomeMy WebLinkAboutC2R Engineering, Inc. (2) TOWN OF LOS ALTOS HILLS
STATE OF CALIFORNIA
CONTRACT
2018 Sanitary Sewer Repair and Replacement Project (("�1 ,,y
THIS AGREEMENT, made, executed, and entered into this day of 02/�14N2018,
Cy and etween the Towrlof Los Altos Hills a General Law City, hereinafter referred tolys the Town, and_
Cala 143c/wee-II t ', , hereinafter referred to as the Contractor.
WITNESSETH
ARTICLE 1. That for and in consideration of the payments and agreements hereinafter mentioned
to be made and performed by the Town, the Contractor agrees at its own cost and expense to do all the
work and furnish all materials necessary to complete in a good workmanlike and substantial manner all that
certain work involved and concerned with the 2018 Sanitary Sewer Repair and Replacement Project.
Said work shall be done in manner and according to the terms of the Contract as the same is defined in
Article 4 herein.
ARTICLE 2. Said Contractor agrees to receive and accept the following prices as full compensation
for furnishing all materials and doing all the work contemplated and embraced in this agreement; also for
all loss or damage arising out of the nature of the work aforesaid, or from the acts of the elements, or from
any unforeseen difficulties or obstructions which may arise or be encountered in the prosecution of the work
until its acceptance by the Town and for all risks of every description connected with the work; also for all
expenses incurred by or in consequence of the suspension or discontinuance of the work and for well and
faithfully completing the work and the whole thereof, in the manner and according to the plans and
specifications,to wit,according to Contractor's proposal to the City Council,entitled'EXHIBIT"A,"Proposal
to the City Council'and attached hereto.
ARTICLE 3. The Town hereby promises and agrees with the Contractor, to employ, and does
employ, hereby, said Contractor to provide the materials and to do the work according to the terms and
conditions herein contained and referred to,for the prices aforesaid, and hereby contracts to pay the same
at the time, in the manner and upon the conditions above set forth; and the said parties for themselves,
their heirs, executors,administrators, successors, and assigns, do hereby agree to the full performance of
the covenants herein contained.
ARTICLE 4. The complete Contract consists of the following documents: Notice to Bidders,
Proposal, Contract, Specifications and the Plans and/or Drawings. The rights and obligations of the parties
herein are governed by all of said documents,which are to be construed as a single Contract. The decision
of the Public Works Director of the Town of Los Altos Hills as to the interpretation of said Contract shall be
final and binding on the parties hereto.
ARTICLE 5. It is further expressly agreed by and between the parties hereto that the work shall be
completed within SIXTY(60)working days from and after the commencement of said work.
ARTICLE 6. It is expressly stipulated and agreed that all legal and statutory requirements relating
to the execution of this Contract and the notice inviting bids have been met. Any alleged defector omission
in the proceedings preceding the execution of this Contract is hereby waived by the Contractor.
IN WITNESS WHEREOF, the parties have executed this instrument the year and date first above
written.
t
CONTRACT
TOWN OF LOS ALTOS HILLS
A General Law City
Ciy Manager
ATTEST:
City Clerk, Town of Los Altos Hills
CONTRACTOR
By ;iw.
Title rLSl .
2
CONTRACT
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document.
State of Cyifornia )
County n'f Clara_
OZ 10IN 5f as before me, L La/ I - e#14.144/11. ,"0 410 k-,
Date �• ,,Here not
and Title of theicer
personally appeared
,li
J ✓0✓tom Co 1.3 - -
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isfarc
subscribed to the within instrument and acknowledged to me that he/she/ilwy executed the same in
hisNwrWtheir authorized capacity(iec), and that by his/kerltheir signatures)-on the instrument the persorf(s),
or the entity upon behalf of which the person$)acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
IOELMAN L.MD8VN1 I
�rC Cammhcbn•5101566 WITNESS my hand and official seal.
. ,
' Wary Public-Canla
V 11.1 SoniaClintClintClintCount/ ,may' ,J'/�
ug Comm.Estero" Signature ` '-/ "(/�-�
Signature of Notary Public
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
P Corporate Officer — Title(s): H Corporate Officer — Title(s):
_I Partner — 7 Limited ❑General 7 Partner — J Limited H General
Individual C Attorney in Fact H Individual C Attorney in Fact
7 Trustee L Guardian or Conservator G Trustee C Guardian or Conservator
H Other: H Other:
Signer Is Representing: Signer Is Representing:
02014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907
RESOLUTION 69-18
A RESOLUTION OF THE CITY COUNCIL OF THE
TOWN OF LOS ALTOS HILLS AWARDING A CONTRACT FOR CONSTRUCTION
OF THE 2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
WHEREAS, the Interim Public Works Director of the Town of Los Altos Hills did, in open
session, duly examine and consider all bids submitted to it for the construction of the 2018
Sanitary Sewer Repair and Replacement Project; and
WHEREAS, the Interim Public Works Director recommends that the contract for said project be
awarded to the lowest responsible bidder, C2R Engineering, in the amount of$607,987.00; and
WHEREAS, the Interim Public Works Director recommends that funds of$151,996.75 be made
available for construction contingency; and
NOW, THEREFORE,BE IT RESOLVED by the City Council of the Town of Los Altos Hills
that:
L The City Manager is hereby authorized to award a contract with the lowest
responsible bidder in an amount not to exceed$607,987.00.
2. The Interim Public Works Director is hereby authorized to approve contract change
orders in an amount not to exceed$151,996.75,.
The above and foregoing Resolution was passed and adopted by the City Council of the Town of
Los Altos Hills at a regular meeting held on the 16th day of August,2018 by the following vote:
AYES: Radford,Spreen,Corrigan, Waldeck,Wu
NOES: None
ABSTAIN: None
ABSENT: None �`�"' `•� C
BY•
John Radford, Mayor
ATTEST:
Deborah Padovan, City Clerk
RessolWion 69-1 I
PROPOSALS MUST BE SUBMITTED ON THE ORIGINAL FORMS SUPPLIED WITH YOUR
CONTRACT BOOK. COPIES OF THIS DOCUMENT ARE NOT ACCEPTABLE.
EXHIBIT"A"
PROPOSAL TO THE CITY COUNCIL
TOWN OF LOS ALTOS HILLS
STATE OF CALIFORNIA
FOR
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
NAME OF BIDDER: C2R ENGINEERING,INC.
BUSINESS ADDRESS: 664 WILLOWGATE ST.
CITY,STATE,ZIP: MOUNTAIN VIEW,CA 94043
LICENSE NO.: 994397 CLASS: A EXP.DATE: 02/28/2019
TAX ID NO.: 47-1946596
TELEPHONE NO:(415) 559 28 41 FAX NO:( )
•
The work for which this proposal is submitted is for construction according to the Contract Documents,
including the Special Provisions,the Agreement,the project plans described below,and the State of California
Department of Transportation Standard Specifications, May 2010 Edition. The Contract Book shall be used
in conjunction with the above documents, and the State of California Department of Transportation Labor
Surcharge and Equipment Rental Rates,and the State Department of Industrial Relations General Prevailing
Wage Rates current at the bid opening date.
The project plans for the work to be done are titled"2018 SANITARY SEWER REPAIR AND REPLACEMENT
PROJECT". The work to be done consists installation of new sanitary sewer main via pipe bursting and/or
pipe reaming method;repair various segments of existing sanitary sewer main with open cut construction;
repair manhole connections;manhole rehabilitation;reconnect 4"sewer laterals and new piping;repair and/or
replacement of pavement markings, and street monuments; and doing all appurtenant work as shown on
the plans and described In the specifications.
A bidder's bond, in an amount and of a form described under Paragraph 1 of the Proposal Requirements
Section of these Provisions shall accompany this proposal. The project shall be awarded to the lowest
responsible bidder who meets all the Proposal Requirements, and the requirements of the Contract
Documents.
•
T
PROPOSAL REQUIREMENTS
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
. ,
The bidder shall set forth for each item of work a unit price and a total for the item, and for each lump sum
item a total for the Item,all In clearly legible figures in the respective spaces provided for this purpose. In the
case of unit basis items,the amount set forth under the Total"column shall be the extension of the item price
bid on the basis of the estimated quantity for the item.
In case of conflict between an item price in words and the price in figures,the price in words shall prevail. In
case of discrepancy between an item price and the total set forth for a unit basis Item, the item price shall
prevail. However, If the amount set forth as an Item price is ambiguous, illegible or uncertain for any cause,
or is omitted,or is the same amount as the entry In the'Total"column,then the amount set forth in the Total"
column for the item shall prevail and shall be divided by the estimated quantity for the item and the price thus
obtained shall be the item price.
Failure to provide the required information, or N information provided is subsequently proved false, the
proposal shall be considered as non-responsive and shall be grounds for rejection of the bid.
If this proposal shall be accepted and the undersigned shall fail to enter into the Contract and furnish the two
bonds in the sums required by Section 4-2 of the Special Provisions,with surety satisfactory to the Town of
Los Altos Hills within twelve(12)days,not including Sundays and legal holidays,after the bidder has received
notice from the Town that the Contract has been awarded, the Town may, at its option, determine that the
bidder has abandoned the Contract,and thereupon this proposal and the acceptance thereof shall be invalid.
If the Town declares the proposal as invalid,the forfeiture of such security accompanying this proposal shall
operate and the same shall be the property of the Town.
The undersigned,as bidder,declares that the only persons or parties interested in this proposal as principals
are those named herein;that this proposal Is made without collusion with any other person,firm or corporation;
that he/she has carefully examined the location of the proposed work,the annexed proposed form of Contract,
and the plans therein referred to; and he/she proposes and agrees,if this Proposal is accepted, that he/she
will Contract with the Town of Los Altos Hills In the form of the copy of the Contract annexed hereto,to provide
all necessary machinery,tools,apparatus and other means of construction,and to do all the work and furnish
all the materials specified in the Contract, In the manner and time therein prescribed, and according to the
requirements of the Engineer as therein set forth, and that he/she will take in full payment therefor in the
amounts shown on the following Item Price Schedule,to wit:
e
PROPOSAL REQUIREMENTS
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
ITEM PRICE SCHEDULE
Bid
Item Estimated Unit Price Total
No. Description Quantity UNIT (in figures) (In figures)
1 Sanitary Sewer Spot Repair-8" 45 LF $qoo $31,5cn
2 Plpe Bursting/Reaming-Upsize from 2,097 LF $ 2,01 $421,1164-
6"VCP to 8"HDPE SDR-17
3 Replace Lateral Connection to Main 12 EA $2,5th $30,000
4 Reconnect Sewer Main to Existing 16 EA $3,Z40 $51, zco
Manhole
5 Mobilization/Demobilization 1 LS $30,003 $3010z0
8 Pre-Installation Cleaning and Color 1 LS $15iax $ 1 S1coo
CCN Inspection
7 Post-Installation Cleaning, Pressure 1 LS $1}IOW $1}Icc0
Testing,and Color CCTV Inspection
8 Cleaning and Color CCTV Inspection 1 LS $111 1.g0 $11,-49D
Prior to End of 2-Year Warranty
TOTAL BID ITEMS(14):
14604,984
TOTAL BID(1-8)IN WORDS: SIX HUNDIZ£b SEVEN -1-111)(/5 AND NINE H'VINDR£D
f6tt7y- SEv6)J DOL(ARS
QUANTITIES OF WORK
The quantities of work of material stated In the unit bid price items of the Bid Schedule are supplied only to
give an indication of the general scope of the Work. The Town does not expressly nor by implication agree
that the actual amounts of work or material will correspond therewith,and reserves the right after award to
increase or decrease the quantity of any unit bid kern by an amount up to 25 percent(25%) Increase or
decrease without a change in the unit prices,and shall have the right to delete any bid items in Its entirety
and receive full credit in the amount shown in the Bid Schedule for the deleted item of Work.
COMPARISON OF BIDS
Bid prices will be compared based on the Total Bid
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ITEM PRICE SCHEDULE
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
LIST OF SUBCONTRACTORS
The Bidder shall list the name,address and telephone number of each subcontractor,required to be listed by
the provisions in Section 4-2, "Subcontracts" of the Special Provisions and the Standard Specifications, to
whom the Bidder proposes to subcontract portions of the work.
PLACE OF BUSINESS DESCRIPTION OF PORTION
SUBCONTRACTOR'S NAME (ADDRESS&PHONE) OF WORK SUBCONTRACTED
N/A •
•
10
ADDENDA ACKNOWLEDGMENT AND INFORMATION
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
ADDENDA ACKNOWLEDGMENT AND INFORMATION
The undersigned acknowledges receipt of Addendum No.°through 0 inclusively.
PRINCIPAL PERSONS WITH INTEREST IN PROPOSAL
The names of all persons interested In the foregoing proposal as principals are as follows:
IMPORTANT NOTICE. If bidder or other interested person is a corporation, state legal name of
corporation, also names of the president, secretary, treasurer, and manager thereof; if a
copartnership, state true name of firm, also names of all Individual copartners composing firm; if
bidder or other Interested person is an individual, state first and last names in full.
C2R ENGINEERING,INC.,
TREVOR CONNOLLY, PRESIDENT, SECRETARY,TREASURER AND MANAGER
11
ADDENDA ACKNOWLEDGMENT AND INFORMATION
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
EXPERIENCE AND FINANCIAL QUALIFICATIONS
Provide three(3)projects completed In the last five(5)years of similar scope of services as shown in
Section 4-5. Project information should include the following:
1. Title of Project: 2017 SANITARY SEWER REPAIR
Agency/Client Name: TOWN OF LOS ALTOS HILLS
Brief Project Description: Point Repairs of 6"VCP and pipe bursting of 6"VCP to 8"HDPE
Rehab manholes
Address: 26379 W Fremont Rd, Los Altos Hills,CA
Telephone No.: (650) 941 7222
Year Completed: 2017
Project Construction Cost: $846,293
2. Title of Project: 2017 SEWER REPLACEMENT AND REHABILITATION
Agency/Giem Name: CITY OF PACIFICA
Brief Project Description: Pipe burting of 6"VCP to 8" HDPE
Address: 170 Santa Maria Ave,Pacifica,CA
Telephone No.: (650) 922 4072
Year Completed: 2017
Project Construction Cost: $675,480
3. Title of Project: 2016 ON CALL SEWER REPLACEMENT PROJECT
Agency/Client Name: CITY OF SAN CARLOS
Brief Project Description: Sewer replacement,pipe bursting,point repair of 6"VCP to 8" HDPE
in various locations in San Carlos
Address: 600 ELM ST. SAN CARLOS,CA 94070-3018
Telephone No.: (650) 802 4202
Year Completed: 2017
Project Construction Cost: $537,530
12
ADDENDA ACKNOWLEDGMENT AND INFORMATION
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
The bidder has been engaged In the contracting business under State License No. 994397 for a period of
5 years.
Reference Is hereby made to the following bank or banks as to the financial responsibility of the bidder:
Name of Bank Address
Bank of America 444 Castro St,Mountain View,CA
Reference is hereby made to the following surety companies as to the financial responsibility and general
reliability of the bidder:
company: The Hartford
Address: One Hartford Plaza, Hartford,CT
Company
Address:
13
ADDENDA ACKNOWLEDGMENT AND INFORMATION
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
PUBLIC CONTRACT CODE
Public Contract Code Section 10285.1 Statement
In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985),the bidder hereby
declares under penalty of perjury under the laws of the State of California that the bidder has_, has not
x been convicted within the preceding three years of any offenses referred to in that section, including
any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal
antitrust law in connection with the bidding upon, award of,or performance of, any public works contract,
as defined in Public Contract Code Section 1101,with any public entity, as defined in Public Contract Code
Section 1100, Including the Regents of the University of California or the Trustees of the California State
University. The term"bidder"is understood to include any partner, member,officer, director, responsible
managing officer,or responsible managing employee thereof, as referred to in Section 10285.1.
Note: The bidder must place a check mark after"has"or"has nor in one of the blank spaces provided.
The above Statement is part of the Proposal. Signing this Proposal on the signature portion
thereof shall also constitute signature of this Statement.Bidders are cautioned that making a
false certification may subject the certife to criminal prosecution.
14
NON-COLLUSION AFFIDAVIT
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
Public Contract Code Section 10162 Questionnaire
In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of
perjury,the following questionnaire:
Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in
the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a
federal, state,or local government project because of a violation of law or a safety regulation?
YES NO X
If the answer is yes,explain the ci . y stances in the following space:
15
NONCOLLUSION AFFIDAVIT
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
Public Contract Code 10232 Statement
In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of
perjury, that no more than one final unappealable finding of contempt of court by a federal court has been
issued against the Contractor within the immediately preceding two year period because of the Contractor's
failure to comply with an order of a federal court which orders the Contractor to comply with an order of the
National Labor Relations Board.
Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal
on the signature portion thereof shall also constitute signature of this Statement and
Questionnaire. Bidders are cautioned that making a false certification may subject the
certifier to tocriminal prosecution.
18
NON-COLLUSION AFFIDAVIT
2018 SANITARY SEWER REPAIR ANO REPLACEMENT PROJECT
NON-COLLUSION AFFIDAVIT
(Title 23 United States Code Section 112 and
Public Contract Code Section 7106)
To The Town of Los Altos Hills
Public Works Department.
In conformance with Title 23 United States Code Section 112 and Public Contract Code
7106 the bidder declares that the bid Is not made In the interest of, or on behalf of, any
undisclosed person, partnership, company, association, organization, or corporation; that
the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly
Induced or solicited any other bidder to put in a false or sham bid, and has not directly or
indirectly colluded,conspired,connived,or agreed With any bidder or anyone else to put in
a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,
directly or Indirectly, sought by agreement, communication, or conference with anyone to
fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost
element of the bid price,or of that of any other bidder,or to secure any advantage against
the public body awarding the contract of anyone interested in the proposed contract; that
all statements contained in the bid are true;and,further,that the bidder has not,directly or
indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof,
or divulged information or data relative thereto, or paid, and will not pay, any fee to any
colp„iation, partnership, company association, organization, bid depository, or to any
member or agent thereof to effectuate a collusive or sham bid.
Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on
the signature portion thereof shall also constitute signature of this Noncollusion
Affidavit. Bidders are cautioned that making a false certification may subject the
certifier to criminal prosecution.
Accompanying this proposal is Bidder's Bond
(NOTICE:INSERT THE WORDS "CASH($ ),"CASHIER'S CHECK,'
•
17
NON-COLLUSION AFFIDAVIT
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
•
'CERTIFIED CHECK,'OR 'BIDDER'S BOND,"AS THE CASE MAY BE.)
in amount equal to at least ten percent of the total of the bid.
The names of all persons interested in the foregoing proposal as principals are as follows:
IMPORTANT NOTICE
If bidder or other interested person is a corporation, state legal name of corporation, also names of
the president, secretary, treasurer, and manager thereof'if a copartnership,state true name of firm,
also names of all Individual copartners composing firm; if bidder or other interested person is an
individual,state first and last names in full.
G2R. eN61NE£10.A146, INC. : TRLIOW CONNOW4 , Pe£SIIaW; tem w,
Tatfianeal MJD MKNAtes-.
Licensed in conformance with an act providing for the registration of Contractors,
License No. 994397 Classification(s) A
ADDENDA - This Proposal is submitted with respect to the changes to the contract included in
addenda numberls(Fill in addenda numbers if addenda have beenreceived and insert, in
this Proposal,any Engineer's Estimate sheets that were received as part of the .
• addenda.)
By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California,
that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and
10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the
Fair Employment and Housing Commission Regulations(Chapter 5,Title 2 of the California Administrative
Code).By my signature on this proposal I further certify,under penalty of perjury under the laws of the State
of California and the United States of America, that the Noncollusion Affidavit required by Title 23 United
States Code, Section 112 and Public Contract Code Section 7106; and the Title 49 Code of Federal
Regulations, Part 29 Debarment and Suspension Certification are true and correct.
V
Date: l/Iti• �
Sign
He' TREVOR CONNOLLY,PRESIDENT
Signature and Title of Bidder
Business Address 664 WILLOWGATE ST. , MOUNT/n.1 Ylgtul CA 94043
Place of Business MOUNTAIN VIEW, CA
Place of Residence MOUNTAIN VIEW, CA
18
NON-COLLUSION AFFIDAVIT
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
TOWN OF LOS ALTOS HILLS
STATE OF CALIFORNIA
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
BID BOND
KNOW ALL PERSONS BY THESE PRESENTS,that we C2R Engineering, Inc. as
Principal,and Hartford Fire Insurance Company ,as Surety,are held and firmly bound unto the Town of Los
Altos Hills, hereinafter called Town', in penal sum of ten percent(10%)OF THE TOTAL AMOUNT OF THE
BID OF THE PRINCIPAL submitted to the said Town'for the work described below for the payment of which
sum in lawful money of the United States,well and truly to be made,we bind ourselves,our heirs,executors,
administrators,successors and assigns,jointly and severally,firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH that whereas the Principal has submitted the
accompanying Proposal dated August 9 , 2018,for 2018 SANITARY SEWER REPAIR AND
REPLACEMENT PROJECT
NOW,THEREFORE,if the Principal shall not withdraw said Proposal prior to the date and time for the opening
of bids,and if the Principal is awarded the Contract and shall within the period specified in the Proposal after
receiving notice that the Contract has been awarded and the prescribed forms are presented to him/her for
signature,enter in a written Contract with the Town, in accordance with the Proposal as accepted and give
insurance and bond with good and sufficient surety or sureties, as may be required, for the faithful
performance and proper fulfillment of such Contract and for the payment for labor and materials used for the
performance of the Contract,or in the event of the withdrawal of said Proposal within the period specified or
the failure to enter into such Contract and give such Town bonds, within the time specified, if the Principal
shall pay the Town the difference between the amount specified In said Proposal and the amount for which
the Town may procure the required work and/or supplies, if the latter amount be in excess of the former,
together with all costs incurred by the Town in again calling for bids,then the above obligation shall be voided
and of no effect,otherwise to remain in full force and virtue.
Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or
addition to the terms of the Contract on the call for bids, or to the work to be performed thereunder, or the
specifications accompanying,the same, shall In anywise affect its obligation under this bond, and it does
hereby waive notice of any such change,extension of time,alteration or addition to the terms of said Contract
or the call for bids,or to the work,or to the specifications,
19
BID BOND
2016 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
•
In the event suit is brought upon this bond by the Town and judgment is recovered,the Surety shall pay all
costs incurred by the Town in such suit,including a reasonable attorneys fee to be fixed by the court.
IN WITNESS WHEREOF,the above-bounded parties have executed this Instrument under their several seals
this 31st day of July ,2018,the name and corporate seals of each corporate party being
hereto affixed and these presents duly signed by its undersigned representatives, pursuant to authority of Its
governing body.
(Corporate Seal) C2R Engineering. Inc.
Principal
BY /M1(i r-
(Ackrawtedgment) Tittle litTock (osroLly fie8,\IDENT
(Corporate Seal) Hartford Fire Insurance Company
Surety
By \ �
Attor -In-fact !l
(Acknowledgment) Tittle Ryan'rash.Attorney-In-Fact
20
BID BOND
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
SEE ATTACHED NOTARY ACKNOWLEDGMENT
NOTE TO SURETY COMPANY: The following form
of acknowledgment should be used. If any other form
of acknowledgment is used,there must be submitted
a certified copy of unrevoked resolution of authority
for the attorney-in-fact.
NOTARIAL ACKNOWLEDGMENT OF ATTORNEY-IN-FACT OF SURETY
STATE OF CALIFORNIA )
)ss.
COUNTY OF
On ,before me,a Notary Public,personally appeared
, personally known to me(or proved to me on the basis of
satisfactory evidence)to be the person(s)whose name(s) 's/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same In his/her/their authorized capacity(ies),and that by
his/her/their signature(s) on the Instrument the person(s), or the entity upon behalf of which the person(s)
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Notary Public
(Seal)
21
BID BOM)
2018 SANITARY SEWER REPAIR AND REPLACEMENT PROJECT
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County
�offSSacramento
On ,cc -2 ' ,�3'/ tc%/'before me, Susan Fournier, Notary Public
/ (insert name and title of the officer)
personally appeared Ryan Tash
who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
SUSAN FOURNIER
WITNESS my hand and official seal. tNotary Public•California
Ci[
i Sacramento County
2 . Commission I 2167974
MY Comm.Expires Nov 11,20201
Signature ( (Seal)
Direct Inquiries/Claims to:
THE HARTFORD
BOND,T-12
POWER OF ATTORNEY HartfOne ord,Connecticut 06155
Bond.Claimsethehartford.com
calf 888-266.3488 or fax.860457-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: SURETY SOLUTIONS INSURANCE SVS INC
Agency Code: 57-130046
X Hartford Fire InsuranceCompany,a corporation duly organized under the laws of the Slate of Connecticut
Hartford Casualty Insurance Company,a corporation duly organized under the laws of the State of Indiana
Hartford Accident and Indemnity Company,a corporation duly organized under the laws of the State of Connecticut
Hartford Underwriters Insurance Company,a corporation duly organized under the laws of the State of Connecticut
Twin City Fire Insurance Company,a corporation duly organized tinder the laws of the State of Indiana
Hartford Insurance Company of Illinois,a corporation duly organized under the laws of the State of Illinois
Hartford Insurance Company of the Midwest,a corporation duly organized under the laws oldie State of Indiana
Hartford Insurance Company of the Southeast,a corporation duly organized under the laws of the State of Florida
having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the"Companies")do hereby make,constitute and appoint,
up to the amount of Unlimited :
John T. Page of Rancho Cordova CA, Susan Fournier, Ryan Tash of RANCHO CORDOVA,
California
their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies)only as
delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the
nature thereof,on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and
executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
In Witness Whereof,and as authorized by a Resolution of the Board of Directors of the Companies on May 6,2015 the Companies have
caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant
Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are
and will be bound by any mechanically applied signatures applied to this Power of Attorney.
John Gray,Assistant Secretary M.Ross Fisher,Senior Vice President
STATE OF CONNECTICUT
ss. Hartford
COUNTY OF HARTFORD
On this 5th day of January,2018, before me personally came M.Ross Fisher,to me known,who being by me duly sworn,did depose and
say that he resides in the County of Hartford, State of Connecticut; that he is the Senior Vice President of the Companies, the corporations
described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said
instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his
name thereto by like authority.
aliEF Kathleen T.Maynard
Notary Public
CERTFICATE My Commission Expires July 3 I,2021
I,the undersigned,Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct
copy of the Power of Attorney executed by said Companies,which is still in full force effective as of July 31, 2018
Signed and sealed at the City of Hartford
tux
� y I� z41 2y pts t?. 1s ��.'.s.o rsrs
Kevin Heckman,Assistant Vice President
5'10G5r"
BUR°NUM$6962
PREMIUM
elr
PREM"M 1S eog E�TD AD�st oot _ 10810 FOP 000
OS Nt ON
"ILLS
sSUS tE
AHOEO ow Olga GOKfRACf PM BOND
PERFORMANCE
SE PRESENTS. OR Engineering,lnc.
THE awardedt°
it and Replacement
KNOW ALL PERSONS BY a Calrfornia,nos 8anitaN sews
RgPa
Bilis,State of 2818
of Los Altos can" for the
WHEREAS,the Tawn •Princ'Pah fa the faithful
1 noted as the
on
er desolated
os 9 tract t°furnish a b
hereinatt of said Con
Project and, the terms
said Principal is required under
WHEREAS, Contract Compony as
Surety. are held and
performance of said HUnd,ea Erexelse
se°a"
and Hanford Fire Insurance,CHundred sevenTna sasnott well
the Principal, the penal sum of the payment of which sum
THEREFORE,we Hills l" States forsigns jointly
NOW Town of Los
Altoswfiul money of the United
executors, adminisbalors,successors,w as
fumy bound unto the
DOLLARS(S 607 967 our heirs,
e bin
and troy to be made.these presents. hls�hef or d5 helra,
and severally,firmly y that it the above bounded principal,
successors or assigns,shall in all ttrings stand to and abide by, an
tl well and truly
THE CONDITION OF THIS OBLIGATION IS SUCH,
executors,administrators,succe sondoir as and agreements in said Contract and any alteration thereof made
keep thereinend perform the, on covenants, and performed at the time and in the manner therein
as provided, his/her or their part to be kept
specified and in all respects according to their true intent and meaning,and shall defend, indemnify and Sava
harmless the Town of Los Altos Hills, its officers and agents as therein stipulated, then this obligation Shall
become invalid;otherwise it shall be and remain in full force and virtue.
Surety, for value received hereby stipulates and agrees that, h accordance with the Plans, Standarc
extension
Specifications, Special Provisions and other Contract Documents,to change, of lime,alteranoo c
addition to the terms of the Contract or to the work to be Wormed thereunder or the specification
accompanying the same shall in anywise affect its obligations orchis bond, and d does hereby waive notic
of any such change, extension of time,aeration or additions to tie terms of the Contract or to the work or
the specifications.
PERFORMANCE BOND 1
• i '
IN WITNESS WHEREOF, the above bounded parties have executed this instrument under their seals this
day of August 23 , 2018, the name and corporate seals of each corporate party being hereto
affixed and these presents duly signed by its undersigned representative,pursuant to authority of its governing
body.
(Corporate Seal) C2R Engineering, Inc.
Principal /
By I '!-c UfXLY
�!/1
(Acknowledgment) Tittle fEMParr
(Corporate Seal) Hartford Fire Insurance Company
Surety
^
By \ - � �
Attor -in-fact
(Acknowledgment) Tithe Ryan Tash,Attorney-In-Fact
(Seal)
Approved as to form:
City
2
PERFORMANCE BOND
•
NOTE TO SURETY COMPANY: The following form
of acknowledgment should be used. If any other
form of acknowledgment is used, there must be
submitted a certified copy of unrevoked resolution of
authority for the attorney-in fact.
NOTARIAL ACKNOWLEDGMENT OF ATTORNEY-IN-FACT OF SURETY
STATE OF CALIFORNIA )
)ss. SEE ATTACHED NOTARY ACKNOWLEDGEMENT
COUNTY OF
On before me, a Notary Public, personally appeared_,
personally known to me(or proved to me on the basis of satisfactory evidence)to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/hey executed the
same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s)acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct,
WITNESS my hand and official seal.
Notary Public
(Seal)
3
PERFORMANCE BOND
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Sacramento
On '6/2.3/14 before me, Katherine DuPont, Notary Public
(insert name and title of the officer)
personally appeared Ryan Tash
who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
KATHERINE DUPONT
WITNESS my hand and official seal. 'A`., COMM. K2206140 z
o itr;,,1/4- Notary Public California o
Sacramento County
i;�� 202021
COMM
Signature K/ o " a/D�,—(Seal)
Direct Inquiries/Claims to:
THE HARTFORD
POWER OF ATTORNEY Hartford Centre cutt 06155
Bond,ClaimsathehartfofdCOm
cal!080-266-3488 or fax:860-757-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: SURETY SOLITTIONS INSURANCE SVS INC
Agency Cale: 57-130046
X Hartford Fire Insurance Company.a corporation duly organized under the laws of the State of Connecticut
X Hartford Casualty Insurance Company,a corporation duly organized under the laws of the State of Indiana
[] Hartford Accident and Indemnity Company,a corporation duly organized under the laws of the State of Connecticut
Hartford Underwriters Insurance Company,a corporation duly organized under the laws of the State of Connecticut
Twin City Fire Insurance Company,a corporation duly organized under the laws of the State of Indiana
Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois
Hartford Insurance Company of the Midwest,a corporation duly organized under the laws ollhe State of Indiana
1 Hartford Insurance Company of the Southeast,a corporation duly organized under the laws of the State of Florida
having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the"Companies")do hereby make,constitute and appoint,
up to the amount of Unlimited
John T. Page of Rancho Cordova CA, Susan Fournier, Ryan Tash of RANCHO CORDOVA,
California
their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(les) only as
delineated above by 0, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the
nature thereof,on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and
executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
In Witness Whereof,and as authorized by a Resolution of the Board of Directors of the Companies on May 6,2015 the Companies have
caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant
Secretary. Further,pursuant to Resolution of the Board of Directors of the Companies,the Companies hereby unambiguously affirm that they are
and will be bound by any mechanically applied signatures applied to this Power of Attorney.
8 yl ( .see V..."-..1:<? •,^•W 1,:::::::::, ?astir a° 4i'
tiven
/j;�/�/11: r
V fr
John Gray,Assistant Secretary M.Ross Fisher,Senior Vice President
STATE OF CONNECTICUT
ss. Hartford
COUNTY OF HARTFORD
On this 5th day of January,2018,before me personally came M. Ross Fisher,to me known,who being by me duly sworn,did depose and
say: that he resides in the County of Hartford, State of Connecticut, that he is the Senior Vice President of the Companies, the corporations
described in and which executed the above instrument, that he knows the seals of the said corporations: that the seals affixed to the said
instrument are such corporate seals: that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his
name thereto by like authority.
V
Kathleen f.Maynard
Novy Public
CERTIFICATE My Commission ExpiresJuly 31.2021
I,the undersigned,Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct
copy of the Power of Attorney executed by said Companies,which is still in full force effective as of
Signed and sealed at the City of Hartford
A.
s '! :'7-II
JI ) •.,•\s it, sae>� _i) , .,•.
1�' S t J '•£+.. i.' •
• �••er.9 i:!°7°/,s=tiA mar 't MO
•
Z---- /
f.417t3-5r �._...,__....
Kevin Heckman.Assistant Vice President
PREMIUM IS FOR CONTRACT TEM BOND NUMBER: 57BCSHT7925
AND IS SUBJECT TO ADJUSTMENT PREMIUM INCLUDED IN PERFORMANCE BOND
BASED ON FINAL CONTRACT AMOUNT. TOWN OF LOS ALTOS HILLS
STATE OF CALIFORNIA
PAYMENT BOND
KNOW ALL PERSONS BY THESE PRESENTS:
WHEREAS,the Town of Los Altos Hills, a General Law City, has awarded to C2R Engineering, Inc.
hereinafter designated as the "Principal", a contract for the for the 2018 Sanitary
Sewer Repair and Replacement Project and;
WHEREAS, said Principal is required to furnish a bond with said Contract, to secure payment of
claims of laborers, mechanics, or material persons employed on work under said Contract, as provided by
law.
NOW, THEREFORE, we the undersigned Principal and Surety are held and firmly bound unto the
Town of Los Altos Hills in the sum of Six Hundred Seven Thousand Nine Hundred Eighty Seven DOLLARS
($ 607,987 ), said sum being equal to the estimated amount payable by said Town of Los
Altos Hills under the terms of the Contract,for which payment well and truly to be made,we bind ourselves,
our heirs, executors,administrators, successors,or assigns jointly and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that if said Principal, his/her or its heirs,
executors, administrators, successors, or assigns, or subcontractors shall fail to pay for any material,
provisions, provender or other supplies, implements or machinery used in, upon,for or about the performance
of the work contracted to be done,or for any work or labor thereon of any kind,or for amounts due under the
Unemployment Insurance Code with respect to such work or labor or for any amounts required to be deducted,
withheld,and paid over to the Franchise Tax Board from the wages of employees of the Contractor and his/her
subcontractors pursuant to the Revenue and Taxation Code,with respect to such work and labor,the Surety
or Sureties hereon will pay for the same in an amount not exceeding the sum specified in this bond,otherwise
the above obligation shall be voided. In case suit is brought upon this bond,said Surety will pay a reasonable
attorneys fee to be fixed by the court.
This bond shall inure to the benefit of all persons, companies and corporations entitled to The claims under
Section 3181 of the Civil Code of the State of California so as to give a right of action to them or their assigns
in any suit brought upon this bond.
t
PAYMENT BOND
Said Surety, for value received, hereby stipulates and agrees that, in accordance with the Plan, Standard
Specifications, Special Provisions and other Contract Documents, no change, extension of time, alteration or
addition to the terms of the Contract, or to the work to be performed thereunder, or to the specifications
accompanying the same,shall in anywise affect its obligations on this bond, and it does hereby waive notice
of any such change, extension of time, alteration or addition to the terms of the Contract or to the work or to
the specifications.
IN WITNESS WHEREOF,the above-bounded parties have executed this instrument under their seals
this 23rd day of August , 2018, the name and corporate seals of each corporate party being
hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its
governing body.
(Corporate Seal) C2R Engineering. Inc.
Principal
(Acknowledgment) Tittle f 'IDE
(Corporate Seal) Hartford Fire Insurance Company
Surety
By
Attorne in-fact
(Acknowledgment) Tittle Ryan Testi.Attorney-In-Fact
(Seal)
Approved as to form:
City
2
PAYMENT BOND
NOTE TO SURETY COMPANY: The following form
of acknowledgment should be used. If any other form
of acknowledgment is used,there must be submitted a
certified copy of unrevoked resolution of authority for
the attorney-in-fact.
NOTARIAL ACKNOWLEDGMENT OF ATTORNEY-IN-FACT OF SURETY
STATE OF CALIFORNIA )
Ss. SEE ATTACHED NOTARY ACKNOWLEDGEMENT
COUNTY OF
On , before me, a Notary Public, personally appeared
, personally known to me(or proved to me on the basis of satisfactory evidence)to be the person(s)whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the
same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s)acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Notary Public
(Seal)
3
PAYMENT BOND
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Sacramento
On 81Z3l8 before me, Katherine DuPont, Notary Public
(insert name and title of the officer)
personally appeared Ryan Tash
who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
KATHERINE DUPONT
WITNESS my hand and official seal. ;k., COMM. #2206140 n
rc - Notary Public California o
� / // z N.�,�' CSS cramenun
Epees Ai 2o,2021
Signature ;(1.,e(09.4 Yn/ (Seal)
Direct Inquiries/Claims to:
THE HARTFORD
BOND,T-12
POWER OF ATTORNEYHartfOne Hartford Piaza
ord,Connecticut 06155
Bond.Claim setheha rtford.com
calf 888-266-3488 or fax'860.757.6835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: SURETY SOLUTIONS INSURANCE SVS INC
Agency Code: 57-130046
X Hartford Fire Insurance Company,a corporation duly organized under the laws of the State of Connecticut
X Hartford Casualty Insurance Company,a corporation duly organized under the laws of the State of Indiana
Hartford Accident and Indemnity Company,a corporation duly organized under the laws of the State olConnecticut
Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut
[] Twin City Fire Insurance Company,a corporation duly organized under the laws of the State of Indiana
[] Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois
I1 Hartford Insurance Company of the Midwest,a corporation duly organized under the laws of the State of Indiana
TH Hartford Insurance Company of the Southeast,a corporation duly organized under the laws of the State of Flonda
having their home office in Hartford, Connecticut,(hereinafter collectively referred to as the"Companies")do hereby make, constitute and appoint,
up to the amount of Unlimited :
John T. Page of Rancho Cordova CA, Susan Fournier, Ryan Tash of RANCHO CORDOVA,
Calif ornia
their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies)only as
delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the
nature thereof,on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and
executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
In Witness Whereof,and as authorized by a Resolution of the Board of Directors of the Companies on May 6,2015 the Companies have
caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant
Secretary. Further,pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are
and will be bound by any mechanically applied signatures applied to this Power of Attorney.
�l 4 e I I as /. a ', i 117:\+1io F.ir acaail ; fe»
•
...
/s.. fr
John Gray,Assistant Secretary M.Ross Fisher,Senior Vice President
STATE OF CONNECTICUT
} as. Hartford
COUNTY OF HARTFORD
On this 5th day of January,2018, before me personally came M. Ross Fisher,to me known,who being by me duly sworn,did depose and
say'. that he resides in the County of Hartford, State of Connecticut, that he is the Senior Vice President of the Companies, the corporations
described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said
instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his
name thereto by like authority.
Kut aMaynard
7
Notary Public
CERTIFICATE My Commission Expires
July 31,2031
I,the undersigned,Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct
copy of the Power of Attorney executed Ly slid Companies,which is still in full force effective as of
Signed and sealeddNattt the Cite of Hartford
r `y, £ r"sicia r9t9
Kevin Heckman,Assistant Vice President
----.. ..t Policy Number: Date Entered:
A��® CERTIFICATE OF LIABILITY INSURANCE 8/22/2D0 8 '
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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the teens 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 rv"ME"OTMAChael Watters_
Benedetti Insurance Agency PHONE (650)69]-]224 FAX .(650)697-9506
199 California Dr. #202
HNC No EncTac.xql.
EMAIL
Millbrae, CA 94030